Dental knowledge: tissue regeneration in periodontology

After the initial treatment the environment is free of inflammation again, but the deep periodontal pockets created by the periodontitis may still be there. The body begins its own repairs: scar tissue forms, and with it a so-called long junctional epithelium.

Bone lost to the inflammation does not grow back without supporting measures. If the damage to the supporting structures is merely repaired, tooth and bone are not reconnected by the ligament; instead the attachment is by connective tissue that merely surrounds the tooth. Without a firm connection between tooth and jawbone the supporting apparatus cannot do its job. The junctional epithelium also creates a kind of slide for new bacteria, which can recolonise the periodontal pocket.
Where the supporting structures have broken down because of periodontitis, they can, depending on the extent of the loss, be partly rebuilt by regenerative measures. In many cases additional treatment is needed to give the body the support it requires to rebuild them. Ideally the newly rebuilt supporting apparatus should have the same properties in form and function as the original.

Various methods are available for the regenerative treatment of pronounced periodontal defects. Few tissues are able to regenerate after damage without scarring or loss of function. The tissues of the tooth-supporting apparatus, too, can restore themselves only sparingly on their own, which is why the body has to be offered appropriate support for the process of regeneration.