Services

Periodontal disease is more prevalent than tooth decay, yet few people know what it is or what to do about it. Periodontics deals with the gums and supporting bones around the teeth. Our primary concern is preventing and treating periodontal disease, which when severe enough can cause tooth loss.

Our practice is also concerned about those patients who may already have missing teeth. The area of dental Implantology is a new field within the specialty of Periodontics which deals with the placement and maintenance of implants that replace missing teeth. Our practice is committed to providing dental implant services to meet the needs of all our patients.

The services we provide include:

Diagnostic Services

Comprehensive Periodontal Examination and Oral Cancer Screening
Implant Diagnosis and Treatment Planning
Cranio-Facial Pain/ Dysfunction Examination (TMJ)

Therapeutic Procedures

Non-Surgical Periodontal Therapy

Scaling and Root Planing: When plaque extends below the gumline, gingivitis can deteriorate into a condition known as periodontitis. Periodontitis is an inflammation that can erode the ligament and bone beneath the gums, creating deep pockets that foster the growth of destructive bacteria. Treatment includes the use of antibiotics when needed and root planning (deep scaling of the bacteria-filled pockets).

Arestin (Antibiotic Therapy): Arestin is a product that consists of a powder with microspheres containing a low dose of the antibiotic minocycline for treatment of patients with adult periodontitis. When placed in the periodontal pocket, the microspheres release minocycline in a controlled, continuous pattern over a ten day treatment period.

Bacteriologic Culturing: Plaque samples from deep pockets can be sent for culturing to help identify which bacterial species are present in the pocket. This will help in determining the potential for gum disease and also the appropriate antibiotic to treat periodontal disease.

Surgical Periodontal Therapy

Osseous Surgery: Osseous surgery is the surgical removal of deep periodontal pockets adjacent to the teeth created by plaque and calculus deposits. This procedure allows for effective removal of these deposits.

Gum Grafting: Gum grafting is the addition of gum tissue next to the tooth to prevent further recession and irritation of the gum margin. Root coverage is also possible to enhance aesthetics. Wherever possible, Dr. Richter uses his highly successful grafting technique with Alloderm material instead of having to harvest donor tissues from some other part of the mouth.

Guided Tissue Regeneration and Guided Bone Regeneration: Guided Tissue Regeneration (GTR) involves the placement of a synthetic membrane over the bone to allow the regeneration of lost tissue between the roots of a tooth. A bone graft may be used in conjunction with this procedure to enhance further bone regeneration.

Sinus Lift (closed and Lateral window techniques): When nasal sinuses come to close to dental implant sites in the upper jaw, a sinus lift procedure with bone grafting can create the additional bone to support an implant in that site.

Ridge Augmentation/Preservation: When extractions are necessary, bone may be added to the extraction site to maintain or enhance ridge height. This procedure may be followed by implant placement or bridge fabrication.

Crown Lengthening: Decay can at times occur below the gumline. Crown lengthening repositions the gum tissue so that your general dentist has adequate room to place a restoration. Also, esthetic crown lengthening will reduce the “gummy smile” appearance.

Gingivectomy and Gingivoplasty: A gingivectomy reduces excessive gum tissue. Some medications (i.e. Dilantin) can cause tissue overgrowth. Often tissues grow as a response to bacteria (plaque). Tissue is removed and recontoured to improve esthetics and facilitate better hygiene.

Implant Therapy

Placement and Maintenance of Dental Implants: If you are missing a single tooth or many teeth, implants may be the option for you. Dental implants are surgically attached to the jawbone so they become a permanent part of your mouth. They look, feel and function like natural teeth.

TMJ Therapy /Bite Appliances

Treatment of Cranio-Facial Pain /Dysfunction Disorders (TMJ): TMJ Therapy - Commonly referred to as TMD, Temporomandibular Joint Dysfunction is a condition that afflicts thousands of people. Frequent indicatiors of TMD include:

• Popping and clicking of jaw
• Limited jaw function
• Pain in the neck, shoulder and upper back
• Pain in the face & ears that includes pressure and a “plugged up” feeling

Nightguard Appliance Therapy: Nightguards are used as a treatment option to deter grinding and clenching from damaging teeth and straining the muscles used for normal chewing. Some patients with more extreme symptions may require surgical procedures. The goal of surgery is to provide measurable improvement in comfort and function.

Occlusal Adjustment: The forces of your bite can sometimes affect the positioning of the jaw and teeth. Minor polishing of the surface enamel of the teeth an help to redistribute and redirect the biting forces so that your bite feels normal and comfortable.

Orthodontic Procedures

Circumferential Fiberotomy (CFS)

CFS is provided by a periodontist to release the periodontal fibers around the tooth/ teeth to prevent the tooth/ teeth from rotating, shifting, malpositioning after orthodontic treatment. Your orthodontist has positioned the teeth properly and the CFS prevents “memory” so they will not return, relapsing to their pre-ortho position.

A CFS is a minimally invasive procedure involving local anesthetic around the teeth involved, similar to a “filling” procedure. You will not be visually aware of any changes and suture or stitches are not required. The total time needed in the office will be approximately 50-60 minutes or less for one visit only.

Surgical Exposure for Orthodontics

When a canine or another tooth is impacted, it is sometimes necessary to uncover or expose the tooth in order for the orthodontist to align it in the arch of teeth. Tissue and sometimes bone is removed to expose the tooth and a bracket is placed on the tooth. It may take several months for the tooth to erupt.

Temporary Implants for Orthodontic Tooth Movement

Temporary Anchorage Devices are immediately loaded mini-screw implants that are placed to help with orthodontic tooth movement and are removed when the treatment is completed. These may be used instead of extra-oral orthodontic appliances.

Lanap

• Perio probe indicates excessive pocket depth.
• Laser light removes bacteria and diseased tissue.
• Ultrasonic scaler and special hand instruments are used to remove root surface tarter.
• Laser finishes cleaning pocket and aids in sealing the pocket closed so new germs cannot enter.
• Healing of gums to clean root surface occurs.
• Bite trauma is adjusted.
• Healing occurs.