Our Approach
Through both surgical and non-surgical procedures our specialists are skilled in reversing bone & tissue damage, gum grafts to cover exposed roots, reduce a gummy smile or re-contour an uneven gum line. A thorough examination and consultation will be performed to assess your periodontal health prior to treating periodontal conditions or cosmetic procedures.
request an appointmentOSSEOUS SURGERY (POCKET REDUCTION)
Pocket Reduction is performed as a preventative measure to reduce pockets around affected teeth with the outcome being an environment that is easier to keep clean and achieve our ultimate goal of retaining the tooth. The gum is retracted to open access to the bone and root, then the bone defects are removed and the gum tissue is sutured back around the tooth. After healing the gum is tightly healed around the tooth.
FRENECTOMY
A Frenectomy is the surgical removal of a frenum either under the tongue, or Labial. A frenum is a naturally occurring muscle attachment found between both the upper and lower front teeth. It connects the inner part of the lip with the gum. A lack of attached gingiva, in conjunction with a high frenum attachment, which exaggerates the pull on the gum margin, can result in recession. An excessively large frenum can prevent the teeth from coming together, resulting in a gap between the front teeth. Both types of frenectomies can affect the fitting of dentures. Untreated frenectomies can also cause speech impediments in children and adults.
GINGIVECTOMY
Gingivectomy is a surgical procedure used to treat gum disease. The procedure involves the removal of diseased gum tissue for the purpose of reducing pockets and slowing the progression of gum disease.
SCALING & ROOT PLANING
Often performed prior to a Gingivectomy – Scaling & Root Planing is a special cleaning that removes the dental calculus the has accumulated on the tooth and root surfaces, for the purpose of healing gum tissue and shrinking periodontal pockets. Imperio uses ultra sonic pieziosurgery and laser technology – a gentle way to break up dental calculus through ultra sonic vibrations or water, air & laser energy. The benefit of both these technologies are faster healing times, less bleeding and decrease discomfort.
CROWN LENGTHENING (GUM RESHAPING)
This is a minor surgical procedure to rebuild a heavily restored tooth, a tooth with a deep cavity that ends under the gum and cannot be reached or a fractured tooth with little remaining tooth above the gum. This surgery aims to raise the gum or make it recede in a controlled fashion, thus exposing some of the healthy root under the gum and bone. The tooth can then be restored more securely since a crown will hold onto an adequate amount of solid root structure.
This surgery is also done to make a tooth look better; this is referred to as esthetic crown lengthening. It is generally considered in the front of the mouth or on teeth/gums that are displayed when smiling. This type of surgery aims to improve the smile by creating an ideal tooth size in cases where teeth are short or squat. It is also done to enhance gum symmetry across the mid-face, usually before new crowns or veneers are considered. It may be considered to correspond chronically red/purple/puffy gums that result from crown margins/edges that are too deep under the gum.
In all of these situations, crown lengthening surgery is done under local freezing. A flap is reflected (gum is slightly lifted away from the tooth), and a small amount of bone is trimmed away, just like a cavity would be drilled. By removing a small amount of bone, more root is exposed. It is not adequate to remove gum since this would result in bone exposure. The gum is then stitched in a new position; higher in the upper jaw or lower in the bottom jaw. Once the gum has healed, the tooth will appear slightly longer than it did prior to the surgery. The majority of crown lengthening procedures are routine and rarely present complications. There is often no or little post-surgical pain. It is possible to carry on with normal activities and diet the day after the surgery. Follow-ups are done to ensure that the area heals well. The minimum time frame for healing prior to the required dental work with your dentist is 6-8 weeks. When treatment is done around the upper front teeth, we often recommend longer healing times, usually three or more months, before beginning the restorative phase of treatment.
BONE GRAFTING
The process used to rebuild or reshape bone and soft supporting tissue destroyed by periodontal disease is bone grafting or regenerative surgery. There are specific bone loss patterns that lend themselves well to these treatments and others which are not appropriate. Our periodontists will assess the bone loss pattern and advise you if the bone loss pattern around your teeth will lend itself to this procedure.
DERMAL GRAFT
Today gum recession problems are generally treated by gum grafting treatments. This graft aims to improve the gum quality in the area of recession and regrow gum over the exposed root surface. The degree of root coverage possible varies with each case, and a site must be evaluated by one of our periodontists to determine what can be achieved based on the pattern of the recession and tooth/root form.
SINUS LIFT
A Sinus Lift is a surgery involving the addition of bone to your upper jaw above your molars and premolars between your jaw and maxillary sinuses. The sinus membrane is moved upward to make room for the bone to increase the bone height in the upper jaw to support the placement of implants.
RIDGE AUGMENTATION
Ridge Augmentation will correct the defects caused by bone loss and gum recession in areas with missing teeth. It is intended to allow for future implant replacement or to provide better functional and aesthetic restorations in the aesthetic zone.
RIDGE EXPANSION
Ridge expansion is performed when the jaw is not wide enough to support implants. The bony ridge of the jaw is increased by splitting the bone with surgical instruments. Bone graft material is inserted and allowed to heal before placing the implant. This surgery is performed under IV sedation or general anesthesia.
SOCKET GRAPHS & TISSUE REGENERATION
A socket is the area of the jaw bone where the tooth is anchored. When advanced periodontal disease or injury has caused significant bone loss in the socket area, the tooth socket may need to be reconstructed.
The bone which surrounds the tooth socket deteriorates very quickly once a tooth is removed. If a socket continues to be empty after tooth loss, the accelerated bone loss can impact adjacent teeth and prevent the placement of a dental implant later on. Thus, it is important for appearance and health to rebuild the socket at the time of tooth loss.
Socket grafting is a procedure that can rebuild or preserve the bone in the tooth socket, allowing future replacement by a dental implant or bridge restoration. At the time of your dental extraction, if you are unsure whether you will want a dental implant in the future, socket grafting may decrease the rate of bone shrinkage. It may allow a dental implant to be placed later on without any other bone grafting procedure.
EXTRACTIONS
The first step in any extraction is a digital x-ray examination to assess the position of the tooth roots and the condition of the surrounding bone. A thorough medical and drug history is reviewed to ensure that you are healthy enough to undergo the procedure, and your options for anesthesia will be discussed.
Tooth extraction is usually carried out with local anesthesia, which will numb the teeth to be removed, and the surrounding bone and gum tissues. Additional sedatives might also be used, including oral sedatives (taken in pill form), or conscious sedation, which is given intravenously (into a vein). The latter is usually required for more complicated (or multiple) tooth extractions. By the time the sedation medication has worn off, you won’t even be aware that the surgery was done.
As your tooth is being removed, steps are taken to ensure the bone that surrounds it isn’t damaged. Sometimes, in the process of removing a tooth, a small amount of lab-processed bone-grafting material is placed into the socket to help preserve the bone volume there. This is particularly important when the extraction is going to be followed at some point by the placement of a dental implant, which needs to fuse to existing bone, or orthodontics, which gently moves teeth through bone.
Immediately after your tooth is extracted, the socket will be covered with sterile gauze; gentle pressure will be applied for 10-20 minutes to control any bleeding. Small sutures (stitches) might also be used for this purpose. It’s normal to experience some mild to moderate post-operative discomfort and/or swelling. Taking non-steroidal, anti-inflammatory drugs such as ibuprofen and/or aspirin the day of surgery should control most symptoms. Antibiotics may also be prescribed to ensure infection-free healing. Using ice packs on the outside of your jaw and eating softer foods until you feel more comfortable can also be helpful. Within a few days, all should be back to normal.
COMPUTER GUIDED IMPLANT SURGERY
Our goal of dental implant therapy is to accurately and predictably restore our patient’s dentition. The specialists at Imperio work as a team to diagnose, plan and reconstruct your treatment for optimum results.
With 3D diagnostics technology, we can plan your treatment with the results in mind through virtual case planning. This technology allows us to place implants to achieve the desired restorative outcome accurately. Computer Guided Surgery: This powerful visual improves our ability to communicate and collaborate from the computer to the operative environment, leading to better patient care for both surgical and restorative outcomes.
BIOPSY
Biopsy is a simple surgery that removes a sample of gum tissue, tooth, or jaw from the body for a pathologist to examine to determine if it is cancerous. The goal is to find the source of an abnormality or lesion, which may cause illness or injury.
To supplement our specialist’s comprehensive oral head and neck exam, Imperio also uses VELscope technology in detecting cancerous or pre-cancerous tissues. This harmless handheld device emits bright blue light, which is used to inspect the mouth and tongue. The device is susceptible to abnormal tissue changes, and the distinctive blue-spectrum light causes the soft tissues of the mouth to fluoresce naturally. Healthy tissues fluoresce in distinct patterns visibly disrupted by trauma or disease, such as neoplastic lesions, fungal, viral, or bacterial infections.
EXPOSURE FOR ORTHO
In some cases, teeth do not erupt properly through the jawbone and gum tissue, into the mouth. Impacted teeth may cause problems including bone loss, root resorption, or formation of cysts or tumours. A minor surgical procedure can be preformed to expose the tooth and working with your Orthodontist, be brought into alignment.