Guided
Tissue Regeneration Surgery
The ideal outcome in the treatment of periodontal disease is to return the tissues to
their original state, as they were before the infection started. While we cannot do this
with all cases, today more and more pockets can be restored, at least partially, with
regenerative surgery. There are three primary types of regenerative surgery:
1. Bone
Grafting
The oldest technique used in regeneration surgery calls for placing various materials in
the bone defect, to stimulate the patient's bone to re-grow. Bone grafting has been used
for over 75 years, but today's materials are much superior in stimulating new bone to
form. The implanted material is resorbed by the body, and after 6-12 months has completely
disappeared, replaced by new bone. Various materials are available, with the selection
made on a case by case basis. |
Synthetic bone stimulates
patient's natural bone to regenerate |
2. Guided Tissue
Regeneration
A more recently developed type of regenerative surgery depends on guiding the proper
tissue to heal the periodontal lesions. Gum tissue heals very quickly, and after surgery
migrates down into the bone pocket quickly. Unfortunately, this does not allow time for
the bone to refill the pocket, so the defect persists. With guided tissue regeneration,
the gum tissue is excluded from the bone defect with a resorbable membrane, allowing time
for the bone to fill back in. This technique has been available for 18 years, and in
certain areas is extremely predictable. |
3. Cell Stimulation
The most recent development in periodontal regeneration is the use of proteins to induce
the formation of tooth supporting structures lost to periodontal disease. Available since
1999, the procedure calls for placing embryonic cells into the defect, which in turn
stimulate production of new bone and tissue cells which reform the normal periodontal
complex. These cells are porcine (pig), and carry no risk of disease transmission. While
long-term studies are not yet available, the research to date warrants use of this
approach under certain circumstances. (See Emdogain) The periodontist must decide
in each case whether the chances of improvement warrant the added expense of bone
regeneration. However, restoring bone and the periodontal complex is the gold standard,
and periodontal regeneration is being used more and more. |
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