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
The services we provide include:
Comprehensive Periodontal Examination and Oral Cancer Screening
Implant Diagnosis and Treatment Planning Cranio-Facial Pain/
Dysfunction Examination (TMJ)
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
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
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
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.
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
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.
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.