Treatments for bone loss due to periodontal disease
In chronic gum diseases there is loss of bone support around the root. The remaining bone does have the capacity to regenerate in certain circumstances. The bone support may be lost either in vertical direction leading to 2 or 3 walled defects or in horizontal direction. If the bone is lost in a horizontal direction then this is not amenable to any bone growth using regenerative the techniques. However where there has been bone loss in vertical direction then there is good prognosis for bone growth using surgical regenerative therapy. Bone regeneration maybe encouraged or enhanced using different techniques and materials.
Bone regenerative procedures
The regenerative procedure has 2 main components. Firstly the gum is peeled back gently to expose the root and expose the bone anatomy around the tooth and all bacterial deposits on the root are removed. This will provide a cleaned root for which the newly regenerated bone and soft tissue to attach itself to. Secondly, the root is further prepared with the use of root conditioner. Then a bioactive gel called Emdogain (Porcine derivative) is placed on the root surface and the surrounding bone. The gum is then closed back up and a soft dressing is applied to protect this area for a few days. This bioactive gel promotes the growth of lost bone around the root.
One of major benefits of this procedure is the rapid healing and minimal post operative pain and discomfort. The result of the bone regeneration means that there is more bone around the root and the tooth longevity is increased also. This is extremely well documented procedure with over 20 years of research and a bone graft can also be used to in conjunction with this technique. Patients who do not wish to have any animal products used in their treatment may opt for synthetic product such as Straumann Bone Ceramic. This animal free synthetic product has also well documented and we have been using this as an alternative for the last 5 years. In multiple areas for bone regeneration and deeper sites both these products can be used together for an improved result.
Treatment for bone loss – Sinus graft procedure
All types of bone grafting procedures from using guided bone regenerative techniques to block bone grafting (Chin or ramus of mandible) are also carried out at the Birmingham Periodontal and Implant Centre. When using these techniques the patient is usually sedated for a more comfortable procedure. Sinus grafting is also carried out where there is limited bone volume in the posterior maxilla to place implants.
The patient requested implant therapy in the upper left quadrant. Due to inadequate bone volume to place implants a sinus graft procedure was carried out.
Result show two Astratech implants and the extent of sinus augmentation is clearly seen. The restorative phase will be carried out by the referring dentist.