Periodontal Diseases

What is periodontal disease? This is a type of periodontitis, which is inflammation of the supporting tissues of the teeth (resulting in loss of supporting bone). It is the major cause of tooth loss in adults and unfortunately can only get worse without appropriate treatment (periodontitis is a progressive disease). The bacteria that accumulate on the teeth in the form of plaque and the body's immune reaction to it are considered the main causative factors. Of course susceptibility of the individual is an important factor in disease initiation and progression. You should also be aware that there is a potential association between periodontal disease and heart disease, although it has not yet proven to be causative. However, periodontal disease treatment tends to improve inflammation markers related to heart disease. Please note that a major risk factor for periodontal disease is smoking. Further people with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered a complication of diabetes. Those people who don't have their diabetes under control are especially at risk. Research has suggested that the relationship between diabetes and periodontal disease goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar. Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts people with diabetes at increased risk for diabetic complications. Periodontal disease often tends to progress almost silently without giving much cause for concern, until it has reached an advanced stage and the supporting tissues around the teeth are seriously compromised. Research has shown that periodontal disease is associated with several other diseases. For a long time it was thought that bacteria was the factor that linked periodontal disease to other disease in the body; however, more recent research demonstrates that inflammation may be responsible for the association. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions.

Periodontal Treatment

The plaque is removed under the gum line through a deep-cleaning method called scaling and root surface debridement. Scaling means scraping off the tartar from above and below the gum line. Root surface debridement gets rid of rough spots on the tooth root where the germs gather under the gum line, and helps remove bacteria that contribute to the disease. Then a periodontal review appointment is the next step where the pockets are re-measured to evaluate the degree of healing, the pocket depths and the plaque score. If inflammation and deep pockets remain following treatment with deep cleaning and medications the periodontal surgery may be considered. Your periodontist may need to pull gently the gum away from the teeth surfaces to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient to keep the area clean. This common procedure involves lifting back the gums and removing the tartar. The gums are then sutured back in place with tiny stiches so that the tissue fits snugly around the tooth again. After surgery the gums will heal and fit more tightly around the tooth. This sometimes results in the teeth appearing longer. In addition to flap surgery, your periodontist may suggest procedures to help regenerate any bone or gum tissue lost to periodontitis. Bone grafting, in which natural or synthetic bone is placed in the area of bone loss, can help promote bone growth. A technique that can be used with bone grafting is called guided tissue regeneration.

Guided Bone / Tissue Regeneration

When periodontal disease is established in the mouth, inflammation is present, periodontal pockets are formed around the teeth and the bone that supports the teeth is lost. The harmful bacteria that hide in the deep pockets create bone irregularities. When the shape of these irregularities allows it, we can use artificial bone substitutes with growth factors that enhance periodontal regeneration and re-grow the bone that was lost, increasing the longevity of the teeth and eliminating the depth that the harmful bacteria could hide. This periodontal surgical grafting technique is called Guided Tissue and Bone Regeneration and the most up to date procedures that contribute to periodontal regeneration are available in the clinic by Dr. Evdokia Chasioti Treatment results depend on many things, including how far the disease has progressed, how well you will keep up with oral care at home. Given the current evidence it is essential to act in the prevention, early diagnosis, and effective treatment of periodontal disease in order to combat the devastating oral and general health effects for the individual and society. For more information the dentists could visit: http://www.efp.org/ http://www.bsperio.org.uk/ http://www.perio.org/

Teeth Splinting

When the teeth are compromised from a periodontal point of view and lost most of their bone and gum support due to periodontal disease, they become wobbly. As a result the chewing efficiency, phonetics and function is compromised. To increase patient comfort during chewing we can connect multiple teeth together (teeth splinting) to reduce mobility and improve the patients function and chewing efficacy. Also, when the teeth are used as abutments for partial dentures they can be connected together to increase support of the periodontally compromised teeth. However, splinting makes oral hygiene procedures difficult. To ensure the longevity of the connected teeth, special attention must be taken towards oral hygiene. To connect teeth to each other, the enamel surface of the tooth is etched, most commonly with a 37% solution of phosphoric acid and composite resin can then be bonded to the etched surface to rigidly connect the teeth to each other. The connection cab be strengthened by adding a fibre or metal framework. No healthy tooth substance is removed and if the splint requires repairs in the future it can be easily reinforced without harming sound tooth structure.

Treatment of Gummy Smile - Crown Lengthening Procedures

You may ask your periodontist about procedures to improve a "gummy" smile because your teeth appear short or because you feel you expose excessive gum when you smile. Your teeth may actually be the proper lengths, but they're covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure. During the crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile. Your dentist or periodontist may also recommend a crown lengthening procedure for a tooth which will soon receive a dental crown or veneer to make a restorative or cosmetic dental procedure possible. Your tooth may be decayed, broken below the gum line, or it may have insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening redefines the gum and bone level to expose more of the tooth so it can be restored.

Lightening of Dark Gums

Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of “black dark gums” are common, particularly in patients having a very high smile line (gummy smile). With the removal of unsightly pigmented gingival areas we create a pleasant and confident smile. This could be easily attained by using various methods including laser lightening of dark gums.

Socket Preservation

After having a tooth extracted, there will be an empty "socket" , a void, where the tooth used to be. If the void is left empty to heal by itself, the bone that used to support the tooth starts to disappear and becomes thin and shallow. This can cause a problem when we look at possible treatment to replace the gap with a partial denture, bridge or dental implant. Socket preservation is the act of minimizing bone shrinkage, and therefore preserving the bone's depth and height to allow better outcome for a future restoration. Once the tooth has been extracted, a bone graft material is inserted inside the socket. This bone graft material will harden overtime and become part of the jaw bone, ensuring provision of sufficient foundation for placement of future implants, bridges and dentures. After insertion of the bone graft material, a collagen membrane is placed on top to cover the graft material and allow good healing of the gum tissue. Socket preservation after having a tooth extracted has several advantages: -Prevents the bone from shrinking therefore maintaining horizontal facial bone structure -Less likely for a replacement denture or reline to be needed, as less bone and gum shrinkage occurs -Lower gap formation under the pontic (part of bridge replacing a missing tooth)of a bridge -Better bone depth and height and therefore a better prognosis when placing a dental implant and less need for future bone graft

Atraumatic Tooth Extraction

This technique is specifically designed to remove teeth using specialized tools. With an atraumatic tooth extraction minimal damage or trauma is caused to the surrounding bone and tissues. It is a minimally invasive technique, which is something that will certainly appeal to any patient that needs a tooth extraction, and is the technique we use wherever possible at contemporary Periodontics & Implant Surgery.

Dental Implants

A dental implant is an artificial tooth root that is placed into your jaw to hold a replacement tooth or bridge or denture. Dental implants may be an option for people who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason. This procedure is a team effort between the periodontist and the restorative dentist. The periodontist and dentist will consult with you to determine where and how the implant should be placed. Depending on the specific condition you will receive a tailored treatment plan to meet your needs. To learn more about dental implants, please contact our office.

Sinus Lift Procedures

A key to implant success is the quantity and quality of the bone where an implant is to be placed. If you've bone quantity and quality in close proximity to the sinus area in upper back jaw due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants. Sinus lift surgery can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Your periodontist can explain your options for graft materials, which can regenerate lost bone and tissue. Undergoing sinus lift surgery has been shown to greatly increase your chances for successful implants that can last for years to come.

Conventional Gum Graft

Porcine Gum Grafts

Article I: Name

The name of this corporation shall be Stuart Area Restoration Association (Also SARA or Stuart)

Article II: Purpose & Powers

2.01 Purposes of the Corporation The purposes of the corporation shall be:
To improve the quality of residential life in the Stuart Neighborhood by:

1. Communication: Facilitating opportunities for communication between association members and the community at large for advocacy and public relations.
2. Information: Providing residents with educational information regarding home repair, rehabilitation, energy conservation, needs of residents, and their rights and responsibilities.
3. Historic Preservation: Encouraging the preservation of the historical architecture in the area.
4. Program Activities: Sponsoring and promoting programs and activities related to the social, educational, and recreational needs of residents.
5. Quality of Life: Conducting activities that will improve the quality of life in the Neighborhood, including working with residents, the City of Kalamazoo, Public Safety, Community Planning and Development, Historic, Housing Code Enforcement and other programs in the city as needed.

Article III: Geographic Boundaries

The Stuart Area Restoration Association shall be defined as that region bounded on the North by the north property line on the north side of North Street; on the West by the center line of Douglas Avenue; on the South by the center line of West Main and West Michigan; and on the East by the center line of North Westnedge Avenue from West Michigan Avenue to Kalamazoo Avenue, thence West on Kalamazoo Avenue to the Kalamazoo River Valley Trail; thence North on said Trail to the North boundary of the church property at 804 W. North Street to the point of beginning. The Board of Directors shall have the authority to alter these boundaries in order to better meet the needs of area residents.

Article IV: Membership

4.01 Members All residents, business owners and property owners (18) years of age or older, within the geographic boundaries defined in Article III, 3.01, shall be members of the corporation.
4.02 Voting Rights of Members Except as otherwise may be provided by these bylaws, a majority of those members voting on any matter shall be sufficient to carry the vote.
4.03 Rights of Members to Attend Meetings Meetings shall be open to members of the corporation, except for meetings, or portions of meetings, relating to personnel, contracts, legal issues, Board Member development or other matters exempt from disclosure by State or Federal law.

Article V: Meetings of the Members

5.01 Annual Meeting of the Members The annual meeting of the members of the corporation shall be held each year in the spring. It shall include a presentation of annual reports to the members; the election of Directors and such other business as may properly come before the meeting.
5.02 Special Meetings of the Members Special meetings of the members may be called at any time by order of the Board of Directors, the Chairperson of the Board, or five members of the Board, by written notice to the Recorder or Chairperson of the Board.
5.03 Time and Place of Meetings The time place of each meeting of the members shall be determined by Board of Directors shall be within periods specified by these bylaws, and shall be specified in the notice of the meeting.
5.04 Notice of Meetings of the Members For annual meetings of the members, written notice shall be made either by mail, publication, or public posting not less than ten (l0) days or more than sixty (60) days before the day on which the meeting is to be held. For especial meetings, notice shall be given by such means as the Board may deem effective not less than four (4) days before the day on which the meeting is to be held. All notices shall state the purpose, the time, and the place of the meeting. Notice of special meetings shall state by whose order the meeting is being called.
5.05 Annual Report The meeting agenda and the following written reports shall be available to the membership at the Annual Meeting:

1. Summary of actual and projected receipts, expenditures and a balance sheet prepared by the Treasurer for the current fiscal year from January to December.
2. Summary report of the program activities of the current fiscal year to date.
3. Summary report by the Chair of Stuart or its designee.

Article VI: Board of Directors

6.01 Powers & Duties of the Board All the rights, powers, duties, and responsibilities relative to the management and control of the property and affairs of this corporation shall be vested in the Board of Directors (hereinafter the Board). These powers exist in the members of the Board meeting as a group and not in individual members except as such powers may be delegated by the Board. The Board Members have a duty to exercise reasonable care and prudence in the administration of the affairs of this corporation and shall be responsible to disburse the funds and property received by the corporation only for the purposes for which they were received. The Board may not delegate this responsibility. The Board shall require a regular accounting of all funds disbursed by the corporation. Board Members shall not otherwise be liable for the debts of this corporation, unless they expressly consent to personal liability for specific debt.
6.02 Directors: Number and Term of office The Board shall consist of between five and ten Board Members who shall be elected by the members of the corporation by secret ballot at the Annual Meeting. All Board Members shall meet the criteria of members as defined in these bylaws. Board may include a seat for one person that is not a member (resident, property or business owner). Once elected this individual will have all the rights as a member of the Board with the exception that they may not serve on the Executive Board. This individual must be elected yearly and can serve for a maximum of a 3-year term. Board Members shall be elected to terms of one (1), two (2), or three (3) years. 6.03 Joint Board Members Two members (known as Joint Board Members) may share a seat on the Board of Directors. Joint Board Members must be nominated together and elected together. Each member serving in a joint capacity shall enjoy the opportunities and responsibilities of Board membership, except that the two (2) members in a joint membership shall share one (1) vote. No more than two (2) joint memberships shall be allowed on the Board at any given time.
6.04 Nomination of Directors A Nominating Committee of two (2) Board Members not up for re-election and one (1) non-Board Member of the corporation shall be appointed by the Board. In the event a non-Board Member does not volunteer, a third Board Member may be appointed by the Chair. The Nominating Committee shall seek out and accept requests from members of the corporation to serve as Board Members. The Nominating Committee shall present the entire list of candidate to the Board of Directors and recommend candidates for open Board positions. After reviewing the recommendations from the Nominating Committee and the candidates’ qualifications, the Board may recommend candidates to the membership. The names of the candidates seeking election to the Board shall be announced in the neighborhood newsletter not less than one (1) month prior to the day of the Annual Meeting. When the number of candidates recommended by the board exceeds the number of open board positions, any candidates from the same household must be considered as running for as joint board membership, subject to the provisions of 6.03.
6.05 Voting at the Election of Directors For the election of new members to the Board, each eligible voting member may vote for as many candidates as there are positions to be filled. The candidates receiving the greatest number of votes shall be deemed elected to the Board. If there is a tie that would result in more candidates being elected to the Board than there are seats available, then a runoff vote shall be taken between the candidates with the lowest number of votes.
6.06 Regular Meetings of the Board The Board shall meet on the second Tuesday of April, July, October, and January. The Annual meeting on the second Tuesday in April shall constitute the first quarterly meeting of the newly elected Board Members
6.07 Special Meetings of the Board Special meeting of the Board may be called at any time by the Chairperson or by three (3) Board Members. Notice of special meetings shall be given at least 24 hours prior to the meeting and shall state the time, place, and purposes of the meeting. Special meetings of the board shall be announced in the most efficient and effective means possible given the time constraints.
6.08 Organization and Conduct of Board Meetings Each Board meeting shall be presided over by the Chairperson of the Board, or in the case of his/her absence, by the Vice-Chairperson. In the absence of the Chairperson and the Vice-Chairperson, the Treasurer, or in his/her absence, the Recorder shall preside. Board meetings may be conducted under Robert's Rules of Order, or less formally, at the discretion of the presiding officer.
6.09 Quorum of the Board The presence of a majority of the Board Members shall be necessary at each meeting of the Board to constitute the quorum needed to approve neighborhood business. In the event that it is necessary to resolve a business item prior to the next board meeting, a vote of the board members present shall be taken and the absent board members shall be contacted for their vote following the meeting. Board members shall be allowed to participate in the meeting by phone. However, no more than two (2) Board Members attending by phone shall be counted in establishing a quorum.
6.10 Voting at Board Meeting Except as otherwise provided by the bylaws, all matters before the Board shall be decided by a majority of Board Members present.
6.11 Attendance at Board Meetings All Board Members are expected to attend the 4 required Board Meetings per year. However, the Board may, by majority vote, excuse one absence from a regularly scheduled meeting if one of the following conditions is met:

1. The Board Member makes a verbal or written request to be excused, through the Neighborhood Director or Chairperson, prior to the meeting.
2. The absence is due to circumstances that are of an emergency nature or are beyond the control of the member. In this case, an explanation will be given at the next regularly scheduled Board meeting.

Article VII: Officers

7.01 Titles and Qualifications of Officers The principal officers of the corporation shall be the Chairperson, Vice-Chairperson, Recorder, Treasurer, and Facility Manager. Nonetheless, the Board may, from time to time, appoint such additional or assistant offices, as it may deem appropriate.
7.02 Election and Term of Office The officers shall be selected and approved by the Board at the conclusion of the Annual Meeting. Each officer shall hold office until his/her successor is elected, or until the officer becomes incapacitated, resigns, or is removed.
7.03 The Chairperson The Chairperson shall preside at all meeting of the Board and of the Executive Committee and shall have such other power and duties as may be assigned to him/her by the Board provided they are not inconsistent with these bylaws. In the absence of and Executive Director, the Chairperson will assume the official title of "Executive Director/Chair" of the organization. The Chair will have the right to be placed on all financial accounts. The Chair has authorization to enter into legal contract for the organization with a majority vote of the Board Members or in an emergency the approval of the Executive Board. When emergency action is necessary the Chair will report to the Board at the next Board meeting. The Chairperson will have the responsibility of representing Stuart in Legal, Political, Structural, Financial matters with the City of Kalamazoo, other agencies in the community, and the Media. The Chair will be the primary holder of the Neighborhood phone, and can delegate responsibility to other executive Members when needed.
7.04 The Vice-Chairperson The Vice Chairperson shall be responsible for planning and executing Social Events; and assisting with board development. The Vice-Chairperson shall, in the absence of the Chairperson, have all the powers normally vested in the Chairperson and may attend city meetings in the absence of the Chairperson.
7.05 The Recorder The Recorder, or his/her designee, shall be responsible for:
Keeping the minutes of all meetings of the Board and of the Executive Committee. Performing all other duties that are incidental to the office of Recorder or that may be assigned by the Board or Chairperson and that are not inconsistent with these bylaws. Overseeing production of newsletters, website, Facebook, and Twitter accounts and any other social media. The recorder shall be responsible for keeping the email lists as current as possible, and shall maintain a hard copy as well. No e-mail on behalf of Stuart will be sent out without the prior approval of a majority of the Executive Board.

7.06 The Treasurer The Treasurer, or his/her designee, shall be responsible for:
Accounting and oversight of receipts and disbursement of funds on behalf of the corporation, and keeping of financial records of such funds. Giving a report of all the corporation's accounts at each regular meeting of the Board. Exhibiting the account books of the corporation and all securities, vouchers, papers, and documents of the corporation in his/her custody to any member (or designee of a member) upon reasonable request. Overseeing the filing of all tax and other financial reports required of the corporation. Performing all other duties that are incidental to the office of the Treasurer or that may be assigned by the Board or the Chairperson and that are not inconsistent with these bylaws.

7.07 Facility Manager The Facility Manager shall be responsible for overseeing the building at 530 Douglas Ave. Duties include but are not limited to, serving as Rental Agent for apartment, assuring that mowing and snow removal are maintained. All expenses related to above must be approved by the Chair and Treasurer. When possible, Bids or Agreements of Service must be voted on by the Board of Directors.
7.08 Executive Director The Board may hire administrative assistance as may be required for the performance of its purposes. The Executive Director, when separate from the Chair, shall be an exofficio, non-voting member of the Board. He/she shall be responsible for the planning and daily management of the specified activities of the corporation in accordance with the policies of the Board and the decision of the Board and the Executive Committee. In the event that the Board chooses not to hire an Executive Director, the Chair can assume the role of Executive Director-Chair, without financial hourly compensation. The Board may hire an Office Manager/Social Media Manager/ or other staff as the Board deems appropriate. This staff will answer to the Executive Board, Compensation to be voted on by the Board of Directors.
7.09 Resignation of Officers Any officer may resign at any time by submitting his/her resignation to the Executive Director or Chairperson.
7.10 Removal of Officers Any member of the Board may be removed at any time by a vote of two-thirds of the Board Members then in office.
7.11 Vacancies in Offices Any vacancy in an office may be filled for the remainder of the unexpired term by appointment of the Chair with approval of the Board at a regular or special meeting.

Article VIII: Committees

8.01 Executive Committee Except as otherwise provided in these bylaws, the Board of Directors may delegate its power to manage, direct, and control the operational affairs of the corporation to the Executive Committee. All actions of the Executive Committee shall be subject to the approval of the directors at the following meeting of the Board:

1. The Executive Committee shall consist of the officers of the Board and two (2) alternates selected at the conclusion of the Annual Meeting. The chairperson shall designate one of these alternates to serve on the Committee in the absence of any officer. Each member of the Executive Committee shall serve for a term of one (1) year or until his/her resignation.
   
2. The Executive Committee shall meet as needed. The Chairperson of the Board shall serve as the presiding office. Reasonable notice of the time and place of the meetings shall be given by the Chairperson or the Recorder. A majority of the Committee must be present to constitute a quorum.
   

Article IX: Financial Procedures & Restrictions on Transactions

The Fiscal year of the corporation shall begin on January 1st and end on December 31st of each year. A summary of the corporation's receipts and expenditures and a balance sheet listing all its assets and liabilities shall be prepared shortly after the end of the fiscal year.

Article X: Indemnification

Any person (or his/her estate) made or threatened to be made a party to any action, suit or proceeding by reason of the fact that he/she is was an officer or director of this corporation shall be indemnified by the corporation against any liability and reasonable expense (including attorney's fees) incurred by him/her in connection with the defense or settlement of such action, except in relation to matters as to which it is judged by the Court that such officer or director is liable for gross negligence or misconduct in the performance of his/her duties. Such right of indemnification shall not be deemed to be exclusive of other rights to which such officer or director may be entitled.

Article XI: Dissolution

Upon dissolution of the corporation and after the provision for payment of all the liabilities of the corporation, the Board shall dispose of all the assets of the corporation exclusively for the purposes of the corporation.

Article XII: Amendments

Amendments to these bylaws may be proposed by a simple majority of the Board of Directors. Adoption of any amendment(s) to these bylaws shall require a simple majority vote of the members attending an annual or special meeting of the membership. Notice of proposed amendments shall be given to members at least one month before the meeting. The proposed wording of the amendment(s) shall be available at the STUART office and website during reasonable hours for one month prior to such vote on the amendment(s).

Article XIII: Non-descrimination

The Stuart Area Restoration Association will not discriminate against anyone because of race, religion, color, sex, national origin, familial status, sexual orientation, handicap, age, height, or weight.