Our Services & Procedures
Learn more about dental implants and periodontal procedures.
Dental Implants
What are dental implants?
Dental implants replace missing teeth and serve as an alternative to detachable partials, bridges and complete dentures. Implants are known for their longevity and are resistant to decay, providing comfort while maintaining bone height and the natural structure of your smile.
Reasons for dental implants:
- They restore a tooth/teeth while maintaining healthy neighboring teeth.
- They look and feel like genuine teeth.
- They are more sanitary (easier to clean) than a tooth-supported bridge since they do not decay (get cavities).
- They help patients regain their self-esteem and a confident grin.
- They enhance or restore speech, digestion, and chewing.
- They maintain the jawbone while restoring or enhancing face tissues.
- They provide stability and comfort for a bridge or denture by supporting them.
How do they work?
Dental implants are an artificial root system and serve as an anchor for a missing tooth/teeth and do not have to rely on neighboring teeth for support. Implants are placed into the jawbone to create a firm foundation. A custom-made crown is affixed on top of the implant to mimic the look and feel of your natural teeth.
How can implants preserve the natural look and feel of my smile?
Natural tooth roots are embedded in bone and function as bone support. When teeth are extracted (crown and root) the integrity of the bone collapses causing ridge atrophy and bone resorption, creating the shrinking appearance of facial tissue. Implants act as a stimuli for bone tissue and prevent further bone loss, returning foundational structure and reducing the appearance of a shrinking jawline.
Extractions
If a front tooth needs to be extracted, Augusta Periodontics and Implants work with your dentist to produce a replacement for you right away. The appliance will be positioned without interfering with your appearance. There is usually an adjustment time to the new appliance for patients who have never worn a detachable appliance.
Extractions with Immediate Implants
When teeth are extracted, single or multiple implants can be inserted, only if underlying tissue and bone is capable of sustaining implants. The socket is prepped and then the implant is positioned in the space where the natural tooth formerly stood.
Extraction with Ridge Preservation
Whether bone loss is caused from decay, an abscess, gum disease, or an injury, it is important to maintain the most of your underlying jawbone. After teeth are extracted, the surrounding bone starts to deteriorate significantly. Unpredictable shrinking occurs. Although this shrinking is a natural process, it can have a negative impact on the appearance of facial tissue and the structure of the jawbone. It can also make replacing teeth with dental implants more difficult or in some cases impossible.
To restore bone loss after a tooth is extracted, a bone graft can be inserted in the socket. At Augusta Periodontics & Implants we attempt to reduce bone loss with ridge preservation limiting the need for additional bone grafts.
Guided Implant Surgery
Guided dental implant surgery involves a comprehensive planning process and utilizes advanced technology to improve the precision and success of dental implant placement. The use of CBCT scans allows for a detailed three-dimensional view of the patient’s oral structures, which aids in creating a custom surgical guide.
The surgical guide plays a crucial role during the actual implant procedure. By following the guide’s instructions, the dental surgeon can accurately position the implants in the right location, depth, and angle. This precision reduces the risk of complications and helps ensure the long-term success of the dental implants.
Guided surgery has several advantages, including:
- Shortened healing time: By precisely placing the implants, there may be less trauma to the surrounding tissues, leading to a faster and smoother healing process.
- Lower risk of complications: The precise placement of implants reduces the risk of nerve damage, bone perforation, and other potential issues that can arise during traditional implant surgery.
- Predictable outcomes: With guided surgery, the dentist can plan and visualize the entire procedure beforehand, leading to more predictable and successful results.
Despite these benefits, guided implant surgery may have some downsides:
- Longer treatment time: The planning and fabrication of the surgical guide may add some time to the overall treatment process.
- Increased costs: The use of advanced technology and the creation of custom surgical guides can result in higher treatment costs compared to traditional implant placement methods.
However, many patients find the benefits of guided surgery, such as reduced risk and improved outcomes, to be well worth the extra time and cost. Each patient’s case is unique, and it’s essential to discuss the options and potential benefits with your periodontist to determine the best approach for your specific situation.
Sinus Elevation
Sinus Elevation
The upper back molar and premolar areas are historically the most challenging to successfully place dental implants. This is due to the less-dense quality of the bone and the proximity of the maxillary sinus, (an air-filled space within the upper jawbone).
The maxillary sinuses are spaces in the skull that are situated right above the top teeth, behind the cheekbones. The upper molar and premolar root tips are typically close to the floor, or base, of the maxillary sinus. In some cases, bone loss in this area creates issues with sustainable implant placement.
What is a Sinus Elevation Procedure?
A sinus lift is an operation that gives more height by lifting the skin-like tissue bordering the sinus floor to insert a bone graft beneath it. This is also known as a “sinus elevation” and can help treat the issue of having insufficient bone for the insertion of an implant. CBCT imaging is required before any sinus elevation procedure.
Crestal Sinus Elevation
Dr. Kondur conducts a procedure known as a crestal (or internal) sinus elevation when there is at least 5 mm of jawbone below the sinus cavity’s base. He preps the implant location to a shallower depth. Next, he uses a specialized drill attachment that can push up the skin-like sinus membrane. Once the sinus membrane has been made visible, the bone graft can be used to elevate it hydraulically. Once a sustainable bone height has been generated, the implant can be inserted simultaneously with the bone graft.
Lateral Sinus Elevation
A lateral wall sinus elevation is necessary when the bone needed for proper implant placement requires a few millimeters of bone height. After making an incision, a little circle is made into the lateral (or side) wall of the sinus’s bone. Dr. Kondur gently elevates the membrane from the boney sinus floor to provide space for a bone graft.
Once the bone graft material is positioned beneath the raised membrane, the incision is stitched up and recovery is permitted. Before implants may be implanted, the bone must be allowed to develop for six to nine months. Growth time is largely dependent on the amount of bone being regrown. Oftentimes an additional healing period is needed after implants are inserted. In some circumstances, the implant placement and sinus elevation can be done simultaneously.
Sinus lifts and elevation procedures are known to increase the effectiveness of implant placement. A majority of individuals only feel a little discomfort following this operation.
Ridge Augmentation
Some patients do not have enough bone in their jaw to support dental implants. The loss of bone during or after tooth extraction, periodontal disease, wearing dentures, birth deformities, accident, or trauma all contribute to bone loss in the jaw. These malformations might not only make it difficult to place dental implants, but they can also leave unsightly indentations in the jawline next to implant restorations. Cleaning and maintaining these indentations can be challenging.
Prior to the treatment, Dr. Kondur will go over all grafting options to ensure the patient is fully informed. Once the grafting option is selected the operation is planned.
During the operation, Dr. Kondur reveals the bone defect by pulling the gum away from the ridge. Next, he places a bone substitute to recreate and support the deformed ridge. The incision is closed and recovery is permitted after the transplant is confined and safe. Before implants are inserted, the bone is given four to six months to mature, depending on the case. In some circumstances, the implants can be inserted simultaneously with the ridge.
Procedures
Periodontal Disease
“Periodontal” translates to “around the tooth.” Periodontal tissues are defined as the gums covering the teeth and jawbone by supporting and keeping them firmly in place. The cementum, a thin layer of cells on the tooth roots, and the alveolar bone, a unique type of bone that maintains teeth, are additional tissues. Diseases that affect one or more of these periodontal tissues are referred to as periodontal diseases.
The dental specialty known as “periodontics” deals with the prevention, identification, and management of periodontal diseases. Specialists in the prevention, detection, and treatment of periodontal disease as well as the implantation of dental implants, have attended additional training or residency past the usual dental school requirements.
What exactly causes tooth loss or periodontal disease?
Bacterial plaque, a sticky, white film that continuously builds on your teeth, is the primary cause of periodontal illnesses. However, the following elements also have an impact on your periodontal health:
- tobacco use/smoking
- marijuana smoking
- ongoing drug use
- genetics
- women’s puberty, pregnancies, and menopause
- stress-related teeth grinding or clenching
- diabetes
- poor nutrition
Periodontal Procedures & Treatments
What is Periodontal Disease?
Though there are many different types of periodontal disorders, the most frequent is inflammation brought on by plaque, which can either be gingivitis or periodontitis. Both can impact a single tooth or several teeth.
In many cases the body attacks itself, destroying the bone and other supporting tissues around the teeth as inflammation reacts to present bacteria. At this stage, the illness has developed into periodontitis, a more severe and dangerous form of periodontal disease. Gum pockets, the areas between the teeth and gums, are created when gums become so inflamed they separate from the teeth. As the disease worsens, more bone and gum tissue is destroyed causing the pockets to get deeper. The progression of this disease is subtle, rarely showing signs of an existing problem. Teeth may eventually become loose and require extraction.
Over one-third of adults over the age of thirty have periodontal disease that has progressed past gingivitis. Yet, the majority of people are unaware they have periodontal disease since it progresses silently and painlessly.
Current research suggests periodontal diseases are linked to general health conditions like cardiovascular disease, stroke, diabetes, respiratory disease, and preterm low birth weight babies. According to the Centers for Disease Control and Prevention, there are several factors that increase the risk of periodontitis, one of the leading causes of adult tooth loss in the developed world.
- Smoking
- Diabetes
- Poor oral hygiene
- Stress
- Heredity
- Crooked teeth
- Underlying immune-deficiencies
- Fillings that have become defective
- Taking medications that cause dry mouth
- Bridges that no longer fit properly
- Female hormonal changes, such as with pregnancy or the use of oral contraceptives
It is possible to have periodontal disease and not exhibit any symptoms since symptoms may not appear until the illness has progressed. This is why routine periodontal and dental exams are essential. The following may be warning indicators when they are present:
- Gums that bleed after brushing or flossing
- Loss of bone or weakened periodontal fibers
- Increased spacing between teeth
- Persistent bad breath
- Pus on the gums and around the teeth pointing to infection
- Receding gums
- Gums that are red and swollen
- Plaque, calculus (tartar), and germs irritate the gums and teeth, causing tenderness or discomfort.
Periodontal Disease Treatment
Non-Surgical Periodontal Disease Treatment
Some individuals believe periodontal therapy at a periodontist’s office entails surgery. Periodontal disease actually responds very well to nonsurgical periodontal therapy in its early stages. Surgical intervention is only required when the disease is more advanced. Surgery is only used in cases where nonsurgical treatments have been ineffective when restoring periodontal health.
Dr. Kondur’s additional training and experience makes him qualified to conduct full assessments and create a strategy to effectively treat periodontal conditions. Our staff adheres to the American Academy of Periodontology’s recommendations – treatment by achieving periodontal health in the least intrusive and most affordable way possible.
Periodontal Disease Surgical Treatment
Patients can sometimes require surgical procedures to treat periodontal disease. Dr. Kondur is able to conduct a thorough assessment of these cases, discover the root of the problem and create a treatment plan with the appropriate measures to treat his patients. He is knowledgeable and experienced in sedation techniques to provide comfort while improving the structure and function of a patient’s smile.
Pocket Reduction
The term “pocket reduction surgery” (also known as “gingivectomy,” “osseous surgery,” and “flap surgery”) refers to a variety of procedures designed to get access to the tooth roots and remove tartar (calculus) and bacteria.
Plaque contains certain bacteria that set off an inflammatory reaction in the body and can eventually result in periodontal disease.Once bacteria enters the subgingival area (below the gum line), periodontal infections trigger a chronic inflammatory response in the body, essentially destroying bone and gum tissues. As more tissue is removed from the area around the teeth and gums, gum pockets develop and get deeper.
Periodontal disease is a degenerative disorder that, if untreated, results in significant bacterial colonization in the gum pockets and may ultimately result in tooth loss. In an effort to break this harmful cycle and lessen the depth of the pockets that contain bacteria, pocket reduction surgery is performed.
Periodontal Procedures & Treatments
Periodontal Surgery
Esthetic Crown Lengthening (Gum Lift)/Gingivectomy
You have probably encountered individuals with what appear to be small teeth or an unflattering “gummy” smile throughout the years. Many celebrities and personalities have had crown lengthening procedures to reduce this “gummy” look and enhance the esthetic look of their smile.
During the crown lengthening procedure, we display the enamel’s inherent form and beauty by moving the gum line and revealing the entire contour of the enamel. The fact that esthetic crown lengthening is typically performed in a single visit is one of its main benefits. In essence, extra gum tissue that covers your teeth is removed to reveal the healthy length of the tooth.
Esthetic crown lengthening improves:
- Teeth that no longer appear short or like “baby teeth”
- An appealing smile
- Enhanced confidence
- Healing period is less than other procedures
- Immediate and obvious outcomes
In addition to the cosmetic advantages of crown lengthening, fixing a “gummy” grin can enhance your general periodontal health. Gum pockets can occur when gum tissue does not naturally recede as adult teeth erupt, which can cause severe periodontal disease. Not only can this procedure enhance the appearance, but it can also boost confidence.
Functional Crown Lengthening
Functional crown lengthening is a dental procedure performed to expose more of a tooth’s structure above the gumline to improve its functionality. The treatment involves the removal of gum tissue and sometimes bone from around the tooth to lengthen the clinical crown (the visible portion of the tooth above the gumline). This allows the dentist to access and restore a tooth that was previously covered by excessive gum tissue or bone.
The procedure may be necessary for various reasons:
- Insufficient tooth structure for restoration: When a tooth has decay or damage near the gumline, there may not be enough sound tooth structure left to support a dental crown or filling. Crown lengthening can expose more of the tooth, providing enough space for the restoration.
- Fractured or broken tooth: If a tooth is fractured or broken below the gumline, crown lengthening may be necessary to expose enough of the tooth to restore it properly.
After functional crown lengthening, the tooth will be better prepared for restorative treatment, such as a dental crown or filling, and the patient can enjoy improved dental function and aesthetics. It’s essential to consult with a qualified dentist or periodontist to determine if functional crown lengthening is the right solution for your dental needs.
What is considered soft tissue?
A healthy mouth has mucosa and gingival tissue covering the teeth. Under a microscope, gingival (gum) tissue appears coral pink, thick, and dense. This tissue creates a tight seal around the teeth, acting as a barrier to prevent bacteria from accessing the supporting bone beneath. Additionally, gingiva aids in protecting soft tissue from the daily stress of eating and brushing. This tissue band is referred to as “attached” or “keratinized” tissue. Mucosa, the second kind of tissue, is situated immediately beneath the gingiva. Under a microscope, mucosal tissue is crimson, incredibly thin, and seems loose. Both its ability to endure stress and its ability to seal securely around the tooth are lacking. This area of tissue is known as the “alveolar mucosa” by dentists.
Gums may recede for a number of reasons, such as periodontal disease, incorrect tooth positioning, or vigorous brushing. When there is just a slight recession and some healthy gingiva still exists, no treatment is required as long as the patient is not having symptoms. In this situation, Augusta Periodontics and Implants will discuss changing a few care routines and ask the patient to come back after a year to assess the case for further recession.
When recession is more extensive, or there is loss of gum tissue, Dr. Kondur will work with you to determine what type of gum graft is best for your individual needs. Recession will expose the root surface, which is softer than enamel and susceptible to decay. As a result, extensive recession can cause root damage, root caries, increased sensitivity, or poor esthetics.
Free Gingival Graft vs Root Coverage Procedure
A free gingival graft and a root coverage procedure are both types of gum grafting techniques used in periodontal (gum) surgery, but they have different purposes and applications:
Free Gingival Graft:
A free gingival graft is a procedure used to increase the width and thickness of the attached gingiva, which is the gum tissue that tightly adheres to the underlying bone around a tooth. Some individuals may have inadequate attached gingiva, which can lead to gum recession and increased susceptibility to gum disease. Some individuals may already have recession and complete loss of gum tissue as a result.
During a free gingival graft, Dr. Kondur harvests a small piece of gum tissue (graft) from the roof of the mouth (palate) or a nearby donor site and then transplants it to the area of insufficient attached gingiva. The graft is sutured in place, and over time, it integrates with the existing gum tissue, creating a broader band of firmly attached gingiva.
The main goal of a free gingival graft is to prevent or halt existing gum recession, improve gum health, and enhance the stability of the gum tissue around the teeth. Dr. Kondur will use a free gingival graft when root coverage is not feasible or predictable.
Root Coverage Procedure:
A root coverage procedure, on the other hand, is performed to address gingival recession, where there is still gum tissue present. Gum recession can lead to tooth sensitivity, an unappealing smile, and potentially put the tooth’s root at risk of decay or abrasion.
Connective tissue grafts involve taking a small piece of connective tissue from beneath the surface of the palate and placing it over the exposed root to cover the recession. GTR procedures utilize barrier membranes to encourage the regeneration of gum tissue and bone. Augusta Periodontics and Implants can also use graft substitutes for root coverage in certain cases.
The primary aim of a root coverage procedure is to restore the gum tissue to its original position, covering the exposed root surface and improving both aesthetics and sensitivity.
In summary, while both free gingival graft and root coverage procedures involve gum grafting, they serve different purposes. Free gingival grafts aim to increase the width and thickness of attached gingiva to enhance gum health, while preventing further recession. Root coverage procedures address gingival recession to restore gum tissue over exposed tooth roots for both functional and cosmetic benefits.
Dr. Kondur will work with each patient to determine a customized treatment plan depending on their individual needs.
Perio Protect Trays
Why Perio Protect?
Perio Protect Trays are a type of dental appliance used in the treatment of periodontal disease. They are designed to deliver medication deep into the pockets of the gums, where bacteria and plaque can accumulate.
Reasons for Perio Trays:
- For Your Health
- Pathogens gain easy access to the bloodstream via the gums, leading to potential inflammation spreading throughout your body.
- For Your Comfort
- Perio Trays from Perio Protect are non-invasive. And although they are prescribed by dentists, they are applied by patients—at home, for only minutes a day.
- For Your Hygiene:
- Side effects include fresher breath and whiter teeth.
Here’s how Perio Protect trays work and how they are used:
- Custom-Made Trays: Perio Protect trays are custom-made for each patient. Augusta Periodontics and Implants will take impressions of your teeth and gums to create trays that fit your mouth precisely. These trays are usually made of a flexible, clear material.
- Medication Application: The key feature of Perio Protect trays is that they have a special reservoir or “pocket” built into them. This reservoir holds a prescribed antimicrobial solution, often a hydrogen peroxide-based gel. This gel is placed in the reservoir before inserting the trays.
- Treatment Process: Once the trays are filled with the antimicrobial gel, you’ll be instructed by your periodontist on how to insert the trays over your teeth. The trays create a seal that holds the gel in place, allowing it to be delivered directly into the gum pockets.
- Wearing Time: The trays are typically worn for a specified amount of time each day, as directed by your periodontist. This allows the medication to penetrate deep into the gum pockets, where it can help control bacterial growth and reduce inflammation.
- Home Care: Alongside using the Perio Protect trays, your dentist will also advise you on maintaining good oral hygiene practices, such as regular brushing, flossing, and professional cleanings. The trays are often used as part of a comprehensive periodontal treatment plan that may also include scaling and root planing (deep cleaning), surgical procedures, and other interventions as needed.
- Follow-Up: Regular follow-up appointments with your periodontist will be scheduled to monitor your progress and adjust the treatment plan as necessary.
The goal of using Perio Protect trays is to improve the effectiveness of gum disease treatment by delivering medication directly to the source of the infection. By targeting the bacteria within the gum pockets, these trays can aid in reducing inflammation, preventing further damage to the gums and supporting structures, and promoting better overall oral health.
If you’re considering using Perio Protect trays as part of your periodontal treatment, it’s important to consult with your periodontist to determine if this approach is appropriate for your specific case and needs.
Other Periodontal Services
Frenectomy
A frenum is a flap of muscle or tissue that attaches the tongue, cheeks, and lips to the jawbone. The midline between the top and bottom front teeth, as well as the area linking the tongue to the lower jawbone, are where frenums are most frequently found. The excision of one of these tissue folds is known as a frenectomy.
When a frenum is excessively closely affixed to the teeth, the gums may recede or develop voids in between the teeth. During a frenectomy, the tissue connection between the teeth is removed. Studies have indicated that without a frenectomy surgery, there is a 70% chance of the spacing reopening once the braces are taken off in cases when the two front teeth are spaced apart prior to orthodontic closure. The frenectomy operation is typically finished right after the orthodontic therapy is over.
Biopsy
An oral soft tissue biopsy is a procedure in which a sample of soft tissue from the mouth is taken and examined under a microscope to diagnose various oral conditions, such as lesions, ulcers, growths, or suspicious areas. The purpose of the biopsy is to determine the nature of the tissue, whether it’s benign (non-cancerous) or malignant (cancerous), and to aid in developing an appropriate treatment plan.
The tissue sample is sent to a laboratory, where it is examined under a microscope by a pathologist. The pathologist will analyze the tissue’s cellular and structural characteristics to determine whether it is benign, precancerous, or malignant.
Once the pathology report is available, Dr. Kondur will discuss the results with you. Depending on the diagnosis, further treatment recommendations will be made. This could include additional testing, monitoring, surgical removal, or other appropriate interventions.
It’s important to note that a soft tissue biopsy is a standard and safe procedure. If you have any concerns about an oral lesion or abnormality, it’s recommended to consult your dentist or periodontist for proper evaluation and guidance.
Oral Sedations
Many people suffer from dental visit anxiety, but at Augusta Periodontics and Implants we can help even the most fearful patients overcome their anxiety with sedation.
Several different types of sedation are available. Utilizing sedation allows patients and our staff to work together to complete needed procedures.
- Nitrous Oxide Sedation (Laughing Gas)
Nitrous oxide, known as “laughing gas” is a gas mixed with Oxygen that is inhaled through a small nose piece. One advantage of using Nitrous Oxide is that you do not need to have a driver or escort for the procedure.
- Oral Sedation (Pill)
If oral sedation is chosen, a sedative pill will be taken prior to your procedure. You will need to have an escort or driver to and from your procedure with this sedation option.
Platelet Rich Fibrin
Augusta Periodontics and Implants makes the use of Platelet-Rich Fibrin (PRF) technology in office. Platelet-rich fibrin (PRF) is a concentrate of platelets and growth factors derived from a patient’s own blood. It is a form of autologous platelet therapy and is used in various medical and dental applications to promote tissue healing and regeneration.
The process of obtaining PRF involves the following steps:
- Blood collection: A small amount of the patient’s blood is drawn, typically from the arm, using a syringe or specialized blood collection tubes.
- Centrifugation: The blood sample is then centrifuged at a specific speed and duration. This process separates the blood into its components based on density, with the red blood cells at the bottom, a PRF clot in the middle, and platelet-poor plasma at the top.
- Harvesting PRF: The PRF clot, which is rich in platelets, fibrin, and various growth factors, is collected from the middle layer and processed further.
PRF contains a high concentration of platelets, which are cell fragments responsible for blood clotting and releasing growth factors. Growth factors are essential proteins that play a crucial role in the healing process and tissue regeneration.
PRF has various applications in dentistry, including:
- Dental Implantology: PRF is often used in oral surgery, particularly in dental implant procedures, to enhance bone and soft tissue healing around the implant site.
- Periodontal Surgery: PRF can be utilized in periodontal surgeries to promote tissue regeneration and accelerate wound healing in cases of gum disease or gum tissue grafts.
- Socket Preservation: After a tooth extraction, PRF can be placed in the socket to promote faster healing and preserve the bone structure, which is beneficial if a dental implant is planned for the future.
- Guided Tissue Regeneration: PRF can be combined with barrier membranes to aid in guided tissue regeneration, a technique used to promote the growth of specific tissues and prevent unwanted tissue invasion.
By incorporating PRF technology into their practice, Augusta Periodontics and Implants may provide their patients with improved treatment outcomes, reduced healing time, and a lower risk of complications. Additionally, the use of autologous PRF can minimize the risk of adverse reactions or rejection, as it is obtained from the patient’s own blood.
If you are a patient at Augusta Periodontics and Implants, it’s essential to follow your dentist’s or periodontist’s recommendations regarding PRF treatment and its potential benefits for your specific dental condition. Always feel free to discuss any concerns or questions you may have with your periodontist.