Periodontal Surgery, Periodontists Chevy Chase MD & Greater Washington

Drs. Rose and Apgar's practice provides a variety of surgical services. They pride themselves on the fact that they are very conservative in their treatment recommendations and limit surgery to the areas where it is absolutely necessary. Periodontal procedures are available to regenerate the bone and gum tissue to their original function and cosmetic appearance.

Our office serves Chevy Chase MD, and the surrounding area: Montgomery County, Bethesda Maryland and Washington DC.

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 be greatly improved by a combination of periodontal procedures by Dr. Rose and Dr. Apgar and cosmetic dentistry by your dentist.

Gum Grafting Procedures
(Subepithelial connective tissue grafts)

Reversing Gum Recession

The Problem
This patient has receded gums. She was unhappy with the appearance of her teeth due to the gum recession. Her teeth were also sensitive to hot and cold because of the recession.

The patient was treated at an earlier time by another periodontist in an attempt to address her problem. The treatment that was performed was a Gum Graft.

The gum graft treatment that was provided was, in itself, unsightly. Also, it did not change her root sensitivity.

The patient was referred to PIAGW for treatment.

The Solution
The old gum graft was removed and a different type of gum grafting was performed.

You will note that the new gum graft covered the roots of the teeth which addressed the patient’s esthetic and sensitivity problems. Also, note how natural the gum appears (as compared to the previous graft).

When recession of the gingiva occurs, the tooth 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 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. Also, gum recession may lead to root caries (decay), gouging and wear because the root's dentin is relatively soft compared to tooth enamel.

A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.

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

Crown Lengthening

Crown Lengthening Surgery To Improve Appearance

This patient presented with a complaint about the gumminess of her smile. She had been self-conscious of her smile for years.

Periodontal and Restorative therapy was prescribed to change the appearance of her smile.

Periodontal surgical treatment was performed to raise the level of her gum.

Ceramic veneers were placed to reshaped her teeth. The appearance of her smile was greatly improved.

Crown Lengthening Surgery For Rebuilding Damaged Teeth
	This patient had decay that destroyed the heads of her teeth. There was not enough tooth structure exposed to reliably rebuild the tooth. In order to rebuild these teeth, Crown lengthening surgery was needed.
	The gum, and underlying bone was raised (upward) so that more of the roots of the teeth were exposed. A set of temporary crowns was fabricated to fit on the newly exposed tooth roots so that the patient had teeth with which to function. The edges of the temporary crowns were kept shy of the gums, so as not to interfere with their healing.
	After healing was complete, the teeth were crowned. What was a devastated (dental) situation, was salvaged. The teeth were returned to their original function and health. Before these techniques were widely used, these teeth would have been extracted and replaced by a removable denture.

Osseous Surgery

Traditionally, gum disease is treated by eliminating the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.

Guided Tissue Bone Regeneration

This surgical procedure "regenerates" the previously lost gum and bone tissue. Most techniques utilize membranes, which are inserted over the bone defects. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bioactive gels.

Bone grafting

Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.

We now have the ability to grow bone where needed. This gives us the opportunity to place implants of proper length and width, and it also gives us a chance to more effectively restore esthetic appearance and functionality.

Ridge Preservation

Careful management of extraction sockets after tooth extraction prevents unsightly bone loss and a better cosmetic outcome of tooth replacement.

Periodontal Surgery: Gum Grafting & Crown Lengthening