Franklin Periodontics
Don D. Franklin, D.D.S., M.S.
Surgical Periodontal Procedures
Laser Periodontal Therapy
Laser periodontal therapy is a laser-based approach to gum disease using an Nd:YAG free running pulsed laser using specific knowledge and training based on sound biologic principles.
To you the patients this means:
- Less pain
- Less bleeding
- Less swelling
- Less tissue removed
- Less down time
- Less recovery time, which is decidedly less costly to you and your employer
The reasons we use Laser Periodontal Therapy™ are to:
- Remove only the diseased tissue without removing any of the healthy tissue
- Maintain the height of the tissue around teeth
- Minimize pain and discomfort to the patient
- Get a closure of the periodontal pocket wound and allow healing to take place.
Controlling periodontal disease makes it possible to save and restore otherwise hopeless involved teeth.
Dental Implants
Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants themselves are tiny titanium posts that are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, implants can help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.
Dental implants are changing the way people live! With them, people are rediscovering the comfort and confidence to eat, speak, laugh, and enjoy life.
Dr. Franklin has received extensive training in Implantology. He has been successfully placing implants since 1997. Through continuing education, Dr. Franklin is abreast of the most current information on implant dentistry.
Evaluation
If, like many others, you feel implant dentistry is the choice for you, we ask that you undergo a dental/radiographic examination and health history. During these consultation visits, your doctor will address your specific needs and considerations. Your questions and concerns are important to us and our team will work with you very closely to help make your procedure a success.
We will also discuss fees and insurance at this time. There are many types of insurance plans, and coverage for implants is varied. We will be happy to assist you in obtaining any benefits to which you may be entitled.
Procedures
Dental implants are metal anchors that act as tooth root substitutes. They are surgically placed into the jawbone. Small posts are attached to the implant to provide stable anchors in the gums for replacement teeth.
Most implants require one surgical procedure. Local anesthetic is used to anesthetize the tissues. A small access is made through the gum, the implant is placed within your jawbone and a healing collar is placed on the implant. Six weeks of healing is usually adequate to allow the bone to bond to the implant. The implant is now ready for the restorative dentist to proceed with fabrication of the crown, bridge or denture that is planned.
For some patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. Healing time following surgery varies from person to person and is based on a variety of factors that include hardness of bone. In some cases, implants may be restored immediately after they are placed.
For the first six weeks following surgery, the implants are gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your restorative dentist designs the final bridgework or denture that will ultimately improve both function and aesthetics.
After the implant has bonded to the jawbone, the second phase begins. Dr. Franklin will uncover the implants and attach a small healing collar. After two weeks your general dentist will be able to start making your new teeth. An impression must be taken. Then posts or attachments can be connected to the implants. The teeth replacements are then made over the posts or attachments. The entire procedure usually takes eight to ten weeks. Most patients do not experience any disruption in their daily life.
Cosmetic Periodontal Surgery
These procedures are a predictable way to cover unsightly, sensitive, or exposed root surfaces and to prevent future gum recession. If you are unhappy with the appearance of short unsightly teeth this can be greatly improved by a combination of periodontal procedures by Dr. Franklin and cosmetic dentistry by your dentist.
Cosmetic Crown Lengthening
Although your teeth appear short, they may actually be the proper length. The teeth may be covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure, crown lengthening.
During this procedure, excess gum and bone tissue are reshaped to expose more of the natural tooth. This can be done to more than one tooth, to even your gum line, and to create a beautiful smile.
Gum Grafting
Another cosmetic procedure is the soft tissue graft. It is used to cover unattractive tooth roots, reduce gum recession, and protect the roots from decay and eventual loss.
Tooth loss causes the jawbone to recede and can lead to an unnatural looking indentation in your gums and jaw, an appearance of a general aging. The original look of your mouth may not be recaptured because of spaces remaining under and between replacement teeth. They may appear too long compared to nearby teeth.
Bone Grafting
Bone grafting following tooth loss can preserve the socket/ridge and minimize gum and bone collapse. There is less shrinkage and a more aesthetic tooth replacement for either an implant crown or fixed bridge around the replacement teeth.
Gum Grafting (Subepithelial Connective Tissue Grafts)
When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.
When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.
In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.
A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.
The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.
Crown Lengthening
Crown lengthening (or crown exposure) is required when your tooth needs a new crown or other restoration. The edge of that restoration is deep below the gum tissue and not accessible. It is also usually too close to the bone or below the bone.
The procedure involves adjusting the level of the gum tissue and bone around the tooth in question to create a new gum-to–tooth relationship. This allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease. The procedure takes approximately one hour.
When the procedure is completed, sutures, and a protective bandage are placed to help secure the new gum-to-tooth relationship. You will need to be seen in one or two weeks to remove the sutures and evaluate your healing.
Osseous Surgery
One of the most common surgical procedures, incisions are made around the tooth, and the gum tissue is pulled back slightly. This provides access to thoroughly remove all plaque and calculus. Irregularities of the bone caused by the disease are smoothed over and the tissue placed at a higher level around the tooth, closer to the bone. When the procedure is completed, “dissolving” sutures are used. A protective dressing often is placed around the necks of the teeth to cover the surgical area and to help secure the new gum-to-tooth relationship. You will need to be seen in 10-14 days to remove any remaining sutures and evaluate your healing.
By moving the gum closer to the bone, the pockets will be reduced or eliminated. However, the tooth will appear longer and the spaces between the teeth will be larger. In cosmetic areas, other treatment options may be considered depending on how much gum tissue is exposed (“Smile Line”).
Guided Tissue Bone Regeneration
Traditionally, eliminating the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue treats gum disease. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.
Guided tissue bone regeneration regenerates the previously lost gum and bone tissue. Most techniques utilize membranes that are inserted over the bone defects. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bioactive gels.
Major & Minor Bone Grafting
Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.
Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance.
Major Bone Grafting
Major bone grafts are typically performed to repair defects of the jaws. Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease, or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw. Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.
Sinus Lift Procedure
The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are hollow spaces within the cheek bone. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.
There is a solution called a sinus graft or sinus lift graft. The dental implant surgeon enters the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and donor bone is inserted into the floor of the sinus. Keep in mind that the floor of the sinus is the roof of the upper jaw. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.
The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option other than wearing loose dentures.
If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implants well, sinus augmentations and implants placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.
Ridge Expansion
In severe cases, the ridge has been reabsorbed and a bone graft is placed to increase ridge height and/or width. This is a technique used to restore the lost bone dimension when the jaw ridge gets too thin to place conventional imPlants In this procedure, the bony ridge of the jaw is literally expanded by mechanical means. Bone graft material can be placed and matured for a few months before placing the implant.
Ridge Preservation
Careful management of extraction sockets after tooth extraction prevents unsightly bone loss and provides a better cosmetic outcome for tooth replacement.
Frenectomy
A frenum is a naturally occurring muscle attachment, normally seen between the front teeth (either upper or lower). It connects the inner aspect of the lip with the gum. A lack of attached gingiva, in conjunction with a high (closer to the biting surface) frenum attachment, which exaggerates the pull on the gum margin, can result in recession. Additionally, an excessively large frenum can prevent the teeth from coming together resulting in a gap between the front teeth. If pulling is seen or the frenum is too large to allow the teeth to come together, the frenum is surgically released from the gum with a Frenectomy. Often a Gingival Graft is added to re-establish an adequate amount of attached gingiva.
When Orthodontic treatment is planned or initiated, the removal of an abnormal frenum, with or without a gingival graft, can increase stability and improve success of the final orthodontic result.
1408-A Orchard Lake Dr. • Charlotte, NC 28270
704-841-2802 • Fax: 704-841-9503