Periodontal Regeneration
Regenerative periodontal surgery is aimed at regaining some of the previously lost bone support.
Bone Graft and Guided Tissue Regeneration
Bone grafting is a way to replace or encourage new growth of bone or gum tissue destroyed by gum disease.
A technique that can be used with bone grafting is called Guided Tissue Regeneration, in which a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow.
Since each case is different, it is not possible to predict with certainty which grafts will be successful over the long-term. Treatment results depend on many things, including how far the disease has progressed, how well the patient keeps up with oral care at home, and certain risk factors, such as smoking, which may lower the chances of success.
A technique that can be used with bone grafting is called Guided Tissue Regeneration, in which a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow.
Since each case is different, it is not possible to predict with certainty which grafts will be successful over the long-term. Treatment results depend on many things, including how far the disease has progressed, how well the patient keeps up with oral care at home, and certain risk factors, such as smoking, which may lower the chances of success.
This 35 years old man complained about gum bleeding around his lower canine tooth and bad taste. He presented with a very deep gum pocket on the lower right canine tooth, with pus discharge from the gums. The radiographs showed advanced bone loss around the tooth (left picture). Following a deep cleaning, a localised periodontal surgery was carried out. A demineralized bovine bone matrix graft and a collagen membrane were adapted around the tooth. The results after six months (right picture) show formation of new bone, near its original level. The tooth appears more firm and the gum pocket and bleeding was resolved. (Case by R. Zambon)
Enamel Matrix Proteins (EMP)
Emdogain® Gel (Straumann) is a biology-based product that promotes the predictable re-growth of hard and soft tissues lost due to periodontal disease.
Emdogain is comprised of a number of proteins. The dominant protein in this matrix is amelogenin. Since this protein is involved in the development of teeth, it has been shown to enhance the regeneration of tissue lost due to periodontal disease. Amelogenin has been remarkably well-conserved throughout evolution and functionally consistent in many species. Therefore, although the matrix proteins in Emdogain are of porcine origin, they are considered as “self” when encountered by the human body.
In some cases, a bone graft material is applied with the Emdogain. This graft forms a good “scaffold” on which to grow bone.
Emdogain is comprised of a number of proteins. The dominant protein in this matrix is amelogenin. Since this protein is involved in the development of teeth, it has been shown to enhance the regeneration of tissue lost due to periodontal disease. Amelogenin has been remarkably well-conserved throughout evolution and functionally consistent in many species. Therefore, although the matrix proteins in Emdogain are of porcine origin, they are considered as “self” when encountered by the human body.
In some cases, a bone graft material is applied with the Emdogain. This graft forms a good “scaffold” on which to grow bone.
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