The Treatment of Periodontal Disease
In order to understand treatment of periodontal disease, a good understanding of the disease itself may be helpful.
The goal to ALL types of periodontal treatment is to create a situation that can be kept free of plaque and tarter. This requires elimination of deep pockets, removal of tarter, and knowing proper plaque removal techniques.
Non-Surgical Periodontal Therapy
Gingivitis and Early Periodontitis can almost always be treated with scaling and root planing (deep cleaning). Patients that will require surgical therapy will often times have scaling and root planing completed first, as an initial setp.
Surgical Periodontal Therapy
When deep pockets are present, the goal of keeping them clean cannot be achieved. The most definitive method of pocket reduction is periodontal flap surgery. Using a combination of osseous surgery and regenerative techniques (bon grafting), deep pockets can be eliminated, which will allow the periodontal health of the teeth to be maintained in the long term.
Regenerating lost bone often includes the use of bone grafting materials. Bone grafting can be done with various materials, including human donor bone, bovine bone, or synthetic bone, depending on the particular case. Bone grafting can be used in treating both periodontal disease, as well as preparing areas with missing teeth for future dental implants.
In certain applications, the use of a laser can be used for the treatment of periodontal disease. Our office has the capability of using both the Nd:Yag and the Erbium (Er:Yag) Laser, which are the two most useful types of lasers for treatment of periodontal disease. Dr. Bernstein and Busan may choose to use the laser in cases where it would provide an advantage over traditional flap surgery.
Implants have been part of Dr. Bernstein’s practice for 20 years. Dr. Bernstein and Busan perform the surgical portion of implant treatment, which involves placing a titanium screw into the existing jaw bone, in preparation for a crown that will be placed once the implant has healed.
Extraction and Bone Grafting
Occasionally, existing teeth must be extracted in preparation for replacement with a dental implant. In these situations, a bone graft is placed at the time of the extraction, in order to maintain as much bone volume as possible during healing. This will allow for more predictable healing of the bone, and more bone volume in which the implant can be placed.
In certain cases where teeth may have been missing for an extended period of time, there may be an inadequate amount of horizontal bone volume to support a dental implant. In these situations, a procedure called ridge augmentation, or guided bone regeneration, can be done. Using a combination of bone grafts, membranes, and growth factors, the ridge of bone is rebuilt to create the necessary amount of bone volume for an implant to be placed.
When looking to place implants in the upper jaw, there is often times a deficiency of bone below the floor of the sinus. A procedure called a sinus augementation allows the floor of the sinus to be raised, which then provides enough bone in which to place the implant.
Dr. Bernstein and Busan utilize digital radiographs (x-rays) in the office. In addition to allowing the radiograph to be seen instantaneously, digital radiographs also significantly reduce the amount of radiation exposure to the patient. Dr. Bernstein and Busan also provide CBCT (Cone Beam CT) technology, which allows them to view a three dimensional representation of the the patient’s jaw bone, allowing for safe and accurate implant placement.
Periodontal Plastic Surgery
Oftentimes cosmetic issues may result from loss of gum tissue (recession). In these situations, tissue grafts can be taken from other areas of the mouth to correct the defects, and return to the teeth and gum to their normal appearance. Additionally, periodontal plastic surgery procedure can often be used to correct a “gummy smile.”
Pathology and Other Surgical Procedures
Abnormal growths or lesions can sometimes occur, which require biopsy. The abnormality is removed and sent for microscopic pathology analysis. This procedure is commonly performed by Dr. Bernstein and Busan, using an experienced Oral Pathologist for the analysis for the best possible diagnosis.