We are now open!

Greetings to all of our patients!  

I want to take this time to reach out to you all and reconnect so as to let you all know what we've been up to during the Novel Corona Virus Pandemic.  I want to state that our #1 priority is, and has always been the health & safety of our patients, and, of course, to provide to you the highest quality dental care we can!  

I am sure most of you have questions and concerns regarding the safety of dentistry during this time, so we'd like to share the measures and actions we are taking to ensure your safety here at our office.

First of all, the culture here will be a little bit different in the “post novel corona virus world”.  At least until researchers come up with therapies and /or a vaccine!  We will be implementing some new systems in our practice to mitigate the risk of disease transmission here.  

What to expect when you come to the office?  Prior to your appointment, when Diana calls you to confirm your appointment date and time, she will ask a few quick questions regarding your medical status, and any symptoms suggestive of an illness...We ask that if you are ill with a fever, coughing, etc. to please reschedule for when you are well.  

We ask that you please call when you arrive to the office. Diana, Chelsea or Susie will meet you at your car to take a quick, touch-less temperature scan of the forehead, also you will have a small device clipped to your finger called an oximeter. This gadget shines light through your fingertip or earlobe. It works out how much oxygen is in your blood. We will then escort you directly to your treatment room.  

We will be spacing out our patient appointments so that there is only one patient on the dentistry side with Susie and I, and only one patient in the hygiene side with Chelsea.  For the most part, no one is allowed to wait in the lobby until further notice...We will of course, accommodate people escorting children or elderly patients.

All surfaces will be disinfected with Hospital Grade Disinfectants (as we've always done in the past) between patients.  All door knobs, light switches, etc. will be disinfected every 30 minutes throughout the day!  This will mitigate the risk of any infectious disease transmission via surfaces.

Ever since the HIV epidemic in the 1980's, dentistry as an industry has employed “Universal Precautions” (masks, gloves, “single use” disposable equipment, etc.) to mitigate disease transmission.  

The most concerning of transmission routes for infection, including novel corona virus, is via “'aerosols”.  Dentists and hygienists  have used “High Volume Evacuation” (HVE) routinely for decades to capture aerosols generated by dental hand pieces (drill) and ultra-sonic scaling devices.  HVE reduces aerosols by 90% !  

We will continue to use HVE for all procedures that generate aerosols.  In addition to HVE, we've invested in Medical Grade H-13 HEPA aerosol scavengers in our operatories (basically a very powerful vacuum) with a snorkel hose that we can position adjacent to the treatment field to scavenge any aerosol the HVE misses.

We have also invested in nine medical grade H-13 HEPA air filtration units placed throughout the office which will completely clean/turn over the air every 10 minutes, or six times per hour.

Another investment made was having medical grade UVC (Ultra-Violet C) units installed in our Central  Air Conditioning/Heating units that kill Bacteria and Virus as the air passes through. 

Finally, we will fog the office with Hypochlorous Acid, a human safe, yet powerful disinfectant at the end of each day.

We want you all to know that we are taking all possible precautions and measures to ensure your safety, and the safety of our team here!

To further streamline your experience at the office, we will be scheduling return visits for you in the operatory, at the end of your appointment.  We will make available electronic payment options in order to minimize visiting the front desk.

Warm regards,

Dr. Paulerio and Team

Types of Bone Grafting

Bone grafting allows dentists to rebuild or strengthen the upper and lower jaws. A graft can address isolated bone loss or more widespread degeneration. There are several different types of bone grafting materials, including natural and synthetic options. Although grafting can be performed to correct the effects of injuries or congenital defects, the procedure is most often recommended for dental implant patients. The prerequisite procedure can increase the chances of an implant successfully fusing with the jaw, and also help patients who would otherwise not be considered good candidates

Treatment Planning

Dental roots are necessary to maintain a dense, healthy jaw. Once a tooth is lost or extracted, the bone will naturally begin to deteriorate. Grafting can be performed immediately, known as socket preservation. The procedure can also be done after months or even years have passed. This is most often referred to as ridge augmentation. A sinus lift is a special type of graft in which the sinus floor is raised and the material is packed into the space below. Grafting techniques can also be combined to achieve the best outcome.

The dentist will typically base their recommendation on several factors, such as the location of the surgical site, the patient's health and treatment goals, and the properties of the graft material. Ideal bone grafting material should integrate well with the patient’s natural bone, promote the growth of new tissue, and have a low likelihood of rejection at the surgical site.

Autografts

An autograft, also referred to as an autologous or autogenous bone graft, is bone taken from the patient’s own body. Autografts for dental procedures are typically harvested from the jaw, hard palate, or the chin. If there is not enough bone available in these areas, the tissue graft may be taken from the hip or shinbone. The main benefit of an autograft is that there is a low risk of graft rejection since the bone is native to the patient’s body. A drawback, however, is that an additional surgical site is required.

Understanding Autografts

Dotted lines on jaw showing recipient and donor areas for bone grafting
In order to perform an autograft, a sample of healthy bone tissue can be taken from the chin.

Allografts

An allograft is usually harvested from deceased donors. Before bone or any other tissue can be used, the donor must be thoroughly screened to ensure no infectious diseases are present. After it is harvested, the bone must undergo a series of treatments to make it compatible with a recipient, with the goal of minimizing any potential immune reaction. Some of these treatments include irradiation (exposure to radiation), freeze-drying, and other chemical processes, such as the application of hydrochloric acid. The main drawback of allografts is the potential for an immune reaction or rejection of the donated tissue.   

Xenografts

A xenograft is taken from an animal source, typically a cow or pig. With this type of graft, the bone is carefully processed so that the remaining tissue is primarily made up of mineral components. One advantage of xenografts is the ease of harvesting large samples of bone with the desired microstructure, which improves compatibility at the intended surgical site. Xenografts work well to help rebuild bone because they act as both a mechanical and biological placeholder in the jaw. Initially, the xenograft adds physical support at the surgical site. Over time, the body replaces the xenograft with new bone. 

Alloplastic Grafts

An alloplastic graft is composed of material that is not taken from an animal or human source. Alloplastic grafts can be derived from natural sources (such as an elements or minerals), synthetic (man-made) substances, or a combination of the two. One reason many dentists prefer alloplastic grafts is that they do not require tissue to be harvested from another source.

Bone grafting can increase the chances of an implant successfully fusing with the jaw, and also help patients who would otherwise not be considered good candidates. 

Alloplastic grafts can be made of hydroxyapatite (HA), calcium carbonate, and tricalcium phosphate. Hydroxyapatite is the most frequently used due to its strength, durability, and ability to integrate well with bone. In fact, a large percentage of human bone is composed of a form of hydroxyapatite. Calcium carbonate is becoming less popular because it tends to resorb more quickly and make the bone susceptible to breakage.

Ceramic

Another frequent component of alloplastic grafts is ceramic. Ceramics are inorganic, non-metallic materials composed of one or more elements. Ceramics are extremely hard and able to withstand very high temperatures. One major benefit of ceramic grafts is their ability to integrate with existing bone and promote the growth of new bone.

Bioglass

Bioglass, or bioactive glass, is similar to ceramic and is another potential source for dental bone grafts. Bioglasses can bond completely and seamlessly to bone. Unlike some other types of bone grafts, bioglass is available in many malleable forms, such as pastes and putties, making it ideal for shaping into a jawbone socket.

Polymers

Polymers are molecules composed of many repeating, smaller units. Polymers occur naturally, and they can also be synthetic. Dentists may choose a polymer-based alloplastic graft because it completely resorbs into the body over time.

Many types of alloplastic bone grafting materials can be combined to form a product with the most desirable characteristics. Alloplastic grafts may also contain one or more growth factors, which are made using recombinant DNA technology. These growth factors serve to facilitate new bone growth.

Protect Your Oral Health

For the right patients, a bone graft can provide the strong foundation needed to ensure their oral health. Consulting with your dentist or a specialist is necessary in order to learn more about your candidacy for these types of procedures. 

Point Loma Family Dentistry team

Point Loma Family Dentistry

Dr. Louis E. Paulerio is a top-rated dentist who is committed to providing the latest dental treatments in a caring, warm setting. He is a member of several prestigious dental organizations, including: 

  • Academy of General Dentistry
  • International Dental Implant Association

He also uses CEREC technology to create beautiful, long-lasting dental restorations in just one appointment. Ready to schedule a consultation at our Point Loma office? Request your appointment online or call us at (619) 223-3811.

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1635 Rosecrans St
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