• Periodontal Care • Periodontal Disease • Treatment Methods • Osseous Surgery • Gum Grafting • Crown Lengthening • Bone Regeneration • Cosmetic Periodontal Surgery • Oral Pathology

TREATMENT METHODS

Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Even in severe cases, non-surgical periodontal therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to help limit the areas requiring surgery.

Scaling and Root Planing

The initial stage of treatment is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line.

The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion (bite) may require adjustment.

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Breiterman may place slow releasing antibiotics in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.

When deep pockets between teeth and gums are present, it is difficult for Dr. Breiterman to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.

Chemotherapeutic Agents

Sustained release of antimicrobial agents has shown to have a positive effect on periodontal disease used in conjunction with scaling and root planning. They can be introduced systemically as pills or directly into the periodontal pocket. Since the antimicrobial agent needs to reach the infecting bacteria, the antimicrobial needs to be released in an effective concentration.

Arestin
Arestin is unit dosed 1 mg microspheres of minocycline Hcl that are placed directly into each tooth site where pocketing exceeds 5 mm. There are 6 sites on each tooth where this may occur. They are easily and painlessly placed into the pockets. The microspheres are bioadhesive, bioresorable polymer in powder form produced by a microencapsulation process. The drug resorbs over a 21 day period.
http://www.arestin.com/c_patients.asp

Atridox
Atridox is also a chemotherapeutic agent (doxycycline hyclate 10%) that is in gel form. It solidifies into a wax-like substance when it is placed into the gums and is mixed with crevicular fluid. It releases antibiotic slowly over a 7 day period.
http://www.atridox.com

Periostat
Periostat is a pill (doxycycline hyclate 20 mg) that is taken twice daily for a period of at least nine months. It is an extremely low dose. The dose is so low in fact, that the drug does not have any antibiotic effect. Instead, it acts to alter the way the body reacts to inflammation. With periostat, the body will not break down gum tissue in response to the attack by plaque toxins.
http://www.periostat.com