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Archive for gum grafting

Following tooth extraction which could be the result of periodontal disease, fracture roots, abscess formation etc. the bone and gum around the removed root starts to shrink away. Research has shown that up to 40-60% of the remaining bone shrinks away within 2-3years.
This leaves areas which areas which are unsightly because of the reduction of hard (bone) and soft tissue (gum) volume. This results in less than ideal final crown or bridgework in terms of size and shape compared to the adjacent natural teeth. We can offer rebuilding of this soft and hard tissue as we have had years of experience in providing these sorts of procedures.

gum grafting used to treat periodontal conditions

Gum grafting and bone graft treatment before dental implant placement

Should a patient request dental implants to replace these teeth than bone grafting may have to be done prior to any implants placed. The replaced teeth look odd as it maybe much longer and the gum around this tooth will also look sunken in. A procedure called ridge augmentation restores the natural hard and soft tissue profiles so that the replaced teeth look much more in harmony with the natural teeth. There are many different techniques of ridge augmentation and the actual procedure used will depend on the volume of tissue lost and also final restorative therapy to replace the missing teeth. This procedure can be carried out under local anaesthetic and depending on the size of the area to be filled can either be done with small bone graft or a soft tissue graft taken from the roof of mouth. You will be given a choice of materials to be used in the bone graft.

The bone graft can either be taken from the patient (back of mouth) or usually from an either animal source (Bovine Bio-Oss) or synthetic material (Straumann bone ceramic. The bone graft helps to provide a stable base for the dental implants and gum tissue by bonding with the natural bone over a period of several months. After it has matured then the bridgework or implant therapy can be carried out. The healing period can vary and the success rates are very high but smokers are advised to refrain from smoking for at least 1 week prior to the procedure and for 3 weeks afterward for the best results. In some more advanced cases both hard and soft tissue grafts are used together.

bone and soft tissue grafts for treating gum disease

Non-surgical management of periodontal diseases

This could include any of the following, instruction in plaque control, scaling and root surface debridement, bacterial analysis and antimicrobial therapy, occlusal analysis and adjustment and splinting of teeth.
The patient’s response to non-surgical therapy is closely monitored; if periodontal problems persist further treatment may be required.

Non surgical treatment for severe periodontitis

Gum disease severe periodontitis before and after treatment

Gum disease severe periodontitis before and after treatment

BEFORE
This gentleman has severe gum problems caused by neglect and also medication for his high blood pressure. After undergoing a course of gum treatment, the swelling and bleeding was completely eliminated. His teeth were much more comfortable and felt his breath was much fresher. The long term outcome is very good with good flossing and brushing.
AFTER
After treatment the periodontal condition has been stabilised with just non-surgical therapy and has been maintained by excellent plaque control by the patient.

Periodontal plastic surgery.

Problems such as excessive recession around teeth that cause aesthetic and sensitivity problems can now be dealt with great success. The use of soft tissue grafts can increase the zone of keratinised tissue and cover exposed roots. They can also be used for ridge augmentation and papilla regeneration around implants. The use of microsurgical techniques has greatly enhanced the predictability and success rate whilst also minimising post-operative discomfort.

Surgical periodontal and regenerative therapy.

This is usually performed if there are still problem areas after non-surgical therapy. Various surgical techniques are used for pocket elimination and predictable regenerative therapy using the latest materials available.

Periodontal resective therapy

BEFORE
Non-responding sites that after root surface debridement still have deep pocketing and bleeding on deep probing.

AFTER
Pocket reduction periodontal surgery was carried out resulting in minimal probing depths and no bleeding on deep probing. This also provides the patient with proper access for plaque control in home maintenance.

Periodontal regenerative therapy

BEFORE
Advanced bone loss on the distal surface of the premolars. Surgical regenerative therapy was carried out using Emdogain bone regenerative material.

AFTER

Bone regenerative therapy establishes new tooth support through new bone growth thereby enhancing the long-term prognosis of the tooth.

Root resection : root hemisection surgical procedure

Often multi-rooted teeth have a localised infection around one root. This surgical procedure is used to remove an infected root or to divide a two rooted tooth. The tooth remains functional because the infection is eliminated making it possible to perform effective plaque control and keep the site healthy.

Root resection surgery before and after treatment

Root resection surgery before and after treatment

BEFORE
Extensive bone loss and failed root filling around the distal root of the molar. The mesial root was found to be sound.

AFTER
The distal root has been removed and the mesial root retained. The mesial root will be subsequently restored by the referring dentist.

Crown lengthening.

Short and inadequate tooth length prevents the placement and retention of a new crown or bridge. This procedure increases the amount of tooth structure to support a crown or bridge by contouring the gingiva and the underlying bone. In addition it can also be used to improve the appearance of the anterior teeth prior to any advanced dental treatment or by removing excess gum tissue in the case of a “gummy” smile.

Periodontal surgery for tooth fracture

crown lengthening surgical procedure

crown lengthening surgical procedure

BEFORE
A tooth fracture with inadequate tooth structure for crown retention.

AFTER
After crown-lengthening procedure was carried out additional tooth is available to provide successful placement of a crown. After the procedure you can see a full coverage crown that is more retentive and natural looking.

Periodontal surgery for gummy smile

BEFORE
Short teeth and a gummy smile that compromises the aesthetic appearance of the smile.

AFTER
After aesthetic periodontal surgery the gums were positioned in a more pleasing position and contour. The beauty of this smile was completed with new porcelain veneers.