Periodontal Procedures

Periodontics & Implantology In Winter Park & Winter Springs, FL

Gum Disease Treatment Methods

Dr. Sevor
s practice provides a variety of surgical services. We pride ourselves on the fact that we are very conservative in our treatment recommendations and limit surgery to the areas where it is absolutely necessary.

Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Even in severe cases, non-surgical periodontal therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to help limit the areas requiring surgery.

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Laser Periodontal Therapy


Dr. Sevor strives to provide the most modern techniques designed to provide maximum efficacy and comfort for his patients. Dr. Sevor was the first periodontal specialist to bring the FDA-approved, patented LANAP protocol to the central Florida area. He is the most experienced provider of this technology with thousands of successfully treated patients.

Treatment Procedure

A. Perio probe indicates excessive pocket depth.

B. Laser light removes bacteria and diseased tissue.

C. Ultrasonic scaler and special hand instruments are used to remove root surface tarter.

D. Laser finishes cleaning pocket and aids in sealing the pocket closed so new germs cannot enter.

E. Healing of gums to clean root surface occurs.

F. Bite trauma is adjusted.

G. Healing occurs 2325570F-C00F-4F0F-9B6B-6DFB981C8262

Laser Periodontal Therapy
for General & Periodontal Practices

F16C6274-594C-473B-B796-5F668CA09C9BLaser Periodontal Therapy
is a laser-based approach to gum disease using an Nd:YAG free running pulsed laser requiring specific knowledge and skills drawn from the whole dentistry field. To you the patients this means: less pain, less bleeding, less swelling, less tissue removed, less down time, and less recovery time which is decidedly less costly to you and your employer.
lanap-video
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.

Read more about the benefits of laser gum surgery.

 

Scaling & Root Planing

The initial stage of treatment is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line.

The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion (bite) may require adjustment.

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Sevor may place antibiotic fibers in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.

When deep pockets between teeth and gums are present, it is difficult for Dr. Sevor to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.

Learn more about scaling and root planning
from definition to application and tools.

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Bite Adjustment

A bite is considered to be healthy when all or most of the teeth are present and not destroyed by normal daily usage.

It is destructive when teeth show wear, looseness or when TMJ (jaw joint) damage is seen. Bite therapy helps restore a bite that can function without damage and destruction. The therapy may include:

    • Reshaping the biting surfaces of the teeth and eliminating spots of excessive pressures where the teeth are brought into contact with each other. This is done by carefully dividing bite pressures evenly across all of the teeth.
    • Bite splint therapy using a custom-fitted and adjusted plastic bite guard to keep the teeth apart, day, night, or both.
    • Braces to reposition mal-aligned or drifted teeth.

Replacement of old, worn out, or damaged fillings.
Reconstruction of badly worn and damaged teeth.

Bite adjustment holds many benefits to your oral health and reduces the risk of gum disease. Learn more about the importance and types of bite adjustment.

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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. Sevor has received extensive training in Implantology. Through continuing education, Dr. Sevor is abreast of the most current information on implant dentistry. He has lectured extensively, both nationally and internationally on the science of implantology and bone rejuvenation.

You can find more on how dental implants work and what types there are here.

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.

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 three to six months following surgery, the implants are beneath the surface of the gums gradually bond 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. Sevor 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 six to eight months. Most patients do not experience any disruption in their daily life.

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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. Sevor and cosmetic dentistry by your dentist.


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.

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 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 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 dental implant crown or fixed bridge around the replacement teeth.

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Gum Reshaping

Sometimes the gingiva (gums) will develop irregularly or not achieve an adult appearance.

Various medications including some heart medications and antirejection drugs can cause a hypertrophication or overgrowth of the gums. In these instances Dr. Sevor can re-contour or reshape the gum tissue for a more pleasing smile.

Gum Grafting


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.

Before Gum Grafting

before and after gum grafting

After Gum Grafting

After Gum Grafting

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.

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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.
topinsertmiddleinsertbottominsert

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Osseous Surgery

Traditionally, gum disease is treated by eliminating the gum pockets. The infected gum tissue is trimmed away and uneven bone tissue re-contoured. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.

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Guided Tissue Bone Regeneration

This surgical procedure “regenerates” the previously lost gum and bone tissue. Most techniques utilize membranes, which 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.

This technique is used to enhance bone grafting or bone regrowth by preventing rapidly proliferating gum tissue out of a bone defect allowing the slower-growing bone to fill in.

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Bone Grafting


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

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, hip, or tibia (below the knee.) 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.

Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient
s own bone. This bone is harvested from a number of different sites depending on the size of he defect. The skull (cranium), hip (iliac crest), and lateral knee (tibia) are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.

beforegraftaftergraft(Green line denotes healthy bone level.)

Sinus Lift Procedure

The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. 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.

graftdiagram

If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant 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.

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Ridge Preservation

Careful management of extraction sockets after tooth extraction prevents unsightly bone loss and provides a better cosmetic outcome for tooth replacement.

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Intravenous Conscious Sedation

Dr. Sevor provides Intravenous Conscious Sedation to allow patients to receive care with maximum control and greatly decreasesd anxiety. Patient sedation is provided with state-of-the-art monitoring and safety equipment.

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