West Michigan Periodontics offers a wide variety of surgical services. We are very conservative in our treatment recommendations and limit surgery to the areas where it is absolutely necessary.
The early stages of periodontal disease can be treated with non-surgical periodontal therapy. Non-surgical periodontal therapy is often the first line of defense and precedes surgical therapy for the more severe cases. This is done to improve the overall health of gingival tissue before surgery and help reduce the areas requiring surgery.
Non-Surgical Treatment Methods
Scaling & Root Planing:
This treatment method is a thorough deep cleaning including scaling to remove plaque and calculus (tartar) deposits beneath the gum line. The roots of the teeth may also have to be “planed” to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. Scaling and Root Planing is performed with local anesthesia in addition to oral sedation. When the procedure is completed a protective oral bandage is placed to help reduce cold sensitivity.
This procedure is typically completed in one visit, however multiple appointments may be necessary. A follow-up appointment, in one to two weeks, is needed to evaluate and monitor healing.
In some cases, if the pockets between the tooth and the gum have not adequately healed, a surgical procedure may be required to restore periodontal health.
Myofascial Pain Dysfunction / TMJ
Myofascial Pain Dysfunction is characterized by acute or chronic pain that occurs when the muscles of mastication and the tempormandibular joint (TMJ) have been contracted. This can be caused by repetitive motions used in jobs, hobbies or by stress-related muscle tension.
Some common signs and symptoms include tender jaw muscles, difficulty opening or closing your mouth, stress headaches, pain in or around the ear, jaw joints that appear to be “locked” and clicking noises when you open or close.
There are several ways the pain can be treated. Some forms of treatment include the use of an occlusal guard or bite splint, modifying pain by applying moist heat, relaxation techniques and or medication.
Surgical Treatment Methods
The traditional treatment for gum disease is to eliminate the pockets that have formed between the tooth and the gum tissue. Infected tissue is trimmed away and uneven bone is re-contoured in that area to promote proper healing.
Gingival “Gum” Grafting Procedures:
When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. Gingival reconstruction using grafting techniques is an option to treat recession. Recession can result in root sensitivity to hot and cold temperatures and create an unsightly appearance of the gingival tissue and tooth of the affected area. Gingival recession can worsen exposing the root surface, which is softer than enamel, leading to root caries.
A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. The gingival graft can be placed to cover the exposed portion of the root. In certain cases, the graft may have to be buried in the new location under the current tissue to allow it time to mature and grow. It is then re-exposed at another appointment when maturation has reached its maximum capacity.
Crown lengthening (or crown exposure) is often required when not enough tooth structure is available for a crown or a cavity under the gum line needs to be exposed. The procedure involves adjusting the level of the gingival tissue and bone around the tooth. This procedure takes approximately one hour and can be done during your initial visit. When the procedure is completed, sutures and a protective oral bandage are placed to help secure the new soft tissue-to-tooth relationship. A follow-up appointment in one to two weeks is needed to evaluate and monitor healing.
The healing time for this procedure must be 5-6 weeks following surgery before you can return to your dentist for any necessary restorative work. Timing is a very crucial.
Bone grafting helps restore the previously lost bone tissue. Sometimes this treatment involves using resorb-able collagen membranes that are inserted over the bone in combination with the bone graft. Furthermore, Bioactive gels can also be used during these procedures.
Ailing or Failing Implants:
Implants are an alternative option to replace missing teeth; however they still can develop gum and bone infections. Peri-implantitis is the destructive inflammatory process that affects the tissues surrounding the implant. This disease will gradually decrease the amount of bone surrounding the implant, thus causing it to fail.
Treatment for peri-implantitis may include surgical intervention along with the supplemental use of antibiotic therapy. Following treatment diligent oral hygiene and regular dental visits are important to maintain a healthy implant.
A frenectomy is simply the removal of a “Frenum.” The most common are the lingual frenum, which connects the tongue to the floor of the mouth “tongue-tied”, and the labial frenum which connects the inside of the lip to the gums by the two most front teeth. When these thin muscles are causing recession or are a concern during orthodontic treatment they should be removed.
Cosmetic Periodontal Surgery
Providing the best cosmetic periodontal surgery demands a high level of training and expertise that is enhanced with an aesthetic touch. Techniques offered also play vital roles when delivering a cosmetically pleasing smile. We offer a variety of procedures to allow us to select the right combination to give each individual the optimal results they seek.
If teeth appear short, they may actually be the proper length but are covered with too much gingival tissue. This problem can be corrected by performing a periodontal plastic surgery procedure known as a Gingivectomy, in which excess gingival and bone tissue is reshaped to expose more of the natural tooth. A Gingivectomy can also be performed after orthodontic treatment to get rid of that “gummy smile.” In combination with this procedure a frenectomy is usually required. This is when the thin muscle connecting the lips to the jaw bone needs to be removed to allow for proper and complete alignment of teeth during orthodontics.
Periodontal Maintenance Services/Cleanings
The cleanings recommended following a periodontal cleaning or surgery is called, “periodontal maintenance.” Maintenance visits are very important for periodontal and gum health. Most patients will require periodontal maintenance every three to four months. Our office prefers that most patients alternate with their restorative dentist. The lack of periodontal maintenance can lead you back into active gum disease and further bone loss or tooth loss.