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 also be greatly enhanced by a combination of periodontal procedures by Dr. Ceravolo to expose your natural tooth contours. Cosmetic periodontal procedures will also set the stage for aesthetic dentistry to be performed by your restorative dentist.

 


Long Teeth/Exposed Roots


Gum Grafting Procedures


Subepithelial connective tissue grafting was performed for the purpose of achieving root coverage. Afterwards, new crown restorations were fabricated for the central incisors by Dr. William Hinsley, Stuart, Florida.

If one or more of your teeth are too long, exposing the unattractive tooth root, there are special procedures that can cover those roots. Tooth roots can become exposed as gums recede and can make you look older than you are. This recession can happen as a result of a variety of causes, including periodontal disease. Whatever the reason, exposed roots are unappealing and can leave you at risk for developing cavities on you tooth root.
 


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 to 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 the continued loss of supporting bone.

A gingival graft is designed to solve these problems. Recent development of the acellular dermal graft has allowed the periodontist the option of not having to take donor tissue from the roof of the mouth. In the past, a piece of tissue was taken from the roof of the mouth, or from adjacent areas, to provide a stable band of attached protective gingiva around the tooth. This procedure created a second site of trauma, which increased the amount of postoperative discomfort. Today, acellular dermal grafts replace the need for a second traumatic site to obtain tissue needed for grafting.

The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue covering the root of the tooth.

Gummy Smile or Uneven Gumline

Crown Lengthening

If you feel that your teeth are too short and your smile is too "gummy" or that your gumline is uneven, covering too much of some teeth, while leaving others the right length, a simple cosmetic treatment might be just right for you. Your teeth probably are not too short at all. In fact, they may be just the right length. You simply may have too much gum tissue covering your teeth, and hiding your smile. Crown lengthening procedures remove excess gum to expose more of the crown of the tooth. Your gumline is then sculpted to give your new smile just the right look. If restorations are necessary, this procedure sets the stage allowing your new veneers or crowns to have the correct length and shape, giving you a beautiful smile.

When decay occurs below the gum line, it may be necessary to make your tooth longer above the gum line to expose the decay or to obtain more tooth structure to support your final restoration. Your dentist may ask for this procedure before he or she makes a new crown for your tooth.

 

Case courtesy of Dr. Jay M. Lerner, DDS

Case courtesy of Dr. Jay M. Lerner, DDS

 

This will allow your general dentist adequate room to place a quality final restoration.

Crown lengthening can be limited to laser surgery to remove excess gum around the tooth. Sometimes small incisions are required to allow the gum to be repositioned on the tooth to create more tooth structure for adequate restoration. This will allow your general dentist adequate room to place a quality final restoration.

Indentations in the Gums and Jawbone

Ridge Augmentation

Sometimes when you loose one or more teeth, you can get an indentation in your gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indentation unnatural looking, it also causes the replacement tooth to look too long, compared to the adjacent teeth.

To prevent this condition from developing, careful management of the tooth extraction site in aesthetic areas of the mouth are now treated by gently removing the tooth and placing synthetic bone materials and/or resorbable membranes at the time of extraction to prevent bone and gum tissue from receding.

Where teeth have previously been extracted and deformities in the gum and bone have formed, a procedure called ridge augmentation can fill this defect, recapturing the natural contour of your gums and bone. Ridge augmentation involves the use of a combination of synthetic bone materials, resorbable membranes, and acellular dermal grafts, depending on the extent of the defect. A new tooth can be created that is natural looking and easy to clean.

Ridge augmentation also allows for the formation of new bone in sites that are not suitable for dental implants.