Penam Periodontics - Evidence based Personalized Periodontics

Guided Tissue Regeneration

Many ways of trying to replace the tissues lost due to gum disease have been investigated in the past. One of these is called guided tissue regeneration. This technique was devised to try to prevent the most rapidly growing tissue types from recolonizing the trauma site.

Different tissue grow at different rates. There are fast growing tissues such as epithelial cells (skin surface cells) and those that line the patients gastrointestinal tract. These have a life span of days. The slowest growing tissue is bone and this can take up to 6-8 weeks to grow into a site such as an extraction site.

The guided tissue regeneration procedure tries to stop the fastest growing tissue from entering the healing wound site and allow the slow growing tissue to fill the void. The fastest growing tissue such as the epithelium will always win the race compared with the connective tissue or the slowly growing cementum or bone. The technique attempts to place a barrier to exclude the rapidly growing tissues from the surgical site thereby allowing the cells from the slower growing tissue to invade the surgical site to regrow the bone or cementum.

Whilst there have been minimal evidence of large gains in the correct tissues the clinical trial studies have failed to show the expected outcomes. The mean amount to new cementum and bone is around 1mm which unfortunately is not considered sufficient in relationship to the cost of the procedure to provide a significant benefit to the patient.

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