New Dental X-Rays Offer Great Advantages

CT scan technology combined with new computer programs allows periodontists to plan dental cases in advance, get better results, and shorten treatment time.

We have been using CT scan technology in our practice now for about a decade.  It is perhaps the single most important tool that we have in our office.  It literally lets us see through the bone, very much the way I would take an apple, cut that apple in half and be able to open it up and look inside.  With the CT scan, I have that same ability to take an image of your jaw, cut it in half and look at the inside of your jaw.  In doing so, we have so many advantages.  Diagnostically, we can find certain types of lesions that are related to root canals or failing root canals that we may not ordinarily see on regular dental X-rays.  We can certainly see the anatomy much better.  We can find where the sinuses are with great accuracy.  We can find where certain nerves are located, so we can avoid them during surgery.

We also have planning software that works with these images that allows us to use our computer to plan out an entire case in advance, whether it is for a single implant or for many implants and make sure that we place the implant in the most ideal position.  That planning lets us do a much better job, more accurately, more efficiently when it comes to doing the actual surgery.

Beyond that, in many instances, we then mill guides that allow us to take our plan that we made on the computer and with tremendous accuracy replicate t through a CAD cam, meaning a computer-assisted design, computer-assisted milling process.  We mill a guide and replicate our plan that we made without the patient there and then deliver  on the day of treatment the same exact plan that we designed in advance.

This process allows us to do certain procedures that may require going around a nerve or a sinus much more accurately and safer than we would ordinarily.  It also allows us the opportunity to maximize what little bone some patients may have remaining.  It also lets us place implants in the most ideal position.  Finally, with high-tech x-rays and software, we work much more efficiently and we can do less invasive procedures.  By taking advantage of CT scan technology, we minimize chair time for the patient.

In sum, we are able to take CT scan information, combine it with computer planning ahead of time, and then ultimately deliver a superior outcome for our patients.


IMG_3490_lowDr. Frederic J. Norkin
South Florida Center for Periodontics & Implant Dentistry

Boca Raton Periodontist Explains Board Certification

Boca Raton Periodontist Dr. Fred Norkin explains the rigorous board certification process and how it makes him a better clinician.

After completing dental school at Tuft University, in Boston, Massachusetts, a general practice residency at the Miami Veterans Administration Hospital, in Miami, Florida, and a periodontal residency at Nova Southeastern University in Fort Lauderdale, Florida, I went on to become board-certified.  Becoming a board certified periodontist is essentially a two-step process.  First, you take and pass a written examination, and the next step is an oral examination.  At that point, the periodontist is board certified and becomes what is called a “diplomate” of the American Board of Periodontology.

Many people are surprised to learn that only about 50 or 60 percent of all practicing periodontists become board-certified.  Every seven years diplomates must be recertified in our specialty through a written examination.  This is the process we use to maintain our board certification.

The value of this voluntary and prestigious credential is that it forces us, as periodontists, to hone our specialty knowledge and make sure that we are current on all of the recent studies and scientific literature.  We need to show that we are able to weave that knowledge into thoughtful, sensible treatment plans and outcomes for our patients.

There may be many ways to treat a patient or an individual problem, and I may not agree completely with another colleague.  The board certification process essentially makes sure that different potential treatment plans put forth by various periodontists for particular case plans make sense.  By constantly challenging ourselves to think through all the treatment issues in depth and be prepared to defend our conclusions in front of our colleagues, we help ensure that patients are getting the best we have to offer.

I know from experience that my commitment to board certification has caused me to sharpen my skills and stay on the leading edge of periodontal and dental implant treatment.



Dr. Frederic J. Norkin
South Florida Center for Periodontics & Implant Dentistry

Sinus Lift: what is it and do you need one?

A sinus lift is recommended when there is not enough bone height in the upper jaw or not enough room between sinuses for dental implants to be placed. The surgery adds necessary bone to the jaw and the sinuses on either side of your nose to build a stronger foundation in preparation for dental implants. The sinus membrane is lifted by a dental specialist (oral surgeon, endodontist or periodontist) to make room for the bone transplant.

Do I Need a Sinus Lift? Maybe…

You may be a candidate for a sinus lift if you have bone loss due to periodontitis or resorption of bone after a prolonged period of having missing teeth (sunken jaw). It’s often necessary in these circumstances to augment the existing bone in the jaw in preparation for dental implants. The donor bone may come from your own body or other medically appropriate substitute. If the bone comes from your own body, it is most often taken from your hip or tibia. You will have x-rays taken to determine the anatomy of your jaw and sinuses, as well as a CT scan to accurately measure the height and width of your existing bone.

How’s a Sinus Lift Done?

The actual sinus lift procedure starts with your dental specialist creating an incision in the back of your mouth to reveal the bone, raising the sinus membrane up and away from your jaw. Then a small, circular shaped hole in the bone is opened. Granules of the bone graft are packed into this hole, and the tissue will then be closed with stitches.

don't sneezeAftercare Instructions for Sinus Lift

After the procedure it is important to avoid blowing your nose or sneezing forcefully. These place you at risk for loosening the graft and stitches. You’ll have a saline wash to keep the inner lining of your nose wet, as well as an antimicrobial mouthwash that helps prevent infection at the incision site. Pain meds will be prescribed as will antibiotics. Be sure to complete the full round of antibiotics.

After a sinus lift, contact us if swelling or pain gets worse over time. Should bleeding not stop after two days or if the blood is bright red and continuous, your bone graft may have become dislodged, call us immediately. Also let us know if you develop a fever as this could be a sign of infection. The healing process generally takes between four to nine months. This allows the bone graft to mesh with your bone, and after it’s healed, you will be ready for your dental implants.

If you are interested in dental implants or have questions about the sinus lift procedure, call us today at (561) 912-9993

index_dr_ganales-xsDr. Jeffrey Ganeles
South Florida Center for Periodontics and Implant Dentistry
Boca Raton, FL
New Patients Welcome

Dental Lasers Provide Minimally Invasive Treatment and Much Faster Healing Time.

Periodontist and implant dentistry expert Dr. Jeffrey Ganeles uses different lasers for treatment that is minimally invasive and comfortable.

We have different lasers that we use.  One is called the diode laser and we use that one simply to do small surgical procedures where we are just trying to trim tissue.  The advantage is there is virtually no discomfort, there is no bleeding, and the treated area heals very quickly.

The other kind of laser that we have is called a YAG laser and that has a number of special properties associated with it. This laser specifically destroys the bacteria in the gum that causes periodontal disease.  The YAG laser seems to be able to distinguish or selectively treat diseased tissue and leave healthy tissue alone, which is specific to the wavelength of the YAG laser.  Other lasers do not have this capability and that is the reason that this one is FDA approved for that purpose while other ones are not.

The YAG laser also seems to stimulate the healing process so that the cells that are involved in repair get turned on as a result of stimulation by the specific wavelength of this laser.  In addition, the YAG laser was just FDA approved for their claim of periodontal regeneration, which means that it stimulates new bone and attachment to root surfaces that have been damaged as a result of periodontal disease.  We have observed this process occasionally and somewhat inconsistently but it certainly is a possibility.

Another advantage of using lasers is they cause the patient virtually no discomfort.  One of the other properties of lasers is that they tend to seal off the nerve endings associated with pain.  This means that we can do a fairly aggressive procedure with a laser and patients may only need to take a Tylenol or an Ibuprofen afterwards, because the nerve endings have been treated by the laser and discomfort is greatly reduced..

The YAG laser also appears to be helpful in treating problems around implants.  We are very enthusiastic about this property because some implants can develop problems, including infections around them.  The laser destroys the bacteria and promotes healing in the gum around the implant.  The beauty of this again is that there is virtually no discomfort associated with it.

The procedure we used to do to accomplish the same thing was a much more invasive surgical procedure that required healing time, a lot more expense in terms of materials that were used, such as bone grafting materials, and we were not getting any better results than we get with a laser.  So the laser allows us to do more with a minimally invasive approach, much faster patient healing time, and no surgery

index_dr_ganales-xsDr. Jeffrey Ganeles
South Florida Center for Periodontics and Implant Dentistry
Boca Raton, FL
New Patients Welcome

Gum Reshaping: Simple Procedure that Dramatically Improves Smile

Gum reshaping is a relatively simple procedure performed by Dr. Jeffrey Ganeles to reveal tooth structure and give patients a better smile.

Gum reshaping is a procedure that we do when patients have too much gum covering their teeth.  The problem is not so much that they have short crowns but some patients appear to have small, square teeth when they smile, or when they smile they just show a lot of gums and very little white teeth.  When that happens it is often a condition called “altered passive eruption,” which is a fancy term for saying that the gums simply are overlapping the teeth too much.  As a result, the patient has a less than desirable smile.

The patients who have too much gum tissue often think that their teeth are the problem and they assume that very little can be done to make their teeth larger or less square.  However, the problem may just be that the surface of the teeth are hidden by too much gum.

To solve this problem, we reposition the gum so we can expose all the natural tooth structure that is there.  This procedure is used commonly for adolescents after orthodontics, and we create really dramatic results for patients when we can reposition their teeth.  We call it a “gum lift,” even though it is not a very accurate term, but gum reshaping is a quick and simple one that we do routinely in our periodontal office and it brightens up a patient’s smile immediately.

Gum reshaping is one of the most gratifying procedures we do in our office and it is not too uncomfortable, it is certainly not very involved, and the patient’s recovery time is very quick.  This procedure provides a huge cosmetic advantage for many patients.  Many patients are pleasantly surprised that such a simple procedure provides them with a dramatic esthetic benefit.

Dr. Jeffrey Ganeles
South Florida Center for Periodontics and Implant Dentistry
Boca Raton, FL
New Patients Welcome