After a detailed clinical and radiographic examination using the most advanced diagnostic tools, problems are diagnosed and treatment options are suggested to the patients by the Head of our Clinic Dr. George Goumenos.
PERIOCARE GOUMENOS L.P. has developed further training which aims in the improvement of clinical skills of colleagues who wish to be trained in the most advanced techniques in Periodontics and Implantology.
The periodontal services of our clinic include the prevention, diagnosis and treatment of periodontal diseases (gingivitis, periodontitis). The initial periodontal treatment is a non-surgical one (conservative treatment). This includes the individualized training of our patients in an oral hygiene routine, where, depending on the anatomical particularities of their mouth, we select the appropriate means and brushing technique as well as dental scaling (removal of tartar) using ultrasounds and root planing. In some cases, conservative treatment is complemented by the use of lasers. Special attention is given to the treatment of “sensitive” teeth.
If necessary, surgical treatment is likely to be used to control periodontal disease, always following the re-evaluation of the results of the previous non-surgical treatment.
Lasers are state of the art tools with a wide variety of applications. In our clinic, they are used as a complementary tool in cases of periodontal or peri-implant disease, where the traditional techniques have not yielded the desired results. They are always used by a specialized Periodontist who is highly qualified in laser treatment.
The main goal of using lasers in periodontal treatment is to reduce the need for surgical treatment, as well as to preserve teeth with poor prognosis, which wouldn’t otherwise be treatable by surgical intervention. In certain surgical procedures lasers also offer the advantage of a bloodless intervention, due to the induction of hemostasis following their use (e.g. gingivectomy, frenectomy).
When it comes to treating peri-implantitis, laser treatment is a reliable tool for the complementary treatment of the implant surface affected by bacteria.
One of the most frequent reasons patients visit our clinic is that their gums exceed when they smile causing esthetic disharmonies. The most common esthetic problems of the upper anterior teeth are the following: receding gums which results in the exposure of the root surface in one or more teeth, asymmetry of the gingival margin, shrinkage and formation of a gum concavity after the extraction of one or more teeth, dark pigmentation of the gums and, lastly, too much gums showing in the patients’ smile.
Using the most advanced plastic surgery techniques and with the help of non-traumatic instruments, microscope-aided microsurgery, and often lasers alone or in combination with these techniques, we are able to solve the most difficult esthetic problems of your smile.
In the past, the main goal of periodontal treatment was mainly to cease and prevent further bone loss. Advances in molecular biology and the evolution of biomaterials in recent years offer, – in many cases- the possibility of periodontal tissue regeneration. More specifically teeth which had to be extracted can now be preserved in patients’ mouths for years and without symptoms.
Our clinic’s extensive experience in regenerative periodontal treatment allows us to treat the most challenging cases, using documented techniques with spectacular results.
Until a few years ago, the inability to regenerate certain bone defects resulted in placing implants in areas that were not always ideal, since the main criterion for implant placement was not the site of the prosthetic restoration, but the preexisting in the area bone tissue. Today we are able to restore to their original condition even large jaw bone defects, so that the implants are placed in the ideal positions.
Our clinic, having many years of experience in the field of bone regeneration, has evolutionized traditional protocols of bone regeneration, using safe techniques for our patients. Additionaly the option of volumetric tomography with a state-of-the-art cone beam computed tomography (CBCT) scanner allows the accurate calculation of the amount of bone existing in the area where implants are to be placed. The patient is informed in advance about the need for bone regeneration and the treatment plan for this area is organized accordingly.
In recent years, the use of stem cells, as well as of growth factors from the patient’s blood, – important substances that promote healing – is a significant progress in the field of bone regeneration. The isolation and processing of these factors is performed in our clinic, in a special centrifuge device, after blood sampling. The integration of these blood concentrates named A-PRF in the traditional bone regeneration protocols maximizes the results of bone regeneration in a completely natural and safe way.
Implantology offers the possibility of replacing missing teeth or teeth that have a poor periodontal prognosis and need to be extracted, with their artificial substitutes, i.e. osseointegrated implants.
The high success rate of our clinic is a result of our experience of more than 25 years in the field of Implantology, as we follow tested protocols, with minimal operational trauma for our patients.
The final implant restorations may be supported by one or more implants and may be fixed or removable.
For the convenience of our patients, and if they meet the anatomical and biological requirements, there is the option of immediate implant loading, in which patients receive fixed interim prosthetic restorations supported by the implants on the same or the next day after implant placement (Same Day Teeth).
The technique of immediate loading has been long used in our clinic, but in recent years it has evolved by integrating in the surgical procedure growth factors of the patient’s blood, in combination with bone grafts.
In our clinic, we have the option of computer-assisted Implantology. Initially, a specialized device makes digital impressions and a diagnostic wax-up of the jaws, therefore creating their three-dimensional cast in the computer. We, then, enter the results of the X-ray examination of the jaws – performed in our state-of-the-art cone beam radiography scanner (CBCT)- in the computer, thus generating an extremely accurate three-dimensional imaging of the bone. Using the appropriate software, the three-dimensional digital cast is matched with the CT scan of the jaws and we obtain the exact anatomy of the patient’s jaws.
From a library of implants in the program, the type and desired dimensions of the implants are selected per area, and then, they are virtually placed in their ideal position.
Preoperative virtual implant placement has the advantage of knowing in advance the exact amount of bone surrounding the implant, so that the patient is informed whether there is a need for bone regeneration or not. With preoperative virtual implant placement, implants are placed more safely, even in extreme cases, since we know the exact locations of important anatomical features (vessels, nerves, etc.)
After the virtual implant placement is completed on the computer, the data are transferred to a digital printer (3D printer), which manufactures a personalized surgical guide that will be used during the placement of the implants.
The latter is the most advanced application of new technology in Implantology, as it offers the ability of safe implant placement with the highest accuracy and the smallest operational trauma, even in the most challenging anatomical conditions.
The philosophy of our clinic is in line with “minimally invasive dentistry”. Since teeth have not the ability to regenerate, we are, therefore, responsible for respecting them trying to preserve their integrity.
Inlays and onlays are a typical example of this philosophy. If the missing tooth structure is more than half of the tooth and the restoration covers a cusp, it is called an “onlay”.
In the past, following endodontic treatment, crowns were placed on most teeth, something that required removing more than 65% of the volume of tooth structure. Nowadays, however, with the use of onlays, no more than 30% of the remaining tooth structure is removed. The materials used can be composite resins or porcelain. With the application of inlays and onlays, the use of crowns is limited only to severely damaged teeth.
Similarly, amalgam fillings have been replaced with composite resin ones. The modern resins used have excellent durability, while their appearance is no different from that of natural teeth.
Lastly, one of the most important services of minimal intervention offered by our clinic is changing the shape of anterior teeth only by adding material, without the use of cutting instruments, thus giving shine to our patients’ smile with completely non-traumatic tools.
Esthetic dentistry represents the clinical application of scientifically proven techniques and knowledge that can give a natural appearance to dental restorations.
Its main applications concern the improvement of the position, shape and color of the teeth, providing our patients with a beautiful smile. The modern dental materials used resemble the ones of natural teeth to such an extent, that are hardly noticeable, and they include composite resin fillings, porcelain and resin veneers and all-ceramic restorations (crowns or bridges).
Porcelain veneers are very thin pieces of porcelain cemented permanently to the front of the teeth in order to improve their appearance. Porcelain veneers can be used to close gaps, improve the color of the teeth and change their shape or position.
In some cases, achieving an aesthetically pleasing smile requires the application of the above in combination with plastic surgery techniques, as described in the section of Esthetic Periodontal Surgery services of our clinic.
A smile is one of the most dynamic elements of a person’s face and is a very important feature of one’s image. Healthy and bright teeth play a major role in a smile.
The whitening process is a minimally invasive way to improve a person’s smile. In this way, and without compromising the integrity of the dental tissues, we can improve the color of the natural, as well as the endodontically treated teeth, which sometimes may become discolored.
Teeth whitening should always be performed under the supervision of a dentist, irrespective of whether it is performed in a dentist’s office or at home.
Before any whitening procedure, a clinical examination of the mouth’s health should be performed. In case of periodontal disease or caries, whitening should be postponed until the patients’ dental and periodontal needs are addressed. Tooth sensitivity to cold stimuli should be especially taken into account, too.
In our clinic, the whitening process is always performed under the supervision of a specialized dentist who monitors the treatment’s progress and evaluates any possible symptoms of the patient (e.g. sensitivity, etc.). The whitening process is always personalized, with the dentist choosing the appropriate whitening agents at the appropriate concentration for each patient.
Nowadays, by applying this new technology in clinical practice, before any intervention, we are able to show to our patients, on a computer screen, the predicted final appearance their smile could have.
With digital smile design, patients choose in advance the color, shape and size of their teeth, as well as how much of their gums they would like to show when they smile. Thus, it can be decided whether the desired appearance could be achieved by dental interventions alone or in combination with periodontal plastic surgery.
This designing process starts by taking multiple digital photos and videos of the patient’s smile in different shooting angles, at different times, depicting different emotional states (soft, medium, big smile). Then, these photos are entered in a computer and the interventions suggested to the patients are captured on the screen by using special software. Patients can form a personal opinion by seeing the whole processing of their smile on screen, may suggest changes and, depending on whether these changes can be integrated or not, the final treatment plan that will be followed is decided.
The selected shape and size of the teeth is created with the appropriate prosthetic means (usually resins, porcelain veneers and all-ceramic crowns).
The prosthetic work is completed by a dental laboratory. Our clinic collaborates with high level dental laboratories, which complete the clinical result in a predictable way, allowing us to solve esthetic issues even in the most demanding smiles.
Our clinic offers dental prosthetics services, which include the most up to date methods for the functional and esthetic restoration of missing or damaged teeth.
After a detailed collection of all the necessary data, we plan the prosthetic work with cutting edge technology and create a treatment plan for each patient.
The most conservative choice regarding inlays and onlays is described in the section of Minimally Invasive Dentistry services while porcelain veneers are described in the section of Esthetic Dentistry services.
Crowns cover the entire tooth in order to protect it from possible fracture during chewing or to improve its functional or aesthetic characteristics. All-ceramic crowns are the latest type of prosthetic restorations. Apart from their flawless aesthetic appearance, they also have excellent biocompatibility with the adjacent tissues and, -as they are metal-free- are the most advanced approach to dental restorations. Alternatively, traditional metal-ceramic crown (porcelain-coated metal frame) may be used in restorations.
Bridges consist of two or more crowns joined together to repair the loss of one or more teeth.
A possible alternative in patients with tooth loss are complete and partial dentures, depending on the number of missing teeth. In our clinic, we focus on their excellent aesthetics appearance, but also on their perfect fitting.
The latest and most conservative solution of treating a missing tooth is the one that uses a crown on top of an implant (implant-supported crown), provided that the appropriate requirements are met. This avoids grinding the adjacent teeth, – that are possibly intact-, in order to create a bridge.
Services on implant prosthetics in our clinic include fixed and removable restorations that are supported by them. Fixed restorations are always screwed on the implants.
The lack of more teeth in a row can be treated with fixed screwed restorations, supported by more than one implants. In order to prosthetically restore all the maxillary or mandibular teeth with fixed prosthesis, 6 implants are usually required per jaw.
Removable implant restorations are called “overdentures”. Οverdentures are kept in place by the implants through attachments, making it a very good alternative to conventional complete dentures. With implant-supported overdentures, the chewing ability, speech and quality of life of patients who have had conventional dentures for years is significantly improved. Usually 4 implants are required in the maxilla, while 2 implants are usually enough for this purpose in the mandible.
Immediate dental implant loading is a very well documented treatment process in the literature, and we have been successfully implementing it in our clinic for many years. In favorable circumstances, during implant placement (adequate bone tissue, sufficient primary stability), fixed interim prostheses are screwed in the implants within a few hours or by the next day (Same Day Teeth). These prostheses are replaced with the permanent restorations after a few months.
The endodontic services of our clinic mainly include the diagnosis, prevention and treatment of issues in the pulp, namely in the interior of the tooth. Deep dental caries, repetitive dental work, problematic crowns and tooth injury (cracks, fractures), are some of the most common causes of pulp infection which may be accompanied by severe pain and which eventually leads to abscess formation.
Endodontic treatment, commonly known as “root canal treatment”, is the treatment method for tooth pulp infections. With proper care, most endodontically treated teeth can last for life.
In our clinic, as part of the overall treatment of our cases, patients are examined by a specialized Endodontist, who copes with the differential diagnosis of dental pain, endodontic treatments of teeth with live or dead pulp, repetition of incomplete previous endodontic treatments, dental trauma, as well as the surgical completion of endodontic cases, where conservative treatment was not able to solve the endodontic problem. Lastly, there is the option of whitening discolored endodontically treated teeth.
The diagnosis and endodontic treatment is made using the latest surgical microscope by ZEISS, which allows extreme precision.
Halitosis is a common problem with multiple social and psychological implications (25% of the general population, concerning people mainly over 20 years old).
It is noteworthy that, in 85% of the cases of halitosis the cause lies in the oral cavity, while in 10% the problem is related to the respiratory system and in a very small percentage it is caused by esophageal or gastric disorders. It is also interesting that in 80% of the cases concerning the oral cavity, the cause lies in the microbial flora of the tongue, while in the remaining cases, it lies in periodontal disease and in other conditions of increased microbial retention (e.g.decayed teeth, partially impacted teeth, etc.). The latter metabolize residues of certain foods that have remained in the mouth (e.g. garlic, onion, dairy) and produce foul-smelling sulfides.
Other causes of halitosis are smoking, alcohol, unrestrained diet, as well as some general diseases (e.g. chronic kidney failure, uncontrolled diabetes, etc.).
In our clinic, we pay special attention to the accurate diagnosis of the cause of halitosis and, then, we suggest individualized treatment protocols. In the vast majority of cases, ensuring dental health, successful periodontal treatment, analysis of our patients’ dietary habits, organized preservation of the result with modern recall programs and the selective use of medication help control the problem.
If the cause of halitosis is outside the limits of the oral cavity, our patients are referred to reputable colleagues of the respective specialty.
Preserving the treatment results in the long-term is a very important service of our clinic. Organized and effective follow-up of patients who have completed active treatment is the only way to prevent relapse, or even treat it at an early stage.
Our clinic, having started in 1993 as a purely Periodontics and Implantology one, has the experience, know-how and potential for the planning of individualized follow-up programs for our patients, related to the prevention of periodontal disease, dental diseases (e.g. tooth decay) and peri-implant disease.
The administration of the necessary oral hygiene products to the patients is done by competent staff members who select the prime products in the dental market. The training of each patient in oral hygiene is done individually, before the beginning of the treatment, and is repeated at all stages.
After the end of the active treatment and depending on their final results, our patients are placed in the follow-up program of our clinic, where they are checked upon every 2, 4 or 6 months.
Our clinic’s secretary is responsible for confirming our patients’ appointments via telephone, e-mails and SMS and is willing to address any problem with professionalism.