We’re thrilled to be adding more comprehensive periodontic services to our practice! Dr. Shango, a board certified periodontist, is on site 2-3 days a month to perform surgical periodontal procedures.
What is Periodontics?
Simply put, it’s a specialty in the dental field that treats the supporting tissues of your teeth, i.e. the gums and bone. Early stages of periodontal disease in these tissues can often be treated by our hygienists using a procedure called scaling and root planing, but for more advanced infections/complex conditions, a surgical option may be necessary. The most common of these are:
Gum Tissue Grafting
While this procedure can be performed cosmetically, most often we see connective tissue grafting performed to address significant gum recession. The ultimate goal here is to increase the amount of attached, hard (keratinized) gum tissue that supports the tooth or teeth in question. There are two main types of grafting:
- Subepithelial Connective Tissue Graft: Here, a small piece of tissue is borrowed from your maxillary palate (roof of your mouth) and then secured to the area that lacks adequate tissue by tucking it underneath the existing gum. The palatal donor site is then closed using medical grade superglue or resorbable stitches. Donor tissue can also be used here, especially if the area requiring surgery is larger than what’s available from the palate. This is used often for root coverage and almost always in cosmetic cases as it is difficult to distinguish the graft from the surrounding area.
- Free Gingival Graft: This procedure also involves using tissue from your maxillary palate, but in this case the surface tissue is taken instead of the tissue underneath. A free gingival graft will often be used on the lower jaw if there is a shallow attachment between your cheek and your gum tissue, the goals are not cosmetic, or if keratinized tissue and not root coverage is the main objective.
If a patient’s periodontal disease progresses far enough, it can result in bone loss so significant that regeneration may be necessary in order to support the remaining teeth or, more commonly, place an implant in an edentulous space. In these cases, bone grafting will be performed, usually in conjunction with the extraction of an infected tooth.
To perform a bone graft, bone material from a donor (allograft) is placed in the area where support is required and allowed to heal/integrate with the surrounding bone. Osseointegration usually takes several months to achieve, after which the space can be restored with a dental implant.
When you lose a permanent tooth from your upper arch, the alveolar bone that supports it begins to resorb and the socket that held the tooth begins to collapse. This bone loss can happen rapidly or slowly, but it is usually progressive over time. As the bone loss occurs, the maxillary sinus expands, moving into the newly created space.
To restore the upper arch with dental implants after this occurs, you may require a sinus lift (also known as a sinus augmentation), where the sinus floor is carefully elevated and bone graft material is pushed into the edentulous space. This bone is allowed to heal and integrate with the existing sinus floor for several months before implants are placed.
Dr. Shango will also be fielding some of the more complex extractions and implant cases for us. If you have any questions or are ready to get scheduled, contact us today!