Periodontal Implant Center Jacob D. Hager, DDS, MS 8203 S. Walker Oklahoma City, OK 73139

A Recurring Publication from the Periodontal Implant Center ♦ No. 10, September 2012

Jacob Hager, DDS, MS ♦ Board Certified by the American Board of Periodontology

Our office is located

in OKC just south of

I-240 on Walker in the

Willow Brook Gardens

Condominiums.

The courtyard view above

is overlooked by our

consultation and

treatment rooms.

Contact Us

8203 S. Walker

Oklahoma City, OK 73139

405-636-1411

800-525-9355

405-636-1197 fax

email: okperioimplantcenter@yahoo.com

DDeevvoonn BBooaatthhoouussee CCEE

Hygienists, please join us at the Devon

Boathouse on Thursday, October 25th from

6:00 to 9:00pm. The complimentary two-

hour education course will focus on the basic

principles of dental implants from initial

treatment planning through final restoration

and long term maintenance. Significant

emphasis will also be placed on the dental

hygienist’s role in recognizing candidates for

dental implants, maintenance strategies and

managing peri-implantitis.

Please RSVP prior to October 17th at

www.perioimplantcenterokc.com - click on

‘Devon Boathouse CE’ on our homepage.

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Patient referrals can now be completed online at

www.perioimplantcenterokc.com by clicking on

‘Contact Us’ and then selecting ‘Referral Form’

from the drop-down menu. Please make sure to

select your desired correspondence method

(phone, email or letter) and if you prefer to be

contacted prior to your patient’s consultation.

Traditional faxed or mailed referral forms are still

welcomed as well.

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Over the last two years, our office had the

opportunity to develop working relationships

with two excellent Oklahoma-based dental labs

for implant-related services. If you are looking

for a new fixed-pros / implant-pros lab, you

might consider contacting one of the following:

Classic Dental 11315 E 32nd St, Tulsa, OK

(918) 627-8980

Dental Creations 2330 N Interstate Dr, Norman, OK

(405) 307-0070

OOuurr NNeeww AAssssoocciiaattee –– MMeeeett DDrr.. TTrraann The Periodontal Implant Center is pleased to announce the arrival of a new periodontist to

our practice - Dr. Trung T. Tran.

Dr. Tran was born and raised in Tulsa, Oklahoma and graduated from Union High School.

He completed his undergraduate studies, dental education, and periodontal residency at the

University of Oklahoma. Dr. Tran will complete his periodontal training this upcoming

May and is looking forward to joining us here at the Periodontal Implant Center as an

associate periodontist while he establishes a private practice in Tulsa, OK.

Dr. Tran currently lives in Edmond with his wife, Thao, and their son Ethan. He is excited

about this opportunity to provide patients with quality periodontal and implant services.

The Periodontal Implant Center is looking forward to this new journey with Dr. Tran and

encourages you to join us in welcoming him.

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Of all the procedures offered in our office,

esthetic crown lengthening is one of the most

rewarding – for both me as the treating clinician and

the patient. Just like a new set of veneers, there

can be an immediate and dramatic esthetic

improvement following anterior crown lengthening,

often very life-changing for the patient.

Unfortunately, very few patients are referred to

our office for this particular procedure. Why is

this? Most patients with excess gingival display due

to altered passive eruption (gingiva covering

enamel) are unaware that any improvement can be

made to their smile. They assume their gummy

smile is due to having short teeth and resign to the

fact that nothing can be done to change it. How

would they know that their gum tissue is actually

covering a portion of the enamel that should be

exposed?

These patients have to be told by a dental

professional that treatment options exist. Often

times, a visual example of a before-and-after picture

explaining a crown lengthening procedure is all that

is needed for patients to pursue this elective

treatment. Some patients may decline treatment.

Nevertheless, it is important that patients with

excess gingival display be educated that treatment

options exist and let them decide for themselves

whether the procedure is worthwhile to pursue.

Identifying Potential Candidates for Treatment:

Any patient with a complaint of excess gingival

display

Any patient with significant asymmetry in the

gum position across the maxillary anterior teeth

Any patient with short clinical crowns, excess

gingival display, and CEJ’s that cannot be

detected in the gingival sulcus

Any patient treatment planned for anterior

prosthetics (crowns or veneers) with gingival

asymmetry, excess gingival display, severe incisal

wear or poor height to width ratio of their anterior

teeth

Any patient with excess gingiva contributing to

difficulties with plaque control

Other causes of excess gingival display exist and

require treatment apart from anterior crown

lengthening. Patients may have a skeletally long

maxilla (requiring orthognathic surgery), extrusion

of their maxillary dento-alveolar segment (requiring

orthognathic surgery or orthodontic intrusion), or a

short or hyper-mobile upper lip (limited treatment

35 year old female referred to our clinic for tissue grafting in the

mandibular arch. Patient had never been told there was any way to

address her gummy and asymmetrical smile.

45 year old female that had never been previously told there was any way

to address the short appearance of her teeth or excess gingival display.

18 year old post-orthodontic male. This patient was a severe mouth

breather who likely had poor plaque control during orthodontic

treatment.

options exist). Certainly, careful examination is required to determine the exact cause of any excess gingival display and the also correct

treatment. The same care should be taken in informing patients when these treatments would have significant benefits for improving the

esthetics of their smile.

Pre-prosthetic crown lengthening to improve both esthetics as well as the

retention form of the final restorations (yet to be placed).

_____________________

Copyright 2012 by Jacob D. Hager

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Zirconia is a Ceramic Oxide (ZnO2) that was developed

for industrial use in the 1970’s. Dentistry has embraced

Zirconia as a restorative material over the last decade for

use as solid fixed restorations, restorative copings and as

dental implant abutments. Prized for its strength and

stability, Zirconia has a tetragonal crystalline structure that

is highly resistant to crack formation and propagation and

has significantly higher compressive and tensile strength

compared to earlier dental ceramics. Just recently, there

has been a release of a new solid Zirconia ceramic that can

be tinted and shaded during the fabrication process

resulting in much more esthetic restorations than previous

BruxZir or other solid Zirconia restorations while still

retaining their impressive strength . What about Zirconia

abutments?

Zirconia implant abutments are best utilized when: A highly esthetic restoration is needed with high

translucency properties

Peri-implant gingiva is extremely thin with a risk of

“graying” if a metal abutment were selected. *If you can

see the tip of a periodontal probe through the gingival

tissue when the probe is inserted in the sulcus – consider

a Zirconia abutment.

This?

Or This?