Many PM&R physicians choose to pursue additional advanced degrees (MS, PhD) or complete fellowship training in a specific area of the specialty. Fellowships are available for specialized study in such areas as musculoskeletal rehabilitation, pediatrics, traumatic brain injury, spinal cord injury, and sports medicine.
If you have advanced periodontitis, your gum tissue may not respond to nonsurgical treatments and good oral hygiene. In that case, periodontitis treatment may require dental surgery, such as: 1  Flap surgery (pocket reduction surgery).2  In this procedure, your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and root planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. 2  After you heal, it's easier to clean these areas and maintain healthy gum tissue. 3  Soft tissue grafts.
Periodontitis Causes. Left untreated, gingivitis can progress to periodontitis. The bacteria from plaque causes gum inflammation, which leads to infection. Bacterial toxins and the bodyâs natural response to infection start to break down the bone and connective tissue that hold teeth in place.