Surgical Procedures

Dental Implants | Bone Grafting | Cosmetic Periodontal Surgery | Crown Lengthening | Osseous Surgery | Post-Operative/Emergency Care | Conscious Sedation

Dental Implants

When patients lose a tooth or teeth due to trauma or periodontal disease, dental implants are an ideal option for patients with good general oral health. Implants look and feel like your own teeth and can last a lifetime if given the proper placement and maintenance.

Why are Implants Better than Dentures and Bridges?
There are other routes a patient can take to replace missing teeth, including dentures and bridges; however, dental implants are a much better solution for many reasons.

  • Adjacent teeth do not have to be altered to support an implant, such as with bridgework. This is significant for your overall oral health by leaving more of your own teeth untouched. With a tooth-supported fixed bridge, the adjacent teeth are ground down to support the fixed bridge.
  • Dental implants are integrated into the structure of your bone, preventing gum recession and possible bone loss that can sometimes be attributed to bridgework and dentures.
  • Dental implants function just as your natural teeth do, offering you more comfort and stability than conventional dentures.

Placement of Dental Implants
Dental implants aid in replacing a single tooth, several teeth or even all of your teeth. The implant itself looks like a screw or cylinder and is placed into the jaw. Over the period of 2-6 months, the implant and jawbone bond together to provide an anchor for the crown. An abutment is used as an extension to complete the foundation for the new tooth to be attached.

Sometimes several teeth need to be replaced, and implant-supported bridges are a prime option as opposed to fixed bridges or removable partial dentures. The bone is better preserved with implant-supported bridges as it replaces some of your tooth roots that had deteriorated.

Replacing all of your teeth is also possible with implant-supported full bridges or implant-supported dentures. Patients are able to preserve their natural bite with implants and achieve more comfort and stability than with conventional dentures.

Post Implant Care
Although proper oral hygiene is always recommended for maintaining good dental health, it is especially important when a patient has received a dental implant. Bacteria can attack sensitive areas in the mouth when teeth and gums are not properly cleaned, thus causing gums to swell and jaw bones to gradually recede. Recession of the jawbone will weaken implants and eventually make it necessary for the implant to be removed. Patients are advised to visit their dentists at least twice a year to ensure the health of their teeth and implants. Dental implants can last for decades when given proper care.

Bone Grafting

A bone graft may be needed in areas where bone is missing. A surgical procedure, bone grafting replaces missing bone and aids in the re-growth of new bone by placing material from the patient’s own body or an artificial, synthetic or natural substitute into the area where bone existed. The new bone growth strengthens the grafted area by forming a bridge between the existing bone and the graft material. Over time, new bone growth will replace much of the grafted material.

For periodontal needs, bone grafts are most commonly used to restore or regenerate bone as needed prior to the placement of bridges or implants.

Cosmetic Periodontal Surgery

If you’re not happy with the appearance of your smile, your periodontist can suggest a number of options to correct the aesthetics of your teeth and gums. Cosmetic surgery has become more popular than ever before, and now periodontal cosmetic surgery has also jumped on this upward trend.

Are you unhappy with your smile? Many procedures now exist that can give you the smile you’ve always dreamed about. For patients with teeth that look too short or have the “gummy smile,” crown lengthening might be your solution. Excess gum tissue is removed, exposing more of the tooth. The gum line is then evenly sculpted to develop your new, broad smile.

Another problem patients want to repair is gum recession, which causes the tooth root to be exposed. Periodontal disease is one cause for receding gums, which make your teeth look long. Left untreated, your exposed roots are prone to bacteria and at risk for developing cavities. Root coverage procedures, including soft tissue grafts, are performed to cover the exposed tooth roots to protect them from decay and further recession.

Other popular cosmetic procedures include implants to restore missing teeth and ridge augmentation to repair indentations in the jawbone and gums.

Ask your periodontist today about the different cosmetic procedures that we can offer you.

Crown Lengthening

As one of many specialty periodontal procedures performed by our office, crown lengthening is a long-lasting restorative process utilized to help patients regain a beautiful smile and allow them to eat and speak with comfort and confidence.

Crown lengthening is a simple surgical procedure where the position of the gum around a tooth is adjusted to expose more of the tooth structure. If a tooth is decayed, broken below the gum line or has insufficient crown height, there might not be enough tooth structure available to accommodate restoration procedures, such as a crown or bridge. In these instances, crown lengthening surgery may be necessary in order to provide more tooth structure for your periodontist to work with.

For the patient’s comfort, a local anesthetic is used to numb the surgical area. Typically, little to no discomfort is felt as your periodontist reshapes the gum and bone tissue to expose more structure of the damaged tooth. Following the surgery, the treated area may be a little tender, sore or swollen; painkillers and antibiotics may be prescribed to help relieve discomfort and prevent infection from occurring.

In most cases, recovery time after crown lengthening surgery is minimal, and patients can resume their normal routines the day after surgery.

Osseous Surgery

Periodontal disease destroys supporting tissue and bone around the teeth, forming deep pockets for bacteria to potentially live in. As bacteria develops around the teeth, they can accumulate and advance under the gum tissue. Once under the gum tissue, these bacteria can further bone and tissue loss. If too much bone is lost, teeth may need to be extracted.

Used to treat moderate to severe periodontal disease, osseous surgery is an effective procedure to reduce pockets and control infection. During osseous surgery, the gum tissue is folded back and the disease-causing bacteria is removed before the gum tissue is put back into place. In addition to bacteria removal, damaged bone may be smoothed to limit areas where bacteria can hide – allowing gum tissue to better reattach to healthy bone.

Osseous surgery is typically performed in the office under a local anesthetic. In most cases, patients are able to return to normal activity the following day.

Post-Operative Emergency Care

  • Bleeding: Blood tinged saliva is normal for several hours after a procedure. However, if significant bleeding resumes later in the day, contact Dr. Varlamos as soon as possible. Pressure with a small piece of gauze will usually be all that is required to stop any post-operative bleeding that occurs.

  • Discomfort: Take pain medication exactly as instructed. It is usually wise to try to take the first dose before your local anesthetic has completely worn off, if possible. Sometimes narcotics are prescribed to treat post-surgical discomfort. If this is the case, avoid alcohol consumption, driving a car or operating any sort of potentially dangerous machinery while under the influence of these drugs.

  • Swelling: Expect some swelling (or bruising) in the surgical area and possibly also around lips and cheeks for 2 to 3 days. This can be minimized by using ice for the first post-surgical day. Use a few ice-cubes in a plastic bag against your face about 15 minutes on then 15 minutes off. The teeth involved may seem more mobile (loose) than before the treatment; they should gradually become less mobile as the site heals.

  • Nutrition: you may generally eat as you ordinarily would. Try to chew in an area other than the surgical site, if possible, and avoid coarse foods (pretzels, chips, seeded fruits, popcorn, etc.). Also, the roots of your teeth may be extra sensitive to extreme hot or cold after treatment.

  • Oral Hygiene: You may clean your teeth as you normally do in all areas, except the surgical site. Use the Perioguard/Peridex rinse (if prescribed), as directed, twice daily beginning on the morning after your surgical appointment unless otherwise directed.

  • Stitches: Stitches (sutures) will generally be used to close your surgical site. These will be removed in about one week at the office. Stitches occasionally become loose before your post-operative appointment. If this occurs and they become bothersome, please contact the office. Remember, that certain stitches dissolve on their own.

  • Periodontal Dressing: A periodontal dressing (Perio-pack) may be placed in some cases. Attempt to keep this in place as long as possible. These frequently come out during eating (and sometimes while talking or even sleeping). If swallowed, all ingredients are harmless. If the area is still very sensitive or the dressing is present but loose, please call the office.

  • Infection: Since bacteria cause periodontal disease, rarely, a post-operative infection can occur. The signs of this may include pain getting worse a few days after the surgery, pus drainage at the surgical site, swelling returning or getting worse a few days after surgery or a temperature you cannot explain due to another illness (cold, flu, etc.). If any of these occur, contact the office as soon as possible.

If you think you have an emergency, please contact us immediately at the office (914-315-6510) or page Dr. Varlamos at (914-891-0504)

Conscious Sedation

Our office provides nitrous oxide alone or in combination with an oral sedative medication before your visit. With nitrous oxide administration, a sweet smelling gas is applied via a nozzle, on your nose, which allows you to breathe the sedative. During nitrous administration you are still aware of your surroundings, but you don’t care about what is being done. You do not need the assistance of a driver unless you have been given a sedative with the Nitrous Oxide. 
Please be aware that you should not eat or drink anything a minimum of 4 hours before sedation procedures. If you think you would like to be sedated for any periodontal procedures, please inform one of our staff and we will gladly schedule it into your visit.