Gingival Regeneration: Principles and Procedures
In this case, the molar was extracted and covered with a d-PTFE membrane. The gingiva and membrane are bonded in place with Oral Bond. The suture-less membrane technique is used for two reasons. First, suturing induces inflammation in the gingival tissues immediately over the regenerating tissue in the extraction socket, which violates the first principal of regeneration. Second, sutures fix the membrane in place and does not allow for the regenerating tissue to move according to its preferred growth, which violates the second principal of regeneration.
In non-esthetic areas, regeneration of ideal gingival contours via the gingival regeneration protocol outlined here promotes simple, effective oral hygiene and avoids food impaction.
This radiograph is two weeks post extraction, showing intense mineralization in the extraction socket and the membrane has elevated off the alveolar crest.
By following the regenerative principals listed above with a science-based bone graft material that stimulates bone formation, gingival regeneration occurs and predictable gingival esthetics are achieved.
A final note: When using this regenerative technique, the membrane must be placed deeper under the flap to compensate for the rise of the membrane during healing. We recommend placing the membrane approximately 6 mm apical to the alveolar crest so the regenerative process does not push the membrane out of the gingiva resulting in loss of the membrane and exposure of the graft material.