Our practice provides a variety of surgical services. Dr. Fleckenstein prides himself on the fact that he is conservative in his treatment recommendations and limits surgery to the areas where it is absolutely necessary. Periodontal procedures are available to regenerate the bone and gum tissue to their original function and cosmetic appearance.

Aesthetic Periodontal Surgery
These procedures are a predictable way to cover unsightly, sensitive or exposed root surfaces and to prevent future gum recession. If you are unhappy with the appearance of short unsightly teeth, this can be greatly improved by a combination of periodontal procedures by our doctors and cosmetic dentistry by your dentist.

Microsurgery: an Atraumatic Approach
Drs. Fleckenstein specializes in periodontal microsurgical techniques, and is one of West Virginia's pioneers in this minimally invasive, atraumatic, advanced surgical approach. Dr. Fleckenstein has studied under the guidance of, and uses techniques pioneered by Dennis A. Shanelec, D.D.S. of Santa Barbara, CA, the innovator of periodontal microsurgery. As a result of refined specialized microsurgical techniques, the patient experiences small incisions, less pain, faster healing and more predictable esthetic results. Advanced surgical skills and technological innovations make periodontics with the benefit of the surgical microscope the most comfortable and effective therapy possible. Our clinical team looks forward to answering your questions about how surgical microscope techniques can benefit you.

Crown Lengthening
There are several reasons for crown lengthening: When decay or fractures occur below the gum line, it may be necessary to remove a small amount of bone and gum tissue to expose it. Your dentist may ask for this procedure before he or she makes a new crown for your tooth. Reshaping the gum and supporting tissues will allow your restorative dentist adequate room to place a quality final restoration.

Another indication for crown lengthening is when the front teeth are too short or of uneven length. Here esthetic crown lengthening can help create a healthy, symmetrical, highly esthetic result.

Osseous Surgery
Traditionally, gum disease is treated to eliminate the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today in clinical situations where they apply. Osseous surgery provides access to tooth roots in deep pockets so that they can be cleaned to better eliminate bone destroying periodontal disease.

Guided Tissue Bone Regeneration
This surgical procedure "regenerates" the previously lost bone tissue. Most techniques utilize membranes, which are inserted over the bone defects. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bioactive gels and bone grafting around teeth to help rebuild lost bone.

Bone Grafting
Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.

We now have the ability to grow bone where needed. This gives us the opportunity to place implants of proper length and width, and it also gives us a chance to more effectively restore esthetic appearance and functionality.

Ridge Preservation
Careful management of extraction sockets after tooth extraction prevents unsightly bone loss and a better cosmetic outcome of tooth replacement. Ridge preservation can leave the bone ready to receive dental implants after healing.

Non-Surgical Services
We can use modern techniques to help rebuild lost bone support. The emphasis in our practice is conservative periodontal therapy. Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. This usually consists of placing a fine ultrasonic tip in between the tooth and gum tissue to remove any plaque and calculus below the gum line.

This procedure is called root planing. Four to six weeks later, many shallower periodontal pockets are eliminated due to gum shrinkage. Then the patient can personally maintain these areas with routine brushing and flossing.

Even in most severe cases of periodontal disease, non-surgical periodontal therapy most often precedes surgical therapy. This is done so that the overall tissue quality is improved prior to surgery, to help evaluate the patient’s ability to heal, and limit the areas of required surgery.

Treatment Methods
Treatment methods depend upon the type of disease and how far the condition has progressed. The first step is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line. The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion (bite) may require adjustment.

When deep pockets between teeth and gums are present, it is difficult for the doctor to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.

Dental Implants
Dental implants have been one of the greatest advances in dentistry over the last 20 years, if not the biggest! With them, people are rediscovering the comfort and confidence to eat, speak, laugh and enjoy life

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. The implants themselves are  titanium cylinders that are placed into the jawbone where teeth are missing. The bone bonds with the titanium, ultimately serving as a replacement of the natural tooth root, on which a prosthetic tooth can be fabricated. In addition, implants can help preserve facial structure, preventing the bone deterioration which occurs when teeth are missing.

Dr. Fleckenstein has received extensive training in Implantology. He has been successfully placing implants for several years and through continuing education, has kept current on the ever evolving subject of implant dentistry.

If, like many others, you feel implant dentistry is the choice for you, we ask that you undergo a dental/radiographic examination and health history. During these consultation visits, the doctor will address your specific needs and considerations. Your questions and concerns are important to us and our team will work with you very closely to help make your procedure a success.

For some patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to four months following surgery, the implants are beneath the surface of the gums gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your restorative dentist designs the final bridgework or denture, which will ultimately improve both function and aesthetics.

After the implant has bonded to the jawbone, the second phase begins. The doctor will uncover the implants and attach a small healing cap. After two weeks your 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 six to eight months. Most patients do not experience any disruption in their daily life.

Photos illustrating connective tissue grafts performed with a microsurgical technique designed to cover root recession.
Before and after xrays of a dental implant used to replace the upper left first molar.
Xrays demonstrating bone repair after guided tissue regeneration procedure.
Kurt B. Fleckenstein DDS, MS
Periodontal Procedures
Kurt B. Fleckenstein, DDS, MS, PLLC
Diplomate of the American Board of Periodontology

Practice Limited to Periodontics and Implant Dentistry
Kurt B. Fleckenstein, DDS, MS, PLLC
2674 5th Avenue, Huntington, WV, 25702