GINGIVECTOMY VS GINGIVOPLASTY

What is a gingivectomy?

Gingivectomy is a procedure that includes removing the diseased gingival tissue, mostly in the treatment of gum disease. In many cases root planing, scaling and antibiotics are not effective enough. In those cases, gingivectomy might be the right solution. If all of the non-surgical procedures haven’t helped the course of the gum disease, this surgical procedure is the next step. It is usually done by a periodontist or an oral surgeon. It is a very common procedure and it usually provides very good results.

What is the purpose of gingivectomy?

The main reason why this procedure is done is to remove the inflamed gum tissue that is forming the periodontal pockets. This diseased tissue is a very important factor in the treatment of the periodontal disease. Once the tissue is removed, the dentist will be able to completely gain access and visibility to the roots that are affected with the condition and properly remove all of the bacteria. This way, the depth of the periodontal pockets will be reduced and the gum disease will be under control.

Gum disease is, in fact, a progressive condition that is caused by bacteria. If the disease is not treated in time it might lead to loss of the teeth. The pathogen bacteria that cause this condition tend to cause inflammation of the gum tissue and bone tissue, which results with deep periodontal pockets. Very often the conservative, non-surgical measures do not completely remove the bacteria, calculus and inflamed tissue. That is why the disease keeps on progressing.

How is the procedure performed?

There are several ways to perform gingivectomy. It can be a simple surgical one, electrosurgical, chemosurgical, or the latest advancement in dentistry- laser gingivectomy.

The procedure starts with conventional root planing and scaling to remove as much bacteria and diseased tissue as possible. After that, a local anesthetic is used to numb the gums. There are dentists that only practice the surgical gingivectomy and they use a surgical scalpel to remove the gum tissue. If the procedure is performed with a laser, it is faster, there is less bleeding and the tissue heals much faster. Other advantages of the laser are that it provides a good antibacterial effect, the patient doesn’t feel any pain, and there are fewer complications. After the gingivectomy, the gums have to be protected with a surgical dressing, that protects them and helps the healing. The periodontal dressing stays for 7 to 10 days. During the recovery, patients need to provide good oral hygiene and wash their mouth with antibacterial mouthwash. Patients are mostly allowed to eat soft food.

What is a gingivoplasty?

Gingivoplasty is also a surgical procedure, very similar to gingivectomy. The difference between the two is mostly in the objective. Gingivoplasty is in most cases a cosmetic procedure, that is done to improve the look of a person’s gums. This procedure also can be done right after gingivectomy for the same purpose. There are people that are just not happy with how their gums look, so they decide to have them reshaped. Some of them have sufficient gum tissue that has to be removed, while others don’t have enough. For the second type, dentists use a special gum graft. Different gingival deformities are another reason to undergo this procedure.

What is the purpose of gingivoplasty?

The main purpose is that the patient gets a whole new, natural appearance of his gums and smile. If there is an excessive growth of gingival tissue that can cause many problems. First of all, those people have a hard time properly cleaning these areas, and there are higher chances of plaque buildup. In other words, this condition can lead to periodontal pockets and periodontal disease. Also, these patients have a hard time accepting their appearance, which is usually the main reason why they choose gingivoplasty. Other reasons include genetic gingival defects and malformations, crown lengthening, trauma and more.

How is the procedure performed?

The procedure is almost exactly the same as the gingivectomy, only the objective is different. The patient gets numbed, in order to avoid pain. Gingivoplasty can be done by a surgical scalpel, electrosurgery or laser. The procedure can last from minutes up to an hour depending on the number of teeth and the complexity of the case. After the procedure, the wounds are protected with a periodontal dressing that stays in the mouth up to 10 days. Just like with the gingivectomy, the patient has to provide a good oral hygiene and wash the mouth with antibacterial mouthwash. The dentist will give you advice on what you are allowed to do, and how to do it. They will also schedule regular checkups to control the progress after the procedure.

ALL ON 4 IMPLANTS – NO MORE LOOSE DENTURES

Attempts at coming up with a method to achieve successful dental implants have been around for a very long time. In fact, since the 1700s scientists and dentists have been hard at work trying to find a successful method of implanting a false tooth into a human jaw to replace a missing tooth. These include the earliest (unsuccessful) attempts of taking a dead person’s tooth and sticking it in the extraction socket of a living person; to years of trial and error using different tooth root shaped designs of different metals and ceramics and finally to today’s highly technical modern dental implants with 92%-99% success rates.

One innovation directly related to these implant advances was discovered through research and named “All on 4”. This technique is a real breakthrough for patients who wear full dentures. This unique means of utilizing implants eliminates the problems inherent in patients having to wear removable full or “complete” dentures. Some of these inherent problems include:

  • Loose or ill-fitting dentures
  • Having to use increasing amounts of denture adhesive to stabilize dentures
  • Avoiding foods that are very difficult or impossible to eat
  • Having to remove dentures at night.
  • Needing to have them replaced every three to six years
  • Having long-term wearing of dentures cause gradual bone loss of the supporting ridges
  • Breakage
  • Negative psychological factors involved in wearing removable “false teeth”.

“All on 4”

“All on 4” is a very apt description of the procedure. It means attaching a complete (ALL) set of non-removable artificial teeth to four (4) dental implants; “All on 4”.

Dental Procedure

The procedure is straight forward and patients can have a temporary (provisional) set of teeth placed immediately (24-48hrs) after the surgery.

  1. Each patient will have a complete oral examination and consultation.
  2. Special x-rays are taken to evaluate the amount and condition of the bone for implant treatment planning.
  3. A temporary non-removable set of replacement teeth similar in form and function to the final permanent restoration will be fabricated by a dental laboratory before the implant surgery. If the patient has an acceptable set of dentures, they may be used instead as the temporary denture.
  4. An antibiotic treatment is ordinarily started 2 days before surgery and continued for ten days after.
  5. Most patients are given intravenous conscious sedation and/or nitrous oxide and local anesthetic for the duration of the surgery. Some patients may require general anesthetic.
  6. The bone is exposed and inspected to make sure it is suitable for the implants and if there are any teeth needing removal, they will be extracted.
  7. The 4 implants are placed in each arch; two near the front of the arch and two in the back part of the arch. The two in the back are tilted which is the main feature that allows only 4 implants to support a full set of artificial teeth.
  8. The gum tissue is sutured back around the implants.
  9. The temporary denture is adjusted and attached to the 4 implants.
  10. Follow up visits are scheduled at 1 week, 2 weeks, 3 weeks and 3 months.
  11. At the 3-month appointment, the implants will be inspected and if indicated by complete and correct healing, the temporary denture will be removed and the permanent replacement attached to the implants.
  12. Follow up implant maintenance appointments are scheduled.

In some rare cases at the time of surgery unexpected, unfavorable conditions may be discovered that may require placing standard implants, delaying the placement of a temporary denture that is attached immediately to the implants.

Standard Implants

Standard implants have many things in common with the implants used in the All on 4 procedure. The basic surgery is similar as are the shape, material, etc., of the implants.

The primary difference is that standard implants are placed into the jaw, and are covered back up completely by the gum tissue and allowed to heal for 3 months and the temporary replacement is not attached to the implants.

During this healing time, a temporary removable denture will have been fabricated for patient use, or the patient’s existing denture will be adjusted and refitted to serve as a temporary replacement. So, until the standard implants have healed enough for the attachment of the permanent set of teeth, the patient will be wearing a conventional type denture.

Immediate Versus Delayed Loading

The All on 4 procedure uses a concept known as immediate loading. Immediate loading means that the patient receives a functioning temporary dental restoration that is placed at the same time as the implant surgery. In the case of the All on 4 full mouth procedure, the patient can eat, and function with a full set of temporary teeth which immediately places a force or load on the implants, hence immediate load.

Advantages of Immediate loading include:

  • Improves bone healing over traditional implant procedures (osteointegration).
  • No need for a removable temporary replacement and its attending maintenance.
  • Eliminates standard implant exposures from the wearing away from the pressure of a removable temporary appliance (partial denture, denture).
  • Gingival (gum) tissue shaping is facilitated.
  • Can’t be used on every patient.
  • Shortened treatment time.
  • Only one surgical procedure.

Torqueing

Dental implants need to be screwed into the channel made in the bone. The amount of pressure applied to the implant is called torque. As an example, if you have a flat tire and neglect to tighten the lug nuts enough the wheel may become loose and fall off. On the other hand, if you overly tighten the lug nuts, you may not be able to loosen them to take the wheel off.

Dental implants are similar in some ways to the lug nuts of a car. With implants, if you do not tighten the implant with enough torque, the implant has a greater chance of failure. Conversely, overtightening the implant also carries a risk of greater failure. To lessen this chance, dentists use a torque wrench or hand piece to precisely measure the correct torque which usually has a range of 30 ncm to 60 ncm. There are some disagreements among dentists concerning the range of torque.

Delayed loading is defined as it sounds once the definition of immediate loading is understood. For various reasons, some implants cannot withstand any force being placed on them immediately until they have healed and are stable. In these instances, other temporary replacements are used that do not put any stress on the implants. In these cases, putting any pressure or a load on the implants is put off or delayed, until complete healing of the implants, hence delayed load.

At Tooth and Go dental clinic we have the latest training, equipment and modern facilities to provide our patients with quality and affordable All on 4 procedures. We also provide standard implants. See what our implant plans can offer you at Tooth and Go.

DENTAL IMPLANT HOME CARE – PROTECTING YOUR INVESTMENT

You may have struggled with gum disease, dental decay or an accident that resulted in loss of some or all your teeth. You researched your dental treatment options and with the help of your dentist you decided dental implants were the best choice for you. You invested a considerable amount of money, time, and effort in them.

In this article, we are going to advise you on how to protect your dental implant investment through the very latest dental implant home care methods. We’ll also let you know how your dentist and dental hygienist will partner with you to assure that you will have the best implant experience possible, for a lifetime of satisfaction and healthy smiles.

It might not surprise you that one of the biggest reasons dental implants fail is because of poor dental implant home hygiene. Old habits are hard to break sometimes.

If you get nothing else out of this article, remember that it is up to you to take care of your implants. If you originally lost your teeth through decay or gum (periodontal) disease because of poor oral hygiene, it is imperative that you develop new habits. Your dental team can help and advise you, but once the implants have stabilized, impeccable home oral hygiene practices are essential.

There are two pitfalls that patients should be aware of when first beginning to take care of their implants.

  1. Being too timid with oral hygiene practices. Some patients may be afraid that they may damage the implants and gum tissue. This results in inadequate brushing and flossing. Failing to remove plaque and dental debris from around the implants can cause an infection around the implant (peri-implantitis).
  2. Being overzealous with oral hygiene practices. Some patients may go the other way and over-brush and over-floss their implants along with using other oral hygiene aids that may not be appropriate. In this case, damage might occur from possible scratching of the implant surface and irritation of the gum tissue surrounding the implant(s).

Your dentist or dental hygienist will help instruct you during one of your initial visits on the proper pressure, methods and dental cleaning aids you will need to properly remove plaque and debris from your implants. They will also advise you on specific dental hygiene practices if you have:

  • Natural teeth with implants
  • Overdentures/partial dentures with implants
  • Overdentures/partial dentures with implants

Home Care Hygiene Specifics

  • Toothbrushing: Implants need to be brushed twice a day using either a soft toothbrush or a very gentle electric toothbrush. Smaller end tufted toothbrushes can be used in harder to reach areas. Some electric toothbrushes may be too harsh for implants, so ask the advice of your dentist.
  • Flossing: There are various types of floss. Your dentist or hygienist can advise you of the appropriate type to use in your case.
    • Plastic
    • Braided
    • Satin
    • Woven
    • Yarns
    • Tapes

Ask your dental hygienist about ‘floss threaders” and the “shoe shine” method of flossing as well as the regular method of utilizing dental floss.

  • Interdental Cleaners/Aids: These oral hygiene devices are used in between teeth (interproximal) where tooth brushing and flossing do not effectively remove dental plaque and food debris. They include:
    • Foam/rubber tips
    • Disposable wooden picks
    • Interproximal brushes with plastic wires
  • Water Irrigators: Water irrigators can be very effective in home care for dental implants. Direction of the jet stream of the irrigator is important and your dental team can instruct you in the proper use of your irrigator.
  • Dentures: Patients who have overdentures/partial dentures should give their dental appliances the same high degree of hygiene they give to their implants. Dentures should be soaked in a recommended cleaner, brushing the denture thoroughly and inspecting the retention rings and/or retention clip.

Your dentist may recommend that you use a chemical rinse such as chlorhexidine. These rinses help keep oral bacteria rates low and many of the dental hygiene aids such as an interproximal brush can be used to deliver chemical rinses into and around the implant to further reduce harmful bacteria.

Working with Your Dental Team

Impeccable home care is essential, but even with the best home care, your dentist and dental hygienist are indispensable in the long-term success and protection of your investment. It is important that you schedule maintenance visits at least twice a year. At that visit you will receive:

  1. A cleaning (prophylaxis) of your implants by your hygienist or dentist to remove hard deposits (calculus). Special cleaning instruments are used that will not scratch the implants.
  2. A check of how your implants are fitting together (occlusion).
  3. A check to make sure your implants are secure in the bone and not movable.
  4. X-rays to check the bone surrounding the implants.
  5. Helping you with any difficulties you may be having with your dental implant home care.

When it comes to investments. We all want to assure that we receive the very best return. Tooth and Go dental clinic has been awarded “The best dental clinic in the Philippines” by the Global Clinic Rating service. (2016).

“At Tooth and Go dental clinic, we are confident that using cutting edge technology allows us to provide our patients with the best possible treatment they deserve.”

We understand the amount of time, money and effort you put into maintaining your oral health.

Besides offering dental hygiene services and information to protect your dental investments, we also offer quality and affordable implants along with general and cosmetic dentistry.

ARE YOU A GOOD CANDIDATE FOR DENTAL IMPLANTS

Dental implants replace natural teeth for patients who have suffered tooth loss due to various causes (gum diseases, accidents). Normally, anyone who is healthy enough to go through tooth extraction and surgery is a good candidate for dental implants. However, people suffering from diabetes, cancer or heart diseases should be carefully evaluated before undergoing such a treatment. Also gum diseases should be treated properly (a periodontal treatment is recommended) before starting any dental implant procedure.

Prior to dental treatment, it is important to inform your dental surgeon about your medical status, as well as all medications you are taking. If you consider dental implants, note that you should have healthy gums and enough bone to hold the implant. You should also maintain a good oral hygiene and pay regular visits to the dentist.

Success rates of dental implants vary, usually, dental implants have a success rate of up to 98%.

ADVANTAGES AND RISKS OF DENTAL IMPLANTS

Dental implants have many advantages:

  • Permanent implants contribute greatly to the improvement of patients’ appearance, who will have natural looking, healthy teeth for many years.
  • The improvement of the appearance will have a great impact on the patient’s self-esteem.
  • Dental implants contribute to easier eating – patients no longer experience difficulties and pain when chewing their favorite foods.
  • With proper care, good quality implants can even last for a lifetime.
  • Individual implants allow easier access between teeth, improving oral hygiene.

RISKS RELATED TO DENTAL IMPLANTS

Dental patients who just got dental implants should look after them just as they look after their natural teeth: brushing, flossing, rinsing with antibacterial mouthwash are a must. In rare cases, patients can experience complications after implants:

  • Infection of the area around the implant
  • Injury or damage to other surrounding teeth or blood vessels.
  • Pain, numbness or tingling in natural teeth, gums, lips or chin due to nerve damage

WHY CHOOSE THE PHILIPPINES AS A DENTAL TOURISM DESTINATION

If you are looking for a good clinic where you can have affordable dental implants, a quality Philippines dental clinic might be the answer. Getting a dental implant in Manila is a very good idea, if we consider a few aspects:

  • Philippines dentists are very good specialists, trained in some of the best European medical schools
  • The prices of the best dental implants in the Philippines are far better than the prices for the same procedures in the US, Western Europe, UAE or Australia.

COST OF DENTAL IMPLANTS IN THE PHILIPPINES

The dental implants costs in the Philippines range between $1,000 – $15,000 (P43,000 – P645,000 in Philippine Pesos) whereas in western European countries, US or Australia the prices can be much higher. The average completed dental implant in the U.S. costs about $4250 and in Australia the implant post costs between $1000 to $3000 and the abutment and crown cost between $500 to $3000.

If we make a simple calculation and consider the numerous advantages offered by a dental implant in Manila, the choice is easy. Contact our clinic for a detailed consultation and a careful treatment planning. Our dentists will offer you a big, beautiful smile that will improve your self-esteem.

THE ALL ON 4 DENTAL IMPLANT TECHNIQUE – CHARACTERISTICS AND COSTS

The all on 4 dental implant is a modern technique used to restore a full arch of teeth, using four dental implants. The procedure is increasingly popular, as it is a perfect alternative to dentures most people avoid due to slipping struggles, maintenance requirements and food restrictions.

ADVANTAGES OF THE ALL-ON-FOUR DENTAL IMPLANTS

Due to the all-on-four technique, now dentists can replace all missing teeth with just 4 implants. During the All-on-4 implant process, your dentist will place four implants into the jaw bone immediately after removing your teeth. These implants can be placed in just one day.

Patients should just eat soft food for up to eight weeks after the procedure, to help keep the implants in place. If the implant is strong enough, it is possible to deliver the whole arch of permanently fixed teeth. This eliminates the pain caused by immediate dentures or the embarrassment of wearing no teeth at all for a period of time.

One more advantage of the all-on-four implants is bone restoration and bone loss prevention, leading to a beautiful smile. Unlike dentures, these implants won’t make it hard for patients to chew, bite or speak. The all-on-fours will feel like natural teeth and no adhesive is needed.

ALL ON 4 CLEANING

The all-on-four dental implant must be properly taken care of. The patient must pay regular visits to the dentist for:

– the regular exam
– yearly X-Rays
– tartar removal

If all of natural teeth are missing, then a once a year visit may work fine. However, patients who tend to build up a lot of tartar should come to the clinic more often.

RISKS AND MAINTENANCE

> With proper care, the all on fours can last a lifetime. To protect this costly dental work, patients can wear a night-guard for acrylic or porcelain all on 4 teeth; a night-guard will protect the investment and is well worth the up front cost.

THE COST OF DENTAL IMPLANTS

Getting the all-on-four dental implant procedure is an important investment in your appearance and health. The cost for such an elaborate yet effective dental work depends on several factors. In the US for example, the cost of a single dental implant averages between $1-3000 per implant. Therefore, for the complete procedure, a patient can pay up to $12,000 per arch and even more if we add the cost of x-rays or tooth extractions.

If you choose to get the all-on-four implants in our clinic in Manila Philippines, you can discover the quality treatment we offer for affordable prices. At Tooth &Go, first we make sure the patient is a perfect candidate for this procedure, then, after a close documentation about the patient’s medical history we proceed to treatment planning and implant placement. The cost for the entire procedure can range from $8900-9900 per arch in our clinic. If you are convinced of the effectiveness of this technique, contact us and get a price quotation now.