Periodontal disease is bacterial invasion of the tissue that surrounds the teeth destroying the attachment to the roots of the teeth and the bone that surrounds the teeth. This process creates “pockets” around the teeth filled with bacteria. In order to remove the infection surgery is performed to remove the pocket. Traditional surgery called osseous surgery removes the gingiva (gums) and bone around the pocket thus eliminating the pocket. The positive side of this surgery is that the remaining tissue is healthy and the disease can be controlled but the negative side of this surgery is that significant tissue is removed around the teeth leaving exposed roots that are sensitive and unattractive. In addition osseous surgery does not replace the tissue lost to the disease The Inverted Periosteal Graft and Regen Biocement was developed to regenerate the lost tissue and return the gingiva and bone to normal. The following case illustrates how tissue was removed by osseous surgery years ago to treat periodontal disease and how the Inverted Periosteal Graft can be used to regenerate the tissue removed during osseous surgery.

The following patient was referred to The Bone Institute for recurrent periodontal disease in the upper molars. She was middle aged with a history of osteoporosis and bisphosphonate therapy. The appearance of her anterior teeth caused her to cover her mouth when she smiled. Regenerative surgery was planned to treat the periodontal disease on the upper right molars.  While the bicuspids were healthy she wanted regenerative therapy in this area in an attempt to regenerated bone and gingiva on her upper right bicuspids for esthetic reasons.