Medical Health Encyclopedia

One 1999 study found that guided tissue regeneration techniques surpassed open flap curettage alone in improving pocket depth and attachment gain. In one study of patients who were followed for 4 to 7 years after guided tissue regeneration, the general failure rate was 41%. In smokers, however, the failure rate was 80%.

Bone Grafting. In some cases of severe bone loss, the surgeon may attempt to encourage regrowth and restoration of bone tissue that has been lost through the disease process. This involves bone grafting:

• The surgeon places bone graft material into the defect.
• The material may be either bone from the same patient or a substance called decalcified freeze-dried bone allografts (DFDBA) which is obtained from a donor. In one study, bone gain from freeze-dried bone was still maintained after 3 years, although another study indicated that commercial batches of DFDBA varied in their ability to induce new bone growth. Bone from older donors appears to be less effective for restoring new bone.
• This material then stimulates new bone growth in the area.

Enamel Matrix Protein Derivative. Amelogenin is a derivative of a major protein in the structure (the matrix) of enamel that helps stimulate gum tissue growth. A gel containing amelogenin (Emdogain) is applied during surgery and forms a coat over the roots of the teeth. The gel itself dissolves after 2 days, leaving the active substance behind. Studies are reporting that it is safe and may significantly reduce the effects of periodontal disease. A 2001 study suggested that the benefits, as indicated by bone attachment, can persist for at least 4 years. (Results were similar to guided tissue regeneration.)

Cosmetic and Gum Grafting Treatments

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Gum grafting techniques can also be very useful for improving the looks of the gum as well as adding support to the teeth. During this procedure, the periodontist takes gum tissue from the palate or another donor source to cover the exposed root in order to even the gum line and reduce sensitivity. Other procedures are available to improve the look of the gums and teeth. The gum line can be sculpted to improve uneven or excess gums and to cover exposed roots as gums recede.

Implants

Periodontists report that they are achieving greater success with tooth implants in patients who have lost teeth due to periodontal disease. The average cost for a single implant is high, however, and one implant requires 5 to 7 months for completion.