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

AIM: The present case illustrates how a tooth, which had a highly questionable prognosis, was preserved by carrying out a periodontal regeneration surgery. BACKGROUND: Treatment of periodontitis involves a careful consideration of all the factors that may allow the achievement of a favorable outcome; among those, the skillful use of guided tissue regeneration (GTR) membranes is of paramount importance. CASE DESCRIPTION: A 39-year-old patient presented with a mobile central upper incisor due to severe periodontitis and was treated according to GTR principles using a collagen membrane. A collagen-preserving bone graft was also used, as a scaffold for clot formation and cellular infiltration, which was covered with a second collagen membrane. The patient was contacted for follow-up assessment at 3, 6, 12, and 18 months after surgery. Follow-up radiographs showed that bone regeneration occurred around the involved tooth and very little tooth mobility was observed. The patient's masticatory function, appearance, and comfort were favorable. CONCLUSION: The use of two equine collagen membranes with the purpose of creating the best conditions to carry out periodontal regeneration according to GTR principles, in association with an equine, collagen-preserving, enzyme-deantigenic bone graft, allowed sufficient bone regeneration to salvage a tooth that was deemed otherwise lost because of periodontitis. CLINICAL SIGNIFICANCE: In cases of teeth that are severely compromised by periodontitis, the use of collagen membranes according to GTR principles can allow the regeneration of the periodontal tissues; the association with a bone substitute having well-known performance rates, covered with a collagen membrane (guided bone regeneration, GBR) can, in some cases, improve bone regeneration at the defect site.