We are reaching new advancements in regeneration of tissue.
As early as the early 1960’s, periodontists have been well aware of the advantages of healthy gum tissue in withstanding the mechanical stresses that attack the teeth.
What do you mean healthy gums and unhealthy gums? This may require some looking in the mirror, but this isn’t the first time I’ve asked you to put down this page and look at your mouth. Here’s what to look for. Just adjacent to the tooth surface itself, you should see whitish-pink or pink gum tissue. Put your finger on it. You’ll notice that this tissue is firm and doesn’t move. Now look a little lower and just adjacent to that tissue, you’ll see a redder tissue that is freely moveable and is connected to the inside of your lip or the inside of your cheek. That is called the “mucosa.” You see the difference?
If you have a lot gum tissue around your teeth, you’re in great shape. But as we get older, we lose more and more of that gum tissue and the result is mucosa around the teeth. This is called “gum recession.” The roots of the tooth that are supposed to be protected by the gum tissue are now exposed. Root sensitivity is one consequence. The more devastating consequence is the erosion of the root surface. You’ll feel the erosion as a cupped-out or grooved portion of the root at the gum line. If your fingernail finds a depression in the root, you have erosion. That erosion worsens over time, producing a weakness in the tooth, just the same as there would be weakness in a tree if you started to chop it down with an ax. And if you have a denture that rests solely on mucosa, your chance for denture soreness goes up enormously.
Traditionally, we’ve used the roof of the mouth as a surgical source of new gum tissue to replace what has been lost. The next advancement in treatment utilized harvested cadaver tissue to act as a scaffold upon which the body can grow new gum tissue. The latest entry into the market, in limited release and not in general use quite yet, is a living cell sheet called Gintuit. Gintuit is a laboratory-grown sheet of cultured cells and collagen that is surgically placed in an area of weakened gum tissue. It contains the cells and the natural tissue components that are missing from the gum tissue. Gintuit acts as a signaling device to tell the body to place the correct gum tissue in the correct place. So in a few weeks, Gintuit is gone and in its place is the correct gum tissue. I’ve been impressed with the speed and comfort in healing as well as with the end result.
The company that manufactures this product, Organogenesis, also makes Apligraf, a living cell product used to speed the healing of venous leg ulcers and diabetic foot ulcers. Apligraf has been successfully used in over 500,000 applications. This is just one of many examples of the crossover of one biotechnology breakthrough to another application.
Lee N. Sheldon, DMD
Dr. Lee Sheldon does dental implant and periodontal therapy in Melbourne. His new book, The Ultimate Mouth Manual, may be found at all book outlets (also downloadable for free here).