Periodontics
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Use the drop down menu to jump to different sections about periodontics. |
PERIODONTAL DISEASE: Bacterial infections of the gum and bone that hold teeth in place.
These types of infections are primarily low-grade infections. Therefore, there are usually few warning signs and patients can be unaware that deterioration is occurring. Because there are few warning signs, periodontal diseases affect about 75% of the population.
Periodontal diseases begin as gingivitis. If the infection is not controlled, Gingivitis can progress into periodontitis.
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Gingivitis: Occurs when the bacterial infection is localized to the gum tissue around teeth. |
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Gum tissue shows moderate inflammation (swelling). Radiograph reveals no bone deterioration. Periodontal probe extends 3-5mm deep. Infection has not spread into bone support yet. Bleeding is present when probing. |
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Radiograph reveals no bone deterioration. Infection has not spread into bone support yet.(Solid line indicates proper bone level). |
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PERIODONTITIS: Occurs when the gum infection has spread into the jaw bone beneath the gum tissue and causes deterioration of the bone support for teeth. |
CAUSES OF PERIODONTAL DISEASE: Due to bacteria that becomes trapped under the gum line.
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Secondary factors in periodontal disease progression are: smoking, certain medical conditions and genetics. |
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| These teeth have been lost because of periodontal disease caused by bacteria. The bacteria have calcified on the root portion of these teeth and is seen as calculus (tartar). Before the bacteria calcify on the root surfaces, bacteria live in a soft white matrix with food particles. This is known as plaque. |
SCALING AND ROOT PLANING: A periodontal treatment that removes bacteria from underneath the gum line.
If bacterial penetration is not too far below the gum line, scaling and root planning can be very effective at halting periodontal disease.
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Examination reveals calculus trapped below gum line on cuspid tooth. |
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Under local anesthesia, the gum tissue is pulled back to reveal calculus. Since the calculus has not progressed too far down, it can be effectively removed. |
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Re-evaluation of treatment 3 weeks later reveals success due to due to early intervention. Chances of successful treatment with scaling and root planing lessen when calculus is deeper than 5mm. |
POCKET REDUCTION:
A periodontal treatment that eliminates bacteria trapped deep below the gum line and reduces the pockets that trap the bacteria. Pocket reduction procedures correct periodontal problems when the gum tissue is not responding to regular dental hygiene treatments or scaling.
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This photograph shows the condition present following years of regular hygiene appointments.
- Swollen gums remain due to bacteria still trapped deep under gum line.
- Periodontal pockets are 6mm deep. These pockets are too deep for dental instruments to reach the base of the pocket during hygiene appointments.
- Because bacteria remains trapped beneath the gum line, periodontal disease remains present. THIS INCREASES THE RISK FOR FUTURE TOOTH LOSS.
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This photograph shows the improved condition following corrective pocket reduction treatment.
- Gum tissue is firm and healthy due to complete bacterial elimination.
- Periodontal pockets have been eliminated.
- THE PROGNOSIS FOR LIFE LONG TOOTH RETENTION HAS BEEN GREATLY IMPROVED.
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BONE GRAFTING: replaces the bone support that was damaged by periodontal disease.
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The radiographs on the left show the pre-treatment defects in the bone holding teeth in place.
The radiographs on the right show correction of these defects and new support for the teeth. (Solid line is proper bone level; dotted line is actual bone level). |
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GINGIVAL GRAFTING: Attached gingival tissue is beneficial in preventing progressive gingival recession and loss of attachment.
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The photographs on the left depict pre-operative conditions where there is a lack of protective attached tissue. As a result, there is a high probability of progressive gingival recession. Photographs on the right depict an increase in the amount of attached tissue. This improves the prognosis for tooth retention. The thickness of attached tissue is seen between the dotted black lines. Below the dotted line is the alveolar mucosa. |
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CROWN LENGTHENING: Exposes more tooth structure when decay or fracture is below the gum line.
This procedure can also allow for better retention of restorations when the teeth are too short.
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PRE-TREATMENT
- Patients’ tooth has broken off below the gum-line.
- There is not enough tooth exposed for retention of a crown.
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FOLLOWING CROWN LENGHTENING
- Root portion of tooth has been exposed.
- This will allow the new crown to fit securely against the exposed tooth.
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NEW CROWNS SECURE IN PLACE
An excellent prognosis for the new crowns has been
established through crown lengthening. Secure fitting
crowns have less chance of coming loose or developing
decay at the margins. |
ESTHETIC CROWN LENGTHENING: lengthens teeth to improve the appearance of smiles. These before and after photographs reveal improved esthetics through esthetic crown lengthening followed by restorative treatment.
FRENECTOMY: A high frenum attachment is a risk factor for gingival recession.
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- Pre-treatment photograph reveals high frenum attachment.
- Gingival recession seen on tooth 25.
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- Elimination of frenum pull provides teeth with a good prognosis.
- Complete correction of gingival defect through frenectomy and gingival graft.
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A century ago Americans expected to lose their teeth by middle age. Today, many treatments are available that can significantly reduce tooth loss. Early intervention is the most predictable way to improvement. It is also the best way to eliminate the risk of more costly treatments such as tooth replacement by bridges, dentures and dental implants.
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PRE-TREATMENT condition
- Extreme inflammation of gum tissue due to bacteria trapped below gum line.
- Prolonged presence of inflammation can lead to deterioration of the bone support for the teeth.
- Progressive bone deterioration will lead to tooth loss.
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post-treatment result
- Elimination of inflammation due to complete removal of the bacteria trapped below gum line.
- Prognosis for life long tooth retention is good.
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A healthy mouth has been linked to a healthier body. University studies havefound that the bacteria trapped beneath the gum line can not only be detrimental to teeth, but to ones general health. These bacteria have been shown to enter the bloodstream from the mouth and have been linked to heart disease, increased risk of premature,underweight births; and as a threat to those people compromised by diabetes and respiratory diseases. | 
