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Dental Implant Basics

Dental implants are an option to replace missing teeth and provide a fixed solution to removable dentures. Dental implants offer natural looking replacement teeth that are fixed in the jaw. Implant treatment provides an option to correct the most troublesome cases associated with missing teeth and poorly fitting dentures.

A dental implant is an artificial tooth root made of titanium that is surgically placed into the jaw and allowed to fuse naturally with the bone. The implant will then support tooth replacement structures such as crowns, bridges and dentures. While the implant mimics the root of the tooth, the replacement structure looks and feels just like a natural tooth, providing patients with a permanent solution for missing teeth that replicates the fit and feel of natural teeth.

Benefits of Dental Implants

Dental implants are considered a modern and successful restorative treatment option. They offer many benefits over other tooth replacement methods including:

Dental Implant Supported Dentures

Implants are titanium posts that are surgically placed in the upper or lower jaw, where they function as a strong anchors for replacement teeth or dentures.

Regular dentures rest on the gums and rely on tissue and bone for support. An implant-retained denture, however, has special attachments that snap onto dental implants that have been strategically placed in the bone for support.

Implant-supported dentures are an option that makes dentures more secure, and are not as costly as replacing each individual tooth with a single implant.

Frenectomy

A frenectomy is the surgical removal of all or part of the frenulum, or frenum, which is a thin band of tissue that is found in the mouth. Children undergoing orthodontic treatment, and people who are being fitted for dentures are the most common candidates for frenectomies.

There are two primary locations in the mouth where a frenum is found — under the tongue, and underneath the center of the upper lip. In some cases, this tissue might interfere with the development or function of the lips or tongue. In the event that the frenum is attached too close to the tip of the tongue or too far down the gums between the front teeth, it might need to be clipped or removed.

Labial Frenectomy

When the tissue that is attached to the center of the upper lip on the inside of the mouth is clipped or removed, it is called a labial frenectomy. A frenum that is attached too far down the gum may cause the gums to recede, and possibly result in a gap between the front teeth. Additionally, denture patients often undergo labial frenectomies so that proper denture fits can be achieved.

Gingivectomy

Periodontal disease can cause a loosening of the gum line as bacteria eat away at healthy gum tissue. This can create deep, loose pockets in the gums around the teeth. A gingivectomy is performed to remove the loose, diseased gum tissue. The procedure reduces the pocket depth between the teeth and gums and helps return the gums to health. Gingivectomies are usually only performed when other methods of treatment have not been effective.

The Procedure

The area around where the gums will be removed will first be completely numbed using a local anesthetic. Small incisions are then made to remove the excess gum tissue. The gums are then re-formed and re-shaped to fit more snugly around each tooth. A putty-like substance designed to protect the gums as they heal, is usually placed over the gums.

After the Procedure

After the procedure, diet will be limited to soft foods and cool or slightly warm liquids. Though there is no brushing to the area where the gingivectomy was performed, it is still important to keep the mouth clean. Brushing and flossing the rest of the teeth during healing is permitted. After a few weeks, the gums will be completely healed and it will be possible to resume gently brushing and flossing the area as usual.

Guided Tissue Regeneration

Guided tissue regeneration is a regenerative treatment option for patients who have lost supporting bone tissue as a result of periodontal disease.

During the surgical procedure, the gums will be gently elevated from the teeth so that the periodontist can gain access to the tooth roots and underlying bone. The roots will be thoroughly cleaned and any holes or damaged areas of the bone will be filled with a graft material, biologic modifiers, etc. A barrier membrane is sometimes also used to exclude gum tissue from growing in the area during healing so as to guide the growth of bone into this area instead.

Once the material is in place, the gums will be reattached to the area with sutures. The graft used during this procedure may come from the patient’s own body, a tissue bank, bovine (cow bone) or synthetic material.

Gum Grafting

Gum recession is a condition in which the gum line begins to move toward the root, leaving the tooth root exposed. Signs/Symptoms include increased sensitivity, exposed roots, possible tissue inflammation and aesthetic concerns. Gum grafting is a surgical procedure that helps protect the tooth roots and improve the appearance of the smile for patients who are self-conscious about receded gums. The gums help protect the mouth from bacteria and trauma while also covering the ends of the teeth for a pleasing smile. Gum recession can therefore be both a functional and an aesthetic concern. View Before & After photos »

Gum Grafting Procedures

During the gum grafting procedure, tissue is usually taken from the roof of the mouth to be placed on the receded area of the gum and cover the exposed root. In some cases, the graft may be taken from a donor source if the patient does not have sufficient available tissue. The tissue graft is then attached to the natural gum and carefully sutured into place.
There are three different types of gum grafting surgery:

The Subepithelial Connective Tissue Graft

This type of graft can be surgically obtained from the roof of the mouth or from a tissue bank. The tissue is then used to cover the affected area. If the tissue is obtained from the roof of the mouth, a surgical stent is fabricated to wear to cover the palate and to keep this area comfortable.

The Free Gingival Graft

This is similar to the subepithelial connective tissue graft, but this tissue is obtained exclusively from the roof of the mouth. A plastic surgical stent is fabricated to wear for patient comfort

Chao Pinhole Surgical Technique®

Using a small pinhole for access, specially designed instruments gently loosen the gum tissue to cover the recessed area(s). This minimally invasive procedure does not require an incision or sutures and given the right indication, may provide an alternative to traditional gum grafting surgery.
Gum grafting helps correct the appearance of teeth that may seem “too long” and hence adversely affect the smile. It also helps bolster and stabilize the area treated against further gum recession.

The most common impaction exposure is the canine tooth. The surgical exposure of the impacted tooth involves removing gum tissue, and possibly bone over the underlying tooth to expose the impacted tooth underneath. This creates access to attach an orthodontic bracket to help the tooth erupt. Depending on the individual case, a periodontal packing may be placed over the exposed area.