Regenerative periodontal therapy
Figure 26.1 Guided tissue regeneration.
Figure 26.2 Types of membrane for guided tissue regeneration.
Figure 26.3 Guided tissue regeneration: membrane placement.
Figure 26.4 Procedure for use of Emdogain®.
Figure 26.5 A case treated by the use of Emdogain® and PerioGlas®. (a) Preoperative radiograph of the surgical site. (b) Reflection of the buccal flap. (c) Application of Emdogain® following the use of ethylene diamine tetra acetate (EDTA) conditioner.(d) Flaps replaced and secured with sutures. (e) Radiograph taken 18 months’ postoperatively. Courtesy of Mr P. J. Nixon.
Figure 26.6 Potential growth factors for periodontal regeneration. Growth factors are known to affect osteogenic cells and are being actively investigated for a potential role in periodontal regeneration.
Regenerative periodontal therapy encompasses a number of surgical procedures that aim specifically at gaining healing of periodontal destruction by developing new periodontium rather than by repair with a long junctional epithelial attachment. These techniques include:
• Guided tissue regeneration.
• Enamel matrix derivative (Straumann®, Emdogain).
• Bone grafts (Chapter 27).
• Growth factors.
Guided tissue regeneration
Following conventional flap surgery, cells from the overlying epithelium rapidly migrate apically. A long junctional epithelium results and this attaches onto the cleaned root surface resulting in healing by repair which does not mimic the original periodontal attachment.
Guided tissue regeneration (GTR) attempts to reorder the migration of cel/>
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