Posted on Wednesday, 9th September 2009 by Administrator
Alternative Gum Disease Treatment Options for Deep Gum Pockets
This post will define the available professional “alternative gum disease treatment options” for deep gum pockets.
When traditional therapies such as root planing (deep cleaning) with antibiotics, or basic laser periodontal therapy are exhausted, the next indicated step for a more definitive treatment to stop infection in unresponsive deep pockets may be traditional periodontal surgery. However, many individuals decide to seek alternatives to traditional periodontal surgery for the following reasons: to avoid pain and long term tooth sensitivity, to prevent gaps or black triangles between the teeth, to avoid recession of the gums following surgery, to avoid extractions of teeth deemed hopeless, and to avoid huge costs associated with periodontal surgery and tooth replacement.
The following periodontal treatment options are at this time considered to be “alternatives to traditional periodontal surgery”, yet some of these treatment options may hold promise to replace traditional periodontal surgery in the very near future.
Regenerative Periodontal Endoscopy – Regeneration to close up deep gum pockets
This non-invasive procedure employs the use of a periodontal endoscope. RPE differs from a standard perioscopy procedure in many ways. The inclusion of enzyme inhibitors, a soft tissue laser, and regenerative proteins promotes rapid repair, regeneration, and remission of periodontal disease long term. In addition, RPE is performed with very precise and efficient tools (piezo titanium and diamond coated tips), which allows skilled clinicians to complete the procedure more efficiently and prevents root damage and tissue trauma from occurring. An occlusal adjustment is often performed to aid in overall healing. RPE is a pioneering approach and is not widely available due to the advanced skills required and the limited availability of periodontal endsocopes at this time. Numerous excellent case studies published over the past decade demonstrate consistency, efficacy, and long term results. In the future, laser assisted RPE may replace traditional regenerative surgery, osseous surgery, pocket reduction surgery, and flap periodontal surgery, as well as extractions. Teeth deemed hopeless can be treated with RPE due to the non-invasive nature of the procedure as well as the regenerative elements of the protocol. Contact us to find out more.
Important: This treatment option is a fraction of the cost of traditional periodontal surgery and laser periodontal surgery (LANAP).
Before RPE - deep gum pockets After RPE
See real case studies (actual patients of PerioPeak Innovations)
Perioscopy – removal of tartar in deep pockets only
This non-invasive procedure employs the use of a dental endoscope to “see” microscopically (up to 48X) into deep periodontal pockets. This allows the clinician to better remove the tartar and plaque from the roots which have already been root planed blindly without success. It is simply “visually enhanced root planing” (removing tartar from pockets). Local anesthetic is used. The tools used to actually remove the root deposits (tartar) vary widely from clinician to clinician, as well as the actual proficiency and skill. Results will vary due to skill level, experience, and method. This procedure may include adjunctive therapies such as antibiotics, either placed beneath the gums, or given systemically. While there is some impressive published research to support perioscopy , it has still not been embraced by the main stream dental profession as a viable treatment option for periodontal disease. In some offices perioscopy is only employed when all other methods have been exhausted, rather than utilizing it as a first phase of treatment. This is unfortunate, but it may be because the techniques, proficiency, and outcomes can vary so much between providers.
Perioscope in hand (miniature fiber optic) - 48X magnification on a 10,000 pixel color monitor allows for real time pinpoint tartar removal in deep gum pockets.
Laser Assisted New Attachment Procedure – LANAP – an expensive periodontal surgery approach
This alternative treatment is actually a laser surgical procedure provided by a dentist or periodontist. This laser treatment is intended to close deep gum pockets and regenerate the bone without actually cutting the gums with a scalpel. Potent antibiotics are taken before the surgery and the patient is given local anesthetic and sedation if necessary. The teeth are root planed using a traditional approach (an endoscope is not part of the protocol) with a piezo ultrasonic, this is followed by lasering (cauterizing) the affected pocket to create a fibrin clot, which prevents epithelial down-growth, allowing regeneration to occur . An occlusal adjustment is also performed. The published research is very limited at this time – more studies are needed to demonstrate efficacy and long term results. There are approximately 500 doctors providing this treatment.
Important consideration: This option may be as much as twice the cost of traditional periodontal surgery.
PerioProtect – a non-definitive approach for treating periodontal disease
PerioProtect is a relatively new treatment non-definitive option for patients with unresolved periodontal infections and periodontal pockets. This professional treatment involves having a custom mouth tray fabricated by the dentist for the patient to use at home. These trays are then filled with antibiotics, or antimicrobials such as hydrogen peroxide (depending on the need), and are worn several times a day, up to several hours a day. PerioProtect is intended to be an adjunctive therapy with traditional root planing and periodontal maintenance cleanings. No surgery is performed to correct pockets and no dental endoscope is employed for the removal of tartar from deep gum pockets, therefore periodontal infections and gum pockets continue to be a chronic problem. PerioProtect trays are supposed to kill bacteria in deep pockets, but the depth that the medicament will reach remains questionable. The company has gone to great lengths to market their product but to date have only demonstrated their medicament reaching one pocket of 6mm. Tartar trapped under the gum in deep pockets is not removed by this product, therefore results are temporary. Individuals considering this option should be very cautious about promises made. The research is unremarkable at this time and does not support this option.
If you are interested in having a complementary consultation for RPE please call us today!
Posted in Alternative Gum Disease Treatment Options
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