Periodontal Consultation

It is an essential and necessary feature of any periodontal treatment. In fact, treatment begins with the examination as it is the only way of fully appreciating the extent of the problem and finding the most appropriate method to solve it.

The consultation comprises:

  • Opening Discussion (finding out patient's needs)
  • Medico-Dental History
  • Clinical Examination (detailed charting of clinical findings & measurements)
  • Examination of Occlusion & Tempero-mandibular joint (TMJ)
  • Radiographic Examination
  • Adjunctive Elements (photos, study casts)
  • Diagnosis, Treatment planning & Case discussion

Periodontitis Treatment

Non-surgical (Basic)

All periodontal disease is initially treated through a course of intensive cleaning, also known as initial periodontal treatment or non-surgical treatment. Treatment will be performed generally within a time frame of 3-5 months, and involves between 4-8 appointments (case dependent).

The aim of the treatment is periodontal rehabilitation by removing mechanically as much of the plaque and calculus present on the root surfaces of the teeth as possible. Help is provided to prevent further plaque from growing around the teeth surfaces.

What is involved in the treatment?

1. Help in improving day to day oral hygiene (Oral Hygiene Instructions)
2. Removal of the plaque and calculus (from above and below the gum line)
3. Occlusal adjustment (if necessary)
4. Re-assessment (& further treatment if required)

Many scientific and clinical studies have shown this to be a very effective treatment modality for gum disease.

Surgical – Periodontal Pocket Elimination Techniques

Surgical periodontal treatment is often deemed necessary to restore periodontal health in some patients even at the initial consultation but more often at the review appointment. This is either due to the severity of the disease or the necessity of readjusting the gingival architecture.

Such techniques might be:

  • Guided Tissue Regeneration
  • Regenerative techiques
  • Soft Tissue Grafts
  • Hard tissue Grafts
  • Osseous Recontouring

These surgical interventions are executed under local anaesthesia, pain free and have short duration and recovery period.

Implant Treatment

Guided implant placement

Dental implant treatment is the most contemporary and effective method to replace missing teeth so long as there is proper treatment planning and execution. Since there are a number of important factors to be considered for a successful outcome, it is vital the clinician to be highly trained and experienced.

Lack of the aforementioned prerequisites could contribute to the development of periimplantitis; an infection of the tissues around implants that has similar characteristics with periodontitis.

One major difference between these two infections is that on the contrary to the teeth mobility in periodontitis, implant mobility in periimplantitis is irreversible and an absolute indication of loss of osseointegration and necessity of extraction, rendering thus essential the avoidance of the development of periimplantitis and/or its immediate resolution.

Periimplantitis treatment

This treatment modality has similar principles to the treatment of periodontitis and it comprises both non-surgical and surgical phases as well.

Nevertheless, in contrast to periodontal therapy, surgical modalities are more frequently required and less effective in periimplantitis therapy as infection around implants is not as easily resolved as around teeth.

Periodontal Microsurgery

Treatment of Gum recessions (Root coverage procedures)

These treatment modalities involve the use of grafts (soft tissue/ synthetic) to treat the recessions and cover up the denuded roots either because of health issues (difficulty in cleaning, abrasion, hypersensitivity)or aesthetice needs.

Gingival Smile (Crown Lengthening procedures)

This type of procedures is indicated when there is excessive gingival display
and therefore, exposure of sound tooth surface is necessary either due to health issues (subgingival caries, prosthetic demands) or purely aesthetic demands.

Adjunctive Treatments

It is very frequent that general dentists and/or orthodontists require some forms of periodontal intervention in order to conclude their treatment plans.

Examples of such treatment modalities

  • Clinical crown lengthening / gingivectomy
  • Alveolar ridge augmentation (soft & hard tissue grafts)
  • Frenectomy
  • Vestibuloplasty
  • Extraction socket preservation

 

Periodontal Maintenance

Once active treatment is complete and periodontal rehabilitation is accomplished, all patients would be strongly advised to enter the maintenance phase or else supportive periodontal treatment.

It involves routine monitoring and care for the first year on a 3 monthly basis and this time frame is reconsidered on an annual basis. Susceptible patients and those with advanced disease may require more frequent monitoring. On the contrary, in less susceptible patients these reviews can be scheduled on a 4 monthly or even 6 monthly basis.

Long-term studies have clearly demonstrated the necessity and efficacy of professional periodontal maintenance to prevent disease recurrence