Board Certified Periodontist, Dr. Scott O. Kissel

How does Microsurgical Scaling and Root Planing Treat Advanced Periodontal Disease?

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Periodontal disease is an inflammatory condition of the gums and the bone supporting the surrounding teeth. It can present in any person of any age and affects anywhere between 80-90% of people depending on age. Periodontal disease can happen for a number of reasons, chief among them being poor oral hygiene. Treatment can often include implants, but that carries with it the risk of peri-implantitis. Peri-implantitis is a site-specific infectious disease that affects the soft tissues around integrated implants.

Recently, at my New York City office, I began using the Periolase, a free-running dental laser, in combination with my microscope to treat peri-implantitis.  I have seen many case reports showing a reduction in the severity of intrabony defects and even complete defect resolution. This has been associated with a significant reduction in pocket depths.

The microscope allows me to see deep into the pocket thereby allowing me to be more comprehensive in removing debris off the implant.  I can remove deposits which cannot be seen with loupes or felt with instruments.  The laser will remove inflamed tissues, delay epithelial migration, decontaminate the implant and promote hemostasis of a blood clot between the implant and tissues.  This clot contains factors to promote healing of the hard and soft tissues.

Below is a radiograph showing advanced peri-implantitis with circumferential probing depths of 9-12mm associated with purulence, and severe distal, buccal and palatal bone loss.  Just four months after microsurgical S/RP and laser treatment the second radiograph shows a reduction of the bony defect and probing depths of 5-6mm.  Periodontal healing for any procedure takes about one year to complete, so I anticipate further resolution of the peri-implantitis.  This patient was extremely relieved knowing his implant was now going to be retained.

I use this same premise at my New York City office to treat periodontal disease.  Most often I can resolve advanced periodontal disease using microsurgical scaling and root planning. Scaling involves the removal of plaque, calculus, and biofilm from the surface of the teeth, especially near the gum line. Root planing goes a step beyond and extends below the gumline to clean the surface of the tooth root in the hopes of reducing irritation and inflammation of the gums. Both of these are safe procedures, but often leave teeth sensitive, and may require multiple visits when using traditional techniques. The laser has enhanced my ability to achieve new attachment or regeneration.  Very often surgery and bone graft materials are not necessary to treat periodontal infections. In addition, I am more precise in my care, and the results look and feel better.

Periodontal disease is not permanent. Tooth and gum damage can always be repaired or mitigated; you only need to recognize the problems and seek the proper care. There are ways to deal with mouth issues, and new techniques are being developed and advanced every year. I am at the forefront of micro-surgical techniques and utilize these types of new technologies in everything I do. It consistently provides a higher quality of service and produces better results than traditional techniques. Advanced care is possible, and the discerning people of New York City would demand no less than the best care for their smile.

Periodontal disease affects nearly everyone in some way. It may not seem very severe, but it is a barrier to a perfect smile and perfect oral health. I encourage prospective patients in the New York City area to come in for a consultation to discuss their oral health, and we can develop a care plan for your individual needs. Call (212) 702-9088 today.

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