Dentaltown August 2021 - 39

Principles of guided
tissue regeneration
When teeth have deep pockets and
reduced periodontal support, improvement
in short- and long-term outcomes may
be achieved by carrying out concomitant
regenerative interventions.
Because of differences in the healing
abilities of different periodontal tissues,
regeneration of the periodontium after
traditional access fl ap procedures is diffi cult
to obtain. One of the most important factors
that limit the achievement of a predictable
regeneration is in fact the downgrowth of
junctional epithelium along the denuded
root surface.
Guided tissue regeneration (GTR) therapy
involves the use of barrier membranes and
grafting bone substitutes to allow selective
repopulation from the periodontal ligament
and alveolar bone while excluding the gingival
corium cells that usually repopulate the
wound healing site fi rst.
Many clinical studies and systematic
reviews (with meta-analyses) have shown
that the treatment of one-, two- and threewall
intrabony defects with GTR reduces
periodontal probing depth (PPD) and
improves clinical attachment loss (CAL)
when compared with an open-fl ap debridement
approach.
Prognostic factors
Prognostic factors in GTR may be
classified in four different categories:
patient-related, tooth-related, site-related
and surgery-related factors.2
Patient-related: Significant clinical
improvements can be expected only in
nonsmoker patients with optimal plaque
control and reduced levels of periodontal
contamination.
Tooth-related: Severe and uncontrolled
tooth mobility (Miller Grade II or higher)
may impair the regenerative outcomes.
Site-related: Defect morphology plays
a major role in healing after periodontalregenerative
treatment of intrabony defects.
The depth of the intrabony component of
the defect infl uences the amount of clinical
Fig. 3: Presurgical periapical radiograph.
Fig. 2: Presurgical periodontal chart.
Fig. 1: Presurgical defect sounding.
dentaltown.com \\ AUGUST 2021 39
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Dentaltown August 2021

Table of Contents for the Digital Edition of Dentaltown August 2021

Dentaltown August 2021 - Intro
Dentaltown August 2021 - Cover1
Dentaltown August 2021 - Cover2
Dentaltown August 2021 - 1
Dentaltown August 2021 - 2
Dentaltown August 2021 - 3
Dentaltown August 2021 - 4
Dentaltown August 2021 - 5
Dentaltown August 2021 - 6
Dentaltown August 2021 - 7
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Dentaltown August 2021 - Cover3
Dentaltown August 2021 - Cover4
Dentaltown August 2021 - SI_1
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