Fifth Ave Perio

Improving Smiles

Indications for Gum Grafting

When New York City patients come in to Fifth Avenue Periodontics with gum recession, Dr. Cliff Melnick can help regenerate the lost tissue with a procedure called Connective Tissue Grafting, also called Gum grafting, or gingival grafting. It is a regenerative procedure to reverse gum recession. The goal is to recontour the gums to cover exposed root surfaces which protects the teeth and supporting bone from damage, and and improves your smile.

Recession is usually caused by normal activities like brushing, eating, teeth grinding and aging. If recession is not treated, the teeth, supporting tissue and bone can become so damaged that it may result in tooth loss.

What are the indications for connective tissue grafting?

New York City patients suffering from gum recession do not automatically require connective tissue grafting. There are five main indications for connective tissue grafting:

1. Esthetics: Recession of the gingival (gums) can result in unsightly yellow root exposure, as well as abnormally long appearing teeth. Connective tissue grafts can cover up most, and sometimes all of the recession that has taken place. Once the regenerated tissue has healed and matured the tooth will look more natural, with a beautiful, healthy appearance.

2. Inadequate Gingiva: The tough, pink tissue called gingiva, is found around the teeth and helps form a tight cuff or seal around the tooth. When the gums pull away from the teeth, the tight seal is broken, which creates the perfect environment for bacteria to grow resulting in deep pockets, infection, and recession. A connective tissue graft will regenerate a band of gingiva to reform the tight biologic seal around the tooth. This will help halt recession, reduce sensitivity, improve healthy tooth function, and improve the appearance of your teeth and smile.

3. Pre-Orthodontic: You may have consulted with your orthodontist and were told you need to have connective tissue grafting done before you start your orthodontic (braces) treatment. The gums must be healthy to allow for tooth movement during orthodontic treatment. Moving teeth into proper alignment with inadequate gum tissue can lead to recession. If this is the case, we can regenerate the tissue that has been lost to keep your orthodontics moving ahead.

4. Root Decay: Patients with gingival recession are at increased risk for decay on their root surfaces. The white, hard tooth structure we see is enamel, and it is meant to be exposed to the oral environment. The root surface, which tends to be more yellow, is made of dentin, which is much softer than enamel. Covering the roots back up will reduce your risk to root decay, and help prevent other periodontal conditions.

5. Tooth Sensitivity: When roots are exposed this can cause the roots to be very sensitive to hot, cold or touch. Just drinking a cold glass of water or hot tea or coffee can cause discomfort. Covering up the roots can go a long way towards reducing tooth sensitivity.

How are connective tissue grafts done?

First, Dr. Melnick will make a pouch in your gums. Then Dr. Melnick will borrow some tissue from the roof of your mouth, place the tissue into the pouch and close the flap back up. In essence, we are using your own gum tissue as a Band-Aid. The roof of your mouth will also be sutured and the tissue will regenerate. This tissue will integrate with your gums. Usually we can cover up most and sometimes all of the recession that has taken place.

What type of healing can I expect?

In the early days you can expect your graft to look worse before it looks better. There will be a whitish/yellowish appearance on the surface. This is simply the surface cells of the graft dying off. A few days later you will see a raw, reddish appearance. This is a good sign that the graft is receiving an adequate blood supply. When you return for your post-op appointment 10 days later we will remove the sutures for you. The graft may appear to be lumpy and bumpy. If there is excess tissue regenerated, then this is a wonderful problem to have. Your body will remodel and reshape the graft with time and as it matures, it will blend in beautifully. If, after 3-4 months, there are still some residual lumps and bumps we can usually reshape the tissue in just a few minutes. There is no additional charge for any reshaping. Will it hurt? The site where the graft goes usually does not cause any significant discomfort. The site where the tissue came from (the palate) can be mildly uncomfortable but for more patients, they report little to no pain.

LANAP Laser vs. Osseous Surgery

With recent advancements in periodontal laser technology, New York periodontist Cliff Melnick, DMD offers a minimally invasive alternative to traditional gum disease treatment. Laser Assisted New Attachment Procedure (LANAP) is a breakthrough procedure that is less painful, and more successful than conventional surgery. Patients suffering from periodontal disease now have an excellent alternative to traditional gum surgery.

Periodontal Disease and Osseous Surgery

Gum disease (periodontal disease) is an infection of the gum tissue that damages your gums, teeth and jawbone. Gum and bone tissue should fit tightly around healthy teeth, creating a protective cover from bacteria.  Patients diagnosed with periodontal disease suffer lost supporting tissue and bone. This results in the formation of pockets around the teeth where bacteria accumulate. Over time, these pockets grow and provide a larger environment in which bacteria thrive. As bacteria multiply around the teeth, they advance under the gum tissue, into the bone. Osseous surgery also known as “pocket depth reduction” is a surgical procedure that removes diseased tissue surrounding the teeth. When the pockets are too deep to clean with daily home care,  Dr. Melnick recommends professional care using LANAP.

LANAP vs. Traditional Gum Surgery

One major difference with LANAP vs. traditional periodontal surgery is the use of precise lasers instead of scalpels. For patients with anxiety about dental surgery, this fact alone makes LANAP the clear choice. While this is an important decision-making consideration, LANAP offers equally beneficial advantages for health, comfort and recovery. During traditional gum surgery, an incision is made into your healthy gums, using a scalpel, to gain access and visibility to the site that requires treatment. While this incision will be stitched up after the close of the procedure, the action of cutting and sewing your healthy gum tissue can result in gum recession. Traditional gum surgery can cause your gum line to recede up to 15 millimeters, which creates the need for additional treatments, such as gum grafts. With LANAP, however, there is no need to cut or suture your healthy tissue, as it will remain intact. This also greatly reduces tissue shrinkage, discomfort and healing times during gum surgery recovery.

The PerioLase® MVP-7™ allows Dr. Melnick to control and minimize any bleeding, utilizing blood coagulation to facilitate the recovery from gum surgery by producing a healthier healing environment. This procedure can also reduce up to 90 percent of the inflammation in your treated gum tissues after just one session of laser gum disease treatment in the New York City. And recent studies found that LANAP induced periodontal regeneration- growth of new bone and new tissue that will regenerate back to its original structure.

It is important to our office that our patients are comfortable throughout their laser gum care treatment. LANAP offers a long term health benefit that is unrealized with traditional gum surgery, and that is improved bone health. During the procedure, the laser is utilized to stimulate the bone at the tooth root and spurs the regeneration of bone. This allows Dr. Melnick to save teeth that may otherwise be hopeless.

Why Should You Choose LANAP?

  • 24 Hour Recovery Time with Minimal Discomfort
  • 98% of Laser Treated Patients Remain Stable After Five Years
  • Greater Predictability for Reattachment of Gum Tissue and Bone Regeneration
  • Less Time in the Dental Chair
  • Reduced Risk of Infection
  • Decreased Sensitivity and Less Bleeding
  • Minimum to No Gum Recession

Dr. Cliff Melnick has been a practicing periodontics in New York City for over 30 years. Dr. Melnick has been voted one of America’s Best Dentist in 2016. Dr. Melnick is dedicated to researching and finding the best dental technology to ensure the highest level of periodontal care for his patients. For patients in New York City who need periodontal disease treatment, Dr. Melnick chooses LANAP. If you would like to experience less discomfort and faster gum surgery recovery times with LANAP®, schedule a consultation at Fifth Avenue Periodontics today.

Periodontist Manhattan

Periodontal Specialist

Dr. Cliff Melnick is a periodontist in New York City. A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of gum disease. Periodontists are experts in performing gum surgery, dental implants, gum grafting and tissue contouring. Periodontists receive three additional years of specialized training after dental school. Dr. Melnick received his Certificate in Periodontics from Columbia University. Dr. Melnick employs the latest techniques for diagnosing and treating periodontal disease for his patients in Manhattan.

Dr. Melnick often treats more problematic periodontal cases, such as those with severe gum disease, bone and tooth loss. Periodontists offer a wide range of treatments, such as scaling and root planing (in which the infected surface of the root is cleaned), and root surface debridement (in which damaged tissue is removed). They can also treat patients with severe gum problems using a variety of surgical procedures. In addition, periodontists are specially trained in the placement, maintenance, and repair of dental implants.

Studies show that periodontal disease is linked to cardiovascular disease, diabetes and stroke. In diabetes, studies report that gum disease is a complication of diabetes, makes it more difficult to control blood sugar, and increases the risk of complications from diabetes. Research has confirmed that men with gum disease were 49% more likely to develop kidney cancer, 54% more likely to develop pancreatic cancer and 30% more likely to develop blood cancers.

During the first visit at his New York City periodontal practice, Dr. Melnick reviews the patient’s complete medical and dental histories. It is extremely important for Dr. Melnick to be aware of all medications being taken and whether the patient is being treated for any condition that can affect periodontal health and care, such as heart disease, diabetes, or pregnancy.

Periodontist Dr. Cliff Melnick examines the gums, checks to see if there is any gum line recession, assesses how the teeth fit together when biting, and checks the teeth to see if any are loose. Periodontist Dr. Cliff Melnick will also take a small measuring instrument called a probe and place it between the teeth and gums to determine the depth of those spaces, known as periodontal pockets. This helps the periodontist assess the health of the gums. X-rays may also be taken to observe the health of the bone below the gum line.

Who should see a periodontist?

For some New York City dental patients, periodontal needs can be managed by employing a thorough at home dental cleaning regimen, and more frequent professional cleaning. Importantly, as more and more patients are exhibiting signs of periodontal disease, coupled with research that suggests a relationship between periodontal disease and other chronic diseases of aging, periodontal treatment necessitates a greater understanding and increased level of expertise of a trained specialist. New York City patients who present with moderate or severe levels of periodontal disease, or patients with more complex cases, are best managed in partnership with Dr. Cliff Melnick.

Dr. Cliff Melnick has been a practicing periodontics in New York City for 30 years. Dr. Melnick has been voted one of America’s Best Dentist in 2016. Dr. Melnick is dedicated keeping current on the science and finding the best dental technology to ensure the highest level of periodontal care for his patients.