Over a period of time, the jawbone associated with missing teeth atrophies is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants . In these situations, most patients are not candidates for placement of dental implants.

With bone grafting , we now have the opportunity to not only replace bone where it is missing, but also the ability to promote new bone growth in that location! This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance.

Autogenous bone grafts , also known as autografts, are made from your own bone, taken from somewhere else in the body. The bone is typically harvested from the chin, jaw, lower leg bone, hip, or the skull. Autogenous bone grafts are advantageous in that the graft material is live bone, meaning it contains living cellular elements that enhance bone growth.

However, one downside to the autograft is that it requires a second procedure to harvest bone from elsewhere in the body. Depending on your condition, a second procedure may not be in your best interest.

Allogenic bone , or allograft, is dead bone harvested from a cadaver, then processed using a freeze-dry method to extract the water via a vacuum. Unlike autogenous bone, allogenic bone cannot produce new bone on its own. Rather, it serves as a framework or scaffold over which bone from the surrounding bony walls can grow to fill the defect or void.

Xenogenic bone is derived from non-living bone of another species, usually a cow. The bone is processed at very high temperatures to avoid the potential for immune rejection and contamination. Like allogenic grafts, xenogenic grafts serve as a framework for bone from the surrounding area to grow and fill the void.

Both allogenic and xenogenic bone grafting are advantageous in that they do not require a second procedure to harvest your own bone, as with autografts. However, because these options lack autografts bone-forming properties, bone regeneration may take longer than with autografts, with a less predictable outcome.

This product is processed allograft bone, containing collagen, proteins, and growth factors that are extracted from the allograft bone. It is available in the form of powder, putty, chips, or as a gel that can be injected through a syringe.

Graft composites consist of other bone graft materials and growth factors to achieve the benefits of a variety of substances. Some combinations may include: collagen/ceramic composite, which closely resembles the composition of natural bone, DBM combined with bone marrow cells, which aid in the growth of new bone, or a collagen/ceramic/autograft composite.

Synthetic materials also have the advantage of not requiring a second procedure to harvest bone, reducing risk and pain. Each bone grafting option has its own risks and benefits. Dr. DeTure and Dr. Schetritt will determine which type of bone graft material is right for you.

Periodontal disease is an infection of the gums and/or bone that surrounds the tooth. Generally, the disease is painless and most patients are not aware they have a problem until examined by a dentist.

With a healthy tooth, the root is set in the jawbone with a strong ligament, which keeps the tooth tightly attached to the bone. Gum covers the bone, and like skin, protects it from bacteria that are constantly present in the mouth. The gum connects to the neck of the tooth with a band of fibers, which insert just above the bone into the root. In a healthy situation, the gum edge is higher than the fiber attachment, forming a space around the tooth. This is similar to having a turtleneck sweater and this sulcus should be 2-3 millimeters in depth.

Everyone has bacteria constantly in their saliva. These bacteria collect on all surfaces forming colorless, sticky colonies called plaque. Unfortunately, this plaque also forms in the space underneath the edge of the gum. If the plaque is not removed (something that takes careful brushing and flossing), then it will start to cause an infection in the gum. Plaque that remains on the tooth for a long period of time absorbs salts from the saliva and becomes hard. This calculus or tartar cannot be removed by brushing and flossing and must be dislodged by a dental professional.

Periodontal disease is a bacterial infection. Bacteria initially accumulate along the gum line in the form of plaque. The bodys immune system sends white blood cells to fight the bacteria, but this response actually encourages the gum tissue to break down in order to make room for the blood vessels. As a result, pockets form between the gums and the tooths hard surfaces, providing ideal conditions for more bacterial growth. Eventually, the interaction of bacteria with the bodys immune system can result in destruction of bone that supports each tooth.

There are many normal types of bacteria in our mouths and most of them wont cause any problems for us. However, researchers have identified specific bacteria that are sound in periodontal disease. When these types of bacteria are present, we know the patient is at increased risk for periodontal disease. When the bacteria appear in large numbers, they may signal an acute phase of the disease.

Using a special microscope and/or culturing, we can tell if you are harboring the bacteria associated with periodontal disease. For Patients who have already been treated for periodontal disease, this evidence can alert us to the possibility that the disease is re-entering an active phase.

This is the major challenge we face. There are several treatment alternatives and we try to determine the plan or combination of plans that best suit each individual condition. Treatment options include:

We can provide a very conservative approach without compromising getting the best results. First, we view a bacterial slide of the patients current bacterial levels. We may also take a culture of the bacteria. Then we perform very thorough root planning and scaling in order to remove any trace of calculus and bacteria. We also use antimicrobial irrigation to aid in the fight against bacteria and we prescribe a very specific home care program for the patient. In more advanced cases, the laser can also be used to assist in destroying bacteria and removing infected tissue. Bacterial slides are re-done periodically so that the patient and our staff can monitor the progress of the treatment.

Definitely, and much of that can be attributed to greater patients awareness of gum disease. Our patients tend to be well informed about the risk of gum disease and they are willing to take an active part in the fight against it.

Dr. Avi Schetritt is a board-certified Periodontist. A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants.

Dr. Schetritt grew up in Montreal, Canada, where he completed his undergraduate studies at McGill University where he obtained a Bachelor of Science. He then went on to receive his dental degree (DMD) at the University of Montreal. After two years in general private practice, Dr. Schetritt returned to school, this time to the University of British Columbia in Vancouver Canada, where he completed his periodontal residency program.

Dr. Schetritt is a Diplomate of the American Board of Periodontology and a Diplomate of the International Congress of Oral Implantologist (ICOI). He is an active member of the American Academy of Periodontology, the Canadian Academy of Periodontology, the Florida Association of Periodontists and numerous local dental societies and study clubs.

Dr. Schetritt is Chairperson of the International Congress of Oral Implantologists (ICOI) Table Clinic and Poster Presentations and has served in this capacity for the last several years. He is also a senior reviewer on the editorial board of Implant Dentistry, the official journal of the ICOI.

Dr. Avi as he likes to be called, is a devoted educator, and lectures nationally and internationally on soft tissue procedures, bone regeneration and implants. He has also authored several articles and textbook chapters on these topics. On a personal note, Dr. Avi enjoys cooking for his family and friends, discovering wines and most recently started a salt water fish tank.

Dr. DeTures training was in Evidence Based Periodontics, including regenerative, pocket reduction, antimicrobial, and implant therapy. Special emphasis was placed on root coverage procedures, esthetic periodontal plastic surgery, bone regeneration, implant and laser therapy.