Guided Tissue Regeneration of Lost Bone (GTR)
Guided tissue regeneration involves placing small bone particles and a dissolvable membrane under your gums to fill the bone defect being treating and to control the way the bone heals. The small bone particles are generally the size of coarse sea salt and a few particles usually find a way to work themselves out. This is of no consequence as plenty of bone was placed during the procedure. Simply discard the particles you find and if they are inadvertently swallowed, there is no need to worry.
The dissolvable membrane placed under your gums can take 3-4 months to fully dissolve. During this time, small portions of the membrane or a corner can become exposed above the gum line. If this is uncomfortable, you can contact our office to have the protruding portion removed. It will however, usually weaken and fall off on its own shortly after it becomes exposed. Please do not try to remove it yourself as there is more of the membrane under your gums and if it is disturbed or moved during healing, it can reduce the amount of bone growth we obtain or cause the procedure to be unsuccessful.
We will usually prescribe an antibiotic to be taken after GTR surgery since the dissolvable membrane and bone particles are foreign to your body and there are dissolvable sutures under your gums. Please take the antibiotic as directed and make sure you take the entire prescription until it is gone.
We generally use a special suturing technique during GTR surgery that can sometimes start to unwind as healing progresses. When this happens, it is not a large concern but can become annoying as the sutures unwind. The loops in the suture that are unwinding or the areas that are hanging can be cut back with clean manicure scissors if you feel comfortable, or you can contact the office to have the sutures removed earlier than scheduled. This early loosening usually means things are healing well and the sutures are no longer necessary.
It is quite normal after GTR surgery for the roots of the teeth to be sensitive to changes in temperature and sometimes anything that touches the roots of the teeth. During the procedure, the roots are cleaned very well, making them prone to developing sensitivity. The sensitivity will not harm the teeth and is usually only temporary, but the time it takes to subside can vary from a few days to even a year or two. Plaque accumulations can aggravate this sensitivity, so you should continue to brush normally and use a salt water rinse or over the counter rinse like Peroxyl to help keep the area clean. If the sensitivity is severe or does not seem to be resolving, a prescription fluoride toothpaste or gel can be phoned in to a pharmacy to help with the sensitivity.