I. Stephen Brown, D.D.S. PDL tm “Philadelphia’s Periodontist”

I. Stephen Brown, D.D.S. “Excellence in Non-Surgical Periodontics, Implants & Laser Treatment” Introducing a Breakthrough Treatment for : Dr. John Chao’s Pinhole Gum Rejuvenation Technique® Often Eliminates the Need for the Cutting, Suturing and Downtime of Traditional

According to The Journal of Why Should Gum loss occurs on the facial of the the American Dental Association, Recession Be Taken affected tooth leading to increased the prevalence of gingival Seriously? mobility and possible loss of the recession in the United States tooth. When gum recession occurs, includes 50 percent of people Currently, the most common unsightly root structure of the 18 to 64 years of age and 88 and predictable treatment tooth becomes exposed. This percent of individuals 65 years for gingival recession is the means that tooth decay and of age and older. And, with an connective tissue graft (CTG) sensitivity can affect the teeth aging population, the number in which the patient’s own along the gumline and appearance of recession cases in the U.S. is connective tissue is taken from is often compromised. Bone certain to soar. (continued on the next page)

Case #1 BEFORE AFTER

I. Stephen Brown, D.D.S. 220 S. 16th Street, Suite 300, Philadelphia, Pennsylvania, 19102 I. Stephen Brown, D.D.S. 220 S. 16th Street, Suite 300, Philadelphia, Pennsylvania, 19102 “Philadelphia’s Periodontist” 215-735-3660 “Philadelphia’s Periodontist” 215-735-3660 Brown Center for Laser Periodontics and Implants www.theperiogroup.com • [email protected] Brown Center for Laser Periodontics and Implants www.theperiogroup.com • [email protected] the and used to cover gingival tissue is anesthetized. A coverage in 90% of the teeth the area of recession. Another small entry point is made in the treated with Chao Pinhole Gum treatment option involves using gingiva above the tooth or teeth to Rejuvenation. allograft material such as be treated. A series of specialized Until the invention of Pinhole Alloderm® or freeze-dried donor dental instruments are inserted Gum Rejuvenation, connective tissue to cover the recessed areas. into the entry point and moved to tissue grafting surgery was the While both CTG and allograft free the gingival tissue. Then the standard treatment for recession. procedures tend to be highly gingival tissue is gently guided However, connective tissue successful, Dr. Stephen Brown has apically or coronally to the proper grafting requires tissue to be now been trained and certified to position for a normal gingival taken from the palate or a donor use a new technique called Chao margin. tissue must be used in order to Pinhole Gum Rejuvenation. Next, a small angled instrument complete the treatment. Because Chao Pinhole Gum is used to pass several collagen these procedures generally require Rejuvenation was patented by strips through the entry point and cutting and suturing, Dr. John Chao after years of place them under the gingiva. The the amount of teeth that can development and trials. This collagen helps to keep the gingival be treated at one time is technique, used along with a set tissue in place and stimulates the sometimes limited. Pinhole Gum of specially designed and patented body to generate more collagen. Rejuvenation can address several dental instruments, offers a Pinhole Gum Rejuvenation can teeth through just one tiny entry number of advantages for patients. treat as many as ten teeth at the point and, unlike connective tissue Chao Pinhole Gum same time. The small entry point grafting, multiple teeth Rejuvenation quickly heals and is virtually can be treated in one session. undetectable the next day. Etiology of Gingival Chao Pinhole Gum The primary purpose of Rejuvenation is a sophisticated Pinhole Gum Rejuvenation is Recession way to move receding gingiva to save the tooth by stopping z An anatomical condition with back into place without grafting additional recession and bone loss. a pre-existing or acquired surgery. Rather than transferring Additionally, an attempt is made alveolar bone dehiscence gingival tissue from the palate to cover the exposed root surface. combined with localized to the area of recession, the new This is a breakthrough in treating prominent tooth malposition, technique can be completed with recessions, when applicable. inadequate keratinized gingi- virtually no discomfort and no A research study published by val dimensions in quality and downtime. Dr. Chao in the International quantity, high muscle attach- The procedure consists of the Journal of Periodontics and ment, and frenum pull. following steps: The affected teeth Restorative Dentistry found 90% are cleaned and prepared, and the

The Pinhole Technique vs. The Graft Technique z Occlusal disturbances and accumulation of of the restoration with over- para-functional habits. due to improper brushing contouring or a gap between z Traumatic, overzealous techniques. the margin of the crown and tooth brushing techniques z Iatrogenic factors related the tooth structure). (i.e., forceful, horizontal) to periodontal, orthodontic, Criteria for Patients frequently associated with a and periodontal/restorative pre-existing lack of cortical procedures on thin biotype z Healthy or mild systemic bone, or acquired bone (i.e., , apically disease dehiscence positioned flap, tooth over z No contraindications for z Uncontrolled marginal preparation violating the bio- periodontal surgery. inflammation with logic width, incorrect fitting (continued on the next page)

Case #2 BEFORE AFTER

Case #3 BEFORE AFTER

BEFORE Case #4 AFTER

continued on the next page z Absence of previous peri- z Faster recovery for the patient While both procedures are odontal surgery at the than traditional grafting highly successful, Chao Pinhole involved sites z Usually no need for uncom- Gum Rejuvenation offers PDL tm z History of compliance with fortable sutures many advantages for patients as noted earlier in this article. instructions and z No need for scalpels periodontal recall For the fearful patient, this z No need to take donor tissue procedure could be the difference z Absence of plaque and bleed- from the patient’s palate between possible tooth loss and ing on probing at surgical z continuing discomfort or tooth I. Stephen Brown, D.D.S. “Excellence in Non-Surgical Periodontics, Implants & Laser Treatment” sites Excellent, natural-looking, long-lasting results retention, comfort, and improved z Presence of bone and papilla appearance. z One appointment height between the teeth We are pleased to offer this z Possible tooth loss is avoided What Are the Ben- new technique for your patients z A more attractive smile! with recession. If you have efits of Pinhole Gum questions about Chao Pinhole Rejuvenation? Conclusion Gum Rejuvenation or a particular z Less discomfort for the Pinhole Gum Rejuvenation case to discuss, give us a call. patient after treatment and offers patients an alternative to As always, we welcome your minimal downtime connective tissue graft surgery comments and suggestions. to treat gingival recession.

Did you know? Dr. Brown lectures nationally and Dr. Brown is the first and only periodontist internationally, and is Professor of Periodontics in the Philadelphia area to be certified to use the at The University of Pennsylvania School of revolutionary Chao Pinhole Gum Rejuvenation Dental Medicine and Temple University School Technique. of Dentistry. He is Director of the Dental Dr. Brown has long been recognized as Implant Division at Albert Einstein Medical an “Opinion Leader,” seeking out the latest Center and is an Examiner for the American technologies for the benefit of his patients. He was Board of (ABP). The ABP is the also the first periodontist in the Philadelphia region organization that certifies all periodontists in the to be certified to deliver the LANAP Protocol. He United States. is a nationally recognized pioneer in the use of this Laser Assisted New Attachment Procedure, a ground breaking alternative to conventional surgery for the treatment of gum disease. He recently published an important article on the subject in the journal, Current Advances in Periodontics. Dr. Brown offers his patients and colleagues the Carestream Cone Beam CT, a state-of-the-art 3D Imaging System, which produces low radiation CAT Scans to enhance treatment planning and Dr. Brown and Dr. Chao at the Pinhole Academy surgical success. in California.

I. Stephen Brown, D.D.S. 220 S. 16th Street, Suite 300, Philadelphia, Pennsylvania, 19102 I. Stephen Brown, D.D.S. 220 S. 16th Street, Suite 300, Philadelphia, Pennsylvania, 19102 “Philadelphia’s Periodontist” 215-735-3660 “Philadelphia’s Periodontist” 215-735-3660 Brown Center for Laser Periodontics and Implants www.theperiogroup.com • [email protected] Brown Center for Laser Periodontics and Implants www.theperiogroup.com • [email protected]