Daryl E. Malena DDS Periodontics
10838 Old Mill Road
Omaha, Nebraska 68154
402 330 4100

Bone grafts

Gingival grafts

New agents

Pocket reduction

Special procedures

Questions & Answers

There was a time when periodontal surgery consisted of a single procedure--the gingivectomy, a wholesale removal of diseased gum tissue. That procedure is a rarity in contemporary periodontal treatment. Modern periodontal surgery involves very little removal of diseased tissue (treatment has often made the gingiva quite healthy before surgery is even considered) and more and more is focused on regeneration of the original, healthy gingival anatomy and appearance.

In many cases modern procedures are capable of regenerating lost tissues or the surgeon can reconstruct the bone, the gingiva and the characteristics of your original, healthy mouth and smile.

Reconstructive periodontal surgery is an area of rapid advancement. Dr. Malena has given presentations at the last three annual meetings of The American Academy of Periodontology, demonstrating new innovations in this specific area.

The miniaturization of modern periodontal surgery and the effectiveness of modern drugs have virtually eliminated the pain and swelling problems that many patients have associated with oral surgery in the past. Post-operative swelling is a rarity, and almost all of our patients take no pain medication stronger than over-the-counter ibuprofen.

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Periodontitis destroys tooth supporting bone, often to the extent that the teeth become loose, so bone grafts should be the primary method that periodontists use to fix it--right? Well, no. Bone grafts get a lot of attention, but periodontists use them much less often than one might expect.

The reason is that bone grafts are only successful under certain circumstances. Furthermore, in spite of sometimes serious bone destruction, your teeth may not actually need more bone to keep them healthy and functional.

There are several methods to graft and regenerate bone next to teeth. There also are a bewildering number of products and sources of bone graft material with claims for their effectiveness. For example, there are artificial bone graft materials, allograft materials (processed human bone), and xenograft materials (bone from another species)--all safe and government approved. Each of these is available as particles and blocks of bone.

There are also chemicals with claims to promote bone growth using modern biotechnology, and numerous suppliers of fabric like materials to cover bone grafts and isolate them from the rapidly healing gingival tissue. If you are a modern patient that searches the library and internet before seeking treatment this can be confusing.

Dr. Malena uses some of these technologies, but prefers to use the patient's own bone (known as an autologous graft) or naturally regenerate bone during the healing process. We will discuss this with you if it is necessary to use other graft materials.