Periodontist Dr. Jin Kim's Clinical Case Book

What is What is Periodontal Plastic SurgeryPeriodontal Plastic Surgery??

Can Can Dental ImplantsDental Implants help me? help me?

What does a What does a PeriodontistPeriodontist do? do?

Jin Y. Kim, DDS, MPH, MSBoard-Certified Specialist

A Pictorial Guide for

the Patient Seeking

Care in PeriodonticsPeriodontics and Dental implantsDental implants

© Jin Y. Kim, DDS, MPH, MS, 2005

One of the pleasures in human life is to smile with

confidence.

Smiles are crucial to first impressions.

We all want gorgeous smiles.

Who doesn’t?

This informative booklet

was created in an effort

to introduce various

modern day techniques

available in a practice of

specialist periodontist.

Dental implants are

available to perfectly

restore missing teeth.

Complex surgical

procedures are readily

performed to

immaculately replace

missing gums and bone,

restoring the structures

immediately around

teeth, but also to

drastically effect a

person’s facial contours.

And, yes…

to perfect your smile…

Jin Y. Kim, DDS, MPH, MS

Jin Y. Kim, DDS, MPH, MS Diplomate, American Board of PeriodontologyDiplomate, American Board of Oral Implantologists/Implant Dentistry Fellow, International Congress of Oral ImplantologistsGraduate, University of Sydney & UCLA

Specialist Practice Limited to Periodontics & Dental Implants

Surgical Correction Surgical Correction of “Gummy Smile”of “Gummy Smile”

Darin’s treatment consisted of a simple one-time surgery that corrected his uneven gums and bone level. He has not only regained a beautiful smile, but “confidence” as he describes it.

Elizabeth was always concerned about showing too much of her gum tissues. In fact, she wasn’t even sure what it was about her teeth that didn’t look right.

By chance, she needed surgery on one of her front teeth due to a tooth root infection. A cosmetic enhancement of the upper front teeth was carried out concurrently by excising away the “gummy” part of the soft tissue, making her teeth effectively longer. Consequently she has had her front teeth whitened. She can’t smile more about the “lucky” procedure she walked into.


Dr. Jin Y. Kim is a dual board-certified specialist

in the field of periodontics and dental implants.

Cosmetic Makeover Cosmetic Makeover involving Surgical involving Surgical

Gumline ContouringGumline Contouring

Cindy is a highly successful performance artist. Her concerns were short unattractive teeth. She would like to show more of her teeth when she smiles. Surgical contouring of gums and bone followed by a number of porcelain veneers had achieved a drastic cosmetic enhancement.

Surgery by Drs. Jin Kim, Shen Ling & Henry TakeiSurgery by Drs. Jin Kim, Shen Ling & Henry TakeiRestorative Dentistry by Dr. Franco Bevilacqua. Case completed in 1997Restorative Dentistry by Dr. Franco Bevilacqua. Case completed in 1997




& Cosmetic Enhancementwith Porcelain Veneers*

The porcelain veneers which gave a definitive cosmetic improvement was fabricated and fitted by Dr. Chris Myung, General Dentist, Upland, CA ►

(Surgery by Dr. Kim in 2002)

Angelica didn’t smile very much. She felt that her teeth were small and there were too much gums showing. A standard gum contouring surgery was performed to give the teeth the balanced look.

Her teeth were further enhanced in shape and color by having 6 veneers, made out of paper-thin porcelain, placed in the upper front teeth.

Porcelain veneers* are individually crafted restorations that are as thin as finger nails ►

* Ask your family dentist about Porcelain VeneersPorcelain Veneers and other dental and other dental restotation options.restotation options.



Gum Recession is a common problem brought on by periodontal disease, poor care, harsh brushing habits, and non-ideal bite relationships. Recession can indeed be unsightly, cause sensitivity of the teeth and may be more vulnerable to cavities.

A simple surgical procedure can correct this lesion by grafting of the area with the person’s own gum tissue, often covering the exposed root surfaces completely.

◄ Sheila, a college student, was troubled by the unsightly long tooth visible on smiling. This case was treated in 1997 by Dr. Jin Y. Kim.

Surgical Correction of Gum Surgical Correction of Gum LossLoss

“Root coverage”“Root coverage”



Gum Recession is a common problem brought on by periodontal disease, poor care, harsh brushing habits, and non-ideal bite relationships. Recession can indeed be unsightly, cause sensitivity of the teeth and may be more vulnerable to cavities.

A simple surgical procedure can correct this lesion by grafting of the area with the person’s own gum tissue, often covering the exposed root surfaces completely.

John had lost significant amount of gum

tissue as a result of orthodontic therapy. He

had sensitivity as well as perpetually

worsening recession. The surgical

procedure achieved a drastic cosmetic

result, but more importantly, stopped

sensitivity and worsening recession. ►



Case treated by Dr. Jin Y. Kim, in 1996



Gum Recession is a common problem brought on by periodontal disease, poor care, harsh brushing habits, and non-ideal bite relationships. Recession implies damage to underlying bone, but more immediate concerns are lack of complete seal of the gums, allowing bacteria and plaque to penetrate below the gumline.

A surgical procedure that corrects this lesion involves grafting of the area with the person’s own gum tissue, or in certain cases, processed human skin from tissue bank (called Alloderm™).





Crown “Extension” or Crown “Extension” or “Lengthening” “Lengthening”

ProcedureProcedureA Crown refers to the visible portion of the tooth above the gum line. The term “crown” is

also used to describe artificial tooth restoration made of gold, porcelain or a combination

of materials, to replace damaged portion of the tooth. There are times when placing an

The “crown extension surgery,” or “surgical crown

lengthening” was performed on this case. It is a

quick (less than an hour) outpatient procedure

designed to lower the gum line and the surrounding

bone tissue to expose more tooth structure, as to

allow new crown restoration to be placed.

A new porcelain/gold crown was fabricated and fitted by Dr. Darby Kaiser, Los Alamitos, CA

▲ Immediately after the surgery

artificial crown is not possible due to lack of physical tooth structure. In this case, a previously placed crown had failed due to a fracture of the tooth.



Periodontal RegenerationPeriodontal RegenerationGrafting of Bone Replacement Grafting of Bone Replacement

MaterialMaterial

Patricia has been suffering from moderate periodontitis (gum disease) for some years. It had resulted in loss of bone as seen in the following X-rays and photograph. A periodontal probe is an instrument that measures the depth of bone damage, commonly referred to as “pocket depth.” Patricia’s pocket had measured 12mm deep before the treatment of bone grafting (“guided tissue regeneration”), whicheventually reduced to 4mm after four months of healing. Bone had indeed grown back as the final x-ray shows (right).



At 4-monthsAt 4-months

Extent of Extent of bone damagebone damage

Growth of Growth of new bonenew bone

Dental ImplantDental ImplantReplacement of a single Replacement of a single

toothtoothA 51-year old male presented with concerns looseness of teeth in general. He noted bleeding of his gums on brushing recently. The hopeless lateral incisor (white arrow) which suffered severe bone damage due to advanced periodontal disease was removed. The gums appear swollen and diseased.

▼ X-ray images of the diseased tooth (left) and implanted site (right).

◄ The diseased tooth was surgically removed. In its place, a titanium endosseous dental implant was placed.

► Upon “integration” in 4 months, artificial restoration tooth was made

of gold and porcelain which is attached to the implant.

Case treated by Dr. Jin Y. Kim, in 2001



Shirley had recently lost a molar (back) tooth due to periodontal disease. The site was grafted with bone in preparation for implant treatment. An implant was placed and restored with an almost immaculate replacement of original tooth in less than 4 months.

◄ ▼ The missing tooth space, where an implant was placed.

► The integrated implant (1) and abutment (2) ready

to receive implant crown.

► An implant is a medical device made of commercially pure titanium or alloys (3). The

implant restoration consists of a crown, abutment and a retaining screw (4).

▼ The finished case and its x-ray image.

1 2

3 4


toothtooth



Paul is a Hollywood stuntman. A part of his occupational hazard is exposure to physical trauma, for which he had eventually lost a front tooth. A complete reconstruction was carried out where hard tissue (bone), soft tissue (gums) and tooth (dental implant) was built over a period of 9 months. The surgical phase of treatment is carried out by a periodontist (Dr. Kim) and the restorative phase was completed for Paul by a prosthodontist, a dental specialist who is trained in advanced levels of tooth replacement.


toothtooth

Surgery by Dr. Jin Y. Kim, Implant Restoration by Dr. Thomas K. Lee

Patient: Paul S.Implant treatment for missing tooth



Removable Denture vs Dental Removable Denture vs Dental ImplantsImplants

The x-ray image of two implants replacing missing teeth in the back ►

▲ Katherine, with two back teeth missing had to resort to a removable partial denture. Although functional, she has had her moments of embarrassment (such as the denture loosening in front of others) and constant soreness of the gums.

With two implants and attached permanent crowns, she now eats and smiles with confidence, and comfort.



Dr. Lee is a retired economics professor now residing in upstate New York. He had a number of teeth that were in pain and slowly deteriorating. Not being able to eat well with poor dentition was one of his greatest concerns. After 5 transcontinent trips to California, and 17 implants later (that replaced the aching teeth), he is now able to eat all the things he used to like eating in his youth.

► Many of the hopeless teeth were removed.

▼ Case completed with porcelain-metal restorations supported by dental implants

▼ The finished case and its x-ray image.

◄ Upon removal of the hopeless teeth, endosseous titanium implants were placed strategically to support artificial teeth.

Dental ImplantsDental ImplantsReplacement of multiple missing Replacement of multiple missing

teethteeth



Dental ImplantsDental Implants Supporting Loose DentureSupporting Loose DentureVirginia, an 82-years old lady had been wearing complete upper and lower dentures for over 40 years. Over the years her remaining jaw ridge had flattened, a common problem amongst denture wearers. As a denture functions by “sitting” on the ridge, a flat ridge means loose, uncomfortable, and often embarrassing situation.

In the lower jaw, as little as 2-4 dental implants placed into the jaw bone can be utilized to stabilize the loose denture. The implant top is fitted with a “ball attachment,” whereas the inner aspect of the denture has a housing that fits a rubber “O-ring” that snaps onto the implant attachment.

Virginia’s existing lower denture was converted to an “implant overdenture” ►

The implants with ball attachments ▲

“At my age, all I want is to enjoy and taste my food,” says Virginia. She is now able to do just that. ►



http://www.drjinkim.com/

Augmentation of Augmentation of Collapsed Dental RidgeCollapsed Dental Ridge

Dental ridge consisting of soft gum tissue and hard underlying bone tends to collapse when teeth are lost. The areas under a “bridge restoration” when collapsed can become a cosmetic issue as well as areas of food collection. Rebuilding the ridge to original form is routinely performed prior to new bridge or implant restoration.

John had lost significant amount of gum tissue as a result of orthodontic therapy. He had sensitivity as well as perpetually

worsening recession. The surgical procedure achieved a drastic cosmetic result, but more importantly, stopped

sensitivity and worsening recession. ►

◄ Tochioka is a 64-year old woman. She had soft tissue augmentation procedure in conjunction to a new bridge fabrication.

▼ The before and after pictures depict the changes in contour of the soft tissue around the bridge restoration.

The collapsed dental ridge ▼



Before

BeforeBefore AfterAfter

AfterAfter

Actual case treated by Actual case treated by Dr. Jin Y. Kim in 2005Dr. Jin Y. Kim in 2005

What Dental Implants and What Dental Implants and Ridge Augmentation Can DoRidge Augmentation Can Do

SarahSarah wore dentures for over 20

years. When she noted that her

lips were not as vital any more,

she saw a plastic surgeon, who

performed “lip augmentation”

surgery. As the photos on the left

show, it still did not improve her

concern of “angry” look. Soft &

hard tissue augmentations of her

dental ridges, and utilization of

dental implants (instead of

dentures) gave a new lease of life,

looks and confidence to Sarah.



Augmentation of the Collapsed Dental Ridge

Sixteen implants were utilized to rebuild this case consisting of 24-

artificial teeth. The person lost all her teeth to periodontal disease. Although

a functional result was achieved, a deficiency in the upper lip was

evident. The upper lip was advanced forward by augmentation of the gum ridge above the upper front implants

utilizing Alloderm™ (freeze dried collagen from human tissue bank). ►

▲▼ Before (above) and after (below) images of

facial profile. The upper lip has been advanced

forward significantly, resulting in a more pleasant,

approachable smile.



was raised in Sydney Australia, where he attended the University of Sydney Dental School, graduating with honors in 1986. He furthered his education with an advanced degree in pathology, which was obtained from the medical school of University of Sydney. From 1989-1991, he served as a Christian missionary in his native Korea, having been deployed by the Uniting Church of Australia.

Dr. Jin Y. KimDr. Jin Y. Kim

Dr. Kim then settled in California, where he completed master degrees in public health and oral biology, and a three-year specialty residency training program in periodontics and implant surgery at UCLA School of Dentistry. In 1999 he became board-certified in periodontics, and in 2001, became a fellow of the International Congress of Oral Implantologists (ICOI). He was also board-certified by American Board of Oral Implantologists/Implant Dentistry in 2006, making him one of very few specialists in the country to be dual-boarded.

As a specialist in the field of periodontics and dental implants, Dr. Kim limits his clinical practice to surgical and conservative periodontics, periodontal plastic surgery, soft and hard tissue reconstructive surgery, dental implants and limited orthodontics for periodontally compromised teeth.

About your Periodontist…

Apart from the clinical practices, Dr. Kim is engaged in teaching of dental students, residents and fellow dental professionals, as a lecturer at UCLA School of Dentistry and as a sought-out international speaker. He has spoken at national and international academic and clinical podiums

including the International Association of Dental Research (IADR), Academy of Osseointegration (AO), American Academy of Periodontology (AAP), American Academy of Implant Dentistry (AAID), European Federation of Periodontology (EuroPerio), International Congress of Oral Implantologists

(ICOI), National Institutes of Dental andCraniofacial Research (NIDCR), American Association of Public Health Dentistry (AAPHD), American

Association of Dental Education (AADE), California Society of Periodontists (CSP), Academy of General Dentistry (AGD) and a number of universities including New

York University (NYU), University of Southern California (USC), Loma Linda

What do all these achievements mean?What do all these achievements mean?You’ll be assured that the academic and cutting-edge knowledge and experience translates to comprehensive and advanced, yet, most compassionate therapy and treatment modality that one is looking for.

Dr. Kim is married to a general dentist, Dr. Connie Choi, and they are

proud parents of three boys. He is active in little league activities,

and serves as Cubmaster at Cub Scouts Pack 1238 in Fullerton, CA.

University, University of Miami, Seoul National University, Wonkwang University, Chosun University, Hong Kong University, University of Sydney, UCSF, and of course, UCLA. Dr. Kim’s international lecture “appearances” span over the US, Australia, Canada, Spain, England, Jamaica, Korea, Taiwan and China. His research has been published in respected scientific journals such as Journal of Periodontology, Annals of Periodontology, Dental Implantology Update, Journal of Dental Research, and International Journal of Periodontics and Restorative Dentistry, and in several dental textbooks. Dr. Kim is a consultant to four major dental implant companies and to a US surgical device manufacturer.

Jin Y. Kim, DDS, MPH, MSSpecialist Practice Limited to Periodontics & Dental Implants

GARDEN GROVE PRACTICETiffany View Professional Building

12777 Valley View StreetSuite 282

Garden Grove California 92845 714-898-8757

Fax 714-373-3780

DIAMOND BAR PRACTICEDiamond Bar Executive Park

620 North Diamond Bar Blvd.Diamond Bar California 91765

909-861-3043Fax 909-860-3263

© Jin Y. Kim, DDS, MPH, MS, 2005

Tiffany View

Professional

Building

Diamond Bar

Executive

Park

Tiffany and Valley View, off 22 & 405

On Diamond Bar Blvd, off 57 & 60 Fwys

Dr. Kim & the TeamDr. Kim & the Team

are at two convenient locationsare at two convenient locations

Periodontist Dr. Jin Kim's Clinical Case Book

Health & Medicine

ideal bite relationships

harsh brushing habits

common problem brought

gum lossroot coveragejin

lost significant amount

drastic cosmetic result

simple surgical procedure

surgical procedure achieved