Abstract:

Abstract：Periodontal regenerative surgery can be subdivided into guided tissue regeneration （GTR），bone graft procedures and procedures associated with various growth factors. GTR is periodontal surgical procedures that utilize barrier membranes to ensure periodontal ligament cells to capture the root surface first and to direct the achievement of new attachment. The indications of GTR include intrabony defects，furcation involvements and localized gingival recessions. Some treatment strategies should be followed to reach the predictable objective of the treatment，which includes deep and narrow two/three-wall intrabony defects，classⅡfurcation involvements and Miller classⅠ/Ⅱ recessions. Removal of periodontal plaque and elimination of periodontal infection before GTR surgery are necessary. Minimal invasive technique, blood supply protection，space creation and maintenance，primary closure of the wound，wound protection and clot stabilization and plaque control can make the clinical results more predictable.

Key words: periodontal regenerative surgery, guided tissue regeneration（GTR）

摘要：

牙周再生性手术主要包括引导性组织再生术（guided tissue regeneration，GTR）、植骨术和与生长因子有关的促进再生的方法等。GTR原理是在术区放置生物膜形成膜屏障，阻断上皮和纤维组织贴附根面，确保牙周膜细胞占据根面，形成新附着，即真正意义上的牙周组织再生。GTR适应证包括骨下袋、根分叉病变及局限性牙龈退缩。GTR需遵循一定的治疗策略，窄而深的2壁和3壁骨下袋、Ⅱ度根分叉病变以及MillerⅠ度和Ⅱ度龈退缩的治疗效果更具可预测性。再生性手术前控制牙周炎症，术中尽量采用微创手术、保证血供、创造并维持再生空间、严密关闭创口，术后维持创面及血凝块稳定、保持良好的口腔卫生等，都与获得较好的手术（特别是远期）疗效有关。

关键词: 牙周再生性手术, 引导性组织再生术