When a tooth is lost, both bone and gum tissue compete for the defect space. The gum tissue generates quicker than bone, thus assuming the space. With a membrane placement we can keep the gum tissue from the space, while the bone regenerates. Bone regeneration is often used to rebuild the supporting structures around the teeth which have been destroyed by periodontal disease. Bone surgery may be used to rebuild or reshape bone. Grafts of the patient's bone or artificial bone may be used, as well as special membranes.
Crown lengthening is a surgical procedure that re-contours the gum tissue and often the underlying bone of a tooth. Crown lengthening is often for a tooth to be fitted with a crown. It provides necessary space between the supporting bone and crown, which prevents the new crown from damaging bone and gum tissue.
When deep pockets between teeth and gums (6 millimeters or deeper) are present, it is difficult for a dentist to thoroughly remove the plaque and tartar. Flap surgery is a procedure where the gum flap is lifted away from the tooth. Diseased tissue and sometimes bone is removed. The rough surfaces of the tooth are then smoothed by root planing. The area is medicated and the gum flap is replaced and sutured allowing the bone and gum tissue to heal. One of the goals of flap surgery is to reduce the depth of the periodontal pockets to make them easier to keep clean.
If a patient has an excess amount of tissue that connects the lower and upper lips to the jaw and gum line, a frenectomy procedure is performed to remove the excess tissue.
In the back of the upper jaw bone, dental implants are frequently needed. In order for a dental implant to be successful in this area of the mouth there must be sufficient bone height and width to connect (integrate) to the dental implant. When the upper back teeth are lost and not replaced, the sinus cavity becomes enlarged destroying any bone that is left behind. This very large sinus is like a "giant air pocket" and not capable of supporting an implant. A procedure known as sinus grafting (sinus lift) is performed to create bone that will ultimately hold the implants within the sinus. Sinus grafting is an extremely common form of bone grafting.
A frequent periodontal condition is known as gum recession. This means the existing gum tissue has receded up or down the root of the tooth exposing various amounts of the root. Root exposure can create root sensitivity especially to hot and cold, an increased potential for root decay, and/or esthetic concerns. Gum grafting procedures are the treatment of choice to prevent the recession from continuing further. There are many different types of recession and hence many different types of gum grafting. Some are aimed at covering the root of the tooth and other procedures are focused on providing an excellent new zone of gum tissue to halt the recession.
When a tooth is lost and not immediately replaced, the bone reacts to this event by 'shrinking back'. The bone becomes thinner from a width perspective and the bone height is frequently reduced. This process is known as bone resorption. In order to place implants, it is necessary to rebuild the bone width and height through regenerative surgical therapy. Bone grafting of the ridge is almost always required to enable accurate placement of dental implants. The grafting is completed utilizing tissue bank and/or synthetic bone particles combined with collagen membranes. It is a highly predictable procedure.