Procedures

Individuals undergo surgery for a variety of reasons. For some, the decision is prompted by the need to repair diseased, damaged, or irregular bone and/or tissue. And, for others, the decision is to improve their personal appearance, function, and overall well being. Therefore, Dr. Sam Nechamkin, Periodontist, can diagnose, treatment plan, and perform the following non-surgical and surgical procedures.

Antimicrobial Therapy
Antimicrobials are non-surgically injected around the tooth to assist with elimination of localized infection and to gain control of a more stable periodontal foundation.

Bone Graft
Osseous autographs, allografts, or xenographs, are used for bone formation or to assist with periodontal regeneration when periodontal disease has led to a deformity of the bone. An osseous graft is used to fill in an extraction site defect and/or to create a solid foundation for a dental implant(s).

Crown Lengthening
Hard tissue is exposed to the oral cavity in order to allow proper restoration of a crown by the family dentist.

Dental Implant(s)
A titanium post is placed under the gum line and functions like the root of a tooth. When the implant has integrated into the bone, a crown is placed above the gum line resulting in the appearance of a natural tooth. Dental implants can also be used to anchor a full or partial denture using no adhesive. Dr. ‘Sam’ has a CAT scan in order to accurately measure bone height and density and use the image for precise vertical positioning whenever possible.

Extractions with Alveoloplasty
Upon extractions in preparation for partials or dentures, the ridge is contoured to alleviate negative bone architecture. Also, many times, bone is added to lessen the chance for bone spurs.

Frenectomy
A frenum is a fold of tissue that passes from the movable lip or cheek to the gum. A frenum is excised when the tongue has limited mobility; when a large diastema exists between teeth; when the frenum interferes with a prosthetic appliance; or when it is the etiology of periodontal disease or recession.

Gingivectomy
Gingival deformities, i.e.: gingival hyperplasia, gingival aberration, or asymmetrical or unaesthetic gingival topography, are reshaped and reduced to improve function and aesthetics of the tissue; and to gain access to the teeth facially and interproximally.

Guided Tissue Regeneration
A resorbable or non-resorbable, artificial membrane is fixed on top of the bone graft in order to provide a matrix for the bone to mature, and to prevent epithelial down-growth into the extraction socket or bony defect.

Osseous Surgery
Osseous Surgery is performed after either the dentist or periodontist obtains unfavorable results from scaling and root planning. It is a common requirement in the effective treatment of moderate and severe periodontal disease. Often, the bony support of the tooth assumes an unusual configuration as a result of uneven progression of the disease; thus, modification and reshaping of the altered bone support may be indicated.

Ridge Augmentation
An allograft block of bone or a cortical – cancellous bone graft harvested from the patient’s chin or mandibular ramus is secured to the alveolar ridge in order to create a solid foundation for a denture or implant over-denture.

Scaling and Root Planing
A conservative cleaning procedure meant to remove contamination and infection from beneath the gum. Scaling removes deposits of bacterial plaque, calculus, food debris, and pus that have accumulated in the infect pocket due to periodontitis. Root planing smoothes and cleans the root of the tooth so that the gum tissue may heal next to the tooth.

Sinus Elevation
A sinus elevation coupled with a bone graft lifts up the sinus cavity, thus elongates the alveolar ridge vertically to allow the implant to penetrate only the alveolar ridge and not the sinus cavity.

Smile Lift
An esthetic crown lengthening procedure to balance the gum line on both sides of the mouth to create an even smile line. This procedure is typically performed after orthodontic or prior to application of facial veneers when there is a “gummy smile”.

Soft Tissue Graft
A pedicle, subepithelial connective, or free soft tissue graft is performed to cover an exposed root, eliminate a gingival defect, eliminate the pull of a frena, to extend a vestibular fornix, or to correct localized gingival recession and inadequate keratinized gingiva. The procedure also creates a pleasing smile line.

All surgical procedures are suggested to be performed under IV sedation for the patient’s comfort and safety as well as to allow post-medication to be administered intravenously. Additionally, bone grafts and sinus lifts are suggested to be performed in conjunction with the patient’s own autologus platelet concentrate enriched with growth factors.