Dental Implants - Periodontal Medicine Surgical Specialists - Chicago Periodontist
Tissue Regeneration
Periodontal Treatment & Information
Tissue Regeneration
Periodontal Medicine Surgical Specialists

Gum disease has traditionally been treated by eliminating the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today. One of these advancements is guided bone regeneration, also referred to as guided tissue regeneration. This procedure is used to stabilize endangered teeth or to prepare the jaw for dental implants.

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, Dr. Mandelaris and Dr. DeGroot may recommend tissue regeneration. During this surgical procedure, the pockets are cleaned thoroughly, and 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.

The effectiveness of the procedure generally depends on the patient’s willingness to follow a strict postoperative diet and careful oral care. Drs. Mandelaris and DeGroot will help you determine if bone regeneration surgery is right for you.

Tissue Regeneration Treatments
Periodontal Medicine Surgical Specialists

Dental implants have been available for several decades. However, for most patients, they are still a relatively new concept. When considering the cost of dental implants and comparing quotes, there are several important points that should be kept in mind.

Ridge Augmentation

A ridge augmentation is a common dental procedure often performed following a tooth extraction to help recreate the natural contour of the gums and jaw that may have been lost due to bone loss as a result of a tooth extraction, or for another reason.

The alveolar ridge of the jaw is the bone that surrounds the roots of teeth. When a tooth is removed, an empty socket is left in the alveolar ridge bone. Usually this empty socket will heal on its own, filling with bone and tissue. Sometimes when a tooth is removed, the bone surrounding the socket breaks, and it unable to heal on its own. The previous height and width of the socket will continue to deteriorate.

Rebuilding the original height and width of the alveolar ridge is not medically necessary, but may be required for dental implant placement, or for aesthetic purposes. Dental implants require bone to support their structure, and a ridge augmentation can help rebuild this bone to accommodate the implant.

A ridge augmentation is accomplished by placing bone graft material in the tooth socket. It is often done immediately after the tooth is removed, to avoid the need for a second procedure later. Next, the gum tissue is placed over the socket and secured with sutures. Dr. Mandelaris and Dr. DeGroot may choose to use a space-maintaining product over the top of the graft to help restore the height and width of the space created by the tooth and bone loss, and into which new bone should grow. Once the socket has healed, the alveolar ridge can be prepared for dental implant placement.

A ridge augmentation procedure is typically performed in Drs. Mandelaris and DeGroot’s office under local anesthesia. Some patients may also request sedative medication in addition.

Sinus Augmentation

The maxillary sinuses are behind your cheeks and on top of the upper teeth. These sinuses are empty, air-filled spaces. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.

The key to a successful and long-lasting dental implant is the quality and quantity of jaw bone to which the implant will be attached. If bone loss has occurred due to injury or periodontal disease, a sinus augmentation can raise the sinus floor and allow for new bone formation.

In the most common sinus augmentation procedure, a small incision is made on the premolar or molar region to expose the jaw bone. A small opening is cut into the bone, and the membrane lining the sinus is pushed upward. The underlying space is filled with bone grafting material, either from your own body or from a cadaver. Sometimes, synthetic materials that can imitate bone formation are used. After the bone is implanted, the incision is stitched up and the healing process begins. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.

If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.

The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option besides wearing loose dentures.

Socket Preservation

Removal of teeth is sometimes necessary because of pain, infection, bone loss or fracture of the tooth. The bone that holds the tooth in place (the socket) is often damaged by disease and/or infection resulting in deformity of the jaw after the tooth is extracted. In addition, when teeth are extracted, the surrounding bone and gums can shrink and recede very quickly after the extraction resulting in unsightly defects and collapse of the lips, and cheeks.

These jaw defects can create major problems in performing restorative dentistry whether your treatment involves dental implants, bridges or dentures. Jaw deformities from tooth removal can be prevented and repaired by a procedure called socket preservation. Socket preservation can greatly improve your smile’s appearance and increase your chances for successful dental implants for years to come.

Several techniques can be used to preserve the bone and minimize bone loss after an extraction. In one common method, the tooth is removed and the socket is filled with bone or bone substitute. It is then covered with gum, artificial membrane, or tissue stimulating proteins to encourage your body’s natural ability to repair the socket. With this method, the socket heals eliminating shrinkage and collapse of surrounding gum and facial tissues. The newly formed bone in the socket also provides a foundation for an implant to replace the tooth. If your dentist has recommended tooth removal, be sure to ask if socket preservation is necessary. This is particularly important if you are planning on replacing the front teeth.

Learn more about tissue regeneration.