Background: Guided tissue regeneration (GTR) has the potential to promote periodontal regeneration, which is one of the goals of periodontal surgery. While many successful reports of periodontal regeneration using barrier membranes exist in the literature, considerable heterogeneity of GTR outcomes is more typical of current reports. The reasons for this variability are numerous, but could be attributed to differences in surgical skills and case selection. There is a need for a current analysis of the factors affecting success and the formation of evidence-based treatment guidelines for GTR. Methods: Available English literature pertaining to guided tissue regeneration was reviewed. Sources included peer-reviewed journal publications, online resources, and textbooks. Specific consideration was made to factors affecting GTR outcomes, especially in the context of systematic reviews and meta-analyses. Results: Factors, including patient systemic conditions and compliance, defect features, local factors and surgical techniques and materials, that influence GTR outcomes were analysed and entered into a decision-making model. Conclusion: A decision-making model was formulated based upon current evidence regarding factors that influence guided tissue regeneration outcomes. Meticulous case selection based upon known influential variables may help to minimize inconsistency in GTR outcomes.
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