Oral Plastic Surgery (Gingival Grafting)
When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.
When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.
In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance to the gum and tooth. Also, gum recession, when significant, can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.
A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.
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Laser Surgery
Dental lasers are low-energy-powered units, which are built for general use on the delicate tissue of the mouth. The controlled heat and light of the laser destroys most bacteria and viruses found in the mouth and in general enhances oral health. These lasers are FDA approved and are being used more and more in general dentistry; however there are only a few experienced specialists in the field of laser dentistry.
Perio-esthetic laser dentistry is used:
- To correct gummy smiles
For patients with teeth that look too short or have the “gummy smile,” crown lengthening might be your solution. Excess gum tissue is removed, exposing more of the tooth. The gum line is then evenly sculpted to develop your new, broad smile.
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- To correct hyperplastic tissue
Hyperplastic tissue is excessive tissue that is formed in the mouth as the result of chronic irritation from such things as ill-fitting dentures or a jagged edge on a tooth. This tissue can be easily and comfortably removed with laser surgery.
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- To assist in exposing an unerupted tooth
When a tooth does not fully erupt into the mouth, but remains below the gums, it is said to be impacted. Impacted teeth can present special health problems for most patients, and they are generally removed to prevent future difficulties. Laser surgery can be used to raise the soft tissue flap and assist in the extraction.
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- To perform soft tissue biopsies
Soft tissue biopsies can be performed with laser to remove a small piece of soft tissue that appear as abnormal lesions or growths in the mouth. Once the tissue is removed, a pathologist will examine it with a microscope to determine the cause of the lesion, such as different diseases or oral cancer.
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Functional and/or Esthetic Crown Lengthening
When getting a crown, your dentist must prepare your tooth to receive the crown. Sometimes there is not enough tooth surface above the gum line to accomplish this. A periodontist can do crown lengthening to provide more tooth surface. This ensures a more stable crown with less gum irritation. Also, if you have a "gummy" smile or an uneven gum line, crown lengthening can make your teeth look longer and more even.
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Temporary Anchorage Device for Orthodontics
One of the many important advances in orthodontics has been the development of temporary anchorage devices, or TADs. Made of a bio-compatible titanium alloy, TADs are miniscrew anchors which are inserted into specific places in the mouth to be used as a fixed point from which teeth can move. Before TADs, orthodontists who wanted to move some teeth while keeping others still, or to achieve orthodontic movement in a mouth with missing teeth, had to rely on headgear for their fixed point. But TADs now provide an option for that fixed point that is smaller, more discrete, more efficient and requires significantly less work for the patient.
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Osseous Surgery (Pocket Reduction)
Osseous Surgery is used to modify and reshape deformities in the supporting bone around the teeth and is used when periodontal disease is advanced in nature. The bone is modified when indicated and excess gum tissue is trimmed away.
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Bone and Tissue Regeneration
The main cause of periodontal disease is bacteria in the form of sticky, colorless plaque that forms on your teeth. However, many factors can cause periodontal disease or influence its progression.
Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed and pockets develop. Eventually, too much bone is lost, and the teeth need to be extracted. A regenerative procedure can reverse some of the damaged bone that supports your teeth by regenerating lost bone and tissue.
During this procedure, the gum tissue is folded back and the disease-causing bacteria are removed. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body's natural ability to regenerate bone and tissue. There are many options to enhance support for your teeth and to restore your bone to a healthy level.
Eliminating existing bacteria and regenerating bone and tissue helps to reduce pocket depth and repair damage caused by the progression of periodontal disease. With a combination of daily oral hygiene and professional care, you will increase the chances of keeping your natural teeth - and decrease the chances of serious health problems associated with periodontal disease.
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Socket Graft Preservation
Socket graft preservation is vital in preserving the bone after a tooth has been extracted. The socket is the area of the jaw bone that holds a tooth in place. Once a tooth has been extracted, the socket begins to deteriorate, making it difficult for future implant placement. To preserve bone volume and socket stability, a simple preservation graft is immediately placed. Once sufficient bone volume is present, dental implants can be placed.
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