Periodontal Plastic Microsurgery

Periodontal surgical procedures are a predictable way to cover unsightly, sensitive, or exposed root surfaces and to prevent future gum recession. If you are unhappy with the appearance of short, unsightly teeth, this can be greatly improved by a combination of periodontal procedures by Dr. Noroozi and cosmetic dentistry by your dentist or our prosthetic specialist.

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Although your teeth appear short, they may actually be the proper length. The teeth may be covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure, crown lengthening. During this procedure, excess gum and bone tissue are reshaped to expose more of the natural tooth. This can be done to more than one tooth, to even your gum line, and to create a beautiful smile.

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Another cosmetic procedure is the soft tissue graft. It is used to cover unattractive tooth roots, reduce gum recession, and protect the roots from decay and eventual loss.

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Tooth loss causes the jaw bone to recede and can lead to an unnatural looking indentation in your gums and jaw, and appearance of a general aging. The original look of your mouth may not be recaptured because of spaces remaining under and between replacement teeth. They may appear too long compared to nearby teeth.

Bone grafting following tooth loss can preserve the socket/ridge and minimize gum and bone collapse. There is less shrinkage and a more aesthetic tooth replacement for either an implant crown or fixed bridge around the replacement teeth.

For more information about graftless gum rejuvenation (Chao Pinhole Surgical Technique), gum grafting, and bone grafting, please refer to the treatment section of our website, and click on each individual procedure for an in-depth description.

Periodontists are often considered the plastic surgeons of dentistry. If you are looking to improve your smile, our periodontists at “IMPrESS Perio Implant Center” may be able to help.

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Gummy smile or uneven gum line

Do you feel your teeth look too short and your smile is too gummy or your gums cover too much of some teeth while leaving the others the right length? If so, dental crown lengthening might be the solution for you. During this procedure, excess gum tissue is removed to expose more of the crown of the tooth. Then your gumline is sculpted to give your new smile just the right look.

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Gummy smile treatment with aesthetic crown lengthening

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You may have asked your periodontist about procedures to improve a “gummy” smile because your teeth appear short. Your teeth may actually be the proper lengths, but they’re covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure. During the dental crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.

Gum Recession: long teeth/exposed roots

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option. 

What is gum recession?

Gum recession occurs when your tooth root becomes exposed – and may be a sign of gum disease, which destroys the structures that support your teeth.

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Why Gum Recession Matters?

The role of gum tissue is to cover and protect the tooth root and underlying jawbone. When gum tissue recedes, the bone and other tissues that support your tooth’s root are also lost.  The resulting root sensitivity may also make eating and drinking unpleasant or even painful. It’s important to identify and treat recession early. Left unchecked, recession could worsen to a point where the root becomes unprotected and teeth may loosen and fall out.

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Symptoms of gum recession can include:

  • Sensitive teeth
  • Tender gums
  • Longer tooth line
  • Exposed roots
  • Loose teeth

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When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices may be necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost. A mucogingival defect creates a portal for bacteria to cause a periodontal abscess which can cause bone and tooth loss. Exposed tooth roots are the result of gum recession. Gum graft surgery will repair the defect and help to prevent additional recession and bone loss. In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging. 

Functional Reasons for Connective Tissue Gum Graft:

  • Increase gingival attachment
  • Increase tooth support
  • Establish a gingival seal (close the portal for infection)
  • Reduce Sensitivity
  • Prevent tooth loss

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A gum graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a gum graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During gum graft surgery, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity. The gingival graft procedure is highly predictable and results in a stable, healthy band of attached tissue around the tooth.

Sometimes gum recession causes the tooth root to become exposed, which makes your teeth look long and can make you look older than you are. This recession can happen as a result of a variety of causes, including periodontal diseases. Gum graft surgery and other root coverage procedures such as Pinhole Surgical Technique are designed to cover exposed roots, to reduce further gum recession and to protect vulnerable roots from decay.

Indentations in the gums and jawbone

 Tooth loss can cause an indentation in the gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indention unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth. Ridge augmentation can fill in this defect recapturing the natural contour of the gums and jaw. A new tooth can then be created that is natural looking, easy to clean and beautiful.

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The amount of gums showing in a normal full smile is 1-2mm. A display of 4mm or more of gum exposure is considered unattractive. The incidence of gummy smile may approximate 14 percent in females and 7 percent in males. Hyperfunction of the lip elevator muscles often results in excessive gum display and is the primary factor when lip length is normal and the lower third of the face is proportional to the other thirds. A differential diagnosis of excessive gum display must include an examination for delayed eruption, orthodontic problems, and skeletal deformities. Some cases may require complex treatment involving crown lengthening, orthodontics, orthognathic surgery, lip positioning surgery and restorative dentistry.

Call us today to book your consultation appointment with our specialists!