Covering graft

Root coverage graft

Root covering graft (also called connective tissue graft) is placed over the root to cover the already exposed root surface.

It also increases the attached tissue and stops the progression of gingival recessions.

The success rate of this procedure is variable depending on the shape and extent of the recession. Healing will be compromised with smokers.


A smile makeover

A smile makeover

In all makeover cases, gum tissue provides not only the esthetic framework but is the foundation that will hold the teeth and all the restorative work (crown, bridge, veneer). Therefore, fundamental to the smile makeover is the assessment of the gum tissue. Removal of excess tissue, building up of minimal gum tissue, and recontouring of existing tissues are procedures periodontists routinely perform to provide the best possible framework for your new smile.

Before undertaking extensive cosmetic dentistry, it would be advisable to seek a consultation with a periodontist. The periodontist will assess your goals and work with your family dentist so that you may obtain the best possible cosmetic result.

Sometimes, a smile makeover may also require other treatments prior to the placement of crowns or veneers. These treatments may be a combination of root canal treatment, orthodontics (braces), and periodontal surgery (esthetic crown lengthening). The purpose of these procedures are to enhance the outcome of the cosmetic makeover.


Dental implants

Dental implants

Dental implants are essentially artificial tooth roots. They can be used to replace a single missing tooth, multiple missing teeth, support a denture or restore an entire mouth.

Implants come in different shapes and textures.

Implants are made of titanium. Titanium unlike other metals is not rejected by the body. Titanium is very strong and is biologically inert. To be a candidate for a dental implant two criteria must be met. Your gum tissue should be healthy overall and there must be enough bone present to support the implant.


Following the extraction of a tooth the supporting bone begins to shrink both in height and width. Even if the bone shrinkage has been excessive an implant may still be an option. Depending on the situation, a periodontist may be able to grow back the lost bone using regenerative procedures so that an implant can be placed.

Implants can be used to support a bridge, a removable denture or a fixed denture.

Your periodontist and dentist will discuss the available options and benefits of each.


Laser treatment

Laser Treatment for Gum Disease

Lasers can be used to treat periodontal disease.

Current controlled studies have shown that similar results have been found with the laser compared to specific other treatment options, including scaling and root planing alone.

The position of the CAP on laser treatment is similar to that of the American Academy of Periodontology.


Baking soda & peroxyde

baking soda & peroxide

CAP position on Keyes technique

In the late 1970s an oral hygiene program called the Keyes technique was widely promoted as a nonsurgical alternative for treating advanced periodontal disease (pyorrhea)*.

The technique includes:

As in any medical field, treatment approaches vary according to the condition being treated. The Keyes technique attempts to treat all periodontal conditions the same way. This brings some risks and limitations:

Bacterial monitoring using a phase contrast microscope is a technique sensitive, inaccurate and outmoded technology, which does not accurately differentiate between bacteria associated with a healthy periodontal environment and that associated with aggressive periodontal disease.Local therapy, consisting of scaling and root planing (deep cleaning) has always been part of conventional periodontal therapy. 

However numerous studies, short and long term, have shown that the adjunctive use of baking soda and hydrogen peroxide have not demonstrated any particular added benefit over conventional techniques.

The use of systemic antibiotics in conjunction with root planing has shown minimal or no added value over local therapy alone in treating adult periodontitis. In addition, the possible minor benefit would only be of short duration and the use of antibiotics significantly increases the chances of developing bacteria resistant to many antibiotics.

In conclusion, the Keyes technique offers a single treatment approach, with limited benefits and substantial disadvantages, to a multifactorial disease requiring different therapeutic responses. The Canadian Academy of Periodontology recommends a thorough assessment of any periodontal condition followed by an informed, comprehensive therapeutic approach. A ‘one size fits all’ approach offers a significant risk of under or over treatment and the CAP therefore cannot endorse or recommend this technique. The CAP’s position is in agreement with the position of the American Academy of Periodontology (
*Report of the special committee on NIH-NIDR study of periodontal therapy. American Academy Periodontology, Chicago., Sept. 1984.


The role of amoebas

Le rôle des amibes 

Le rôle des amibes
dans les maladies parodontales

Par Dre Jacinthe Larivée

Vous arrivez sur les lieux de cette scène. D’après vous qui a tué l’éléphant que cette hyène est en train de dévorer? Est-ce la hyène? Ou les vautours? N’est-ce pas plutôt un autre animal qui a commis le crime et ceux que nous voyons ici ne sont en fait que des charognards qui viennent manger l’animal déjà mort.

À présent, nous faisons un prélèvement de plaque dentaire dans la bouche d’une personne atteinte d’une maladie parodontale. Vous regardez ensuite au microscope les microorganismes que nous venons de prélever. Lequel est responsable de la maladie? Est-ce la petite ronde en haut à gauche ou la grosse allongée en bas à droite? Pas évident, me direz-vous. Ce n’est pas écrit à sa surface.

Saviez-vous qu’on retrouve de 60 à 80 espèces de bactéries différentes dans une bouche donnée. D’autre part, on connaît environ 17 bactéries directement reliées à des maladies parodontales ou parodontites. Personne n’a été capable à date de démontrer que les amibes jouaient un rôle actif dans les maladies parodontales. Le seul fait d’en voir au microscope ne signifie pas qu’elles soient responsables de la maladie. Même si elles sont grosses et laides!

Comment peut-on déterminer si une bactérie est la cause d’une parodontite? Eh bien c’est le Dr Sigmund Socransky en 1977 qui a établi des critères stricts nous permettant de démontrer la responsabilité d’une bactérie dans le développement d’une parodontite.

Il faut démontrer que:

On ne peut donc simplement affirmer en voyant une bactérie ou une amibe au microscope que celle-ci est la cause de la maladie. De plus des bactéries utiles et des bactéries dangereuses ont souvent la même apparence au microscope. Présentement, l’amibe est considérée comme un vidangeur qui mange les bactéries mortes. De la même façon que le vautour qu’on trouve aux côtés d’une carcasse d’éléphant est considéré comme un charognard qui dévore un animal déjà mort.