Periodontal supportive alveolar bone loss is one of the characteristic signs of destructive character of periodotnal disease and it is generally considered as an anatomic sequelae (osseous defects) of apical disease spreading. The therapeutic rationale as a whole of guided tissu regeneration in deep infrabonny defects come from the periodontal support increasing necessity of severe compromised teeth by the periodontal disease evolution.
The clinical objectives of these regenerative procedures are inhancement of local anatomy and / or odontal function and prognostic. The major benefits for the patient are inhancement of masticatory function, comfort and the prognostic of involved teeth with a minimal detriment regarding the esthtic appearance by: (i) increasing of funtional teeth support (the increasing of attachment and bone levels), (ii) periodontal pocket depth reducing and (iii) minimal gingival recession. Guided tissue regeneration in periodontal surgery must be considered as a multifactorial therapeutic approach which supposes a judicios selection of the patients, bone defects, barrier membranes, additive materials and multiple surgical procedures. All these aspects may be combined to conceive different therapeutic strategies with different levels of difficulty. It is expected that different associations to lead to different therapeutic outcomes. In this context, this paper shows a decisional strategy in which biological, general and technical factors are evaluated to elaborate an individualized therapeutic plan in order to guarantee a high predictability for an optimal therapeutic result.