Periodontal therapy: rebuilding tissue
After initial therapy the inflammation is pushed back – but deep periodontal pockets can remain. What follows then.
After initial therapy the inflammation has settled. The deep gum pockets it left behind, however, have not gone away.
Repair is not the same as restoration
The body closes a defect in the tooth-supporting apparatus by itself – but it does not restore it. Instead of the resilient suspension of fibres, connective tissue forms; it covers the tooth but does not anchor it in the bone as before. The result holds, yet it is inferior to the original construction.
What regenerative treatment can do
Where bone has been lost, part of it can be rebuilt depending on the extent. Membranes are used to give the slower-growing bone the time it needs, together with agents such as enamel matrix proteins that stimulate natural build-up.
One limitation belongs to the picture: few tissues can re-form after a defect without scarring. How much is regained depends on the shape of the defect – a narrow gap surrounded by bony walls heals better than a broad, flat loss.
The key points at a glance
- Periodontal therapy follows four steps: causes, cleaning below the gum margin, surgery where needed, then aftercare.
- A surgical step comes only when pockets remain after cleaning that cannot be maintained.
- Regenerative procedures can recover bone – but only with funnel-shaped defects, not with horizontal loss.
- Without regular aftercare the inflammation returns. The aftercare is part of the treatment, not an appendix to it.
Answered briefly
Frequently asked questions
When pockets remain after the non-surgical treatment that can neither be cleaned nor recede on their own. The procedure creates access and shapes the bone so that the site becomes maintainable again.
The wound closes within one to two weeks; sutures are usually removed after seven to ten days. Several months pass before the tissue has finally matured.
German statutory insurance covers the surgical step where it is justified after re-evaluation. Regenerative extras such as membranes or substitute materials often have to be paid privately – ask for that in writing beforehand.