Archive for the 'Laser Gum Surgery' category

Periodontal Plastic Surgery: Gum Reshaping Can Improve A Smile

May 04 2010 Published by Dr. Toback under Gum Reshaping, Laser Gum Surgery

When most people think of a nice smile, they think of nice, white, healthy teeth.  It is true that healthy teeth are essential, but those teeth are like a beautiful piece of artwork that must be appropriately “framed” to make them come to life.  The frame of the teeth are the gums that surround them.  Healthy and appropriately shaped gums bring harmony and visual contrast to the teeth they envelop.

laser gum surgery gummy smileA common complaint for many patients is that they feel they have a “gummy” smile.  In fact, as much as 30% of women have some level of excessive gingival display (gummy smile).  This condition can be associated with several different causes including tooth position, skeletal bone relationships, lip mobility, and position of gum tissues surrounding the teeth.

This month’s case highlights Caitlin, a 22 year old female patient who presented following orthodontic therapy (braces).  The teeth were moved into an ideal position by the orthodontist.  However, Caitlin felt that she had a gummy smile and inquired about addressing this.  Caitlin’s teeth and gums were healthy.  Following a thorough diagnostic workup, it was determined that Caitlin was a good candidate for a procedure known as esthetic gum recontouring (also known as esthetic crown lengthening).

The goal of gum recontouring is to create the natural flow and curvature of a pleasing gum line, while exposing the appropriate amount of tooth structure.  In Caitlin’s case, she had beautiful teeth and healthy enamel.  It was just covered by abundant gum tissue making the teeth appear short.  Utilizing a periodontal laser, the gums are shaped to their ideal position.  Following this step, the surrounding bone is gently reshaped to create the appropriate anatomy for sustaining a long-term result.  Without this latter step, the tissue will regenerate once again.  The final step is the securing of the tissue with small diameter, plastic-surgery style sutures.  The entire surgery took less than one hour.

laser gum surgery after photoFollowing 12 weeks of healing, we can see dramatic changes in Caitlin’s gum line, and ultimately, her smile.  The tissues will continue to remodel over the next 12 months to create ideal contours.  In some situations, gum recontouring may be followed by restoration of the teeth with veneers.

Esthetic gum recontouring is one example of how periodontal plastic surgery may impact the smile.  Most patients are focused on how their teeth appear, and may not realize that the position and harmony of the gums can have a dramatic impact on the presentation of the teeth they surround.  Through addition, or in this case, subtraction procedures, a periodontist can help patients achieve their desired goals

This article first appeared in the 2010 May / June edition of the The New London Women’s Journal

I was always self-conscious about my smile, so when Dr. Toback suggested the procedure I was excited to see the difference.  The procedure was unbelievably easy and quick.  The results are amazing!  My smile looks completely different and I couldn’t be happier with how my teeth look now!  – Caitlin

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Laser Gum Surgery: A New Option For Treating Gum Disease

Jul 07 2009 Published by Dr. Toback under Gum Disease, Laser Gum Surgery

Lasers have revolutionized medicine and surgery over the past twenty years, and lasers have now added to the treatment choices for one of the most common dental problems facing adults.  Gum disease (periodontal disease) affects as much as 80% of the population and is the leading cause of tooth loss.  Gum disease results in destruction of the bone that supports the teeth when left untreated.  In addition, we reviewed in the last Women’s Journal, the relationship between periodontal disease and systemic disease.  We know that it is critically important to overall health, to properly diagnose and treat periodontal disease.  Unfortunately, many patients avoid treatment when the periodontist begins discussing gum surgery.

Gum disease (periodontal disease) is caused by plaque deposits on the teeth that harbor bacteria which infect the gums.  As this chronic infection progresses silently, bone is destroyed around the teeth resulting in gaps or “pockets” beneath the gum tissue.  These pockets are difficult to clean with brushing and flossing.  Bacterial debris accumulates further as the disease advances.  Gum surgery is the conventional form of treatment, and has evolved over the past fifty years.  All traditional forms of gum surgery have required incisions and suturing of the gums.

The NdYAG Laser Was FDA Approved in 2004. Lasers have been available in many forms for over twenty years.  However, in 2004 a specialized laser called the NdYAG was FDA approved for the treatment of periodontal disease.  Although lasers can be used for several purposes in dentistry, the NdYAG is the only laser indicated for targeting the causative agents of periodontal disease.  This laser, when applied within a very specific treatment protocol called LANAP, has the potential for restoring health to the gum tissues.  Many patients prefer this approach when compared to traditional incisional surgery, because the “minimally invasive” nature of laser therapy leads to less swelling and discomfort, and speedy recovery times.

How the Laser Works

The NdYAG laser targets inflamed tissue and the bacteria associated with gum disease.  A tiny fiber with a diameter the size of approximately three human hairs, is placed below the gum line and into the pockets.  The laser fiber is moved back and forth within the pocket, killing bacteria and removing the inflamed tissue.  Once the teeth are thoroughly cleaned, the fiber is once again inserted within the pocket and initiates a specialized clot to form between the gum tissue and the tooth root.  No incisions are made with the laser approach.  This leads to a speedy recovery with minimal post operative discomfort.  In addition, laser periodontal therapy results in less gum recession following treatment.  Patients appreciate this as they experience less tooth sensitivity when compared to those with incisional approaches.

Who Can Benefit From Laser Therapy

Patients who have put off gum surgery due to anxiety or concern about the procedure, should consider a laser approach.  Remember that periodontal disease will progress when left untreated.  In addition, patients with very sensitive teeth could benefit from laser approaches due to decreased root exposure following surgery.  Other appropriate candidates are patients with medical conditions that could complicate incisional surgery.  The non-invasive nature of the laser offers an alternative to patients who may have health concerns.

Is Laser Gum Surgery The Best Option For You?

As with all treatments, there are specific indications for different therapies.  While laser therapy is appropriate for many patients, incisional surgery may still be the treatment of choice for other patients, especially where bone regeneration with grafting technologies is desired.  A comprehensive examination with a periodontal specialist is the first step in determining which treatment approach is best for each individual situation.

This article first appeared in the 2009 July / August edition of the The New London Women’s Journal

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