Often certain periodontal procedures are necessary either before, during or after restorative or orthodontic treatment. Dr. Lear works closely with your dentist or your orthodontist to ensure a healthy, beautiful smile.

Dental Crown Lengthening

When a tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge, more of the tooth must be exposed before it can be restored. A dental crown lengthening procedure will provide more tooth structure to make a restorative or cosmetic dental procedure possible.

In this procedure, Dr. Lear adjusts the gum and bone level to expose more of your natural tooth. This allows your dentist the ability to access tooth that was previously under the gum, and have the needed space to ensure that the restoration or crown procedure is successful and prevents gum irritation.

Exposure of Impacted Canine Teeth

An impacted tooth simply means that it is “stuck” and cannot erupt into function. The upper canine is the second most common tooth to become impacted. The canine tooth is a critical tooth in the dental arch and plays an important role in your “bite”. The remaining impacted teeth are found in the middle of supporting bone but stuck in an elevated position above the roots of the adjacent teeth or out to the facial side of the dental arch. Early recognition of an impacted canine is the key to successful treatment.

Your orthodontist and Dr. Lear work together to get these unerupted canines to erupt. The most common scenario will call for the orthodontist to place braces on the teeth (at least the upper arch). A space will be opened to provide room for the impacted tooth to be moved into its proper position in the dental arch. If the baby canine has not fallen out already, it is usually left in place until the space for the adult canine is ready. Once the space is ready, your orthodontist will refer the patient to Dr. Lear to have the impacted canine exposed and bracketed.

Once the tooth is moved into the arch in its final position, the gum around it will be evaluated to make sure it is sufficiently strong and healthy.  In some circumstances, especially those where the tooth had to be moved a long distance, there may be some minor “gum surgery” required to add bulk to the gum tissue over the relocated tooth so it remains healthy during normal function.

Pre-Orthodontic Periodontal Augmentation (POPA)

With Pre-Orthodontic Periodontal Augmentation (POPA), most patients can enjoy a newly straightened smile within 3 to 8 months compared to conventional orthodontic treatment which typically takes between 18 to 24 months. This accelerated orthodontic option is particularly attractive for adult orthodontic patients who do not want to spend upward of 2 years in braces. Pre-Orthodontic Periodontal Augmentation (POPA) is considered a “fast track” method for repositioning the teeth because the technique effectively alters the structure of the surrounding bone facilitating faster tooth movement.

Your orthodontist and Dr. Lear will work together to successfully complete your treatment. Specifically-designed Pre-Orthodontic Periodontal Augmentation (POPA) appliances will be placed on the teeth by your orthodontist, and then you will visit Dr. Lear for a preliminary periodontal surgery to prepare the jawbone for the desired tooth movement. Some alveolar bone material is removed, allowing the teeth to be repositioned quickly as the bone remineralizes. This step prepares the jawbone for the tooth movement, followed by the demineralization of the surrounding bone. If gingival recession is present, gum grafting will also be performed. Following the surgery, you will need to allow approximately 7-10 days for recovery and then continue to visit your orthodontist for regularly scheduled evaluations and adjustments every other week. Pre-Orthodontic Periodontal Augmentation enhances the long term stability of orthodontic treatment.

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