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tvpjournal.com | January/February 2016 | Today's VeTerinary PracTice PracTical denTisTry Peer reviewed 91 BONE REGENERATION regenerating bone lost via periodontal disease is another targeted therapy. Guided tissue regeneration (GTr) has been used for decades, but recent advances in barriers and bone grafting have markedly improved the success rates. 103-106 regardless, only a handful of conditions carry a good prognosis for bone regeneration. The best prognosis is seen with: 107 • 3-walled periodontal pockets typically seen on the palatal aspect of the maxillary canine (Figure 6A) and distal aspect of the distal root of the mandibular first molar (Figure 6B) • lesions with s tage 2 furcation (Figure 6C). Because these are common conditions in small breed dogs, many patients may beneft from these procedures. The theory of GTr is that the downward growth of faster healing soft tissue must be prevented to allow the slower growing bone and periodontal ligament to repopulate the periodontally induced bony defect (Figure 7 and Figure 8 , page 92). 108,109 The procedure involves: 107 1. creating a periodontal fap 2. Performing open root planing (the frst 2 steps create a clean root surface for healing) 3. Filling the defect with bone augmentation 4. Placing a barrier membrane. numerous products are used in humans, but the products of choice for most veterinary dentists are cancellous freeze-dried demineralized bone for the graft and demineralized laminar bone sheets as the membrane. 107, 110-114 IMPLANTOLOGY While rare (and controversial) 115 in veterinary dentistry, implantology is exceedingly common in human dentistry (Figure 9, page 92). it is increasingly being used in place of traditional methods, such as periodontal surgery and even endodontics. The main reason for the use of implants is that they are associated with a better long-term prognosis than periodontal surgery or endodontics A B C D Figure 7. guided tissue regeneration demonstration for an 8-mm periodontal pocket with vertical (angular) bone loss on the palatal aspect of a left maxillary canine (204). (Note this is a cadaver case.) (A) Envelope fap performed on the palatal surface of the maxillary canine. (B) Thorough open root planing. (C) Placement of the bone augmentation. (D) Placement of the barrier membrane.