GUIDED TISSUE REGENERATION

Christy George & Emily Powell

GTR- WHAT IS IT?

Procedures allowing the repopulation of a periodontal defect

by cells capable of forming new connective tissue attachment and

alveolar bone

RACE TO REPOPULATE Epithelium Gingival Connective Tissues Cementum Periodontal Ligament Aveolar Bone

INDICATIONS FOR GUIDED TISSUE REGENERATION

Class II furcation or greater 2 or 3 wall vertical defects Exposed roots Alveolar ridge preservation Tooth mobility should not exceed class II

GTR FACTORS AFFECTING SUCCESS

Systemic factors Level of oral hygiene Hypersensitivity or allergy to chlorhexidine Smoking Pregnant Membrane exposure Post-operative infection

MOST COMMON METHODS Non-Absorbable Barrier Membrane

Must have 2nd surgery to remove membrane Used first as a membrane

Bioabsorbable Barrier Membrane No 2nd surgery Either animal derived or synthetic polymers Usually resorbs in 6-8 weeks

STEP BY STEP Small incision is made and tissue is flapped

back Debride defective area thoroughly Bone graft material is placed onto the defect Then the barrier membrane is placed Tissue flap is then sutured up covering the

membrane The patient’s body resorbs the bone graft and

lays down its own natural bone

POST – OP GUIDELINES

Chlorhexidine rinse 4-6 weeks Antibiotic coverage - 14 days Gentle Brushing - 3 weeks Primary coverage for membranes Maintain excellent home care

3-6 months post GTR

CONCLUSION Missing bone and tissue can be restored

to create a solid foundation for a beautiful smile. The procedure attempts to regenerate lost periodontal structures, lost bone, periodontal ligament and connective tissue attachment that supports the teeth. GTR is accomplished using biocompatible membranes, bone grafts and tissue stimulating proteins. These remarkable therapies have given many people a second chance to enjoy the benefits of their permanent teeth.

QUESTIONS?