This case report will show the potential of space provision for bone regrowth underneath a nonresorbable barrier device in a recession defect where the concept of cell exclusion was intentionally neglected. A deep and wide gingival recession defect associated with a 10mm-deep bone dehiscence was treated by a coronally advanced flap in conjunction with a titanium-reinforced ePTFE membrane. At the time of membrane positioning, the device was intentionally perforated to allow for tissue ingrowth and colonization of the space between the membrane and the root surface by means of cell lines that are usually excluded under GTR provision. Clinical evaluation after tissue maturation phase revealed a substantial bone regeneration and attachment gain onto the previously exposed root surface, which were maintained long-term.
Keywords: guide tissue regeneration, space provision, cell exclusion, periodontal regeneration, perforated membrane