Dental Procedures

Dr. Gamarnik offers a full range of traditional periodontal treatments including the following:

Non-surgical:
-Scaling and Root Planing

Surgical:
-Osseous Surgery/Pocket Reduction
-Soft Tissue Gum Grafting
-Pinhole Gum Surgery
-Crown Lengthening: Esthetic and Functional
-Dental Implants
-Extractons
-Ridge Preservation
-Sinus Lifts

Periodontal non-surgical treatment:

Non-surgical periodontal treatment is the first step or phase in treating periodontal disease. It consists of oral hygiene instruction with scaling and root planing. It is sometimes called "deep cleaning" and often performed using local anesthetic by the general dentist or their hygienist. In more severe cases, the general dentist will refer to the periodontist for this procedure. In all cases, it consists of carefully removing contaminants from the root surfaces under the gums using special instruments. This usually resolves swelling of the gums and the majority of the inflammation pending the initial severity. Antibiotics can be used either locally in the deep pockets or in severe cases, systemically using pills.

Typically 4 to 6 weeks are allowed for the effects of excellent oral hygiene and healing to take place before evaluating the amount of disease resolution. Pending the results, either more home-care, more root planning or surgical treatment will be considered.

Periodontal Treatment - Surgical:

If there is extensive bone loss with deep periodontal pockets that prevents thorough cleaning of the roots of the teeth, then periodontal flap surgery, sometimes called pocket reduction surgery is indicated. This is a procedure that gives direct access to the roots of the teeth for visualization of diseased root surfaces and for removal of diseased and infected tissue.  During the pocket reduction procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria plaque and tartar from the root surfaces of the teeth.  Once the teeth and roots are clean, he/she will secure the tissue back into place. In some cases, irregular surfaces and sharp edges of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. It also allows the gum tissue to reattach better to healthy bone.

It there is extensive bone loss, then bone grafting or guided tissue regeneration might be recommended. This is a procedure that allows for grafting of bone to regenerate lost tissue. We are lucky now to have available techniques and materials  that increase the healing capacity of our tissue to regenerate what was lost.

Tiny fragments of your own bone, synthetic bone, or bone from a bone bank are placed where bone was lost. These grafts serve as a platform for the regrowth of bone. This restores stability to your teeth.

Soft Tissue Grafts:

Soft tissue grafts are procedures a periodontist can perform to treat receeded gums, or to correct deformities of the gumline caused by a lack of "thick" gums around the teeth.

Exposed tooth roots are the result of gum recession, exposed root surfaces are more prone to getting cavities.

During this procedure, your periodontist will take a small piece of gum tissue from your palate (the roof of the mouth) or another donor source.  This piece of tissue is then transferred to the recessed gum area in order to attempt to cover the exposed root. This can be done for one tooth or several teeth.

Crown Lengthening:

Periodontal procedures are sometimes necessary in order to lay the groundwork for restorative and cosmetic dentistry and/or to improve the esthetics of your gum line.

For example, if your teeth appears short and much of your gum is exposed when you smile, this "gummy smile" can be corrected with an Esthetic crown lengthening procedure.

Sometime, your teeth may actually have the proper lengths, but they're covered with too much gum tissue. To correct this, your periodontist can perform a functional crown lengthening procedure to expose more of your natural tooth.

Dental Implants:

A dental implant is an artificial tooth root used in dentistry to support restorations that resemble a tooth or group of teeth.  A typical implant consists of a titanium screw with a roughened or smooth surface.  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. Dental implants are actually more tooth-saving than traditional bridgework, since implants do not rely on neighboring teeth for support.

Ridge Preservation:

When a tooth is extracted, "shrinkage" of the surrounding bone and soft tissue occur.  If left untreated, loss of bone height and width occur.  In order to prevent or lessen this loss of bone and to insure a more predictable site for later implant, bridge or other prosthetic, preservation of the ridge is recommended.  This simple procedure at time of extraction places bone grafting material into the socket and is then covered with a special barrier called a membrane.  Over the next few months, the grafted bone is replaced by the patients own bone often resulting in the complete regeneration of the lost bone in the are of the tooth extraction.

Sinus Lift Procedure:

In the upper back jaw area, the available bone for implant placement is often limited by the location and size of the upper jaw sinus in the region.  The sinus is a hollow structure - above the upper teeth and below the eyes.  Many times not enough bone is available for implant placement due to position of sinus, infection, injury or periodontal disease.  This lack of bone can be replaced with a sinus augmentation, which raises the sinus floor to allow space for  new bone formation.