Mission Perio offers a range of services and treatment options to best meet your periodontal needs. By utilizing available technology and procedures, we ensure that our patients are provided with quality care. After an initial consultation, Dr. Allain or Dr. Yaholnitsky and the team will thoroughly explain various treatment plans that are most conducive to your individual case. Please refer to our list of services and do not hesitate to call our office for more information.
Periodontal disease often results in the development of bone defects around the teeth that contribute to periodontal pockets and reduce access for cleaning. In some situations, deep bone defects have a specific shape that allows for bone grafting to regenerate the bone that has been lost. The procedure involves the placement of a small membrane that dissolves with time over bone grafting particles that have been placed into the bone defect. The source of bone might some other site in the mouth or other bone substitutes. Bone healing is a slow process that occurs over several months therefore a follow up radiograph is recommended roughly 6 months post op.
Biopsies are used to establish a diagnosis for oral tissue that does not appear normal (a lesion). The biopsy can be incisional where only a portion of the lesion is removed or excisional where the entire lesion is removed. An oral pathologist can determine what cells are present, if they appear normal and what the most likely diagnosis for the lesion is.
Crown lengthening or tooth lengthening is completed to expose more of the tooth for the placement of fillings or restorations.
Crown lengthening is often recommended when fillings or restorations are needed where decay has developed under the gums, teeth have broken off, teeth are short from severe wear, or sometimes when teeth are just too short to allow a new restoration to stay in place. It can also be indicated to improve the esthetic appearance of a "gummy" smile, teeth that appear short due to too much gum tissue.
This procedure involves reshaping excess gum and bone tissue to expose more of the natural tooth.
A dental implant is a small medically grade sterile screw composed of titanium that can be used to replace a single tooth, several teeth or the full mouth. The implant simulates the root of a tooth and is put in the bone, usually allowed to heal for a few months and then fit with the appropriate components to support the planned restoration such as a crown, implant bridge or implant supported denture, or full mouth implant supported fixed prosthesis.
Each situation requiring a dental implant dictates the steps necessary for implant placement. In all cases, a dental implant requires solid, healthy bone in sufficient quantity and at the right location to build the desired crown or prosthesis. The number and ideal location for implants can be determined from clinical records and an interactive discussion between the general dentist or prosthodontists, the surgeon Dr. Allain or Dr. Yaholnitsky placing the implants and an interested patient.
Exposure of an Impacted Tooth
When a tooth is impacted it may require surgical exposure to then move the tooth into its correct position. Dr. Allain or Dr. Yaholnitsky make a small window in the gum tissue to expose the impacted tooth. In some cases some bone may need to be removed to expose the impacted tooth. An orthodontic button and chain is generally bonded to the impacted tooth, allowing the orthodontist to then move the tooth into position.
This minor procedure is used when rotated teeth have been straightened by orthodontic treatment. The rotation of these teeth creates tension in the fibers attaching the gums to the teeth so that the teeth attempt to rotate back to their original orientation. A small incision is made between the gums and the teeth to release the fibers and allows the fibers to reattach to the tooth in the correct orientation. No sutures are needed and minimal bleeding or discomfort occurs. This procedure decreases the chance of the tooth rotating back to the orientation it had prior to the orthodontic treatment.
This procedure is used to remove the small fold of excess muscle tissue (frenum) inside the upper or lower lip, usually in the front, where it attaches to the gum. This attachment may cause the separation of teeth, prevent orthodontic movement or cause recession of gum tissue. The procedure is completed under a local anesthetic, the frenum is pinched with surgical forceps, reduced with incisions on either side of the instrument and closed with dissolvable stiches.
When nonsurgical therapy such as scaling and root planning has done all it can to reduce pockets, inflammation and defects in the bone from periodontal disease, gum surgery is usually recommended. This procedure allows the periodontist to gently pull back the gum tissue gaining access to the teeth and bone. Under a local anesthetic, the procedure involves cleaning the roots thoroughly, removing infected gum tissue and possibly reshaping bone around the teeth. The end result is a reduction in periodontal pockets and the creation of gum contours that are optimized for daily cleaning.
Bone Grafting / Ridge Augmentation
Inadequate bone in the upper or lower jaw does not allow placing dental implants or leaves an unaesthetic area for dental bridgework.
Dr. Allain or Dr. Yaholnitsky perform a ridge augmentation involving the placement of bone particles obtained from other sites in the mouth, bone banks or synthetic bone, under the gums to build up the jaw bone. A small dissolving membrane is used under the gums to hold the bone particles in place and give the bone time to heal. Depending on your individual needs, the bone usually will be allowed to heal for four to six months before implants can be placed.
Sinus lift is a procedure to allow a dental implant to be placed where the sinus has expanded into the area where the tooth root was and limits the available bone for an implant.
When teeth are already missing or have recently been removed, Dr. Allain or Dr. Yaholnitsky can lift the gums in the back of the upper jaw to create a small window through the bone, into the sinus. Bone from bone banks, bone from other sites in the mouth or sometimes synthetic bone materials can be placed through this window into the sinus to lift it back to where it was to create additional bone for a dental implant.
The sinus is quite large and the added bone is quite small, so this has very little impact on the normal function of the sinus. Depending on the amount of bone already present, sinus lifts might be completed at the same time a dental implant is placed, the same time a tooth is extracted or several months before an implant is placed.
Extraction with Socket Preservation
When teeth are removed in areas that may have an implant placed or where there is a desire for a nice cosmetic outcome, a socket preservation procedure is often needed. The bone can often be very thin on the outer side of a tooth especially toward the front of the mouth.
Extraction of a tooth without socket preservation can allow some of the bone to resorb or die and the ridge shrinks to the point that an implant may not be possible, or the cosmetic appearance of an implant or bridge is severely compromised.
Socket preservation is a procedure where bone particles obtained from other sites in the mouth, bone banks or synthetic bone, is placed into the socket left by the extracted tooth. A dissolvable membrane is placed under the gum to hold the bone particles in place and gives the bone time to heal. This often reduces the need for more costly ridge augmentation procedures after healing, depending on the condition of the bone prior to the extraction.
Soft Tissue Graft
The purpose of a Gum graft or soft tissue graft is to create an amount of think attached gum tissue to reduce further recession, cover the root surface exposed by recession, treat root sensitivity or root decay and to build up gum collapsed in the dental ridge.
This procedure involves taking gum tissue from your palate, or another donor source such as a tissue bank, to the exposed root or graft site.
Tooth extractions can involve the removal of a single tooth, tooth fragments, multiple teeth or full mouth. Each of these situations can present different challenges and the plan for the type of tooth replacement can influence the method and procedures used.
It is not recommended to allow teeth to deteriorate to the point that bone support is lost with the increased desire for dental implants. Removing a bad tooth while the bone support is still adequate allows later placement of a dental implant or esthetic results for dental bridge work.
If a tooth or teeth are broken down so far that they are under the gums, we will open the gums just enough to get the access needed for removal but still taking care to preserve the bone for a future restoration.
It is not uncommon to have extra bone develop on the inside of the lower jaw, the roof of the mouth or sometimes on the cheek side of the upper and/or lower jaw. This extra bone, while normal, can block a toothbrush and floss from getting to the teeth to clean adequately and can inhibit the fit of dental appliances. They are referred to as tori, torus, exostosis and exostoses depending on their location.
Torus removal involves pulling back the gums to access the bone and removing or reshaping it. The gums are then sutured and allowed to heal.