Periodontal treatments and oral surgeries are performed in-house by our specialists.
A summary of specialist services is as follows:
- BONE GRAFTING
Missing teeth over a period of time can cause your jaw bone to atrophy, or resorb. This often results in poor quality and quantity of bone suitable for the placement of dental implants as well as long-term shifting of remaining teeth and changes to facial structure. Most patients, in these situations, are not candidates for dental implants. Fortunately, today we have the ability to grow bone where it is needed. This not only gives us the opportunity to place implants of proper length and width, but it also gives us a chance to restore functionality and aesthetic appearance.
- MAJOR BONE GRAFTING
Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease, or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee). Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum to protect the bone graft, as well as encourage bone regeneration. This is called guided bone regeneration, or guided tissue regeneration.
- SINUS AUGMENTATION (sinus lifting)
The maxillary sinuses are behind your cheeks and on top of the upper teeth. These sinuses are empty, air-filled spaces. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone. In the most common sinus augmentation procedure, a small incision is made on the premolar or molar region to expose the jaw bone. A small opening is cut into the bone, and the membrane lining the sinus is pushed upward. The underlying space is filled with bone grafting material, either from your own body or from a cadaver. Sometimes, synthetic materials that can imitate bone formation are used. After the bone is implanted, the incision is stitched up and the healing process begins. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone. If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed. The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option besides wearing loose dentures.
- REPLACING MISSING TEETH
Your teeth affect your whole body. When they’re healthy, you’re healthier too. A missing tooth can affect your bite, speech and eating choices. As you rely more on your remaining teeth, you increase the chance they will wear out prematurely, or be damaged or lost. You may also experience headaches and/or jaw pain. Who would want their appearance and health to deteriorate? That’s the natural consequence of missing teeth – the jaw literally melts away. Generally, people will lose 25% of their supporting jawbone structure within the first year after tooth loss. Dental implants are more easily placed when teeth are first extracted because bone replacement becomes more complex as time passes. The great news? Implants act just like your natural teeth. They safeguard and preserve your bone structure, oral health and appearance. Your dentist and the implant surgeon will provide you with options so that you can make the most informed decision concerning tooth replacement.You can select from a number of different options to replace your missing teeth – from temporary to long-lasting solutions. A good candidate is anyone missing one or more teeth, or who is unhappy with their dentures. Age is not a factor. However, smoking, diseases such as diabetes, and radiation therapy to the area, have been shown to lower the success rate of implant placement. X-rays of your jaw will be taken to evaluate whether they will accommodate implants. Detailed x-rays may also be required to determine if other tests or procedures are needed to place implants properly.
- ORAL CANCER EXAM
According to the American Cancer Society, over 30,000 cases of oral cancer are diagnosed each year, with over 7000 of these cases resulting in the death of the patient. Fortunately, oral cancer can be diagnosed with an annual cancer exam provided by Dr. Farhadian. If caught early, oral cancer can be effectively treated. Oral cancer is a pathologic process, which begins by producing no symptoms making it hard to recognize without an exam. There are many types of oral cancer, including teratoma, adenocarcinoma and melanoma. The most common form of oral cancer is malignant squamous cell carcinoma, which typically originates in the lip and mouth tissue. There are many other places in which oral cancers occur, including: the tongue, salivary glands, throat, gums, and face. The oral cancer examination is completely painless. Dr. Farhadian will look for abnormalities and feel the face, glands, and neck for unusual bumps. Lasers may be used to highlight pathologic changes, and can “look” below the surface for spots and lesions invisible to the naked eye. Some of the signs that will be investigated are red patches and sores. Red patches on the floor of the mouth, or the front of the tongue, and bleeding sores which fail to heal easier, can be indicative of cancerous changes. Leukoplakia is a hardened white or gray, slightly raised lesion that can appear inside the mouth, and may be cancerous. Signs of these will be examined as well. Finally, soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathologic signs, and will be examined. If abnormalities, lesions, lumps, or leukoplakia are apparent, Dr. Farhadian will implement a treatment plan that is right for you. Treatment options vary according to the precise diagnosis, but may include: excision, radiation therapy, and chemotherapy. It is also important to note that over 75% of oral cancers are linked with avoidable behaviors such as smoking, tobacco use, and excessive alcohol consumption. Dr. Farhadian can provide you with literature and options about quitting dangerous behaviors such as tobacco use. After careful consideration, if there is a tissue that is not normal such as a lesion, a tumor, or a mass, Dr. Farhadian might consider performing a biopsy. A biopsy is a procedure where a small piece of tissue is removed from an area so that it can be evaluated closely under a microscope.
- CROWN LENGTHENING
Crown lengthening is usually performed to improve the health of the gum tissue, prepare the mouth for a procedure, or correct a “gummy smile”. A “gummy smile” is used to describe an instance where teeth are covered with excess gum tissue resulting in a less esthetically-pleasing smile. The procedure involves reshaping or recontouring the gum tissue and bone around the tooth in question to create a new gum-to–tooth relationship. Crown lengthening can be performed on a single tooth, many teeth, or the entire gum line.Crown lengthening is often required when your tooth needs a new crown or other restoration. The edge of that restoration is deep below the gum tissue and not immediately accessible. It is also usually too close to the bone or below the bone.Crown lengthening allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease.
- SCALING & ROOT PLANING
The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling or root planing. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause gingival inflammation and disease. Scaling and root planing can be used as a stand-alone treatment, or a preventative measure. They are commonly performed on cases of gingivitis and moderate-to-severe periodontal disease. Doctor will only perform scaling and root planing after a thorough examination of the mouth, which may include taking x-rays and visually examining the mouth. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, Dr. Farhadian may recommend scaling and root planing. In some cases, a local anesthesia may be used during the procedure. Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Farhadian may place antibiotic fibers in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.When deep pockets between teeth and gums are present, it is difficult for Dr. Farhadian to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.If treatment is successful, scaling and planing may have many periodontal benefits. One is that it can help prevent disease. Research has proven that bacteria from periodontal infections can travel through the blood stream and affect other areas of the body, sometimes causing heart and respiratory diseases. Scaling and root planing remove bacteria that cause these conditions.Another benefit of treatment is protecting teeth against tooth loss. When gum pockets exceed 3mm in depth, the risk for periodontal disease increases. As pockets deepen, more bacteria are able to colonize, eventually causing a chronic inflammatory response by the body to destroy gingival and bone tissue. This leads to tooth loss.Finally, scaling and root planing may make the mouth more aesthetically pleasing, and should reduce bad breath caused from food particles and bacteria in the oral cavity. Superficial stains on the teeth will be removed during scaling and planing, adding an extra bonus to the procedures.
- FRENECTOMY
A frenum is a naturally occurring muscle attachment, normally seen between the front teeth (either upper or lower). It connects the inner aspect of the lip with the gum. A lack of attached gingiva, in conjunction with a high (closer to the biting surface) frenum attachment, which exaggerates the pull on the gum margin, can result in recession. Additionally, an excessively large frenum can prevent the teeth from coming together resulting in a gap between the front teeth. If pulling is seen or the frenum is too large to allow the teeth to come together, the frenum is surgically released from the gum with a frenectomy. A frenectomy is simply the surgical removal of a frenum.When Orthodontic treatment is planned or initiated, the removal of an abnormal frenum, with or without a gingival graft, can increase stability and improve success of the final orthodontic result.
- EXTRACTION SITE PRESERVATION
A consequence of tooth extraction is alveolar ridge resorption (bone loss). The rate of which may vary between sites and subjects. This may result in inadequate bone volume and unfavorable ridge architecture for future dental implant placement. Site preservation procedure involves placing bone graft into the socket immediately following tooth extraction to prevent resorption of bone which can cause significant problem in implant and restorative dentistry.
- GUM GRAFTING
Another cosmetic procedure is the soft tissue graft. It is used to cover unattractive tooth roots, reduce gum recession, and protect the roots from decay and eventual loss. This procedure is complete by our periodontal specialist in house.
- TORI REMOVAL
Tori are areas of excess bone in the mouth. Dental tori that are along the lower jawline are called mandibular tori, and tori that form on the roof of the mouth are called tori palatinus. In both situations, these excess growths are typically harmless and benign. Tori removals are indicated if it is causing pain, especially if they are punctured by sharp foods, causing food packing, difficulty speaking when interfering with movements of the tongue or problems with the correct fit of dentures or implants. This procedure is complete by our periodontal specialist in house.
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