Treatment Methods
Dr. Nelson Liu and Dr. Claire Wang’s practice provides a variety of surgical services. We pride ourselves on the fact that we are very conservative in our treatment recommendations and limit surgery to the areas where it is absolutely necessary. Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Even in severe cases, non-surgical periodontal therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to help limit the areas requiring surgery
When being referred to our office, we ask that you undergo a dental/radiographic examination and health history. During the first consultation visit, your doctor will address your specific needs and considerations. Your questions and concerns are important to us and our team will work with you very closely to help make your procedure a success.
We will also discuss fees and insurance at this time. There are many types of insurance plans, and coverage for gum procedures and implants is varied. We will be happy to assist you in obtaining any benefits to which you may be entitled. Our office takes any PPO insurance and we are in network with Delta Dental.
Procedures
Dental Implants
Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants themselves are tiny titanium posts that are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, implants can help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing. Dental implants are changing the way people live! With them, people are rediscovering the comfort and confidence to eat, speak, laugh, and enjoy life.
Dental implants are metal anchors that act as tooth root substitutes. They are surgically placed into the jawbone. Small posts are attached to the implant to provide stable anchors in the gums for replacement teeth.
For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. Healing time following surgery varies from person to person and is based on a variety of factors that include hardness of bone. In some cases, implants may be restored immediately after they are placed.
For the first three to six months following surgery, the implants are beneath the surface of the gums gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your restorative dentist designs the final bridgework or denture that will ultimately improve both function and aesthetics.
After the implant has bonded to the jawbone, the second phase begins. will uncover the implants and attach a small healing collar. After two weeks your general dentist will be able to start making your new teeth. An impression must be taken. Then posts or attachments can be connected to the implants. The teeth replacements are then made over the posts or attachments. The entire procedure usually takes six to eight months. Most patients do not experience any disruption in their daily life.
Scaling & Root Planing
The initial stage of treatment is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line. The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion (bite) may require adjustment.
Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, may place antibiotic fibers in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.
When deep pockets between teeth and gums are present, it is difficult for to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.
Osseous Surgery
Traditionally, gum disease is treated by eliminating the gum pockets. The infected gum tissue is trimmed away and uneven bone tissue re-contoured. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.
Guided Tissue Bone Regeneration
Traditionally, eliminating the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue treats gum disease. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.
Guided tissue bone regeneration regenerates the previously lost gum and bone tissue. Most techniques utilize membranes that are inserted over the bone defects. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bioactive gels.
LANAP (Periodontal Regeneration Protocol) = LAR (Laser Assisted Regeneration)
The LANAP protocol is a comprehensive, regenerative approach designed to treat moderate-to-severe gum disease and “hopeless teeth” using the PerioLase MVP-7. The LANAP protocol with FDA clearance for True Regeneration is also known as Laser Assisted Regeneration (LAR).
The LANAP=LAR protocol:
-Targets diseased tissue leaving native tissues intact
-Mantains crestal tissue height
-Creates a clean, sealed, closed environment for wound healing and True Regeneration.
For our office and our patients this means:
-Less pain, less bleeding and less swelling
-Minimal crestal tissue loss and less sensitivity
-Faster post op recovery and better perception of surgery
-Increased patient acceptance rate
-Restoration of functional dentition
*Please note that not every patient is a good candidate for LANAP.
Cosmetic Periodontal Surgery
These procedures are a predictable way to cover unsightly, sensitive, or exposed root surfaces and to prevent future gum recession. If you are unhappy with the appearance of short unsightly teeth this can be greatly improved by a combination of periodontal procedures by and cosmetic dentistry by your dentist. Although your teeth appear short, they may actually be the proper length. The teeth may be covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure, crown lengthening.
During this procedure, excess gum and bone tissue are reshaped to expose more of the natural tooth. This can be done to more than one tooth, to even your gum line, and to create a beautiful smile.
Another cosmetic procedure is the soft tissue graft. It is used to cover unattractive tooth roots, reduce gum recession, and protect the roots from decay and eventual loss. Tooth loss causes the jawbone to recede and can lead to an unnatural looking indentation in your gums and jaw, an appearance of a general aging. The original look of your mouth may not be recaptured because of spaces remaining under and between replacement teeth. They may appear too long compared to nearby teeth.
Bone grafting following tooth loss can preserve the socket/ridge and minimize gum and bone collapse. There is less shrinkage and a more aesthetic tooth replacement for either an implant crown or fixed bridge around the replacement teeth.
Gum Grafting
When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option. When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.
In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gym recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging. A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root. The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.
Crown Lengthening
Crown lengthening (or crown exposure) is required when your tooth needs a new crown or other restoration. The edge of that restoration is deep below the gum tissue and not accessible. It is also usually too close to the bone or below the bone.
The procedure involves adjusting the level of the gum tissue and bone around the tooth in question to create a new gum-to-tooth relationship. This allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease. The procedure takes approximately one hour. When the procedure is completed, sutures, and a protective bandage are placed to help secure the new gum-to-tooth relationship. You will need to be seen in one or two weeks to remove the sutures and evaluate your healing.
Sterilization And Infection Control
Many of our patients ask us questions about our sterilization procedures. Considering the ever-increasing number of contagious diseases in the news today, this is an understandable concern. You can rest assured that your health and safety are one of our primary concerns. The guidelines for sterilization and infection control in dentistry are called Universal Precautions. We follow these guidelines for every one of our patients. The following are some of the methods we employ to assure your safety.
