Guided Bone & Tissue Regeneration

Gum disease has traditionally been treated by eliminating the gum pockets by removing the infected gum tissue and by re-contouring the uneven bone. Although this is still an effective way of treating gum disease, other more sophisticated procedures are used routinely today. One of these advancements is guided tissue or bone regeneration (GTR/GBR). This procedure is used to stabilize endangered teeth or to prepare the jaw for dental implants by regrowing lost bone.  As periodontal disease progresses, pockets of degenerated bone develop in the jaw. These pockets can promote the growth of bacteria and the spread of infection. To address these pockets, Drs. Morse or Cwiklinski may recommend tissue regeneration.

During this surgical procedure, the roots of the teeth affected and the bone defects around them are cleaned thoroughly, a bone graft mixed with growth factors is placed to fill the bone defect and encourage your bone to regrow, and finally a membrane is installed between the soft tissue and the pocket in the bone. Some of these membranes are bio-absorbable and some require removal. The membrane covers the pocket so that fast-growing soft tissue is blocked, and slower-growing bone can begin to grow, or “regenerate” itself.

Whether to perform guided tissue regeneration, or GTR, or bone and gum recontouring depends on how the bone loss has occurred.  Some teeth may have holes or craters in the bone next to them.  These are great candidates for filling in through the GTR procedure to get the bone to grow back.  Other teeth may have had the whole level of the bone become lower but stay flat with no holes .  These are not good candidates for regeneration since there is no hole to fill.  They are better treated by making the gum tissue shrink to get closer to the bone.  This makes the gingival pockets, or gaps between the teeth and gums, shallower so they don’t trap bacteria as much and are easier to clean.

The effectiveness of the procedure generally depends on the shape and extent of the bone loss. Drs. Morse or Cwiklinski will help you determine if bone regeneration surgery is right for you.

Photos of cases treated in our office:

Case 1:

Bone loss almost to the tip of the right front tooth in the left image,

1 year follow-up on the right image showing the bone loss reversed and the bone grown back.

Case 2:

Severe bone loss on the left side of the last tooth on the left image,

1 year follow-up on the right images, showing the severe bone loss totally resolved and new bone grown in its place.

Case 3:

On the left image, bone loss on the left side of the middle tooth, along with dense calculus or bacteria build-up.

1 year follow-up showing removal of the bacteria build-up and regeneration of the bone to its original level on the right image.

Case 4: 

Bone loss on the second from left tooth, caused by a tongue ring, in the left image.

At the 1 year follow-up, bone regrowth on the root in the right image

Case 5:

The implant in the left image has lost about 50% of its bone from periodontal disease

The bone has been completed regenerated on the right image, 1 year after treatment.