Pre-Orthodontic Periodontal Surgery

Periodontal Surgery in Orlando

There are times that your orthodontist will collaborate with Dr. Dowling during treatment to ensure the best results for a healthy and beautiful smile. Your orthodontist may request periodontal surgery, or other treatments, for a better outcome. Dr. Dowling may also need to extract teeth to correct crowding, or surgically uncover impacted teeth.

Here are the most common procedures that your orthodontist may request Dr. Dowling perform.

Periodontally Accelerated Osteogenic Orthodontics (PAOO)

This procedure is an excellent option for patients wanting or requiring braces, but not the lengthy treatment time. It significantly decreases the treatment time, reducing 1-year of treatment to 6 months, and some patients have seen 2-years of treatments reduced to 6-8 months.

This procedure also enhances the range of movement, requires fewer permanent extractions, and reduces the risk of dissolving roots (root resorption).

Dr. Dowling creates a flap by separating the gum tissue from the bone. He creates small cuts into the bone to activate the bone and facilitate the orthodontic movement. Graft material may also be used to augment the surgical sites. After completion of the surgery, the orthodontic treatment can start.

To learn more about this procedure and schedule a consultation, please call us at (407) 532-9856.

Temporary Anchorage Devices (TADS)

In orthopedics, Temporary Anchorage Devices, or TADs, help achieve quicker tooth movement with more efficiency and comfort by using small titanium anchors. We use these devices in addition to braces or as an alternative to headgear.

This procedure involves placing small titanium anchors directly into the gums and jawbone — the TADS then act as an anchor point to assist with the movement of your teeth. The TADs remain in place for the duration of your treatment, with removal after you complete the treatment regiment.

Smiling woman with braces
The use of TADS offers a shorter treatment time, eliminates the need to wear rubber bands (elastics), and can make certain surgeries unnecessary.

To learn more about this procedure and schedule a consultation, please call us at (407) 532-9856.

Canine Exposure Surgery

Sometimes a tooth may develop in the wrong position and cannot break through the gum (erupt). If these teeth are left alone, they may push other teeth out of place, cause damage to the roots of nearby teeth, or develop a cyst. Your orthodontist may request Dr. Dowling to uncover the tooth and allow for movement to its proper position.

The procedure is a relatively minor surgery. Dr. Dowling creates an incision in the gum over the tooth and pushes the tissue back. Some cases require the removal of the bone surrounding the crown. After exposure of the tooth, Dr. Dowling will prep the tooth depending on your orthodontist’s requirements. The bonding of a button or plate to the tooth may occur, allowing the orthodontist can move this tooth into the appropriate place. Or in some situations, the doctor may stitch a pack made from gauze soaked in an antiseptic over the tooth.

Dr. Dowling can partner with your orthodontist to ensure that your treatment is as successful as possible. To learn more about this procedure, please call us at (407) 532-9856 to schedule a consultation.

Related Services:

Pocket Reduction Surgery

Performed when the non-surgical treatments such as scaling and root planing do not work. Pocket reduction surgery is performed to remove the hardened tartar from the deep areas to reduce the size of the pockets, which is done by lifting back your gums. After cleaning the area, the gum is placed back.


LANAP is a noninvasive way to treat periodontal disease, also known as gum disease, without the need for for complex and sometimes painful surgeries and recovery periods.

Traumatic Injuries

Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specializes in treating these traumatic injuries. (For example: Dislodged Teeth or Avulsed Teeth)

Root Canal Retreatment

A tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, a Doctor may need to perform Endodontic Retreatment.

Cracked Teeth

Cracked teeth demonstrate many types of symptoms, including pain when chewing, temperature sensitivities, or even the release of biting pressure.


An Apicoectomy is a surgical procedure that removes the damaged root and surrounding bone that has been affected by the infection. The endodontist will make a small incision in the gum tissue, this will expose the bone and inflamed area. The infected root tip and tissue will then be removed. A root-end filling may be placed and the gum tissue is sutured to its original location.

Sinus Lift for Dental Implants

Just above the bone supporting your upper teeth is a nasal cavity known as the "sinus cavity". If bone grafting material is needed in this area, then the lining of the sinus cavity must be gently lifted and bone material placed under this lining. This is known as a "sinus lift".

Sinus lift procedures are routinely done for upper implants and successfully provide enough bone to anchor them.

Ridge Modification

Sometimes after an extraction, a sunken spot or concave appearance will develop in your gum line. This looks unsightly and can also jeopardize the appearance of a bridge that goes over the area. Grafting material can be inserted under the gum to fill out this depression.

Pre-Orthodontic Periodontal Surgery

There are times that your orthodontist will collaborate with Dr. Dowling during treatment to ensure the best results for a healthy and beautiful smile. Your orthodontist may request periodontal surgery, or other treatments, for a better outcome. Dr. Dowling may also need to extract teeth to correct crowding, or surgically uncover impacted teeth.

Platelet Rich Fibrin and Plasma

Platelet-Rich Fibrin (PRF) and Platelet-Rich Plasma (PRP) have proven valuable for accelerated healing and tissue regeneration in many dental procedures.

Oral Cancer Screening

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer.

We recommend performing an oral cancer self-examination monthly and remember that your mouth is one of your body’s most important warning systems. Do not ignore suspicious lumps or sores.

Gum Grafting

Normally gum tissue surrounds and protects the delicate roots of your teeth. Receding gums expose tooth roots which then are prone to tooth decay, root canals, discoloration, and actual jawbone loss. All of this can lead to tooth loss in advanced cases.

Functional Soft Tissue Grafting replaces the missing gum tissue and protects your teeth. For this reason, Soft Tissue Grafting may be recommended even for back teeth

Crown Lengthening

The "crown" is the part of a tooth visible above the gumline. Sometimes more of the tooth below the gums must be exposed to fill a cavity near the gumline or place a new crown on a tooth. "Crown lengthening" provides more tooth structure to ensure that the general dental procedure is successful and prevents gum irritation.

Cosmetic Periodontal Surgery

People rarely think that the quality of their smile as it relates to their gum health. Gum tissue is the foundation of your smile, and it may impair the cosmetic appearance of your mouth. Dr. Dowling uses his experience to reinstate the beauty and function of your gums.

Bone Grafting

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease, or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee). Sinus bone grafts are also performed to replace bone in the posterior upper jaw.

Gum Disease Orlando

Periodontal disease is an infection caused by the bacteria found in plaque, the thin biofilm that constantly forms around our teeth. In response to these bacteria, our immune system produces toxins. Unfortunately, these toxins also target our gums and other supportive tissues, resulting in the infection known as periodontal disease. Without treatment, periodontal disease can have serious consequences for your oral health.

Dental Implants

Our Dental Implants, at Pinnacle Endodontics in Orlando, FL, are made of titanium and have special coatings that encourage the fusing of human bone. The top of each implant has an internal screw channel so that crowns, bridges, and or dentures can be screwed in place.

Root Canal Therapy

A root canal is a minimally invasive, nonsurgical endodontic treatment. The procedure is performed under local anesthesia and involves opening the crown of the tooth, exposing the roots and pulp of the tooth. When the pulp and root are exposed the infected areas of the tooth are removed.

A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need for dental implants or bridges.