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LASER PERIODONTAL
THERAPY
What
is Periodontics?
Periodontics
is that specialty of dentistry which
encompasses the prevention, diagnosis
and treatment of diseases of the supporting
and surrounding tissues of the teeth
or their substitutes and the maintenance
of the health, function and esthetics
of these structures and tissues.
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Why
You Need A Periodontal Screening
Periodontal
disease is a bacterial infection that
affects the attachment fibers and supporting
bone that hold your teeth in your mouth.
A periodontal screening is an easy way
for your dental care professional to
determine the state of your periodontal
health. During this screening, a small
measuring probe is gently placed between
your tooth and gum to assess your periodontal
health. Early detection and treatment
of periodontal disease can help you
keep your teeth for a lifetime.
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CONTRIBUTING
FACTORS TO PERIODONTAL DISEASE
The response of
the gums and bone to dental plaque may
be modified by one or more of the following
factors.
- Poorly fitting
dental restorations
- Smoking
- Crowded teeth, improper bite alignment
- Clenching or grinding of teeth
- Hormonal changes, including pregnancy,
menstruation and menopause
- Diet
- Systemic diseases, including blood
disorders and diabetes
- Medications, including calcium channel
blockers and anti-convulsants
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Warning
Signs Of Periodontal Disease
-
When gums bleed during brushing
- Swollen, red or tender gums
- Longer teeth
- Pus appears when pressing the gums
- Loose teeth
- Change is position of teeth
- Change in the way your teeth fit when
you bite
- Bad breath or bad taste
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What Is Periodontal Disease?
Periodontal
disease starts by a bacterial infection
that destroys the gums, bone and ligaments
supporting the teeth. Periodontal disease
progresses silently, often without pain
or symptoms. It may develop slowly or
progress rapidly.Nine out of ten people
are afflicted with some form of periodontal
disease in their lifetime. Periodontal
disease affects more than half the population
over 18 years of age. After 35, approximately
three out of four adults develop some
form of gum disease.
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How
Does Periodontal Disease Develop?
Bacteria
called plaque forms at the point where
the teeth meet the gums, as well as
between the teeth. If it is not removed
daily, plaque multiplies into colonies.
Unremoved plaque hardens into tartar,
a tough gritty deposit which, because
of its roughness, collects more plaque.
Tartar can only be removed by a dentist
or dental hygenist. If plaque is allowed
to develop, an inflamation of the gums
occurs called gingivitis. As gingivitis
worsens, gums begin to pull away and
recede from the teeth. Pockets of bacteria
form and deepen, reaching the bone and
destroying the bone that anchors the
teeth. The advanced stage of this disease
is called periodontitis, which can lead
to tooth loss if not treated. Other
causes of periodontal disease, aside
from plaque (the chief cause), are conditions
affecting the immune system such as
diabetes, hormone imbalances, thyroid
malfunction and pregnancy, and also
some medications and hereditary factors.
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Diagnosis
Of Periodontal Disease
During
checkup, the periodontist uses an instrument
called a periodontal probe. This determines
if there is any breakdown in the attachment
of the gums to the teeth, or early development
of pockets between the teeth and gums.
The depth of the pockets is measured
in millimeters with the periodontal
probe. Up to three millimeters is considered
normal.. deeper than three millimeters
indicates a potential problem. X-rays
are taken if there is concern over possible
bone destruction.
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TREATMENT
OF PERIODONTAL DISEASE
The
main goal of periodontal treatment is
eradication of the disease process from
the gums, ligaments and bones that surround
the teeth, and restoration of health
that can be predictably maintained in
the future.
PHASE
I
Initial
treatment involves educating patients
in the proper methods of effective,
daily plaque removal and oral hygiene.
This is a critical component of successful
therapy.
Scaling and root planing are performed
to clean the tooth structure and remove
bacterial plaque and calculus deposits
(the source of the infection) from the
gum pockets. This may be the only treatment
necessary in cases of gingivitis and
very mild periodontitis
PHASE II
In
cases which demonstrate deeper gum pockets
and underlying bone loss, it becomes
necessary to eliminate the diseased
gum pockets and bony destruction with
osseous (bone) surgery. The gum is "flapped"
and retracted away from the teeth to
expose the underlying roots and bone
deformities. The bone is contoured to
approximate a normal physiologic profile,
and the gum is sutured back to place.
When the gum heals, normal probing depth
is re-established between the gum and
tooth (ideally 1-3mm). The attainment
of minimal probing depth facilitates
easy removal of plaque by patients at
home and by hygienists during professional
cleaning.
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SEQUENCE
OF EVENTS DURING OSSEOUS SURGERY
Additional
treatment modalities may be necessary
to treat periodontal disease and restore
health.
These
may include:
-
Bone grafts
for bone regeneration
- Gum
grafts to treat gum
recession and pathological root exposure
- Cosmetic plastic surgery
of the gums to improve appearance
- Fabrication of night guards
for bruxism ( tooth grinding
)
- Splinting or bonding
teeth together for increased strength
and stability
- Orthodontics ( braces
) to straighten and realign teeth
- Removal of diseased roots on some
types of molars
- Use of medications such as antibiotics,
fluoride and antimicrobial rinses
Laser Dentistry Procedures and Effects:
LASER
PERIODONTAL THERAPY
Laser
dentistry or laser periodontics allows
for the treatment of gum disease at
any earlier stage. In addition, it can
be useful to pregnant women and people
with debilitating medical conditions.
While there is no guarantee of total
"pain free laser dentistry"
discomfort is greatly reduced. By receiving
dental laser treatments, patients often
have no need for Novocain or other anesthetics!
Dental laser treatment, often referred
to as laser periodontal treatment, works
well for treating canker sores and bacterial
infections around teeth and gums.
During
a treatment it is also common for the
patient to wear protective glasses toprotect
his/her eyes from continued exposure
to bright light. The laser emits a tiny
ticking sound-a far cry from the days
of traditional dental drills. However,
keep in mind that a laser might not
be appropriate for all procedures. Today,
many dental services can be performed
with either the laser or traditional
treatment, and are generally covered
by most insurance plans. Dr Phillip
F. Ajaje should be able to determine
whether or not laser dentistry is right
for you.
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LASER
PERIODONTAL PROCEDURES
• Full thickness
flap
• Partial thickness flap
• Split thickness
flap
• Laser soft
tissue curettage (The
removal of tissue or growths from a
body cavity)
• Laser removal
of diseased, infected, inflamed and
necrosed soft tissue within the periodontal
pocket
• Removal of
highly inflamed edematous tissue affected
by bacteria penetration of the pocket
lining and junctional epithelium
• Removal of
granulation tissue from bony defects
• Sulcular debridement
(removal of diseased or inflamed
soft tissue in the periodontal pocket
to improve clinical indices including
gingival index, gingival bleeding index,
probe depth, attachment loss and tooth
mobility)
• Osteoplasty
and osseous recontouring (removal
of bone to correct osseous defects and
create physiologic osseous contours)
• Ostectomy (resection
of bone to restore bony architecture,
resection of bone for grafting, etc.)
• Osseous crown
lengthening - refer below
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Osseous
Crown Lengthening
When it comes
to a procedure like osseous crown lengthening,
the OPUS 5 excels. Because it cuts soft
tissue, hard tissue and bone, you can
use a single instrument to create the
biologic width necessary for problem-free
aesthetic restorations.Pre-op
view, no biologic width for crowns
Trough soft tissue,
shaving osseous tissue
Immediately post-op,
temporaries in place
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MAINTENANCE
AND PREVENTION
Once
the active phase of treatment is complete
and health has been restored, it is
extremely important that patients be
seen by a hygienist for routine dental
and periodontal cleaning on a regular
basis. This regimen, along with diligent
home care and oral hygiene, will give
the best chance for preventing recurrence
of disease and maintaining long term
periodontal health.
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