Guided Bone and Tissue Regeneration

Guided bone and tissue regeneration is a relatively new process of eliminating pockets in the gum in order to combat progressive periodontal disease. Instead of the previously used method of recontouring uneven bone tissue, this new technique is now routinely used to stabilize teeth or to prepare the jaw for dental implants. Gum pockets have to be treated because otherwise they promote bacterial growth and spread infection.

Reasons for Guided Bone and Tissue Regeneration

Guided bone and tissue regeneration is used for a number of reasons. These include:

  • Restoring bone in sockets where there has been a tooth extraction
  • Preserving a bone socket for future prosthetic devices or dental implants
  • Replenishing bone loss after removal of cysts (cystectomy) or impacted teeth

Guided bone and tissue regeneration may also be used to repair bone defects after a periodontal wound has been reopened, usually to remove infected tissue.

The Guided Bone and Tissue Regeneration Procedure

During guided bone and tissue regeneration, the gum pockets are thoroughly cleaned and a membrane is inserted between the soft tissue and the pocket in the bone. Typically, such membranes are bioabsorbable. They are used to cover the gum pockets in order to prevent the rapid growth of soft tissue and allow slower growing bone tissue to regenerate. Emdogain, a biologic adhesive, may be used to help the gum and bone attach to the root surface, and Gem 21, a growth factor, may be used to assist in more rapid bone regeneration.

Where in the past treatment of periodontal disease was painful, and sometimes aesthetically displeasing, today surgical procedures no longer result in either the exposure of sensitive root surfaces, or the appearance of long teeth. In recent years, periodontists are frequently able to restore or regenerate missing bone and connective tissue, even around teeth that have been subjected to prolonged periodontal disease.

Guided Tissue Regeneration

Guided tissue regeneration (GTR) involves the attempt to regenerate the lost periodontal structures, including bone, ligament, and connective tissue, that once supported the teeth, but have been lost to disease, infection, or injury. When there has been tooth loss and resulting bone atrophy, there is no longer enough bone volume to support a dental implant. GTR uses biocompatible membranes, often in conjunction with bone grafts and tissue-stimulating proteins, to obtain the desired results.

Guided Bone Regeneration

Guided bone regeneration (GBR) is a prerequisite for an implantation procedure, or, less frequently, for the placement of bridges. Bone grafts and biocompatible membranes prevent tissue growth that may interfere with bone growth. These membranes also act as space holders or stabilize a blood clot that could interfere with healing. Most commonly, a bone graft is made of allograft, bone tissue from another human donor. Sometimes, grafting materials are taken from other species or are produced synthetically in a laboratory. When a very large bone graft is necessary, an autogenous bone graft, obtained from another part of the patient's own body, may be used.

Today, even patients who have lost teeth due to traumatic injury or disease, can have bone restored or regenerated before undergoing dental implantation or the insertion of dental bridges.

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