Allan Hawryluk Jr., D.D.S. Performs the Chao Pinhole® Surgical Technique in Mississauga, Ontario.
The Chao Pinhole® Surgical Technique (PST®), invented and patented by John Chao, D.D.S., is a scalpel-free, suture-free procedure for treating gum recession. This procedure involves making a small hole with a needle in the gum tissue. The gum tissue is loosened and guided over the receded part of the tooth using specially designed instruments. Since there is no incision or suturing, patients can expect minimal post-operative symptoms (pain, swelling, and bleeding). Most patients also are pleasantly surprised by the cosmetic improvement.
Before starting the procedure, Dr. Hawryluk Jr. will clean the teeth with a diamond bur, ultrasonic instruments, and a solution called ‘EDTA’. Chlorhexidine solution is applied to disinfect the roots. This sanitization process produces pristine unclogged ‘dentinal tubules’ on your tooth, which the gum with be amenable to attach.
Dr. Hawryluk achieves excellent results with the pinhole technique by following the guiding principle of ‘overcorrection’ – this is when the dentist moves the gum even higher in the procedure than where it will eventually settle after healing.
Pinhole placement is with a ’16 gauge needle’ about 10mm from ‘gum-line’. The number of pinholes Dr. Hawryluk uses is case dependent, but there is always a ‘two tooth separation’ between them. He ‘releases’ and then lifts the gum upwards to restore your gum-line. Placement of collagen strips under the released gum tissue helps hold it in its desired place. The most critical area which Dr. Hawryluk packs with collagen is called the ‘papilla’, which is the gum in between teeth that sticks up higher than the surrounding gum. It is critical that, although the papilla is packed full, there is no excess tension generation. The purpose of the collagen is ‘space creation’ for new healthy gum to form and stabilize through the 6-week healing process. Dr. Hawryluk regularly sees the gum heal with healthy ‘keratinized tissue’ formation. Not only does the gum often heal at a higher level, but it is also intimately attached to the underlying bone (and is not merely loosely there).
The collagen used in the Pinhole procedure comes under the brand name Bioguide. Uniquely, there is no ‘chemical cross linking’ of this product; therefore, there is ‘no foreign body reactions’, ensuring the best healing possible.
Some teeth have erosion of the tooth inward in addition to the dental recession. In these cases, Dr. Hawryluk does a ‘combination procedure’, which involves both pinhole procedure and composite bonding. Combining these two effective treatment techniques produces an outstanding synergistic result. Below is an example of a combination procedure addressing both dental recession and erosion.