All-on-4 Implants

Guided tissue regeneration (GTR) and guided bone regeneration (GBR) encourage the regrowth of bone tissue adjacent to natural teeth, and in edentulous areas (areas with no teeth) respectively. Both periodontal disease, and prolonged tooth loss, result in atrophy of bone. Bone is essential to the health of your teeth, as it provides the underlying support that they require. Sufficient bone volume is also critical to ensure good aesthetic and functional outcomes in dental bridge and implant placement procedures. GTR and GBR is achieved using membrane barriers and bone grafts, with the addition of growth factors at times, to stimulate hard and soft tissue growth. (Growth factors are proteins that stimulate growth.)

Gum grafting may be used to address root exposure (recession), sensitive teeth, and inflamed gums. It is often necessary to graft teeth prior to placing certain types of dental restorations, prior to having orthodontic treatment, or if a patient has a removable partial denture. There are several types of gum grafts. The most commonly used techniques at DOCS, are connective tissue grafting and free gingival grafting. We also offer allografts (donor tissue) and the Pinhole Surgical Technique in select cases.

Scaling and Root Planing is a nonsurgical method of clearing the bacteria away from the teeth and gums. This technique is typically used for patients in the early stages of periodontal disease, and is completed under local anesthetic. It involves cleaning the tooth crown and the roots below the gum line to remove plaque and tartar (also known as calculus) in order to facilitate healing of the gums, and reduce gum pockets, by 2-3 millimeters. Normal probing depths range from 0 to 3 millimeters, however effective removal of bacteria through brushing and flossing cannot be accomplished beyond those depths. Oral hygiene instructions are provided to ensure that patients achieve an optimal result.

Osseous surgery is a treatment modality used for moderate to severe cases of periodontal disease. DOCS periodontists create a “flap” of gum tissue to access the bacteria in the deep pockets and then remove bacteria, smooth bone, and decrease the periodontal pockets to a depth that is maintainable with regular scaling and root planning appointments. Sutures are normally placed, and often require removal at a follow-up appointment, where oral hygiene instructions are also provided in an effort to assist patients in achieving an optimal result. The goal of surgery is to save teeth, treat infection, and reduce the pocket depth in order to facilitate improved maintenance success.

Dr. MacKay and Dr. McGuire are certified to perform LASER gum disease treatment using the LANAP® protocol. LASER gum surgery is an effective, minimally-invasive technique used in carefully selected cases. With typically less pain, bleeding and recovery time compared to conventional treatment options, LASER gum surgery is an excellent option for suitable cases. Dr.’s MacKay and McGuire can assess your periodontal condition to determine if this technique is an appropriate modality to utilize in the management of your gum disease. LASER may also be useful when treating ailing implants.

Periodontal disease can be very damaging to your oral health, and progressive periodontal disease may also affect your overall health. It is very important for those who have developed periodontal disease , to seek treatment in order to restore their oral health. Treatment options may include “deep” scaling and root planning, osseous surgery, and LASER therapy. Once the periodontal disease has been treated, regular periodontal maintenance is necessary to monitor and control any potential complications, such as infections. This maintenance is typically scheduled at three-to-four-month intervals to facilitate optimal gum health.

The All-on-4/Teeth-in-a-Day dental implant procedures may be the ideal solution to address the needs of those patients who are missing multiple teeth, have extensive non-restorable decay, or have loose teeth due to periodontal disease. This procedure is a graftless (no bone grafting), full-arch solution that provides patients with a fixed prosthesis, instead of a traditional removable denture. In most cases, the teeth are removed, implants are placed, and a fixed restoration is placed, all in one day. Consultation with DOCS will usually include a complete examination, radiographs, CBCT scan and digital impressions. Patients undergoing the this treatment modality can once again enjoy a natural smile with great function, and are able to partake of their favourite meal without the difficulties normally associated with dentures.

There are multiple factors that contribute to the loss of teeth over time, including smoking, an unhealthy diet, and periodontal disease. The periodontists in our clinic specialize in treating periodontal disease and saving natural teeth, however if a tooth cannot be saved, or a dental implant is needed due to a trauma, our periodontists are well versed in managing soft and hard tissue to provide an optimal site for implant placement. Made of titanium, dental implants have a high success rate, and they can be used to replace a single tooth or multiple teeth in order to restore function and aesthetics, thereby improving quality of life.

Heavy gingival pigmentation (hyperpigmentation and/or variations in pigmentation) is a common aesthetic concern for patients. There are multiple causes for increased gingival pigmentation ranging from certain medications, smoking, and genetics. Conventional methods of pigment removal are painful and have significant bleeding complications. Dr. MacKay is experienced in using the LANAP® LASER for gingival depigmentation resulting in less pain and bleeding post-operatively.

Complicated tooth extraction, also known as surgical extraction, is a type of extraction where the gum and bone may need to be modified in order to facilitate the removal of the tooth, or the retained root tips. There may be a need to remove some bone, or to make a gum flap in order to access the remaining tooth structure for removal. Additionally, there are times when teeth need to be cut into several pieces, (sectioned) to allow for removal. Surgical extraction treatment is used for impacted wisdom teeth, other impacted teeth, teeth with larger or longer roots, and teeth that have broken off.

An oral biopsy is a surgical procedure whereby a sample of hard or soft tissue is removed to be examined under a microscope. The purpose of this procedure is typically to confirm a diagnosis for any lesion in the mouth. The main types of biopsy performed at DOCS are incisional (part of the lesion is removed) and excisional (the entire lesion is removed). An incisional biopsy is used when the lesion is large or has multiple appearance throughout the lesion; one or more areas may be sampled in this case. Excisional biopsies are typically done when the lesion is less than one centimeter and results in removal of the entire lesion. Once removed, the biopsies are sent to a lab for microscopic examination, that typically takes up to two weeks to complete. The results are then shared with the patient and the general dentist.