JVD 2015 #4 - Evaluation of an Osseous Allograft Membrane for Guided Tissue Regeneration in the Dog Flashcards
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
hat are treatment options for deep infra bony pockets?
how is the choice of treatment made?
exodontia, osseous resective, osseous additive (GTR, bone augmentation) perio sx;
tx depends on severity of PD dz, tooth involved, purpose of the patient, concurrent medical problems, client wishes/finances/compliance/time
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
what are biological requirements for GTR?
presence of blood, fibrin clot stabilization, space maintenance, epithelial exclusion, periodontal flap coverage since periosteum is rich in osteoprogenitor cells
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
what is the goal of GTR?
preparing tooth surface for re-attachement of healthy periodontium (PDL, alveolar bone) to gain new attachment and eliminate periodontal pocket
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
what is the purpose of a membrane?
what are types of membranes available?
stabilize fibrin clot, exclude gingival CT and epithelium (periodontal barrier);
resorbable, non-resorbable
bioabsorbable, non-bioabsorbable,
synthetic, natural, biodegradable
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
What type of defects have the best prognosis for GTR?
Three-walled intrabony pockets with periodontal probing depths greater than 3 to 4-mm have the best treatment prognosis for GTR.
Site selection important
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
are grafting materials required for GTR?
what is the benefit of including grafting material?
No!;
provide added membrane support, osteoconductive (ALL) and sometimes osteoinductive (auto and allograft) or osteogenic (only autograft)
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
radiographic followup for all 8 patients and 11 teeth were performed.
What were the findings in regard to probing depth pre and post GTR? was it significant?
pre-GTR PPD was 7.2mm;
post GTR PPD was <3mm (gained on average 5.4mm of attachment);
PPD gain improvement was statistically significant
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
what is the difference between regeneration and repair?
Which one more likely occurs in GTR?
Regeneration implies histologic architecture is restored while repair it is not identical;
likely GTR provides more repair, however, can only know with extracting tooth, PDL and bone post GTR and performing histo which is not feasible in clinical setting
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
how quickly can gingival CT, epithelium, and junctional epithelium recolonize a defect?
5-6 days;
takes bone 6-8 weeks
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
what are properties of an ideal GTR membrane?
biocompatible, excludes unwanted tissue, integrates with natural tissue, maintains space and stabilizes fibrin clot, protects newly formed bone, handles easily, provides support for 6-8 weeks
According to “Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog” by stepaniuk, gingerich,
what makes a material osteoinductive? osteoconductive? osteogenic?
osteoinductive materials stimulate undifferentiated mesenchymal cells to transform into osteoblasts after contacting the graft bone matrix (autograft, allograft and alloplasts with BMPs);
osteoconductive materials allow ingrowth of capillaries, perivascular tissue, and mesenchymal cells from the recipient bed to the graft by acting as scaffolding for new bone growth (ALL grafts);
osteogenic osteoblasts and clasts survive in autograft to recipient site (autograft only);
DFDBA is osteoinductive and conductive
