--- title: Guided Tissue Regeneration (GTR) description: Explore Buffy the Beagle's successful Guided Tissue Regeneration (GTR) procedure for vertical bone loss, restoring oral health and function. See the transformative results in our case study. --- [Skip to the main content.](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/guided-tissue-regeneration#main-content) [![Animal-Dentistrylogo-transparent](https://tooth.vet/hs-fs/hubfs/Logos%20(Animal%20Dentistry)/Animal_Dentistry__logo-removebg.png?width=1280&height=720&name=Animal_Dentistry__logo-removebg.png "Animal-Dentistrylogo-transparent")](https://tooth.vet/) [![Animal-Dentistrylogo-transparent](https://tooth.vet/hs-fs/hubfs/Logos%20(Animal%20Dentistry)/Animal-Dentistrylogo-transparent.png?width=1280&height=720&name=Animal-Dentistrylogo-transparent.png "Animal-Dentistrylogo-transparent")](https://tooth.vet/) - [Home](https://tooth.vet) - [About Us](https://tooth.vet/about-us) - [Contact Us!](https://tooth.vet/contact-us) - Services - [3D Imaging](https://tooth.vet/3d-imaging) - [In-House Anesthesia](https://tooth.vet/in-house-anesthesiologist) - [Canine Dentistry](https://tooth.vet/canine-dentistry) - 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[Pet Owners](https://tooth.vet/pet-owners) - [Dentistry Case Chronicles](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles) - [Upcoming Events](https://tooth.vet/events) [Facebook](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/guided-tissue-regeneration#0) [Instagram](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/guided-tissue-regeneration#0) [Linkedin](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/guided-tissue-regeneration#0) [X](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/guided-tissue-regeneration#0) [YouTube](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/guided-tissue-regeneration#0) [Medium](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/guided-tissue-regeneration#0) 2 min read # Guided Tissue Regeneration (GTR) [![Picture of Jennifer Mathis, DVM, DAVDC, CVPP](https://tooth.vet/hubfs/Jennifer%20Mathis%20-%20CV,%20Bio,%20Headshot/Jennifer%20Mathis%20-%20500x500%20Headshot-2.png) Jennifer Mathis, DVM, DAVDC, CVPP](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/author/mathis) : Mar 18, 2024 7:58:43 PM [veterinary dentistry](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-dentistry) [veterinary surgery](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-surgery) [Dental Health Management](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/dental-health-management) [surgical techniques](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/surgical-techniques) [Guided Tissue Regeneration](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/guided-tissue-regeneration) [GTR Procedure](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/gtr-procedure) [Veterinary case study](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-case-study) [Dental bone graft](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/dental-bone-graft) [Vertical bone loss](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/vertical-bone-loss) [Beagle dental health](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/beagle-dental-health) [Pet dental care](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/pet-dental-care) [Bone graft study](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/bone-graft-study) [Periodontal pocket treatment](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/periodontal-pocket-treatment) [Oral tissue regeneration](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/oral-tissue-regeneration) ##### **Case Summary:** Guided Tissue Regeneration (GTR) is a technique performed to promote osseous regeneration, allowing for tissue growth (bone and soft tissues) to replace an infrabony periodontal pocket (a site of vertical bone loss). This involves cleaning the infrabony pocket using hand curettes, potentially with a specialized ultrasonic curette as well. A bone graft, along with a barrier membrane, is placed into the pocket, followed by tight closure of the gingival collar. GTR is performed to preserve structural integrity in cases of vertical bone loss. ##### **Patient Information:** Buffy, a 6yo FS 11# Beagle presented from the referring veterinarian (RDVM), [Dr. Ryan Southard, at Family Pet Veterinary Center](https://www.fampetvet.com/about-us/staff/veterinarians/dr-ryan-southard), for a Comprehensive Oral Health Assessment and Treatment (COHAT). Initial exam findings calculus index 1-3 in varied areas of the mouth; 409 gingival recession (GR) 4mm with exudate at the furcation. ##### Dental Exam Findings: PD2 (Periodontal Disease Index <25% attachment loss) 102-103, 202-203, 104 PD3 (Periodontal Disease Index 25-50% attachment loss) 204 FE2 (Furcation Exposure under the crown) GR (Gingival Recession) 409, 4mm Missing 105-109, 201, 205-207, 306-308, 302-303, 401-403, 405, 408   ##### **Advanced Imaging with RDVM:** Below: CBCT Hard tissue reconstruction ![CBCT Hard tissue reconstruction with RDVM](https://tooth.vet/hs-fs/hubfs/Case%20Studies/December%202023/RDVM/CBCT%20Hard%20tissue%20reconstruction%20with%20RDVM.png?width=1823&height=592&name=CBCT%20Hard%20tissue%20reconstruction%20with%20RDVM.png) Below: High intensity CBCT Image ![High intensity CBCT Image with RDVM](https://tooth.vet/hs-fs/hubfs/Case%20Studies/December%202023/RDVM/High%20intensity%20CBCT%20Image%20with%20RDVM.png?width=1821&height=570&name=High%20intensity%20CBCT%20Image%20with%20RDVM.png) Below: Bone loss affecting upper left canine tooth ##### ![Bone Loss affecting uppler left canine tooth](https://tooth.vet/hs-fs/hubfs/Case%20Studies/December%202023/RDVM/Bone%20Loss%20affecting%20uppler%20left%20canine%20tooth.png?width=1819&height=598&name=Bone%20Loss%20affecting%20uppler%20left%20canine%20tooth.png) Below: Imaging of both sides of the lower right 4th premolar Furcation exposure level 2 indicating bone loss under the crown ##### ![Both sides of the lower right 4th premolar - Furcation exposure through and through - Bone loss](https://tooth.vet/hs-fs/hubfs/Case%20Studies/December%202023/RDVM/Both%20sides%20of%20the%20lower%20right%204th%20premolar%20-%20Furcation%20exposure%20through%20and%20through%20-%20Bone%20loss.png?width=1816&height=676&name=Both%20sides%20of%20the%20lower%20right%204th%20premolar%20-%20Furcation%20exposure%20through%20and%20through%20-%20Bone%20loss.png) ##### **Procedures Performed:**   ##### **Closed Root Planning (RP/C):** During the dental procedure Dr. Ryan noted probing depth of 8mm at the palatal aspect 204 and 5mm palatal probing depth of 104. Closed root planing (RP/C) was performed at this time and referred for Guided Tissue Regeneration (GTR). Below: Presentation at the beginning of procedure with RDVM ![Presentation at the beginning of procedure with RDVM](https://tooth.vet/hs-fs/hubfs/Case%20Studies/December%202023/RDVM/Presentation%20at%20the%20beginning%20of%20procedure%20with%20RDVM.png?width=1819&height=518&name=Presentation%20at%20the%20beginning%20of%20procedure%20with%20RDVM.png) Below: After procedure with RDVM (Before referral to Animal Dentistry Referral Services) ##### ![After procedure with RDVM](https://tooth.vet/hs-fs/hubfs/Case%20Studies/December%202023/RDVM/After%20procedure%20with%20RDVM.png?width=1825&height=538&name=After%20procedure%20with%20RDVM.png) In the one month after the referring DVM performed closed root planing, the upper right canine palatal pocket had improved from 5mm to 3mm (within normal limits) and the upper left canine infra-bony pocket depth had also improved from 8mm to 6mm. It’s typical to have a 1-2mm improvement in probing depth in the short term (1-3 months). Closed root planing turns an active periodontal pocket inactive. Recurrence of active periodontal disease is dependent up on pocket depth and dental home care as well as sooner (3-6 months) professional anesthetic dental procedures. ##### **Guided Tissue Regeneration (GTR) 204:** An envelope flap was utilized, followed by curettage to remove granulation tissue and debris. Osteoallograft periomix bone graft material from Veterinary Transplant Services was then placed in the infrabony pocket. Doxirobe was spread thinly to create a membrane covering the graft material, and closure was achieved using 4-0 monocryl to create a tight gingival collar. The images below were taken at various stages throughout the procedure.   ### CT imaging Showing deep bone loss at palatal aspect of upper left canine tooth before an oral nasal fistula has developed ![CT image after GTR done](https://tooth.vet/hs-fs/hubfs/Case%20Studies/December%202023/GTR/CT%20image%20after%20GTR%20done.jpg?width=404&height=368&name=CT%20image%20after%20GTR%20done.jpg)   ### Opening the defect site View of the granulation bed which must be fully removed to be able to treat ![gtr - before graft placement, granulation tissue from previous closed root planing from rdvm](https://tooth.vet/hubfs/Case%20Studies/December%202023/GTR/gtr%20-%20before%20graft%20placement%2c%20granulation%20tissue%20from%20previous%20closed%20root%20planing%20from%20rdvm.jpg)   ### Cleaned deep bony pocket Also showing some debris, a good lesson to use magnification and clean more ![gtr - site cleaned and ready for bone graft](https://tooth.vet/hubfs/Case%20Studies/December%202023/GTR/gtr%20-%20site%20cleaned%20and%20ready%20for%20bone%20graft.jpg)   ### Bone graft Mixed with blood during GTR procedure ![GTR during procedure - bone graft placed](https://tooth.vet/hubfs/Case%20Studies/December%202023/GTR/GTR%20during%20procedure%20-%20bone%20graft%20placedG.jpg)   ### Custom membrane placed over graft To prevent soft tissue down growth and the bone returns ![GTR - after bone graft placed, membrane on top](https://tooth.vet/hubfs/Case%20Studies/December%202023/GTR/GTR%20-%20after%20bone%20graft%20placed%2c%20membrane%20on%20top.jpg)   ### Closed GTR With tight gingival collar ![After suture placed after GTR perfomred ](https://tooth.vet/hs-fs/hubfs/Case%20Studies/December%202023/GTR/After%20suture%20placed%20after%20GTR%20perfomred%20.jpg?width=1000&height=677&name=After%20suture%20placed%20after%20GTR%20perfomred%20.jpg)   ##### **Surgical Extraction 409:** Envelope flap, section, elevate, graft placement. The site was closed with4-0 monocryl. **Below: (left) BEFORE extraction, (right) AFTER extraction** **![Left - Radiograph After Extraction](https://tooth.vet/hs-fs/hubfs/Case%20Studies/December%202023/Extraction/Left%20-%20Radiograph%20After%20Extraction.png?width=1970&height=657&name=Left%20-%20Radiograph%20After%20Extraction.png)** **![Extraction-](https://tooth.vet/hs-fs/hubfs/Case%20Studies/December%202023/Extraction/Extraction-.png?width=1973&height=666&name=Extraction-.png)** ##### Follow-Up Information: Buffy is a regular client and is doing great. Owner has no concerns and continues to see us regularly for the bone graft study. The most recent dental examination under anesthesia was September of 2023. Dental procedure findings: PP 0-1m 104, 204 with no bleeding on probing ie GTR is looking great, ie bone has returned to the area and attachment loss has been regained. Next dental procedure scheduled June 2024. - [Tweet](https://twitter.com/share) [![Treating Periodontal Disease: Ziggy's Journey with Guided Tissue Regeneration](https://tooth.vet/hubfs/Case%20Studies/December%202024/Before%20COHAT%20right%20side%20.jpg)](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/ics-feline-0) 1 min read #### [Treating Periodontal Disease: Ziggy's Journey with Guided Tissue Regeneration](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/ics-feline-0) ![Picture of Jennifer Mathis, DVM, DAVDC, CVPP](https://tooth.vet/hs-fs/hubfs/Jennifer%20Mathis%20-%20CV,%20Bio,%20Headshot/Jennifer%20Mathis%20-%20500x500%20Headshot-2.png?width=30&name=Jennifer%20Mathis%20-%20500x500%20Headshot-2.png) [Jennifer Mathis, DVM, DAVDC, CVPP](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/author/mathis) : Nov 5, 2024 7:28:23 PM Case Summary: Guided Tissue Regeneration (GTR) is a technique used to promote the regeneration of bone and soft tissue, enabling the replacement of... [veterinary dentistry](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-dentistry) [veterinary surgery](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-surgery) [Dental Health Management](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/dental-health-management) [surgical techniques](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/surgical-techniques) [periodontal disease](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/periodontal-disease) [Guided Tissue Regeneration](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/guided-tissue-regeneration) [Veterinary case study](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-case-study) [Pet dental care](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/pet-dental-care) [Veterinary full mouth extractions](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-full-mouth-extractions) [Veterinary Dental Referral Services](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-dental-referral-services) [Animal Dental Care](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/animal-dental-care) [Pet Oral Health](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/pet-oral-health) [Vet Education](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/vet-education) [Vet Life](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/vet-life) [Iowa Vet Dentistry](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/iowa-vet-dentistry) [Animal health care](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/animal-health-care) [Veterinary Dental Case Study](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-dental-case-study) [Canine Dental Health](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/canine-dental-health) [Read More](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/ics-feline-0) [![Trauma-Induced Dental Infection in Dog: Extraction and Bone Grafting with ReGum Vet](https://tooth.vet/hubfs/Case%20Studies/October%202024/ReGum%20%E2%80%9Cmushroom%E2%80%9D%20application.jpg)](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/regum) #### [Trauma-Induced Dental Infection in Dog: Extraction and Bone Grafting with ReGum Vet](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/regum) ![Picture of Jennifer Mathis, DVM, DAVDC, CVPP](https://tooth.vet/hs-fs/hubfs/Jennifer%20Mathis%20-%20CV,%20Bio,%20Headshot/Jennifer%20Mathis%20-%20500x500%20Headshot-2.png?width=30&name=Jennifer%20Mathis%20-%20500x500%20Headshot-2.png) [Jennifer Mathis, DVM, DAVDC, CVPP](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/author/mathis) : Oct 23, 2024 1:16:12 PM Case Summary & Patient Information: Daisy, a 2.5-year-old spayed female Old English Sheepdog/Poodle mix, presented with a primary complaint of a lump... 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[veterinary dentistry](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-dentistry) [veterinary surgery](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-surgery) [Dental Health Management](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/dental-health-management) [surgical techniques](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/surgical-techniques) [Veterinary case study](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-case-study) [Pet dental care](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/pet-dental-care) [Veterinary full mouth extractions](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-full-mouth-extractions) [Stomatitis](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/stomatitis) [Feline Gingivostomatitis](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/feline-gingivostomatitis) [cat health](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/cat-health) [veterinary oral inflammation](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/veterinary-oral-inflammation) [Tooth Resorption](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/tag/tooth-resorption) [Read More](https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/stomatitis) ##### Quick Links Quick Links - [Refer a Patient](https://tooth.vet/patient-referral) - [Schedule a Consultation - For Pet Owners](https://tooth.vet/pet-owners) - [Dental Education](https://tooth.vet/dental-education) [![Animal-Dentistrylogo-transparent](https://tooth.vet/hubfs/Logos%20(Animal%20Dentistry)/Animal-Dentistrylogo-transparent.png)](https://tooth.vet/about-us) © 2025 Animal Dentistry Referral Services [Facebook](https://www.facebook.com/FamilyPetNorwalk)[YouTube](https://www.youtube.com/@toothvetia) Return to top ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Jennifer Mathis, DVM, DAVDC, CVPP", "url" : "https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/author/mathis" }, "dateModified" : "2024-03-21T19:15:37.113Z", "datePublished" : "2024-03-19T00:58:43.000Z", "headline" : "Guided Tissue Regeneration (GTR)", "mainEntityOfPage" : { "@id" : "https://tooth.vet/beneath-the-surface-animal-dentistry-referral-services-case-chronicles/guided-tissue-regeneration", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject" }, "name" : "Animal Dentistry Referral Services" } } ```