Services provided by Dr. Scharf include : nonsurgical periodontal treatment, soft tissue reconstruction, hard tissue reconstruction, gum grafting, gingival grafting, root coverage, gum recession, crown lengthening, gummy smile, ridge augmentation, ridge enhancement, soft tissue reconstruction, Frenectomy, gingival fiber resection, gingivectomy, periodontal regeneration, sinus lift

A Tour of Periodontal Services

Click here to take a photographic tour of cases treated by Dr. Scharf.

We can use modern techniques to help rebuild lost bone support. The emphasis in Dr. Scharf's practice is conservative periodontal therapy. Many times, early stages of periodontal disease is best treated with nonsurgical periodontal therapy. This usually consists of placing a fine ultrasonic tip in between the tooth and gum tissue to remove any plaque and calculus below the gum line. This procedure is called root planing. Four to six weeks later, periodontal pockets are eliminated due to gum shrinkage. Then the patient can personally maintain these areas with routine brushing and flossing.

Even in most severe cases of periodontal disease, nonsurgical periodontal therapy most often precedes surgical therapy. This is done so that the overall tissue quality is improved prior to surgery and also limits the areas of required surgery.

1. Non Surgical Treatments
2. Surgical Services
3. Soft Tissue Reconstruction
4. Hard Tissue Reconstruction

Cleaning The Tooth Below The Gum.

Antibiotics or irrigation with antimicrobials (chemical agents or mouthrinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Scharf may place antibiotic fibers 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. Scharf to thoroughly remove plaque and tarter. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.

Surgical Services

Dr. Scharf's practice provides a variety of surgical services. He prides himself on the fact that he is very conservative in his treatment recommendations and limits surgery to the areas where it is absolutely necessary. Periodontal procedures are available to regenerate the bone and gum tissue to it's original function and cosmetic appearance.

These procedures are a predictable way to cover unsightly, sensitive or exposed root surfaces and to prevent future gum recession. If you are unhappy with the apperance of short unsightly teeth this can be greatly improved by a combination of peridontal procedures by Dr. Scharf and cosmetic dentistry by your dentist.

Gum Grafting (Gingival Grafting):

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using gingival grafting techniques is an option.

When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.

In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance to the gum and tooth. Also, gum recession, when significant, can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.

A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.

The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.

Case Studies in Gingival Grafting::

Gingival Grafting	Gingival Grafting for Root Coverage	Gingival Grafting to Rejuvenate Crowns

Crown Lengthening

Crown lengthening to save a fractured tooth.	Final Restoration

Case Studies in Crown Lengthening:

Crown Lengthening to save a Fractured Tooth	Crown Lengthening and Gingival Reshaping	Crown Lengthening to Improve a "Gummy Smile"	Crown Lengthening and Gingival Reshaping

Over a period of time, the jaw bone associated with missing teeth atrophies or 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.

We now have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore the esthetic appearance and functionality better.

Careful management of extraction sockets after tooth extraction prevents unsightly bone loss and a better cosmetic outcome of tooth replacement.

Bone Growth for Ridge Enhancement

Ridge Augmentation to Correct Deformities of the Gum Tissue Ridge	Guided Bone Regeneration when Teeth are Extracted

Soft Tissue Reconstruction

In order to provide the highest quality periodontal and implant surgical care, our office employs regenerative surgical techniques to enhance the cosmetic, functional, and phonetic needs of patients.

Root Coverage
This surgical reconstructive procedure is implemented to cover exposed root surfaces and reduce the vulnerability to root sensitivity or caries. It is often utilized as a cosmetic enhancement procedure to create gingival symmetry within the smile zone.

Ridge Augmentation
Bone resorption following tooth extraction can create cosmetic and functional deformities. This often results in poor pontic design, food impaction, and inability to maintain effective oral hygiene. The addition of soft tissue to return the superficial periodontium to optimal form enhances the ability of the restorative dentist to construct esthetic restorations.

Soft Tissue Graft
Enhancing the zone of attached gingiva is particularly important when gingival recession is progressing or restorative dentistry is planned. Increasing the amount of keratinized tissue enables the restorative dentist to more accurately and easily capture the impression of a subcrevicular preparation margin. The restorative dentist can feel confident that the margin will not recede further following insertion of the final restoration.

Frenectomy and Gingival Fiber Resection

When orthodontic treatment is planned or initiated, the removal of an aberrant frenum can increase stability of the final orthodontic result. Gingival fiber resection has been shown to reduce post-orthodontic relapse from 17 percent to 5 percent if performed after the leveling phase of tooth movement has ended.

Case Study: Frenectomy

Gingivectomy/Gingivoplasty
The discriminate use of these procedures to create symmetry compatible with the incisal edge and lip position can enhance the ability of the restorative dentist to achieve esthetic restorative objectives within the smile zone.

Hard Tissue Reconstruction

Advancing toward the next millennium, periodontal science has developed new technologies that provide confidence and predictability in the restoration of the diseased periodontium or residual ridge. These advancements enable a patient to retain a healthy, stable periodontium or develop a permanent implant- supported restoration, returning teeth to natural optimal function.

Periodontal Regeneration
The implementation of the concept of guided tissue regeneration has enabled the dental team to reconstruct the dentogingival attachment while increasing bone support for the tooth. This highly predictable procedure excludes epithelium and connective tissue from the surgical wound site while encouraging bone and periodontal ligament cells to proliferate.

Bone Augmentation

Traditionally, gum disease is treated by eliminating the gum pockets. This is achieved by trimming away the infected gum tissue and by recontouring the uneven bone tissue. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.

Case Study: Bone Regeneration

This surgical procedure "regenerates" the previously lost gum and bone tissue. Most techniques utilize membranes which are inserted over the bone defects. Some of these membranes are bioabsorbable and some require removal. Other regenerative procedures involve the use of bioactive gels.

Bony deformities caused by periodontal disease, acute trauma, periapical pathology, or tissue atrophy can be reconstructed. Autogenous bone grafting (Patient’s Bone) or freeze dried allogeneic grafting can act as the source of donor material. Employing proven methods like bone induction or recruitment, bone grafting can be enhanced to encourage maximal bone growth. The mandibular tori, maxillary tuberosity, or retromolar areas often serve as the source for autogenous bone.

Sinus Lift
The raising of the sinus floor can often be accomplished without ever entering the sinus. An arthroscopic-like technique commonly referred to as osteotome site development can be performed. This method is the least invasive and most predictable approach for locally increasing bone within the maxillary sinus. Augmentation of larger areas requires corticocancellous bone grafting.