Guided Tissue Regeneration

1. Guided Tissue Regeneration Christy George & Emily Powell

2. GTR- What is it? • Procedures allowing the repopulation of a periodontal defect by cells capable of forming new connective tissue attachment and alveolar bone

3. Race to repopulate • Epithelium • Gingival Connective Tissues • Cementum • Periodontal Ligament • Aveolar Bone

4. 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

6. GTR Factors affecting success • Systemic factors • Level of oral hygiene • Hypersensitivity or allergy to chlorhexidine • Smoking • Pregnant • Membrane exposure • Post-operative infection

7. 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

8. 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

10. Post – op guidelines • Chlorhexidine rinse 4-6 weeks • Antibiotic coverage - 14 days • Gentle Brushing - 3 weeks • Primary coverage for membranes • Maintain excellent home care

11. 3-6 months post GTR

13. 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.

14. Questions?