Periodontal Regenerative Procedures

Periodontal disease is an extremely serious progressive condition which can lead to tooth loss if left untreated.  Periodontal disease occurs when a bacterial infection in the gum pockets causes the bone and gum tissue to recede away from the teeth.  The quality and quantity of bone and gum tissue is greatly reduced as the gum pockets continue to deepen.  Fortunately, prompt diagnosis combined with effective regenerative procedures can halt the progression of the disease and save the teeth.

Periodontal Regeneration is a procedure that can help restore the lost periodontal apparatus around teeth. Sometimes, when individuals have lost bone around their teeth, it is possible to grow the bone back. This is only practical in certain situations, and not all periodontal defects are able to be grafted. However, when we think it will be predictable, we can often put a bone graft around teeth and grow back some of the bone that has been lost.  

There are several types of dental bone grafts that we use in our practice for regenerative grafting procedures.  The following are the most common:

• Allograft –  Bone obtained from a bone bank (cadaver bone). The bone is treated and processed in a bone bank facility. It provides a scaffold for your own cells to grow into, and over time, it will turn into your own bone. A secondary donor site is not necessary for this graft. 
  
  
• Xenograft – This is the implantation of bovine (cow) bone. A xenograft is perfectly safe and has been used successfully. A secondary donor site is not necessary. This graft is able to maintain space well.

What does bone grafting treatment involve?

Bone grafting is a fairly simple procedure that can be performed under local anesthetic; however, if large amounts of bone area need to be grafted, sedation may be recommended for your comfort. This is entirely based on patient preferences, but we are happy to discuss these options with you during your appointment. 

Initially, the grafting material needs to either be harvested or prepared for insertion.  A small incision is made in the gum tissue and then gently separated from the bone.  The area is thoroughly cleaned to ensure that no additional buildup is present in the surgical site. The bone grafting material is then placed at the affected site.

The bone regeneration process may be aided by:

• Gum/bone tissue regeneration – A thin barrier (membrane) is placed below the gum line over the grafting material.  This barrier creates enough space for healthy tissue to grow and separates the faster-growing gum tissue from the slower-growing fibers.  This means that bone cells can migrate to the protected area and grow naturally. Typically, we will use donor bone and membranes for this process.
• Tissue stimulating proteins – Enamel matrix proteins occur during natural tooth development, and they can help stimulate the formation of the peridontal attachment between bone and the tooth. Please see our Patient Information about periodontal disease to view how the tissues attach to the tooth. Tissue stimulating proteins help create lost support in areas affected by periodontal disease.
  
• Platelet-rich growth factors – A high platelet concentration liquid can be used to create a blood clot at the site of a wound.  It has recently been shown that PRGF also stimulates bone growth – meaning a denser graft in a shorter time period.

The gum is sutured in place and a follow-up appointment will need to be made within 10 days to assess progress.

If you have any questions about bone grafting, please ask your dentist or give us a call.

If you have any questions about regenerative procedures or periodontal disease, please ask your dentist.