Guided tissue regeneration (GTR) has been defined as those procedures that attempt regeneration of lost periodontal structures through differing tissue responses. The rationale for GTR is based on the physiologic healing response of the tissues after periodontal surgery. After periodontal surgery, a race to repopulate the root surface begins among the four tissue types of the , namely, epithelium, connective tissue, periodontal ligament (PDL), and bone. Epithelium, which migrates at a rate of 0.5 mm per day, typically migrates first along the root surface, preventing new attachment. Therefore to allow the undifferentiated mesenchymal
cells from the PDL and the endosteum of bone to repopulate the root against surfaces, the epithelial
cells and the gingival connective tissue cells should be isolated. This isolation during initial healing enables periodontal structures to become reestablished and may lead to better long-term
health of the tooth. The GTR procedure commonly involves the use of an osseous graft along with a resorbable membrane This technique has the potential to lead to substantial improvement of the periodontal condition when used around carefully selected two- and three-walled osseous defects and mandibular furcation involvements.
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