In Canada, improved oral health care and awareness has resulted in a significant decrease in the number of people who have lost all their permanent teeth (6.4% have no teeth). However, there are many people who are missing one or more teeth due to cavities, fractures, bone loss associated with gum disease, and at times congenitally missing. Historically, teeth were often replaced using non-removable bridges or removable partial dentures. Implants have revolutionized how dental specialists can help restore function and esthetics, for the replacement of one or more teeth. While minor surgery is required to place implants, this approach is considered more conservative in that it can spare other teeth from unnecessary dental treatment.
Drs. Leziy, Dr. Miller and Dr. Nault have advanced surgical /prosthodontic training and experience, coupled with their skilled laboratory technicians, can offer highly precisive and efficient 3D guided surgical and restoration options for small and large cases. They treat hundreds of patients every year with dental implants. Before you have teeth removed, ask us about your suitability for immediate treatment – a more rapid/consolidated treatment approach which can reduce the number of surgical procedures and costs that you will incur. Our consultation process and 3D imaging planning will help you make an informed treatment decision by understanding the pros/cons and risk factors that can influence treatment outcomes.
Why should you consider implants to replace failing or missing teeth:
- Highly successful and stable replacement of teeth/roots;
- Avoid drilling/cutting your adjacent teeth which would otherwise support bridges;
- Eliminate unstable removable dentures;
- Help restore your smile, function and self-confidence.
Gum loss/recession is a common problem. The primary factors that cause this include naturally thin gum tissue, poorly positioned teeth/roots which results in thin bone, crowded teeth and genetic risk contribute to recession risk. Aggressive tooth brushing or poor oral hygiene can also be contributors to the problem.
Gum graft procedures are commonly used to treat receding gums around teeth and at times used in dental implant surgery to enhance tissue stability and esthetics.
There are many different types of gum graft procedures. Our periodontists are experts in this area, helping guide you as to what procedure is best for your situation. While donor tissue from the palate is considered the gold standard, we have extensive experience with substitute materials as well. Dr. Leziy and Dr. Nault have taught many of their colleagues, both dentists and specialists throughout North America, on minimally invasive palatal and dermal skin grafts. While not every problem is suitable for skin graft substitutes, we will evaluate your recession problem, determine the appropriate and highly predictable treatment approach for your unique presentation, helping guide your decision-making. Please contact us to arrange a consultation to learn more about the solutions that we offer.
We often talk about having a healthy mouth – this starts with healthy gums and bone that support your teeth. Increasingly, we also recognize that your overall physical well-being is affected by your oral health- commonly referred to as the oral-systemic link. Periodontal disease is very common- 50% of people will present with varying degrees of problems, but 11% of these will have severe disease making them at risk for tooth loss. Studies have linked gum disease and its associated inflammation as an important contributing factor to many health conditions, including heart disease, dementia, some cancers and pre-term/low birth weight babies. These and other health problems can be impacted by the oral bacteria and immune system response associated with untreated disease.
Early recognition and treatment of gum disease is important to help you keep your teeth. The signs are sometimes subtle, but can include gum swelling, bleeding during normal oral hygiene procedures, and changes in the level of the gum around your teeth. The problem is that this disease is often not recognized early and can be overlooked by dental professionals if they are not routinely examining you, using an instrument called a periodontal probe to measure pockets and recession, or periodically taking x-rays to assess your bone levels. Often, gum disease will not cause pain or infection until the condition is advanced. Contact us to schedule an evaluation should you have concerns about possible gum problems.
Periodontal disease – non-surgical management
How do we manage the damage to your gums and bone caused by gum disease? Our initial approach is generally non-surgical and minimally invasive. Treatment is aimed at lowering the biofilm with methods and instruments that may not be available to you outside of a specialty practice. In the hands of our experienced and knowledgeable hygienists, guided-biofilm therapies using piezo-technology and EMS airflow (a fine powder that effectively disrupts the problematic biofilm) will effectively manage most cases of periodontal disease. Success is also predicated on helping you improve your home care efforts and methods. We establish routine monitoring and care programs, at times jointly with your general dentist/hygienist. People with more complex and advanced disease often need our services on a routine basis since periodontal disease is a chronic condition.
Periodontal Disease – surgical management
At times our patients require gum surgery to access deep/unreachable bacteria and to try to repair bone defects. These treatments can be comfortable with good anaesthesia/numbing- ask us about oral sedation, our gentle STA injection system that can improve your experience, our refined surgical techniques, use of growth factors that can speed healing and recruit your own cells to help heal the surgical site (we will explain Emdogain and PRF technologies- using your own cells and growth factors).
Bone & Sinus Grafting Procedures
Our surgical specialists offer treatment required in preparation for dental implants. For success of your treatment, we offer specialized care and procedures that can generally be managed under local anaesthesia or with oral sedation.
Loss of teeth will in most cases result in bone loss as well. Bone grafts are done at times when a tooth is removed, but often with implant placement. If your tooth or teeth have been missing for a long time, there are times when more extensive bone repair is required. Our modern bone repair procedures to enhance your bone structure (density and volume) are keys to your preparation for successful implant placement. Bone grafting by our experienced clinicians will set the foundation for successful and long-lasting implant treatment.
Sinus bone grafts are sometimes required for implant placement in the back of the upper jaw. In some people, the size and shape of the sinus (a natural cavity in the jaw) may necessitate a procedure to create more bone to accommodate an implant. At times, very minimally invasive procedures can be used to correct the sinus position at the time of dental implant placement, but for some individuals the procedure can be more involved with longer healing periods before implant placement. Let us discuss our experiences and recommendations as they apply to your situation.
Crown Lengthening / Esthetic Tissue Contouring Procedures
For patients who believe that their smile is too “gummy” or that their teeth are too short, we offer crown lengthening services to enhance your smile and improve your confidence. Crown lengthening to correct tissue levels or asymmetries is not as simple as a ‘trim of tissue’ or ‘quick laser’ correction. Our periodontal specialists have gone through extensive training in the surgical management of soft and hard tissues, making them the best clinicians to correct the supporting soft tissue and bone around your teeth. These procedures are done to expose more of a tooth or teeth in order to improve the way your teeth look. Crown lengthening is a minimally invasive procedure that will allow for a more balanced and even smile by sculpting/shaping the gums and at times the underlying bone.
This procedure is also done for non-cosmetic reasons, when teeth have fractured or have deep cavities that extend to or under the gum and require dental restoration. Generally, you would be advised by your dentist if this is required.
During the dental crown lengthening procedure, excess gum and bone tissue is reshaped around the tooth/teeth in the area of concern to expose a more natural tooth length. This procedure can be done to just one single tooth or several, or even to your entire gum line. These changes can be done to help your dentist or our prosthodontist rebuild your teeth with veneers or crowns, and at times is carried out purely for esthetic reasons when there is naturally too much tissue around your teeth (referred to as a gummy smile).
Healing following this procedure is generally very rapid, with minimal impact on your daily function or activities. Some patients report mild discomfort and increased temperature sensitivity after the treatment, but with a personalized treatment plan and post-treatment follow-ups we assist you in the management of your concerns. Most people return to work the day after surgery and resume normal activities including exercise within 2-3 days of surgery. Post-surgical care of the area varies and is reviewed with you depending on the extent of the treatment. The time for tissue maturation between this minor surgery and any required restoration procedures (crowns, veneers) is approximately two to three months in the back of the mouth, while highly esthetic-sensitive areas are often allowed to heal three to six months.