GTR Flashcards
What is the purpose of root surface preparation/conditioning?
Demineralization, removes smear layer remaining post SCRP, eliminates endotoxin, delays epithelial migration over treated roots, promotes CT attachment and new cementum formation
What are some agents that are used for root surface preparation?
Citric acid = has a pH of 1. When used root resporption and anylosis were more frequent
Tetracycline = has an affinity for mineralized tissues (dentin, bone), acidic, and antibiotic. Showed to enhance fibroblast attachment in vitro (Terranova, Trombeilli, Wikesjo)
Doxycycline = Ali-Ali showed in a dog study that it impeded epithelial migration
EDTA: Blomlof showed no benefit from EDTA, TTC, or CA
no human clinical studies have determined any benefit of root conditioning for GTR with any agent investigated
Name 5 factors that affect periodontal regeneration
One of the factors has 4 subcategories
Defect morphology OH/compliance with maintenance Systemic health status Smoking Surgical factors
Subcategories of defect morphology
of walls remianing, defect depth, defect width, defect angle
Discuss evidnece that the # of bony wall affects regneration outcome
Cortellini, Pini Prato, and Tonetti did a study where they took impressions of the defects with PBS. They then did a re entry. They found that bone fill was greatest with 3 walls (95% bone fill) then 2 walls (82% bone fill) then 1 wall (39%)
Discuss evidence that defect angle affects outcome of GTR
Steffensen did a study where defects were treated with MWF and had standardized radigraohs at baseline and then 18 months later. Found that 45 degree angle was cut off. Defects less than 45 degrees had bone gain, defects greater than 45 degrees had bone loss
Give evidence that defect shape affects GTR
Stavropoulos did a study in 2010 where defects were treated with BioOss collagen and covered with BioGide. He found that wide and deep defects did not heal any differently than narrow/shallow defects.
