How do GTR and GBR Differ? A Periodontitis Case Treated Using an Equine-derived, Enzyme-deantigenic, Collagenpreserving Bone Graft, and Collagen Membranes.

The research primarily focuses on showcasing how a severely infected tooth with high chances of loss could remarkably be saved through a guided tissue regeneration (GTR) surgery technique. The technique was amplified by the use of two equine collagen membranes and an equine-derived, enzyme-deantigenic, collagen-preserving bone graft, which combinedly facilitated sufficient bone regeneration.

Overview of GTR and GBR Methods

• Guided tissue regeneration (GTR) is a periodontal treatment method where a membrane is utilized to guide the growth of new gum and bone at sites where there is bone deficiency or erosion due to periodontitis.
• Guided bone regeneration (GBR) is a similar type of technique employed for bone regeneration, specifically targeting critical bone defects. This method is frequently used in conjunction with membranes covered with a bone substitute to facilitate growth at the defect site.

Case Details and Treatment Approach

• The patient under treatment was a 39-year-old with a mobile central upper incisor, caused due to severe periodontitis.
• The tooth, initially with a questionable prognosis, was treated based on the principles of GTR using a collagen membrane. Additionally, a collagen-preserving bone graft was employed as a scaffold for clot formation and cell infiltration, which was subsequently covered by a second collagen membrane.

Follow-Up Assessment and Outcomes

• Post-surgery, assessments were done at 3, 6, 12, and 18 months to monitor the patient’s progress.
• Follow-up radiographs suggested that bone regeneration had occurred around the diseased tooth with only minimal tooth mobility observed.
• The patient reported improvements in masticatory function, comfort, and physical appearance, suggesting a favorable outcome.

Concluding Insights

• The use of double equine collagen membranes to conduct periodontal regeneration according to GTR principles, coupled with an equine, collagen-preserving, enzyme-deantigenic bone graft, proved effective in salvaging a tooth initially considered lost due to periodontitis.
• For cases where teeth are severely affected by periodontitis, the application of collagen membranes under GTR practices can enable the regeneration of periodontal tissues. Moreover, GTR coupled with a bone substitute with proven effectiveness, covered with a collagen membrane (GBR approach), can further enhance bone regeneration at the defect site in some cases.