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. We can also rebuild missing or lost bone.
Drs. Dennis Nishimine, Dee Nishimine, & Sophia Tseng, may provide various Regenerative Procedures to restore health to the gums, bone, and teeth. The following are the most commonly used regenerative procedures:
Guided Tissue Regeneration(GTR)
GTR is provided when the pocket depths are greater than 5mm. This is "like a moat around a castle" or we want to fill in or rebuild the bone that is missing. The gum tissues will be gently reflected and the roots and infrabony pocket will be cleaned out and a bone graft will be placed. A membrane may be placed to hold the graft in place. Biological products may be utilized to help stimulate bone growth for you. The tissue will then be re-adapted with the appropriate suture material
Guided Bone Regeneration(GBR)
GBR is provided to rebuild the bone that is lost due to periodontal disease, loss of teeth, and possibly trauma.
Initially, bone grafting may be obtained from your own body, a bone tissue bank. or made in a laboratory. The gums are gently reflected back, and the defect in the jawbone will be cleaned out very thouroughly. The roots of the teeth will be root planed extensivley. This defect will then be filled or grafted with the appropriate material. A membrane is used to maintain the shape of the new bone, and tissue stimulating proteins and a platelet-rich-plasma growth factor may be applied to promote faster healing. The surgical site will be sutured and maybe packed with protective material. The bone will naturally regenerate and become strong enough to eventually support your natural teeth and dental implants.
Dental implants and other restorative procedures depend on the jawbone being sufficiently strong and wide enough to receive dental implants. When periodontal disease has taken hold, the jawbone may have become too thin to successfully support an implant. Natural bone regeneration (or bone grafting) is one of the best ways to promote growth and thicken the jawbone. Today we can easily rebuild the missing bone. There are many patient that have been told that they do not have enough bone to have dental implants placed. Today with "state of the art procedures" we can easily replace the missing bone.
Bone Morphogenetic Protein(BMP) is one of the newest products that Drs. Dennis Nishimine, Dee Nishimine, & Sophia Tseng, are utilizing to rebuild missing bone. The greatest advantages of this product is that we do not have to harvest any bone from you, utilize any synthetic material, and no residual material will be present later. In 4 months you will have brand new bone!
Gum Tissue Regeneration or Remodeling
Periodontists are considered the Plastic Surgeons of the oral cavity. Gum tissue regeneration is usually performed by way of gum or tissue grafting. When gum tissue has been lost as a result of periodontal disease, the smile may appear discolored, toothy or unpleasant. A soft tissue graft aims to symmetrically contour the gum line, cover any exposed tooth roots and restore health to the gums. Initially, a small strip of tissue will be removed from the roof of the mouth and placed in the middle of a split-thickness incision at the recipient site. The surgical site will be covered with a protective membrane which promotes tissue regeneration, covered in platelet-rich growth factor and tissue stimulating proteins, and then sutured closed. The soft tissue surrounding the teeth will naturally regenerate, producing a healthy, smile.
If you have an excessive or a "Gummy Smile" this may be altered with reshaping or recontouring of your gums to make the teeth look longer, a more even smile, create better gingival harmony. We are trying to create the smile that you deserve.
If you have any questions about regenerative procedures or periodontal disease, please ask our Periodontal Implant Team.