Specialty that manages the structures around teeth and that also support teeth. It’s relevant to be seen by a gum specialist so not only you can maintain your teeth but also have good overall health!

The main condition that a gum specialist manages is gum disease or periodontal disease: Periodontitis is common but fairly preventable. The cause is usually poor oral hygiene in combination with genetics and the existence of other health issues. Periodontitis can lead to tooth loss. It’s a risk factor for heart, kidney and lung diseases, premature birth, Alzheimer’s.

Symptoms include swollen, red and tender gums; also, loose teeth or teeth that change position

Treatment includes professionally cleaning the pockets around teeth to prevent damage to surrounding bone. Advanced cases may require surgery.

CROWN LENGTHENING

This procedure exposes more tooth structure when a significant number of gums are displayed or when is needed in order to be able to reconstruct the tooth after presenting deep decay or a tooth fracture. Is being done with repositioning the gums and underlying bone away from the edge of the teeth. Takes 1 visit after the initial consultation and 1 or 2 post op visits during 1 full business week.

TISSUE GRAFTING

It’s indicated when there is NOT adequate gum to protect the tooth and the underlying bone. Also called subepithelial connective tissue graft. This technique is highly predictable in terms of providing coverage of the exposed roots and also recreating new quality and amount of the type of tissue lost. The donor tissue is taken from the palate, so you will be given a thin, clear guard that will protect it while you heal.  It takes 1 appointment, ideally to stay in the city for 1 week.

 The usual causes of GUM recession are:

• • Post orthodontics: teeth are moved towards the outside of the mouth in order to correct dental crowding, leaving the amount of supporting bone and gums thinned.
  • Thin biotype: gums that genetically are thin and fragile, presents more often amongst thin and skinny women.
  • Traumatic brushing technique or the use of a stiff toothbrush
  • Hormonal Changes: the gums have receptors for hormones, therefore significant changes in your those can impact the level and health of your gums
  • Lack of adequate dental hygiene that inflames and triggers gum disease.

SINUS AUGMENTATION

Indirect Sinus Lift

This procedure is performed when the height of the alveolar bone resorption is minimal and the implant can be placed at the same time of the indirect sinus lift procedure. This technique makes it possible to pull up bone through the drilling preparation of the implant creating the optimum height for the bone.

Lateral wall sinus lift

This procedure is performed when the alveolar bone resorption in the maxillary is severely deficient and the height is not enough to place dental implants. The sinus lift consists in pulling up the membrane that involves the maxillary sinus cavity to create the correct space in height, depth and width which is filled in with bone graft. During a period of six months the bone graft will become a native, solid and healthy bone that can support the future implants.

FRENECTOMY

Humans have muscle attachments that connect the gums and the lips/cheeks/tongue, called frenum.  It is performed when the buccal frenum or lingual frenulum is too short or too tight and causes alterations with breastfeeding, speech development or creates spaces between the upper front teeth, along and prevents teeth from coming into a correct position or triggers progressive gum recession.

 SCALING AND ROOT PLANING (SRP)

This procedure is a deep cleaning under the gumline, to remove tartar which are mineral deposits and bacteria’s that promotes gum disease, bone loss and affects the support around teeth, as well as causing significant health issues. Scaling removes plaque and tartars and root planning smooth the roots and helps to reattach the gums to the tooth. Patients with gum disease in order to preserve health it is necessary to do this procedure periodically.

OPEN FLAP SCALING AND ROOT PLANING

This procedure is performed by incising the gingiva to provide increased access to     the roots and bone supportive around teeth for scaling and root planning. This procedure also removes bone defects and promotes better conditions for home cleaning. Open or close flap is decided upon the clinical evaluation.

APPLICATION OF GROWTH FACTORS, PRF, PRGF, platelet rich factors

A growth factor is a natural protein capable of stimulating cell proliferation and differentiation and wound healing.   Currently these growth factors are used more often in dentistry for many treatments that promote better results for example for tissue and bone grafting.

PRF (platelet- rich fibrin) is extracted by from the blood of the patient treated, which provides the highest reported growth factor released which continues within a period of 10 days after and is responsible of speeding the wound healing process, has antimicrobial effect, increases the quantity and quality of the bone which is and a huge advantage for future implants, and promotes thicker gum tissue.

PRF SYSTEM advantages:

• Non side effects
• Autologous graft, non-cross contamination
• Can obtain high amounts of growth factors in a minimal volume of blood.
• The preparation takes 15-20 minutes
• Increase the osseous neoformation in dental implants and post-extraction sockets
• Can be used instead or in combination of gingival tissue graft using in covering the dental recessions and promoting a thicker tissue
• Decrease the sourness, inflammation and post- operative pain.

PRP SYSTEM

Platelet-rich plasma (PRP) is extensively applied as a bioactive scaffold in cell-based therapy and tissue engineering. It is obtained from the autologous plasma with concentrated platelets. PRP Releases multiple growth factors which plays important roles in different applications of regenerative medicine, including bone remodeling, wound healing, hair regrowth, nerve regeneration, aging facial skin, acne scarring, androgenic alopecia and diabetic wounds.

Periodontal treatment is commonly used to regenerate bone defects when it is treated for periodontal disease.

PRP VS PRGF:

PRF products are spun at a lower speed so that the layers of the blood do not separate out as distinctly. This allows some of the white blood cells and stem cells to remain within the platelet layer that is collected for treatment. Thus, there are more healing factors within PRF than is typically seen in PRP

Other advantages over PRP are ease of preparation/application, minimal expense, and lack of biochemical modification but the main advantages are the biological properties, surgical versatility and all the characteristics that can support faster tissue regeneration and high-quality clinical outcomes.