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Why are guided tissue regeneration (GTR) and bone regeneration (GBR) so critical?
Guided tissue regeneration (GTR) and bone regeneration (GBR) are important technologies in current dental surgery, which use barrier membranes to promote the growth of new bone tissue and gum tissue to solve the current problem of insufficient bone mass. These procedures not only improve functionality but also play an integral role in aesthetics and restoration. This article will take a closer look at the historical background, application status, and impact of GTR and GBR on dental surgery.
Historical BackgroundBarrier membranes were first proposed in 1959 in the study of bone regeneration. In 1976, Melcher proposed the theory of guided tissue regeneration, emphasizing the importance of excluding non-target cells to promote the growth of desired tissues. In the 1980s, as clinical results in periodontal research continued to emerge, the potential of using GBR technology to reconstruct alveolar bone defects began to be explored.
The study of the GBR principle was conducted by Dahlin et al. in 1988. The experiment showed that the selective growth of bone-forming cells in the bone defect area can be significantly improved by isolating the surrounding tissue with a membrane.
Technical Overview
The successful implementation of GBR usually follows the four-step PASS rule:
- Primary closure of wounds to promote undisturbed healing.
- Angiogenesis, providing the necessary blood supply to undifferentiated mesenchymal cells.
- Create and maintain space for bone tissue to grow.
- Wound stabilization to guide blood clot formation and promote smooth healing.
After a tooth is removed, the normal healing process usually takes about 40 days, from the time a blood clot forms until the socket is filled with bone and connective tissue.
Application Scope
In 1982, barrier membranes were first used for periodontal tissue regeneration in the oral cavity as an alternative procedure to reduce periodontal pocket depth. The barrier membrane used in GBR technology can cover the bone defect, create a hidden space, prevent the ingress of connective tissue, and promote the growth priority of bone tissue.
An added benefit of the membrane is that it protects the wound from mechanical disturbance and contamination by saliva.
Biocompatibility and membrane classification
There are two types of barrier membranes available: absorbable and non-absorbable. Non-absorbable membranes such as expanded polytetrafluoroethylene (e-PTFE) and titanium-reinforced PTFE can effectively prevent the entry of fibroblasts and connective tissue cells and promote bone healing.
Indications and contraindications
Indications for bone regeneration include: bone circumference after tooth extraction, bone reconstruction around implants, and sinus augmentation. In some cases, such as smoking, poor oral hygiene or systemic diseases, it is considered a contraindication.
Potential complications include defect recurrence due to unsuccessful treatment, postoperative infection, and poor wound healing.
Future prospects
The development of GTR and GBR techniques has made the results of dental procedures more predictable and successful. With the advancement of materials science and biotechnology, more efficient barrier membrane options may emerge in the future to further improve the effectiveness of surgery.
In short, GTR and GBR are not only revolutionary technologies in dental surgery, but also important cornerstones of future dental treatment. In the face of ever-changing science and technology, what new breakthroughs do you think will occur in the field of dental regeneration?
