PERIODONTAL SERVICES

Lindsey Pikos Rosati, DDS

Dr. Lindsey Pikos Rosati was born in Dunedin, Florida and was raised in the Tampa Bay area.  She graduated Phi Beta Kappa from the University of Florida with a Bachelor of Science (BS) in Biology.  Dr. Rosati then received her Doctor of Dental Science (DDS) degree from the University of North Carolina at Chapel Hill School of Dentistry.  

Dr. Rosati received her residency training in Periodontology from the Department of Periodontology at the University of Florida College of Dentistry (Shands Hospital).  In her final year of training, Dr. Rosati was the Chief Resident and received her Certificate and Master of Science (MS) degree in Periodontology.

At Coastal Jaw Surgery, Dr. Rosati practices a full scope of Periodontal Surgery with an emphasis on soft tissue grafting and bone grafting, periodontal-orthodontic procedures, dental implants and periodontal surgeries.

Dr. Rosati is an active member of the American Academy of Periodontology, Florida Association of Periodontists and Pinnacle Study Club of Tampa Bay.

Dr. Rosati is also actively involved in several community and volunteer organizations, including providing free dental services to those in need at the health clinic and serving and delivering meals at the church sponsored soup kitchens. In her spare time, Dr. Rosati is an avid athlete and has completed an Ironman Triathlon and the Boston Marathon.  She is happily married to her high school sweetheart, Sam, and together they have a Labrador retriever (Jackson) and horse (Trilogy).

Career Achievements

  • Residency: Department of Periodontology, University of Florida College of Dentistry (Shands Hospital), Chief Resident
  • DDS: University of North Carolina at Chapel Hill School of Dentistry
  • BS: University of Florida (Phi Beta Kappa)

Memberships: American Academy of Periodontology, Florida Association of Periodontists, Pinnacle Study Club of Tampa Bay

List of Periodontal Services Provided at Coastal Jaw Surgery

Treatment of Gum Recession
  • Alternatives to taking tissue from roof of mouth/minimally invasive techniques for gum grafting
  • Autogenous free gingival grafts
  • Autogenous connective tissue grafts
Treatment of Gummy Smile/Oral Plastic Surgery
  • Esthetic crown lengthening
  • Functional crown lengthening
Treatment of Periodontal Disease (Gum disease)
  • Scaling and Root Planing (deep cleaning)
  • Routine cleanings
  • Gingivectomy
  • Pocket Reduction (Open Flap Debridement & Osseous Surgery)
  • Guided Tissue Regeneration
Minimally Traumatic Extractions
  • Ridge Preservation after tooth extraction
Bone Grafting-Ridge Augmentation
  • Guided Bone Regeneration
  • Sinus Lifts
Implants
  • Single tooth replacement
  • Implant supported bridge
Periodontal-Orthodontic Procedures
  • Periodontally Accelerated Osteogenic Orthodontics/Wilckodontics
  • Canine exposures
  • Soft tissue grafting to prevent recession
  • Frenectomy
Sedation Dentistry
  • Nitrous Oxide Sedation
  • Oral Sedation
  • Intravenous Sedation
Biopsies
Treatment of Peri-Implantitis

Description of Periodontal Services Provided at Coastal Jaw Surgery

Treatment of Gum Recession

Often times, roots of teeth become exposed as a result of gum recession. Teeth begin to appear to look longer than normal as the gum tissues move towards the root. Gum graft surgery can help prevent the recession from getting worse, and in many cases, can even cover some of the exposed root surfaces to provide improved support for the teeth and a more esthetic smile.

Gum grafting is an attempt to repair the gum line to a state of health and prevent further recession. Gum grafts can be taken from the patient’s own tissues as well as from donor tissues, depending on the patient’s initial presentation and symptoms. Free gingival grafts involve harvesting autogenous tissue (patient’s own tissue) from the patient’s roof of the mouth and transplanting it to the site that needs treatment. Connective tissue grafts also harvest autogenous tissue and are used to help obtain root coverage and thicken the tissues in order to provide additional support and an esthetic result. Autogenous tissues are often considered the gold standard.

A minimally invasive approach to gum grafting involves a procedure known as “tunneling”. This procedure creates a small pouch beneath the gums and uses donor tissue to thicken the patient’s gums and even can cover exposed root surfaces in certain indications.  The benefit is that the grafted tissue does not need to be taken from the patient’s roof of the mouth, thus reducing patient discomfort.

Gum grafts often provide a combined benefit of improving both function and health- crucial to chewing, speaking and smiling with comfort and confidence.

Causes of Gum Recession
  • Aggressive tooth brushing
  • Age
  • Gum disease
  • Genetics
  • Smoking
  • Plaque accumulation
  • Orthodontic treatment
  • Trauma to the gums
Indications for Treating Gum Recession
  • Decay on root surfaces
  • Increased sensitivity- especially to hot and cold
  • Esthetic concerns
  • Prevention of tooth and bone loss
Benefits of Gum Grafting Surgery
  • Prevent further recession and bone loss
  • Improved tissue thickness
  • In some cases, obtain coverage on the exposed root surfaces
  • Improve the esthetics of the smile

Treatment of Gummy Smile/Oral Plastic Surgery

Esthetic Crown Lengthening

Do you feel like your teeth are too short or that you show too much gum tissue when you smile? This is called a “gummy smile” and can be treated with a procedure known as esthetic crown lengthening. This involves removing some of the excess gum tissues to expose more of the tooth crown and resculpting the gums so that they fit your teeth better. This ultimately will make the teeth longer and improve the esthetic appearance of the smile.

Functional Crown Lengthening

Often times due to large cavities or if a tooth is broken below the gum line, a crown is required. However, sometimes the crown is too close to the patient’s gums and bones. In these cases, a procedure known as crown lengthening is needed in order to gain enough space for the crown or filling. Crown lengthening adjusts the levels of the bone and gums in order to expose more tooth structure and allow for a properly fitting crown to be made.

Treatment of Periodontal Disease (Gum disease)

According to the American Academy of Periodontology, periodontal (gum) disease is a chronic inflammatory disease that affects the gums and bone supporting the teeth. It is the leading cause of tooth loss and has associations with systemic health issues such as diabetes and cardiovascular (heart) disease. The Center for Disease Control performed a study in 2012 and found that 47.2% or 64.7 million American adults have mild, moderate or severe periodontitis. In adults 75 and older, the rate increases to 70.1%.

The gums and bone are the foundation for the teeth. In periodontal disease, these supporting structures are destroyed, creating space between the teeth, gums and bone. This ultimately leads to pocketing, which houses harmful bacteria. As the bacteria multiply and invade the supporting gums and bone, they further destroy the foundation, making teeth loose, and eventually causing them to have to be extracted.

Types of Periodontal Disease

Gingivitis- initial stage of periodontal disease involving red, swollen, bleeding, gums. It is reversible with treatment; however, if left untreated, can lead to periodontal disease and potentially tooth loss and other health problems.

Periodontitis- Plaque and disease causing bacteria can spread below the gum line and cause the body to be in a chronic state of inflammation. This ultimately causes the destruction of bone and soft tissues, creating space between the gums and teeth, which leads to the formation of infected periodontal pockets. As the disease advances, the pockets become deeper as more gum and bone tissue destructions occurs. This can lead to tooth mobility and potentially even loss.

Causes of Periodontal Disease

  • Plaque and pathogenic bacteria
  • Smoking
  • Genetics
  • Age
  • Stress
  • Medications
  • Grinding teeth
  • Systemic diseases (diabetes, heart disease, etc)

Non-Surgical Treatment of Periodontal Disease

The first approach to treating periodontal disease is via scaling and root planing (also known as a deep cleaning). This involves meticulously cleaning the diseased root surfaces and removing the plaque and disease causing bacteria. Non-surgical therapy is often sufficient to treat periodontal disease; however, it is crucial to maintain strict maintenance therapy (routine 3 month cleanings) in order to maintain health.

Surgical Treatment of Periodontal Disease

Periodontal Pocket Reduction

The gums and bone are the foundation for the teeth. In periodontal disease, these supporting structures are destroyed, creating space between the teeth, gums and bone. This ultimately leads to pocketing, which houses harmful bacteria. As the bacteria multiply and invade the supporting gums and bone, they further destroy the foundation, making teeth loose, and eventually causing them to have to be extracted.

Deep periodontal pockets are unable to be adequately cleaned by neither the patient nor the dental clinician. If deep pockets remain even after non-surgical therapy (scaling and root planing), surgical therapy is often the next step. Thus, periodontal procedures known as pocket reduction are performed in order to gain access, fold the gum tissues back, clean these deep pockets, remove the disease causing bacteria, create an environment that is amenable to cleaning by the patient and ultimately restore the gum and bone tissues to a state of health. These procedures are performed in order to prevent further damage caused by the disease process and to restore a healthy smile.

Deep pockets are very difficult to clean. Periodontal disease has many connections with the rest of the body and can lead to diabetes and heart disease. Thus, these procedures are necessary not only to maintain a beautiful, healthy smile but also to decrease the risk of serious health issues associated with periodontal disease.

Gingivectomy

Gingivectomies are procedures performed by the periodontist that involve removing and reshaping excess gum tissues that cause deep pocketing around the teeth. Gum tissue overgrowth can arise due to periodontal disease, genetics, or certain medications. Gingivectomies are usually performed when a patient has gum disease that has not responded well to scaling and root planing (deep periodontal cleaning) or other periodontal therapeutic measures. Deep pockets still remain due to excess gum tissue. Thus, gingivectomies are needed in order to restore a state of health and effectively treat gum disease.

Guided Tissue Regeneration

The gums and bone are the foundation for the teeth. In periodontal disease, these supporting structures are destroyed. Procedures known as guided tissue regeneration regrow lost bone and tissue in order to provide support for the teeth and reverse some of the destruction caused by periodontal disease.

Minimally Traumatic Extractions/Site Preservation

Reasons for tooth extraction: periodontal disease, fractured teeth, decayed teeth, loose teeth, infected teeth, etc. Every attempt is made to save the natural teeth; however, when teeth can no longer be saved or restored, extractions are indicated. When teeth are removed, every precaution is taken to minimize patient discomfort and to preserve the surrounding bone in order to minimize the amount of bone loss that will occur naturally as a result of the tooth extraction. 

Unfortunately, bone tends to atrophy (shrink) over time from tooth loss, similar to how muscles atrophy over time when they are not used. After a tooth is removed, the height and width of the tooth socket will shrink over time.

Bone grafts are often placed into the tooth sockets to prevent the gum tissue from having a concavity in the site where the tooth was removed. Socket bone grafting is not only for esthetics, but it is also crucial for providing a foundation of bone that could house a future dental implant. The bone grafts act as scaffolds to help support the tissues and to encourage your body to begin forming new bone cells to regenerate the bone during healing. Thus, a strong foundation of bone with sufficient width and height is needed to support a future implant.

Bone Grafting-Ridge Augmentation

Whether it was one tooth or multiple teeth that were removed, bone tends to atrophy (shrink) over time from tooth loss, similar to how muscles atrophy over time when they are not used. After a tooth is removed, the height and width of the tooth socket will shrink over time. Likewise, the jawbones themselves will also decrease in height and width as a result of tooth loss. There are numerous ways to help regrow the lost bone in these regions in order to support future implants and to also provide support for the hard and soft tissues to provide the most esthetic and functional outcome possible. Our surgeons can discuss the various means (guided bone regeneration, autogenous bone grafts, sinus lifts, etc) of building up this bone with you.

Implants

Dental implants are often the ideal treatment option for patients who are missing teeth. A dental implant is a titanium post that is surgically embedded in your jawbone to replace a natural tooth root. A dental crown, bridge, or full-arch denture is then attached to the implant post to replace the entire structure of the missing tooth. Our practice uses advanced imaging techniques to plan your treatment and ensure your comfort and safety. Please contact us today to schedule your dental implants consultation at our Palm HarborTrinity, or Spring Hill location. Learn more about our dental implants services.

Periodontal-Orthodontic Procedures

Periodontally Accelerated Osteogenic Orthodontics/Wilckodontics

Periodontally Accelerated Osteogenic Orthodontics, also known as Wilckodontics, involves a combination of periodontal and orthodontic treatment in order to speed up the time that you are in braces! This technique takes advantage of the regional acceleratory phenomenon (RAP) in which the bone stimulation spurs the bone to remodel and thus allow for faster tooth movement. Studies have shown that tooth movement via this periodontal procedure is 2-3 times faster than with traditional braces alone. Our periodontist would work in conjunction with your orthodontist to coordinate this treatment in order to obtain the best functional and esthetic result in an accelerated manner.

Canine Exposures

The canines, commonly known as the “eye teeth” often do not come through the bone and soft tissues and into the dental arch in the way that the other teeth do. This is known as an impacted tooth. In order to bring this tooth into the dental arch where it should be positioned, a procedure known as a canine exposure can be performed by your periodontist. This involves getting access to the tooth by folding back the gum tissue and recontouring the bone, bonding an orthodontic bracket to the impacted tooth, and attaching that bracket to the orthodontic arch wire that the rest of the teeth are attached to. Once this tooth is exposed, the orthodontist can activate the tooth and begin moving it into its correct position. Our periodontist would coordinate with your orthodontist to ensure a timely and esthetic treatment outcome.

Soft Tissue Grafting to Thicken Tissues and Prevent Recession During Orthodontic Treatment

Often times, prior to a patient getting braces, or even during the time that they have braces, the gum tissues are thin and need to be thickened. Soft tissue grafting can thicken the tissues so that recession does not develop as a result of orthodontic tooth movement.

In other instances, there is not enough resilient tissue (known as attached and keratinized gingiva), and this lack of tissue can lead to recession. Soft tissue grafting procedures can be performed in order to add more of this resilient gingiva and prevent recession. In cases where recession is already present, this grafting can help prevent the recession from getting worse.

Sedation Dentistry

If you are nervous about the dental procedure, we can provide various forms of sedation in order to put you more at ease.  Our goal is to make sure you are as comfortable as possible during the procedures. We can further discuss these options at the consultation appointment, but here is a brief description.

We offer Nitrous Oxide Sedation, also known as laughing gas. This involves breathing nitrous oxide gas through a mask and it makes you more relaxed. Benefits of extremely safe and effective method of sedation include a short duration of onset and brief recovery time.

We also offer Oral Sedation, which involves taking an oral sedative pill by mouth the night before and the morning of the procedure in order to calm your nerves and make you more relaxed.

Lastly, we offer Intravenous Light Conscious Sedation (IV sedation), which involves administering sedative medications directly into the blood stream by starting an intravenous line. During the procedure, one would be able to respond to the prompts by the surgeon such as opening the mouth, turning the head, etc but the medications allow the patient to be very relaxed and comfortable. The sedative medications also tend to cause memory loss. The surgeons and staff are highly trained and closely monitor the patient during the sedation. Monitoring including Electrocardiogram devices, capnography, pulse oximetry, etc are used to ensure that the patient is safe at all times.

Biopsies

Cancers can occur anywhere in the oral cavity and oropharyngeal region, but are mostly commonly found on the lateral border of the tongue and the floor of the mouth. The American Cancer Society estimates that 49,670 people will get oral cavity or oral pharyngeal cancer and an estimated 9,700 people will die from these in 2017. Thus, it is imperative to routinely perform oral cancer screenings when examining patients. While our surgeons are comprehensively examining the patients, they look for oral cancers, and if they find a suspicious area, can remove it and send it to a pathologist who can determine the proper diagnosis and if need be, further treatment. Our surgeons will discuss the pathology results and coordinate treatment in an efficient and timely manner.

Treatment of Peri-Implantitis

Unfortunately, implants are not entirely immune to problems. If not properly maintained, bone and soft tissue issues can arise, leading to bone loss, implant mobility and potentially implant loss. This is commonly known as peri-implantitis and needs to be treated immediately in order to prevent loss of the implant. Treatment involves cleaning out the area, removing harmful bacteria that cause destruction and potentially building back the bone that was lost in certain cases if possible. It is imperative to routinely see your periodontist and hygienist in order to maintain implants after they are placed, similar to maintaining frequent oil changes in your vehicle.