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New Attachment &Guided Tissue Regeneration

REGENERATION

Aspects of periodontal healing:-

1-Regeneration

2-Repair

3-Attachment

1-Regeneration:-is the growth and differentiation of new cells and intercellular substance to form new tissue. It occurs by growth from the same type of the tissue that has been destroyed or from its precursor.

2-Repair:-Restoration of continuity of diseased marginal gingiva and reestablishment of by scar. Bone loss is arrested with mobilization of epithelial and connective tissue cells into the damaged area with increase mitotic division to provide the sufficient no. of cells.

3-New attachment:-Is the embedding of new periodontal ligament. Fibers into new cementum and attachment of epithelium to the tooth surface previously denuded by diseaas.The term re-attachment were used in the past to refer to the restoration of the marginal periodontium.

Re-attachment:-refer to repair in the areas of root not previously opposed to the pockets but after surgical detachment of the tissues or after traumatic tears in the cementum, tooth fractures, treatment of periapical lesion.

Regeneration of periodontal ligament is the basis for new attachment because:-

1-periodontal ligament provides continuity between alveolar bone and cementum.

2-periodental ligament contain cells that can synthesize and remodel the 3 connective tissue of the alveolar part of periodontium.

Evaluation of new attachment and bone regeneration:-

1-clinical methods:-

A- Pocket probing.

B- Attachment level.

C- Gingival indices.

D- Bone level.

2- Radiographic methods.

3- Surgical re-entry.

4- Histologic methods.