Periodontal Regeneration Dentistry Treatment
Periodontal regeneration means restoring the bone and supporting tissues adjacent to teeth with advanced bone loss. Frequently, periodontal regeneration treatment will prolong the use of the involved teeth. A periodontist or dentist will diagnose the problem by taking a careful medical and dental history.
The tissues adjacent to the teeth will be gently probed with a calibrated, ruler-like instrument. These measurements, together with a dental X-ray, will help determine the appropriate treatment for the involved teeth.
There are many regenerative techniques and methods. Bone purchased from bone banks has been used effectively as a regenerative material for over 30 years. This bone is procured from healthy individuals, is carefully processed, and has been proven safe. Treatment consists of carefully moving the gum tissue away from the involved teeth and removing tarter (calculus) deposits from the root surfaces.
The bony defect is gently filled with the bone bank material (allogenic bone) or other synthetic materials. The gums are then replaced around the neck of the teeth with small sutures. The sutures are removed within five to seven days, and gentle tooth brushing can resume.
Synthetic bone substitutes have been developed to simulate natural bone. These materials are safe, and may help support the involved teeth. Such substitutes are implanted through periodontal surgery. Recently, cow bone, which is carefully prepared, sterilized, and safe, has been used to repair defects next to teeth. This bone is porous, allowing bone from the patient to grow into the pores. New technologies have developed porcine (pig) proteins, which, when painted onto teeth, allow for natural regeneration of tooth cementum and bone. These materials have demonstrated early promising clinical results.
The use of barrier membranes to protect and isolate bony defects has been used for over 15 years. These are made from synthetic, non-dissolvable materials, dissolvable materials, or bovine collagen (cow collagen). Membranes are frequently used either with synthetic graft materials or with bone purchased from bone banks. Recently, proteins have been joined to synthetic bone.
This material enhances cell attachment to root surfaces and may provide an effective method for periodontal regeneration. In the future, proteins that stimulate bone formation and enhance formation of new root cementum will make periodontal regeneration a simple, effective method to save teeth with advanced disease.
The materials discussed above have been published in dental journals, are safe, and generally result in tooth retention with bone fill of the treated bony defects. Articles relating to periodontal regeneration can be researched from PubMed using the following key words: "periodontal," "regeneration," "allogenic bone," "synthetic bone grafting," and "barrier membranes."
By William Becker, DDS
Gum Disease and Preterm, Low Birth Weight Babies
Is there a link between maternal periodontal disease and premature, low birth-weight babies?
The Journal of Periontology published a special supplement in October 1996 to introduce an important study, "Periodontal Infection as a Risk Factor for Preterm Low Birth Weight." This study establishes just such an association.
Periodontal disease is a chronic infection of the oral cavity that can worsen without treatment, especially during pregnancy. This study is one of the first of its kind to suggest maternal periodontal disease as a possible risk factor for premature, low birth-weight babies, according to The American Academy of Periontology.
In order to substantiate these results, more studies are needed. We'd also benefit from determining whether intercepting maternal periodontal disease will reduce the risk of premature delivery.
Until we learn the results, the American Academy of Periontology urges that any periodontal infection during pregnancy should be treated seriously. If a woman has been diagnosed with periodontal disease, she and her obstetrician - with consultation from a periodontist - should follow the best plan of treatment.
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