Surgical Therapy

Osseous Surgery
This is a common surgical procedure designed to gain direct access to areas of bone damage surrounding the teeth. It’s goal is to remove tartar at the bone level that was not physically accessible during scaling/root planing. Irregularly shaped bone surfaces due to disease are smoothed and excess gum tissue is removed resulting in the reduction or elimination of pockets so that proper oral hygiene can be carried out.
Bone Regeneration/Guided Tissue Regeneration
In some cases, some of the lost bone can be restored by using bone grafts, tissue stimulating proteins and membranes.
Guided Tissue Regeneration (GTR)
Teeth are held in place by surrounding gums, bone, and other tissues. But periodontal disease can cause the bone to break down. Certain techniques called regenerative procedures can be used to stimulate growth of new bone. This growth increases the height of the bone around the tooth, giving the tooth more support, and increases the amount of attachment around the root of the tooth. Getting back even half the lost bone height extends the life of the tooth. One type of regenerative procedure is called guided tissue regeneration (GTR).

How GTR Works
GTR is a technique used to repair periodontal defects so that a tooth, or set of teeth has more support and stability. Periodontal disease, or periodontitis, is a process where bacteria trapped under the gums leads to a chronic infection and subsequent breakdown of the hard and soft tissues supporting the teeth. In certain cases, the destruction leads to gaps that form between the teeth and bone. These gaps, or bony defects often require a separate specialized procedure known as a bone graft. This is where special material is placed into the defect to promote new bone growth. GTR uses a resorbable or non-resorbable artificial membranes to keep soft tissue from growing into these defective sites. This membrane is crucial because it blocks the faster migrating soft tissue cells from growing into the site, while allowing the slower migrating bone-producing cells to populate and grow there instead. This is how GTR is done:

  • Surgery on gum and bone. The gum is opened. with a procedure known as a flap. The area under the gums is cleaned out to remove all bacterial deposits. Then a membrane (with or without the bone graft material) is placed over the damaged bone.
  • Separating tissues. Once in place between bone and gum, the membrane provides necessary space and time for the bone to heal and start regenerating itself.
  • After healing. The stitches and membrane dissolve or are removed. In about 6 months, new attachments and bone regenerate to support the tooth or teeth.
    • To decrease your chances of other health problems associated with periodontal disease, it is important to continue with your daily oral hygiene routine, along with professional maintenance care.

Guided Bone Regeneration
Guided bone regeneration or GBR has been used for over 40 years in implant dentistry. It is most often used when the bone is lost in width and/or when a minimal to moderate amount of bone has been lost. It is most often used when a tooth is extracted and a defect in the bone remains, leaving inadequate bone for implant placement.
Functional Crown Lengthening
Crown lengthening is performed to create a healthy relationship between the gum and underlying bone, by working to expose the tooth covered by excessive gum tissue. The treatment can help to enhance gum tissue health, and ready the mouth and gums for permanent crown placement. Crown lengthening works to expose the part of the tooth underneath the excess tissue by reshaping and harmonizing the existing bone and gum tissue. The procedure can be performed on any number of teeth, and results in a healthier and more beautiful smile for patients.

Sinus Augmentation
When the upper posterior teeth (molars) are lost, the sinuses increase in size. This creates an insufficient amount of bone to support an implant. Therefore, a sinus lift procedure involves placing a bone graft in the sinus area. An implant or implants may be placed at the same time as the sinus lift or a healing period of at least 6 months is recommended depending on the amount and quality of your existing bone.
Platelet Rich Fibrin (PRF)
Platelet rich fibrin (PRF) is an autologous platelet concentrate prepared from your own blood at our office just before the dental procedure in which it will assist. Platelet rich fibrin (PRF) is a by-product of your blood that is exceptionally rich in platelets. PRF has been used in hospitals to accelerate the natural healing process, and now it has been introduced into oral surgery procedures. Your blood platelets perform several essential functions in the body, including blood clot formation and the release of growth factors that help to heal wounds. These growth factors stimulate the stem cells to produce new host tissue as quickly as possible, which is why PRF is so effective in the post-treatment healing process.

Biopsy
The smooth, pink skin lining the mouth is called mucosa. Abnormalities in the color or texture of this skin can sometimes indicate pathology. Any concerns with the soft tissue in the mouth – a sore that is not healing properly or a lump on the inside of the cheeks, palate, gums or lips may merit a biopsy so that the tissue sample can be tested for oral cancer.

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