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As periodontal disease progresses, pockets of degenerated bone develop in the jaw. These pockets can promote the growth of bacteria and the spread of infection. Inflammation from untreated periodontal disease can lead to loss of the supporting bone of the teeth with pockets of destruction within the bone surrounding a tooth. Bone loss can lead to looseness of the teeth, and in advanced cases, to tooth loss. In some cases, procedures can be performed to regenerate the lost bone and tissue.

To address these pockets, Dr. Bramanti may recommend tissue regeneration. During this procedure, the pockets are cleaned thoroughly, and a collagen membrane is installed between the soft tissue and the pocket in the bone. The membrane covers the pocket so that fast-growing soft tissue is blocked, and slower-growing bone can begin to grow, or “regenerate” itself. The effectiveness of the procedure generally depends on the patient’s willingness to follow a strict postoperative diet and careful oral care.  Dr. Bramanti will help you determine if bone regeneration surgery is right for you.

Guided Bone & Tissue Regeneration
Bone regeneration

Gum disease has traditionally been treated by eliminating the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today. One of these advancements is guided bone regeneration, also referred to as guided tissue regeneration. This procedure is used to stabilize endangered teeth or to prepare the jaw for dental implants.

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Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In situations where there is extensive bone loss, many patients are not candidates for placement of dental implants.

Dr. Bramanti has the skills and ability to grow bone wherever it is needed. This not only provides the opportunity to place implants of proper length and width, but it also provides an opportunity to restore functionality and aesthetic appearance.


Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries.

Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special collagen membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.

Major bone grafts are typically performed to repair large deformities of the jaws. These deformities may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large areas of bone loss are easily repaired by Dr. Bramanti.

If you have suffered bone loss around teeth and in the jaws, contact Dr. Bramanti for a consultation. Dr. Bramanti will diagnose your condition and provide you with treatment possibilities that make your tooth and jaws whole again.

Call today 559-438-7800.

​Thomas E. Bramanti, D.D.S., Ph.D.

Board-Certified Diplomate American Board of Periodontology/Implant Dentistry

Board-Certified Diplomate American Board of Oral Implantology/Implant Dentistry

​Certified TMJ Expert, The Pankey Institute 

Fellow American Academy of Implant Dentistry
Clinical Assistant Professor at UCSF in the Department of Oral and Maxillofacial Surgery

Clinical Assistant Professor UCSF-Fresno Medical Education Program, School of Medicine

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Bone and Soft Tissue Regeneration