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Periodontics Illustrated

I. Treatment of Chronic Periodontitis

Treatment of chronic periodontitis is highly successful in keeping teeth and improving both comfort and confidence. Non-surgical therapy is the foundation of periodontal care and this can also be successful when the disease is thought to be unresponsive or refractory. Effective self-care oral hygiene is the main key to success and we can help by equipping patients with skills and building their motivation and confidence to achieve this. In addition, meticulous instrumentation of the root surface (deep scaling or Root Surface debridement) will lead to substantial improvements in periodontal health.

II. Surgical Periodontics and Periodontal Regeneration

There are situations where non-surgical treatment may not resolve more advanced levels of periodontitis including: advanced bone loss, deep vertical bone defects, complex root anatomy and root furcations (where the roots divide in back teeth) and where the gum tissue is of a thick and fibrous nature.

Periodontal surgery can facilitate access to remove plaque and calculus (tartar) that is located deep under the gum and also provides the opportunity to reshape the gum in order to minimise or eliminate pocketing. Periodontal surgery is usually delayed until after non-surgical treatment has been provided and can be directed at those sites where it may be beneficial.

• Periodontal Regeneration

Where bone loss associated with periodontal disease is vertical in nature, creating gutters of bone loss, there may be an opportunity to regenerate both the lost bone and periodontal attachment. Regenerative techniques most often employ surgical placement of membranes or bone graft materials, or use enamel matrix proteins in the form of Emdogain gel. Although, regenerative techniques require careful site selection, the results can be dramatic.

• Advanced Periodontal Surgical Procedures

As well as the management of chronic and aggressive periodontitis, we can also help in a variety of pre-prosthetic, aesthetic, mucogingival and periodontal plastic surgery procedures.

• Mucogingival and Periodontal Plastic Surgery

Periodontal plastic surgery refers to a number of procedures that are aimed at restoring or adjusting the nature and position of the gingival (gum) tissue such as in the treatment of gingival recession. The most common forms of treatments are the Free Gingival Grafts often used to treat the recession that can occur next to the lower central incisors (lower front teeth) or Connective Tissue Grafts often used when the aesthetics are the key concern.

III. Crown Lengthening

Extensively broken down or heavily filled teeth require an adequate amount of sound, natural tooth structure above the gum line to achieve a satisfactory and long lasting restoration. Crown lengthening involves rising a small gum flap and removal of a small amount of hard and soft tissue, which will expose enough tooth structure or buried margins to allow for successful restoration of the tooth/teeth.

Crown preparation can usually be performed two to three weeks after surgery.

Aesthetic crown lengthening is used to treat a gummy smile or increase the length of short front teeth.

IV. Implant Dentistry and Related Surgery

Implant dentistry is now firmly established as a successful treatment option for the replacement of missing teeth. At Shape Dental Periodontics we offer support for your patient’s implant needs.

We are experienced in the placement of fixtures from Astra systems. We place implants as single or two-stage procedures according to the clinical situation.

Where implant placement is compromised by a lack of available bone we can undertake appropriate bone grafting procedures. Where the amount of augmentation needed is limited, we can undertake guided bone regeneration using particulate grafts and membranes at the time of implant placement of as a separate procedure.

V. Treatment of Peri-implant Disease

Peri-implant diseases are inflammatory conditions affecting the soft and hard gum tissues around dental implants. Similar to a natural tooth, bacteria can build up on the base of the implant, below the gum line. Over time, the bacteria irritate the gum tissue, causing it to become inflamed, damaging the tissue and if not caught early, causing the bone structure below the implant to deteriorate.

Peri-implant diseases are classified into two categories, Peri-implant mucositis, which involves gum inflammation around the soft tissues of the dental implant with no signs of bone loss and Peri-implantitis, which involves gum inflammation and signs of bone loss affecting the dental implant.

Peri-implant mucositis is a precursor to peri-implantitis. Evidence suggests that peri-implant mucositis may be successfully treated and is reversible if caught early however Peri-implantitis usually requires surgical treatment. ●●●

Website last updated APR 2014
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