Periodontal Disease: Guided Tissue Regeneration (GTR)

Guided Tissue Regeneration (GTR)

If you’ve lost your jawbone due to gum diseases or loss of teeth, you’ll likely require bone grafting to fix your smile to restore your damaged teeth using implant dentistry. To ensure that this process is successful (and occasionally, as a replacement for it), your dentist might employ a method known as guided tissue regeneration. This procedure assists your body in regenerating tissues and bones that might have been destroyed due to gum disease. The process can be used in place of bone grafting as an alternative to minimally invasive. Your periodontist can determine the treatment you require following an assessment and x-rays.

What Is Guided Tissue Regeneration?

Guided tissue regeneration is a procedure that uses tissue membranes to regenerate gum tissues. The process is typically required if periodontitis, or any other dental issue caused by dental problems, has resulted in an extensive loss of gum tissue.

The procedure can also be utilized to enhance your appearance if you think you do not have enough gum tissues to achieve the best cosmetic proportionality and symmetry. We could use guided tissue regeneration for cosmetic or restorative procedures.

In the procedure of guided tissue generation, The dentist will remove all infected gum tissue from your mouth to combat bacterial infections. After that, the dentist installs soft membranes within the gingival flaps. The tissue membranes are responsible for the regeneration of your gums. Eventually, they absorb the tissues and restore healthy gums.

What Does Guided Tissue Regeneration Do?

Because gum tissue and bone develop at different rates, It is essential to separate the gums from the areas where bone growth occurs. This is why Guided Tissue Regeneration uses a collagen membrane that prevents the gums from moving between the tooth and bone, allowing unaffected growth of bone, which will provide teeth with stability.

The Goal of Guided Tissue Regeneration

The purpose of tissue regeneration is to stimulate the jawbone to expand to create solid, stable support suitable for implant dental. In the eighties, tissue regeneration was studied for years using modern techniques to make the procedure more efficient and comfortable than it was before.

Alongside dental implants, guided tissue regeneration is also utilized to strengthen sockets in which teeth have been lost and repair the bone tissue damaged by tumors, cysts, or teeth. The procedure is used in patients suffering from congenital dental issues or ailments that affect the dental tissues’ strength or underlying bone.

Guided tissue regeneration can stimulate the development of connective tissue and other periodontal system structures by using gels designed to encourage cell growth, like Gem 21, a growth factor that assists the body produce healthy tissue more quickly. Solutions like Emdogain may serve as a biological adhesive that helps keep membranes in place as tissue stimulating solutions work or bone grafts develop.

How Guided Tissue Regeneration Works?

GTR is a procedure utilized to repair periodontal damage so that a tooth or collection of teeth has more excellent stability and support. Periodontal disease, or periodontitis, causes bacteria to accumulate within the gums and can cause an ongoing infection and then break down the soft and hard tissues that support the teeth. In some instances, the damage can cause gaps between dental teeth and bones. These gaps, also known as bony defects, often require a bone graft procedure. This is when a particular substance is put into the defect to stimulate the growth of bone. GTR utilizes a resorbable or non-resorbable artificial membrane that prevents soft tissue from expanding within these damaged sites. This membrane is essential as it prevents the faster-moving tissues from expanding into the area and allows the slow-moving bone-producing cells to multiply and grow there instead. This is the way GTR is achieved:

Guided Tissue Regeneration

  • Gum and bone surgery. The gum is then opened. A flap is a method of opening the gum. Must clean the area below the gums to remove any bacterial deposits. Next, a membrane is applied to the injured bone.
  • Separating tissues. Once placed between bone and gum, the membrane gives the bone the space and time it needs to heal and regenerate.
  • After healing. The stitch and membrane dissolve. Within 6 months, the bone and attachments will start regenerating to support the tooth.Periodontal Disease Guided Tissue Regeneration (GTR)

When Is It Used?

This treatment can be used for many different problems but is most commonly used to treat periodontal disease. Advanced periodontal diseases can cause gums to pull away, causing pockets to form that can hold bacteria. These can lead to infection. Traditional treatment consisted of removing gum tissue and reconstructing the roots and bone. The teeth will look longer due to bone loss and could become weaker and more unstable. Guided tissue regeneration is a method that stabilizes the teeth and successfully restores the bone.

Is Guided Tissue Regeneration Necessary?

Guided tissue regeneration (GTR) is crucial because it helps your gum tissues grow back and also hard tissues. Gum disease and periodontitis can cause significant damage to bone and tissue, weakening surrounding teeth and damaging dental structures. GTR is a treatment that helps to regenerate gum tissues to support your teeth.

Who Makes a Good Candidate For Guided Tissue Regeneration?

Guided tissue regeneration is an excellent treatment option for patients suffering from moderate to advanced cases of periodontitis.

It is not invasive and is usually done within a single visit to the office.

Guided Tissue Repair is a non-invasive treatment recommended for patients suffering from:

  • Insufficient bone growth
  • Gum recession
  • Periodontal pockets
  • Sensitivity of teeth
  • Gum recession
  • Spacing
  • The surface of the root is exposed
  • Recession

Guided Tissue Regeneration is a procedure that causes minimal discomfort and no recovery time. This makes it an ideal solution for patients who have busy schedules.

Many people suffer from gum disease that is severe and requires the process of deep cleaning, known as scaling and root planning. This procedure removes plaque and germs from the root of the teeth. After the teeth have been cleaned and healthy, guided tissue regeneration are possible. This procedure helps heal gum tissue and bone.

What Is Periodontitis?

Periodontal disease results from infection and inflammation in the gums and the bone that supports and surrounds the teeth. In the early stages, known as gingivitis, the gums may become swollen, red, and bleeding. The more severe form, known as periodontitis gums, could withdraw from the tooth, and bone may lose its strength. Teeth can loosen or fall out. Periodontal diseases are most commonly seen in older adults. Dental decay and periodontal disease are the two main dangers to the health of your teeth.

Can Bone Regenerate After Periodontal Disease?

Yes, it is possible to regenerate bone following periodontal disease. Your dentist might recommend guided bone regeneration. This is an operation where the dentist places bone graft materials within gum flaps affected by gum disease to help regenerate gum tissue and bone to restore the original look and condition of the bone tissue.

Is it Common to Feel Some Swelling After a Guided Tissue Regeneration Procedure?

Yes, This is normal. This can also cause chapped lips or bruising to the lips or cheeks. You can use an icepack for 20 minutes daily during the first 24-48 hours after surgery. Keep your head above your heart. The worst symptoms of swelling should disappear by the third or fourth day. You should contact your dentist immediately if your swelling is severe.

Is Guided Tissue Regeneration Necessary For Dental Implants?

Dental implants comprise two parts The abutment and the body. The abutment, or the top part attached to the implant, is where the mouth can see the crown. The implant’s body replaces the root of the tooth. It’s placed deep under the bone.

The implant isn’t apparent in the mouth but is inserted within the bone. The alveolar bone has to be sufficient and deep enough so that the implant can be able to embed itself. If the bone is not good enough, the implant won’t be able to integrate itself, and the process will fail.

In your appointment, an implantologist will evaluate the size of the bones in your jaw. he will determine if you require a bone graft. If the bone isn’t strong enough, a guided tissue regeneration procedure can be done to allow the bone to grow for an implant to be placed effectively.

6 Benefits of Guided Tissue Regeneration

Gum disease can cause the loss of teeth and jawbone atrophy. Dental implants can replace your missing teeth, but you may require additional procedures, such as bone grafting, to repair tissues that have been damaged caused by gum disease. However, Bone grafting isn’t the only option. Guided tissue regeneration aids your body in regenerating bone that might have been lost due to gum disease. It could be used as an alternative or a complement to bone grafting. The process of guided tissue regeneration offers many benefits, such as:

1. Prepares the jaw for dental implants. When used in conjunction with or as a complement to bone grafting, the guided tissue regeneration process helps rebuild bone loss and build a solid, stable foundation that can support the dental implants. Dense bone ensures that implants are secured in healthy bone and can keep new teeth for a long time.

2. Helps preserve natural teeth. The process of regenerating the tissues of your body isn’t only for people who’ve already lost teeth. You can use the process to keep your natural teeth as well. This is especially true for people who risk losing their teeth due to loss of bone from gum disease that is advanced.
If you undergo the treatment of guided regeneration to your tissues, it begins rebuilding the damaged tissue and bone surrounding your tooth. This can help strengthen the tooth’s foundation and decrease the chance that it may fall out.

3. More minimally invasive than bone-grafting surgery. Though you can use guided tissue regeneration and the bone graft procedure, you don’t need to do this. The process of guided tissue regeneration is an independent procedure and is less invasive than surgical bone grafts.

4. The treatment reverses the adverse effects of periodontal disease. Jaw bone loss is among the most devastating consequences of periodontal diseases. The loss of jaw bone leads to the loss of teeth and affects your ability to speak clearly and eat quickly. The loss of teeth can impact your self-esteem and your facial shape. The process of guided tissue regeneration promotes the development of jaw bone. This means that this process can reverse some of the destructive adverse effects. Losing your teeth is reduced if you can strengthen the jaw bone.

5. Promotes the regeneration of bone. Guided tissue regeneration involves placing a special membrane between bone and soft tissues surrounding the tooth. The membrane functions as a barrier to ensure that bone can grow and strengthen without interference from the gums that heal faster.

6. Improves the aesthetics of your smile. Gum disease, missing teeth as well as jaw bone loss may influence what your smile looks like. In particular, these conditions could result in a sunken look and low confidence in yourself. The process of guided tissue regeneration can help regenerate these tissues, eliminate unsightly periodontal pockets that are not attractive, and enhance the smile’s overall appearance.

Are There Different Types Of Bone Grafts & GBR Membranes?

Yes, bone grafts are obtained from a variety of sources. It is possible to get bone grafts from different parts of your body, like your hip bone or chin. It is also possible to choose bone grafts from human organ donors and bone minerals purified, animal organs, or even synthetic substances.

There are various kinds of GBR membranes. Some GBR membranes are composed of synthetic polymers and need to be removed as soon as possible after the procedure, while some are made from natural substances that are absorbed into the human body.

Why Use a Barrier Membranes?

Barrier membranes are an instrument employed in oral and periodontal surgery to aid bone growth and support tissues. It is achieved through Guided Tissue Regeneration (GTR) and Guided Bone Regeneration (GBR). GBR is a well-documented, effective technique utilized by dentists to treat oral bone deficiency. Resorbable membranes are used to isolate a bony defect from the soft tissues that surround it to make a space where new bone growth may take place.

Before introducing membranes resorbable, those initially developed were not resorbable and required additional surgery to remove the membrane a few weeks later. GBR and grafting techniques started with ineffective millipore (paper) filter barriers. Expanded polytetrafluoroethylene (ePTFE) membranes were first used in 1984, being non-resorbable but compatible with humans and not leading to infection. While ePTFE is considered the most reliable for membranes, and excellent results have been obtained using this particular material, they can be contaminated by bacteria that limit how much bone regeneration can occur. They will eventually need to be removed through at least one additional procedure within 4-6 weeks following the tissue has grown.

The requirement for this second surgical procedure impeded the use of the existing barrier membranes, leading to the development of membranes that resorb. When using barrier membranes, they ensure that the superficial soft tissue flap is kept separate from the bone underneath during the initial healing phase and has to rely on the vascular supply of the flap. It cannot depend on the granulation tissue that is derived from bone.

Barrier Membranes Guided Tissue Regeneration

Types of Membranes

1. Dissolvable or resorbable membranes: In 2014, membranes that can be resorbed were made of collagen, the protein used extensively in cosmetics. It’s a fantastic barrier. All the collagen membranes available for sale are of the size 15x20mm and appear like an unflattened pieces made from white cardboard.

A dentist will reduce them using scissors and usually adjust them to be able to cover the bone that sticks from the gum. Resorbable membranes can disintegrate quickly within some days and are often called plugs. Some may last up to 4 months, based on their created organic material (usually bovine Achilles tendon or porcine origin). Because of their ability to dissolve, the titanium fixation tacks are seldom used to keep them in the correct position.

There are instances where your blood is utilized to construct an organic membrane that can resorb. In essence, 1 to 6 tubes of your blood are collected and then spun by the centrifuge machine to remove the layers. It also focuses on the blood used to make other preparations, such as PRP and PDGF, that are high in platelets. PRF is strong and slender in consistency. It protects the bone graft. It helps speed up healing. It also reduces the pain and risk of complications.

resorbable membranes Guided Tissue Regeneration

2. Non-Dissolvable or Non-Resorbable membranes: The benefit of membranes that are not resorbable is that they’re exactly in creating bone. But the drawback is that you must undergo a second surgical procedure to remove the membrane. The second procedure ranges from removing this membrane from the socket graft to fully reopening the gum and removing the bone tacks to eliminate the membrane.

Non-Dissolvable or Non-Resorbable membranes

What Can I Expect From Treatment?

After surgery, you should expect to notice improvements in about six to eight weeks; however, it’s essential to ensure that the site is correctly protected since the healing process could take up to six months. In that time, it will rebuild any missing bone, and tissue regrowth will help stabilize the tooth. Proper treatment of the mouth must be carried out to make sure that tissue will be able to regenerate correctly surrounding the teeth.

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