Guided Tissue Regeneration
Concept of guided tissue regeneration is based on the assumption that periodontal ligament cells have potential for regeneration of attachment apparatus to tooth.
- Process of guided tissue regeneration offers possibility of producing new attachment in teeth with advanced periodontal destruction.
- In this technique matrix proteins and growth factors show promising results.
- This technique involves the placement of barrier membrane which bridges the space between the alveolar crest and cervical portion of tooth, thus preventing apical migration of epithelial cells from surgical flap in defective space and facilitating repopulation by cells of periodontal ligament.
“Clinical Applications Of Guided Tissue Regeneration”
Types of GTR
- Two types of guided tissue regeneration membrane are used, i.e.
- Degradable membranes: For example, Collagen, polylactic acid, vicryl and Guidor membrane.
- Nondegradable membranes: E.g. Millipore, teflon membrane, Gore-Tax periodontal material.
Procedure of Placing Guided Tissue Regeneration Membrane
- Step 1: Raise a full thickness flap, extending a minimum of two teeth anteriorly and one tooth distally, to the tooth being treated.
- Step 2: Debride the osseous defect and plane the root surface.
- Step 3: Trim the membrane according to the size of the area being treated. The membrane should be extended approximately
- Step 4: Suture the membrane around the tooth with a sling suture.
- Step 5: The flap is positioned back to its original position or slightly coronal to it and is sutured using interrupted sutures. The membrane should cover completely, in case of nondegradable membrane, after 5 weeks of the operation; it should be removed with a gentle tug.
“Understanding The Benefits Of Guided Tissue Regeneration”
Guided Tissue Regeneration Indications
- Narrow or three wall intrabony defects
- In circumferential defects
- In class 2 furcation defects
- Recession defects
“Best Practices For Guided Tissue Regeneration”
Guided Tissue Regeneration Contraindications
- Medical conditions contraindicating surgery.
- Infection at defect site.
- Poor oral hygiene
- Patients with smoking
- Tooth mobility greater than 1 mm
- Defect less than 4mm deep
- Width of gingiva at defect site is less than 1 mm
“Comprehensive Overview Of Gtr Mechanisms And Techniques”
- Thickness of attached gingiva less than 5 mm
- Furcation with short root trunks
- In generalized horizontal bone loss
- In advanced lesions with little remaining support
- In multiple defects
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