Procedures

Periodontal (gum) disease, including gingivitis and periodontitis, are serious infections that if left untreated can lead to tooth loss. The word periodontal literally means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.

TYPES OF GUM DISEASE

Gingivitis
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and to bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Periodontitis
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

GUM DISEASE TREATMENT

Non- Surgical Treatments
Dr. Holzinger believes that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment including scaling and root planing. Scaling and Root Planing is a careful cleaning of the root surfaces to remove plaque and calculus {tartar} from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Many patients do not require any further active treatment but will require ongoing maintenance therapy to sustain health. Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.

Periodontal Surgery
If you are diagnosed with gum disease, Dr. Holzinger may recommend periodontal surgery. Periodontal surgery is necessary when the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:

  • Pocket Depth Reduction
  • Regeneration
  • Dental Crown Lengthening Procedure
  • Gum Graft Surgery

Pocket Depth Reduction
Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth. Over time these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted. Dr. Holzinger has measured the depth of your pockets. A pocket reduction procedure has been recommended because you have pockets that are too deep to clean with daily at-home oral hygiene and professional care routine. During this procedure, he folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows gum tissue to better reattach to healthy bone.
Reducing pocket depth and eliminating bacteria are important to prevent damage caused by the progression of periodontal disease and to help maintain a healthy smile. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth and decrease the chance of serious health problems associated with periodontal disease.

Regeneration
Dr. Holzinger may recommend a regenerative procedure when the bone supporting your teeth has been destroyed. These procedures can reverse some of the damage by regenerating lost bone and tissue. During this procedure, Dr. Holzinger folds back the gum tissue and removes disease-causing bacteria. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body’s natural ability to regenerate bone and tissue.

Dental Crown Lengthening
This procedure is performed to lay the groundwork for restorative and cosmetic dentistry and/or to improve the esthetics of your gum line, better known as a “gummy” smile. During this procedure excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to your gum line or to several teeth to expose a natural, broad smile. Crown lengthening procedures are also recommended when your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so that it may be restored.

Gum Graft Surgery
Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you’re not bothered by the appearance but the exposed tooth roots are sensitive to hot or cold foods and liquids.
Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment Dr. Holzinger can help you identify the factors contributing to the problem. Once these factors are controlled, gum graft surgery will repair the defect and help to prevent additional recession and bone loss. Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During the gum graft surgery, Dr. Holzinger takes the gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.
A gum graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a gum graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health which are the keys to smiling, eating and speaking with comfort and confidence.

Dental Implants: Replacement Teeth That Look and Feel Like Your Own
A dental implant is an artificial tooth root that Dr. Holzinger places into your jaw to hold a replacement tooth or bridge. Dental implants are an ideal option for people in good general oral health who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason. While high-tech in nature, dental implants are actually more tooth-saving than traditional bridgework, since implants do not rely on neighboring teeth for support.
Dental implants are so natural-looking and feeling, you may forget you ever lost a tooth. You know that your confidence about your teeth affects how you feel about yourself, both personally and professionally. Perhaps you hide your smile because of spaces from missing teeth. Maybe your dentures don’t feel secure. Perhaps you have difficulty chewing. If you are missing one or more teeth and would like to smile, speak and eat again with comfort and confidence, there is good news! Dental implants are teeth that look and feel just like your own! Under proper conditions, such as placement by a periodontist and diligent patient maintenance, implants can last a lifetime. Long-term studies continue to show improving success rates for implants.

What Dental Implants Can Do?

  • Replace one or more teeth without affecting bordering teeth
  • Support a bridge and eliminate the need for a removable partial denture.
  • Provide support for a denture, making it more secure and comfortable.

Advantages of Dental Implants Over Dentures or a Bridge

  • Esthetic: Dental implants look and feel like your own teeth! Since dental implants integrate into the structure of your bone, they prevent bone loss and gum recession that often accompany bridgework and dentures. No one will ever know you have a replacement tooth.
  • Tooth-saving: Dental implants don’t sacrifice the quality of your adjacent teeth like a bridge does because neighboring teeth are not altered to support the implant. More of your own teeth are left untouched, a significant long-term benefit to your own oral health!
  • Confidence: Dental implants will allow you to once again speak and eat with comfort and confidence! They are secure and offer freedom from the erksome clicks and wobbles of dentures. They’ll allow you to say goodbye to worries about misplaced dentures and messy pastes and glues.
  • Reliable: The success rate of dental implants is highly predictable. They are considered an excellent option for tooth replacement.

Are You A Candidate for Dental Implants?
The ideal candidate for a dental implant is in good general and oral health. Adequate bone in your jaw is needed to support the implant, and the best candidates have healthy gum tissues that are free of periodontal disease. Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Since periodontists are the dental experts who specialize in precisely these areas, they are ideal members of your dental implant team. Not only do periodontists have experience working with other dental professionals, they also have the special knowledge, training and facilities that you need to have teeth that look and feel just like your own. Your dentist and Dr. Holzinger will work together to make your dreams come true.

What is Treatment Like?
This procedure is a team effort between you, your dentist and Dr. Holzinger. Dr. Holzinger and your dentist will consult with you to determine where and how your implant should be placed. Depending on your specific condition and the type of implant chosen, Dr. Holzinger will create a treatment plan tailored to meet your needs.

  • Replacing a single Tooth: If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.
  • Replacing Several Teeth: If you are missing several teeth, implant-supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.
  • Replacing All of Your Teeth: If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them. Dental implants will replace both your lost natural teeth and some of the roots.
  • Sinus Augmentation: A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus Augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
  • Ridge Modification: Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.