Periodontal Plastic Surgery

This aspect of treatment is indicated if you feel that:

  • your smile is too "gummy" or uneven
  • your teeth are too short or too long
  • you have an unnatural indentation due to a tooth being lost, or
  • if one or more of your teeth are missing.

Types of Periodontal Plastic Surgery Procedures

Soft tissue grafts:

These procedures cover exposed roots to improve esthetics, reduce further gum recession, reduce sensitivity, and protect roots from decay. Soft tissue grafts are also indicated to enhance the results from cosmetic and implant therapy and to help restore any lost tissue that increase the risks of tooth loss.

Traditional methods for soft tissue grafting include:

1) Palatal tissue (the roof of the mouth)- This is considered the gold standard. There are many advantages and disadvantages to this technique. One advantages includes that it is your own tissue and studies have shown that using your own tissue is superior to other modalities. Another advantage is that we usually do not need to prescribe antibiotics in these cases. The disadvantages include healing from another surgical site and there is only so much we can use in one visit. This is why we combine using your own tissue with other modalities.

2) Allografts-This has been a very important option in my practice. For those that fear having the second surgical site and the lesion is correct, this has been a fantastic alternative. The advantages include that we can avoid that second surgical site. The disadvantages include routinely needing an antibiotic and also that it is more technique sensitive, therefore, we cannot use these allografts in every situation. We will discuss if this is an option.

3) My novel technique that I've been working on which I am calling RC2. RC2 stands for Regenerative Cell Root Coverage. As of now, I have combined a few techniques into one and use platelet rich fibrin (PRF) and a collagen membrane to thicken the tissue. I don't have randomized controlled studies or histological analysis of it because I am just little old me, but in the cases that I've used them in, I am seeing favorable results. I am using this technique in situations where I have multiple teeth and don't have enough of the patient's palate to use (and they don't want to use the allograft). On these pioneer patients, we have stumbled upon another great option. I don't have 20 years with this technique, but the results so far are promising!

Crown lengthening:

This procedure removes excess gum tissue to expose more of the "crown" of the tooth. Your gumline is then sculpted to give your new smile just the right look. This procedure can not only be performed for functional reasons, but is great when you have short teeth or a gummy smile. We use a combination of laser dentistry as needed. We want you to have the smile you've always wanted!

Ridge Augmentation:

These procedures include filling in a defect caused by an indentation in your gums and jawbone where the tooth used to be. This will help recapture the natural contour of your gums and jaw. We can use a combination of materials for this treatment including your own tissue, bone products, allografts, xenografts, collagen membranes and PRF (platelet rich fibrin).

Frenectomy:

This procedure relieves aberrant muscle pulls that may contribute to recession, loss of tissue or orthodontic relapse. This is usually done in combination with a soft tissue graft. Many people worry that we are removing a "muscle" that will affect motion in their face, but I can assure you that this is not the case. At this time I do not perform lingual frenectomies, as seen with babies who have problems with breastfeeding. I will leave that to my talented biologic dentist colleagues.

Dental Implants:

This procedure will replace teeth to feel and look just like your own.

Benefits of Periodontal Plastic Surgery include the following:

  • excellent cosmetic blending of tissue colors and contours
  • appropriate tooth length for a fuller, brighter smile
  • symmetrical gumline
  • regeneration of lost or deficient tissue
  • protection of exposed root structure from sensitivity, erosion, and decay
  • correction of anatomical defects and excess pigmentation
  • enhanced orthodontic treatment results

For more information, please click here http://www.perio.org/consumer/smile.htm