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Periodontics of the Palm Beaches

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Periodontics of the Palm Beaches

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Karina F. Leal, D.M.D

Karina Leal

Dr. Karina F. Leal, D.M.D is originally from New York. She received both her D.M.D. degree and her certificate in Periodontology from Temple University School of Dentistry in Philadelphia, where she received numerous honors. Dr. Leal is a Diplomate, of the American Academy of Periodontology.

Dr. Leal has served on the board and has been past president of both the North Palm Beach and Central Palm Beach Dental Societies. She has been and is involved with the Palm Beach State College Research Clinic and various study clubs. She holds active memberships in the American Academy of Periodontology, Board of Periodontology, American Dental Association, Florida Dental Association and Academy of Osseointegration, among others. She is member of the Pierre Fauchard Academy, an invitation only organization.

Dr. Leal has co-authored and has been sited in numerous journals. She has contributed to lectures and programs highlighting the use of periodontal procedures to optimize dental esthetics, as well as implant dentistry to maximize esthetics and function.

Dr. Leal limits her practice to periodontics and implant dentistry. She not only strives to provide the best outcome in periodontal health using regenerative procedures, but utilizes conservative techniques to obtain excellent esthetics in implant dentistry. Utilizing digital dental cat scans, she is able to preplan surgical treatment in a three dimensional environment to ensure optimal results. Implants can often receive temporary crowns the day of placement. Dr. Leal is passionate about incorporating the advances in digital dentistry to provide her patients with the most advanced dental technologies.

Stuart A. Feldman, BS, D.D.S

Stuart Feldman

Dr. Stuart A. Feldman, BS, D.D.S, FACD, is originally from Washington, D.C. He received both his BS in 1965 and D.D.S. degree in 1969 from the University of Maryland. He served as lieutenant in the U.S. Navy Dental Corps from 1969-1971. He received his certificate in periodontics from Columbia University School of Dental and Oral Surgery in 1973. Dr. Feldman has served as assistant clinical professor of graduate periodontics in the department of periodontology at the University of Florida School of Dentistry for over thirty years. He served as past president of the Palm Beach County Dental Association and the Florida Association of Periodontics. Dr. Feldman served for six years as a member of the executive council of the Southern Academy of Periodontology.

Dr. Feldman has been a very active member and has presented programs for the American Academy of Periodontology, Southern Academy of Periodontolgy, Florida Association of Periodontics, Florida Dental Association, Palm Beach County Dental Association, Palm Beach State College Dental Research Clinic, Department of Periodontology (chairman) and many study clubs.

Dr. Feldman completed his initial implant training in endosseous implants in 1984. He has placed over 15,000 endosseous titanium implants since that time. A special interest has been placement of immediate implants with restorations as well as implants in the esthetic zone. Dr. Feldman is a member of both the Academy of Osseointegration and The International Congress of Oral Implantology.

Dr. Feldman has presented continuing education programs on a variety of subjects including autogenous and alloplastic bone grafting in periodontal defects, interdisciplinary therapies to achieve optimal esthetics, long term results of implant therapies, and periodontal regeneration with enamel matrix proteins. Dr. Feldman is a fellow of the American College of Dentists and the Pierre Fauchard Academy. He has been in private practice in West Palm Beach and Jupiter, Florida since 1975.

Periodontics of the Palm Beaches

Scheduling Appointments

Periodontics of the Palm Beaches

Treatment Methods

Our practice provides a variety of surgical services for the treatment of periodontal issues. We pride ourselves on the fact that we are very conservative in our treatment recommendations and limit surgery to the areas where it is absolutely necessary.

Dental Implants

Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants themselves are tiny titanium posts that are surgically placed into the jawbone where teeth are missing. These anchors act as tooth root substitutes.

The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts that protrude through the gums are then attached to the implant. These posts provide stable anchors for artificial replacement teeth. Dental Implants also help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.

The Surgical Procedure

For some patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. Healing time following surgery varies from person to person and is based on a variety of factors, such as hardness of bone. In some cases, implants may be restored immediately after they are placed.

For the first three to six months following the surgery, dental implants may be beneath the surface of the gums gradually bonding with the jawbone. You should be able to wear a temporary prosthesis and eat a soft diet at this time. At the same time, your restorative dentist designs the final bridgework or denture that will ultimately improve both function and aesthetics.

After the implant has bonded to the jawbone, the second phase begins. We will uncover the implants and attach a small healing collar. After two weeks your general dentist will be able to start making your new teeth. An impression must be taken. Then posts or attachments can be connected to the implants. The teeth replacements are then made over the posts or attachments. The entire procedure usually takes three to six months. Most patients do not experience any disruption in their daily life.

Periodontal Treatments

The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling or root planing. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause gingival inflammation and disease. Scaling and root planing can be used as a stand-alone treatment, or a preventative measure. They are commonly performed on cases of gingivitis and moderate to severe periodontal disease.

Scaling

When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process especially targets the area below the gum line, along the root. Scaling may be performed with a special dental tool called an ultrasonic scaler. The scaling tool usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria.

Root Planing

Root planing is performed in order to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future.

Tissue 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 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 of the gum and tooth. When significant, gum recession 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.

Crown Lengthening

Crown lengtheningis usually performed to improve the health of the gum tissue, prepare the mouth for a procedure, or correct a "gummy smil". A “gummy smile” is used to describe an instance where teeth are covered with excess gum tissue resulting in a less esthetically-pleasing smile.The procedure involves reshaping or recontouring the gum tissue and bone around the tooth in question to create a new gum-to–tooth relationship. Crown lengthening can be performed on a single tooth, many teeth or the entire gum line.

Tooth Restoration

Crown lengthening is often required when your tooth needs a new crown or other restoration. The edge of that restoration is deep below the gum tissue and not immediately accessible. It is also usually too close to the bone or below the bone.

Crown lengthening allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease.

Bone Grafting

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease, or injuries. The bone is either obtained from a tissue bank or from your own bone. Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.

Ridge Expansion

In severe cases, the ridge has been reabsorbed and a bone graft is placed to increase ridge height and/or width. This is a technique used to restore the lost bone dimension when the jaw ridge gets too thin to place conventional implants. In this procedure, the bony ridge of the jaw is literally expanded by mechanical means. Bone graft material can be placed and matured for a few months before placing the implant.

Sinus Lifts

The key to a successful and long-lasting dental implant is the quality and quantity of jawbone to which the implant will be attached. If bone loss has occurred due to injury or periodontal disease, a sinus augmentation can raise the sinus floor and allow for new bone formation.

In the most common sinus augmentation procedure, a small incision is made on the premolar or molar region to expose the jawbone. A small opening is cut into the bone, and the membrane lining the sinus is pushed upward. The underlying space is filled with bone grafting material, either from your own body or from a cadaver. Sometimes, synthetic materials that can imitate bone formation are used. After the bone is implanted, the incision is stitched up and the healing process begins. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.

If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.

The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option besides wearing loose dentures.

Periodontics of the Palm Beaches

Dental Implants

Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants themselves are tiny titanium posts that are surgically placed into the jawbone where teeth are missing. These anchors act as tooth root substitutes.

The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts that protrude through the gums are then attached to the implant. These posts provide stable anchors for artificial replacement teeth. Dental Implants also help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.

The Surgical Procedure

For some patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. Healing time following surgery varies from person to person and is based on a variety of factors, such as hardness of bone. In some cases, implants may be restored immediately after they are placed.

For the first three to six months following the surgery, dental implants may be beneath the surface of the gums gradually bonding with the jawbone. You should be able to wear a temporary prosthesis and eat a soft diet at this time. At the same time, your restorative dentist designs the final bridgework or denture that will ultimately improve both function and aesthetics.

After the implant has bonded to the jawbone, the second phase begins. We will uncover the implants and attach a small healing collar. After two weeks your general dentist will be able to start making your new teeth. An impression must be taken. Then posts or attachments can be connected to the implants. The teeth replacements are then made over the posts or attachments. The entire procedure usually takes three to six months. Most patients do not experience any disruption in their daily life.

Periodontics of the Palm Beaches

West Palm Beach Office

1897 Palm Beach Lakes Blvd., Suite 215
West Palm Beach, FL 33409

Phone: 561-686-2477

Periodontics of the Palm Beaches
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Periodontics of the Palm Beaches

Jupiter Office

1015 W. Indiantown Rd., Suite 102
Jupiter, FL 33458

Phone: 561-746-2679

Periodontics of the Palm Beaches
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