Our practice is proud to feature the following science and technologies in our everyday treatment and practice:
INFUSE Protein for Bone Growth
Discovered in 1965 by Dr. Marshall Urist, Bone Morphogenetic Proteins (BMPs) are the only proteins known to induce new bone formation. More than 20 BMPs have been identified, but studies have shown that only certain BMPs are able to induce new bone formation. BMP-2 is a member of the BMP family that directly on stem cells, leading to the growth of new bone. INFUSE Bone Graft is composed of rhBMP-2 on an absorbable collagen sponge (ACS) carrier. The “rh” stands for “recombinant human” and signifies that the BMP-2 protein is the exact amino acid sequence of the human version of BMP-2, but produced in the laboratory so that no actual human products are involved. The recombinant production also guarantees an extremely pure protein product with a highly controlled and measurable bioactivity. Dr. Silberg and Dr. Roll utilize this technology to accelerate bone growth.
Osteocel: Bone Grafting with Stem Cells
NuVasive Osteocel is a bone graft product that is derived from stem cells that are found within bone marrow. The processing technology that produces Osteocel results in a viable bone matrix product that preserves the native stem cells found in marrow rich bone. It was the first product available to have the desired beneficial properties of live bone and that allows us to provide patients with a complete grafting solution without the added risk and cost of a secondary procedure to obtain donor bone. Osteocel grafts have been used since 2005 in over 25,000 procedures, with no reported adverse events.
As of September 2009. Data on file with NuVasive, Inc.
GEM 21S The First Growth-Factor Enhanced Matrix
Completely unique and synthetic, GEM 21S is an innovative combination of a bioactive protein (growth factor, rhPDGF-BB) and a biocompatible completely synthetic bone-like matrix (beta-tricalcium phosphate, -TCP) PDGF is one of the main growth factors found in the body and has a well-established safety and effectiveness record in medicine as a wound healing agent. It works by stimulating existing cells in the body to produce bone. Like Miracle Grow for plants, it works to make what is already there grow better and faster. GEM 21 has been evaluated in the most extensive, prospective, randomized, controlled, blinded clinical trial conducted for a regenerative product in dentistry. The trial was a large, multi-center study involving 11 clinical sites (4 universities and 7 private practices.) The results of these scientific studies clearly showed that when used to treat areas of bone damage around teeth in specific types of defects, “one can expect more consistently reliable and quantitatively better results (i.e. greater bone fill) with GEMS 21S than with a purely bone promotive material or matrix,, i.e. -TCP, alone.” The addition of the protein PDGF made a significant difference in the performance of the graft in the treatment of damage that occurred as a result of periodontal disease.
Autologous Platelet Rich Plasma (Platelet Gel)
Autologous Platelet Rich Plasma or Platelet Gel is a new procedure that utilizes the patients own platelets to speed up the healing process. In order to increase your natural platelet count, we take a small amount of whole blood just before the procedure, which is then centrifuged to separate the plasma above the red blood cell layer and below the platelet-poor plasma fraction. This platelet concentrate is then used for Platelet Gel, which increases a patients level of blood platelets and stimulates many of the tissue growth factors that attract the cells responsible for all phases of healing, and:
- Increases growth of new blood vessels in the tissues
- Enhances new collagen growth
- Increases the rate of outer skin healing
- Enhances new bone growth
- Reduces post-operative pain
- Reduces bleeding and post-operative bruising of the tissues
Choukroun’s Platelet Rich Fibrin (PRF)
Plateletrich fibrin (PRF) is a matrix of growth factors derived from the concentration of the patients own blood platelets. A simple chairside procedure allows us to obtain a small amount of your own blood and to centrifuge and concentrate the platelets and all of the growth factors that are contained within the platelets. PRF initiates the sustained release of platelet derived growth factor (PDGF) and transforming growth factor (TGF) to stimulate new tissue and new blood vessel growth. The presence of these concentrated growth factors promotes more rapid healing especially during the critical first days after surgery. This is a great benefit because you can have better and faster healing and recovery.
Emdogain is a biology-based bioactive gel that is used in surgical procedures to promote the predictable re-growth of gum and bone that was lost to periodontal disease. Over 40 studies and the treatment of nearly 2,000 teeth have proven that Emdogain is highly successful in helping your body repair gum and bone damage. With its extensive scientific documentation, ease of use and the flexibility it allows to manage areas that are difficult to treat, Emdogain is a reliable and effective solution for treatment of periodontal disease and damage.
Digital X-Ray Technology
Digital x-ray imaging is state of the art when it comes to x-rays. We have been using the world wide leader, the Schick system technology, since 1997. The advantages include 80% less radiation, instant images on the computer screen and image enhancement via the software to see more information on your digital x-ray than on the traditional one inch piece of conventional x-ray film. This means better, safer, faster more effective treatment than ever before with much less radiation exposure. It also means less damage to our environment because we do not have to dispose of toxic chemicals that are used to develop film.
CAT Scan: Gendex CB 500 Conebeam
In 2009 we purchased a Gendex GXCB-500, a Cone Beam 3-D imaging system powered by industry-leading i-CAT technology. This CT scan is a powerful diagnostic and treatment-planning tool for planning implant dentistry, TMJ analysis, and various surgical procedures. The GXCB-500s Silicon Flat Panel sensor yields accurate, highly detailed images with minimal x-ray exposure and at one of the fastest scan and reconstruction rates in the industry. We are proud of the fact that our practice was one of the first in the area to acquire this new technology. It will improve the quality of care that we provide to our patients.
The Perioscope is an endoscope (or microscope camera) that is specifically designed for exploration and visualization of the space under the gum (periodontal pocket) of teeth involved with gum disease . From under the gum, the Perioscope produces a computerized image of the diseased tooth’s root surface, allowing the clinician to see the contents of the periodontal pocket and analyze the root surface of the tooth for disease causing bacterial accumulations, such as plaque and calculus. The Perioscope guides the clinician during the treatment process and allows the clinician to identify problems that previously required surgery to detect. We are proud that our practice was one of the very first on the east coast to have this new technology, and one of only a few in the world to be familiar with its operation.
SimPlant CT Software
Much in the same way that an airline pilot relies upon proper instrumentation and computer guidance for safe and correct flight operation, periodontists have special software and computerized assistance to provide accurate and comprehensive information about a patients oral anatomy and a detailed layout of the implant procedure. Instead of flying blindly as we navigate around the jawbone, we can take CAT scan images and import them into a software program to view a full 3-D image simulation that enables us to:
- Determine the size and shape of the jawbone
- Determine if bone building is needed in advance
- Accurately measure the bone density
- Optimize the implant process through simulation
- Save time and money
In cases of advanced periodontal disease or damage, oftentimes a gum tissue graft is necessary to rehabilitate and restore the gums to optimal health. In order to avoid a patient graft, AlloDerm can be used to restore the gum tissue needed. AlloDerm is processed from donated human tissue, harvested from organ donors that must pass the same stringent screening criteria as any other tissue or organ (heart, kidney, etc.), and the rigid guidelines of the U.S. Food & Drug Administration. AlloDerm has been safely used in dental and reconstructive surgery for nearly 10 years (450,000 procedures). AlloDerm functions by providing the collagen structure and proteins that help your bodys own tissue grow. As the bodys natural processes take over, your own cells move into the AlloDerm, and transform the AlloDerm into your own healthy gum tissue. The advantages of using this treatment over a patients own gum graft include:
- No second surgical site, and a more comfortable healing period.
- An unlimited source of tissue, allowing extensive grafting (if necessary) to be done in one visit, reducing the overall treatment period and cost.
- Proven equivalent or superior esthetic results compared to a patients own tissue.
The average case of gum disease responds extremely well to standard treatment regimens. However, some patients experience episodes of recurrent disease activity, despite good preventive efforts, because there is an over production of tissue destroying enzymes under the gum line or the patient has a bacterial infection. In order to determine the cause of these recurring gum disease episodes and provide an effective treatment solution, Dr. Silberg and Dr. Roll are one of the few periodontists in the area that will:
- Collect samples of the patients bacteria from under the gum line, using sterile paper strips that are submitted to a special lab at the University of California, where the bacterial DNA is analyzed to determine the most effective course of antibiotic treatment.
- Use a low-dose, prescription antibiotic called Periostat, in conjunction with standard scaling and root planing treatment, to treat and inhibit the enzymes that destroy gum and bone.
Voice Recognition Data Collection
Managing and treating periodontal disease requires a significant amount of data collection. At your initial appointment, and every subsequent appointment, we collect and analyze an extraordinary amount of data and information regarding your periodontal health, treatment and condition. Our Voice Recognition software is a state of the art computer program that allows us to record, store and update patient data. This data allows us to monitor and analyze your past and current periodontal health and make timely and appropriate treatment recommendations, designed only for you and your needs, to help you keep your teeth, and stay healthy.