Periodontal regeneration aims to completely restore architecture and function of lost or injured tissue

Author: Gum Specialist Dr Sajni

Various methods of regeneration include guided tissue regeneration, guided bone regeneration, use of bone grafts, graft materials and bioactive molecules.

Osteogenic materials such as autogenous bone grafts, allow new bone formation as a result of bone-forming cells within the graft.

Osteoinductive materials such as demineralised freeze-dried bone allografts, induce bone formation in the immediate surrounding tissues. Osteoconductive grafts such as freeze-dried bone allograft act as scaffolds for bone formation.
The success of regeneration depends on a number of factors. As with any periodontal surgery, patients must be compliant, have optimal plaque control and ideally be a non-smoker. Local prognostic factors include tooth mobility and those related to the bone defect. Wound stability is essential for a successful outcome and teeth with mobility of grade 2 or more should be considered for splinting prior to surgery. The defect morphology has a major role in healing; a 2-3 walled infrabony defect of >3mm depth and angle of <37◦ is most favourable for regeneration.

Careful surgical planning will allow optimal wound closure and enhance outcomes. Consideration should be made to aesthetics and preservation of papilla when designing the flap for surgery. Suturing techniques should aim to achieve tension-free primary closure; incomplete coverage of the regenerated tissues may result in suboptimal outcomes with regards to gain of both attachment and bone.

Although true regeneration can only be assessed histologically, successful clinical outcomes focus on clinical attachment gain, reduction in probing pocket depths and tooth survival.