Periodontal therapy: rebuilding tissue

After initial therapy the inflammation has settled. The deep gum pockets it left behind, however, have not gone away.

Repair is not the same as restoration

The body closes a defect in the tooth-supporting apparatus by itself – but it does not restore it. Instead of the resilient suspension of fibres, connective tissue forms; it covers the tooth but does not anchor it in the bone as before. The result holds, yet it is inferior to the original construction.

What regenerative treatment can do

Where bone has been lost, part of it can be rebuilt depending on the extent. Membranes are used to give the slower-growing bone the time it needs, together with agents such as enamel matrix proteins that stimulate natural build-up.

One limitation belongs to the picture: few tissues can re-form after a defect without scarring. How much is regained depends on the shape of the defect – a narrow gap surrounded by bony walls heals better than a broad, flat loss.