PROCEDURES
Procedure Information
Extractions:
The removal of a tooth is an extraction. Extractions are recommended for various reasons including, but not limited to, severe bone loss around the tooth roots, non-restorable cavities, part of orthodontic plan, part of restorative/prosthodontic plan, abscess, etc.
Extractions with Bone Graft (aka: ridge preservation):
When a tooth is planned for an extraction and there is a lack of bone surrounding the tooth, a bone graft may be recommended. A bone graft procedure involves placement of bone particles inside the fresh socket. It serves to help re-build bone and also to minimize the natural bone shrinkage that occurs during healing from extractions. The bone particulates can come from a variety of sources such as human and animal donors. The bone graft is obtained from bone banks where strict processes are in place and are rigorously regulated by the American Association of Tissue Banks to ensure safety to the public. Oftentimes bone grafting is recommended if an implant is being planned as the replacement tooth option.
Oral Sedation:
A method used in dentistry to help patients relax during dental procedures. It involves the administration of sedative medications in pill form, which can be taken orally before the procedure.
Ridge Augmentation (Guided Bone Regeneration):
A surgical procedure that aims at increasing the volume of bone in an area lacking adequate bone volume for implant placement. A ridge is an extension in our jawbone missing a tooth/teeth. When your dentist recommends an implant, sometimes there may not be enough bone to predictably and safely perform the implant procedure. A ridge augmentation procedure is performed either prior to an implant being placed or at the same time.
Periodontal Disease Osseous Surgery:
A surgical procedure that is recommended when moderate to severe periodontitis is present. It involves surgically accessing the root surfaces of the teeth for debridement (cleaning). It also involves contouring the bone surrounding the teeth. The gingiva may also need to be trimmed in the process. Most patients whom undergo scaling and root planning (deep cleaning) first, and whom still show active periodontitis (deep pockets), may be recommended for this procedure.
Distal wedge:
A surgical technique involving trimming the soft tissue (gingiva) of the last molar in the arch.
Gingival Flaps:
A surgical procedure that is performed when the roots of the teeth need to be accessed for treatment.
Regeneration:
A surgical procedure aimed at regenerating the structures lost due to disease around a tooth. There are several modalities of this treatment including use of biologics with or without a bone graft and membrane.
Frenectomy:
A surgical procedure where binding tissue is cut or modified.
Functional Crown Lengthening:
A surgical procedure that involves exposing additional tooth structure to either provide more tooth surface for a final restoration or to eliminate inflammation around a previously placed restoration. This is typically performed by trimming the gingiva and bone surrounding the tooth.
Esthetic Crown Lengthening:
A surgical procedure aimed at exposing additional tooth structure for esthetic reasons such as a “gummy smile”. It involves trimming excess gingiva and bone.
Gingivectomy:
A surgical procedure that involves trimming the gingiva to expose more tooth structure.
Implants:
- When a tooth/teeth are missing, or when a tooth is planned for an extraction, dental implants are sometimes the replacement of choice. A dental implant is a biocompatible metal screw that is placed into the bone of the jaw or skull to support a dental prosthesis, such as a dental crown, bridge, or denture. This is a surgical procedure involving accessing the bone and utilizing several specialized drills for osteotomy. Once the correct dimension is achieved, a dental implant is placed. Patients typically heal anywhere between 3-6 months before a final restoration can be placed.
Implant provisional:
When a front tooth is missing or planned for replacement with a dental implant, a provisional crown may be a fixed temporary replacement option during the time the implant is healing. This temporary crown can be placed during the implant surgery or after. The benefit of planning a provisional is that it stands as a fixed temporary replacement and it will help achieve the best esthetic outcomes.
Tooth exposure:
When a tooth is impacted (hidden under the gums/bone) and the orthodontic plan is to expose the tooth, this surgical procedure is often necessary. It involves removal of soft tissue or a gingival flap and oftentimes the removal of bone to uncover the tooth. A bracket with chains is then bonded onto the exposed tooth surface where it will be connected to the orthodontic wire to facilitate tooth movement into the arch.
Soft Tissue Grafts
When there is a lack of gingiva around teeth, implants, or ridge areas, a soft tissue graft may be recommended. Autogenous grafts (self grafts) such as a free gingival graft (FGG) and a connective tissue grafts (CTG) can be used for covering recessions around teeth or thickening the soft tissue around a tooth or implant. It can also help widen the band of keratinized gingiva (light pink gums) and deepen the vestibular area for improved denture retention. The location where autogenous grafts are harvested may vary, but oftentimes it is taken from the palate, (roof of the mouth). Another option that may be indicated is an allograft (human donor graft). This type of graft is safe to use for the same reasons as autogenous grafts.
Alveoloplasty:
A surgical procedure aimed at removal of bone in a section of the jaw that does not involve a tooth. This is often performed in preparation for dentures.
Sinus Lift:
A surgical procedure involving placing bone into the sinus space in preparation for a dental implant. This is indicated when there is insufficient natural bone to support a dental implant in a vertical dimension.
Biopsy:
A procedure indicated when an abnormal finding is noted clinically or radiographically. Biopsies involve the removal of a sample of tissue for further review under a microscope. It is often sent to a lab where the tissue is analyzed by an oral pathologist.
Exploratory Surgery:
A surgical procedure typically involving a gingival flap to determine restorability or cause of periodontal problem. This may be indicated when the diagnosis is not achieved through clinical tests or radiographs.
Surgically Facilitated Orthodontic Treatment (SFOT):
A surgical procedure where the main focus is to aid tooth movement during orthodontic treatment. It can also address hard and soft tissue deficiencies through the combined use of bone grafts, membranes, and/or soft tissue grafts. This surgical procedure can accelerate the rate at which teeth move by 50%.
Phenotype Modification:
A surgical procedure indicated in cases where thin gums and bone have been identified or have lead to recession. This is also indicated in preparation for orthodontics where teeth may be at risk of being moved outside of the jawbone. This procedure involves placing bone grafts and membranes/soft tissue grafts to augment the volume of tissue around teeth.
Nitrous Sedation:
A form of mild sedation involving the administration of nitrous oxide via a nose cannula to help patients relax during a dental procedure. Patients need to be able to breathe through their noses in order to obtain the effect of the medication.
Therapy for peri-implant disease:
This category of procedures is indicated when peri-implant mucositis and/or peri-implantitis (implant disease) has been diagnosed around dental implants. It may entail non-surgical and surgical methodologies of therapy. It may involve the use of a gingival flap, debridement (cleaning), disinfection or alterations to the surfaces of the implant, a biological medication application, bone grafts, and membranes.
Tori and Exostosis Removal:
Tori and exostosis are bony growths that are present around the mouth. They can be found around the front or back of teeth and the palate. There are several reasons these growths may be recommended for surgical removal including improved prosthetic retention, esthetic concerns, and functional concerns.
Occlusal Adjustments:
A non-surgical procedure involving changing the way your teeth come together or bites together. It is often indicated when undesirable forces or contacts are noted around teeth that may be contributing to oral disease. It can be performed around one tooth or multiple teeth depending on the diagnosis and severity of the occlusal trauma.
Hemisection:
A surgical procedure performed when a multi-rooted tooth is purposely sectioned and separated and the diseased half of the tooth/root is surgically removed. This treatment often entails a root canal procedure prior to the hemisection.
Root Amputation:
A surgical procedure performed when a multi-rooted tooth has a diseased root and the crown of the tooth can be preserved. The diseased root is sectioned and removed often necessitating a gingival flap for access. This treatment often entails a root canal procedure prior to or after the procedure.
Transeptal Fiberotomy:
This surgical procedure entails separating the gingival fibers from around a tooth to facilitate in tooth movement, typically the vertical eruption of a tooth where movement of the gingival apparatus is undesired.
Splinting of Teeth:
This is a non-surgical procedure where teeth are splinted (connected) to their adjacent teeth. The aim is to minimize tooth movement. This can be performed in a permanent fashion, typically after orthodontic treatment, or it can planned as a temporary fixture. It is often indicated to help stabilize mobile (loose) teeth.
Pontic Site Preparation:
A surgical procedure aimed at contouring the soft tissue under a bridge. When a tooth is lost, the gingiva looses it’s tooth shape overtime. This procedure is often performed so that the gingiva mimics a tooth shape for improved esthetic outcomes. It is also indicated for improved cleansability under a restoration.
Because Keystone is a traveling periodontal practice, we do not have an office location.
Patients who would like to be seen by Dr. Sardenberg-Melcher must first become a patient of record at one of the practices she collaborates with.
Please inquire by messaging us under ‘Contact Us’. Please include as much information as possible about why you are seeking periodontal care.