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Barrier Membrane in Regenerative Therapy: A Narrative Review. MEMBRANES 2022; 12:membranes12050444. [PMID: 35629770 PMCID: PMC9143924 DOI: 10.3390/membranes12050444] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 02/01/2023]
Abstract
Guided bone and tissue regeneration remains an integral treatment modality to regenerate bone surrounding teeth and dental implants. Barrier membranes have been developed and produced commercially to allow space for bone regeneration and prevent the migration of unwanted cells. Ideal membrane properties, including biocompatibility, sufficient structural integrity and suitable shelf life with easy clinical application, are important to ensure good clinical regenerative outcomes. Membranes have various types, and their clinical application depends on the origin, material, structure and properties. This narrative review aims to describe the currently available barrier membranes in terms of history, main features, types, indication and clinical application and classify them into various groups. Various membranes, including those which are resorbable and non-resorbable, synthetic, added with growth factors and composed of modern materials, such as high-grade polymer (Polyetheretherketone), are explored in this review.
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Faraj SA, Kutkut A, Taylor R, Villasante-Tezanos A, Huja S, Dawson D, Almehmadi N, Al-Sabbagh M. Comparison of Dehydrated Human Amnion-Chorion and Type 1 Bovine Collagen Membranes in Alveolar Ridge Preservation: A Clinical and Histological Study. J ORAL IMPLANTOL 2020; 47:385-393. [PMID: 33031520 DOI: 10.1563/aaid-joi-d-19-00335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Alveolar ridge preservation maintains ridge dimensions and bone quality for implant placement. The aim of this randomized controlled clinical study is to compare the use of a human amnion-chorion membrane to a collagen membrane in an exposed-barrier ridge preservation technique. Furthermore, this study will determine if intentional membrane exposure compromises ridge dimensions and bone vitality.Forty-three patients requiring extraction and delayed implant placement were randomly assigned into either the experimental or control group. Twenty-one participants received human amnion-chorion membrane (test) during ridge preservation while twenty-two participants received the collagen membrane (control). In both groups, demineralized freeze-dried bone allografts were used to graft the socket and primary closure was not achieved.The patients underwent implant placement after an average healing period of 19.5 weeks, and 2.7 X 8-mm core bone specimens were obtained for histomorphometric analyses. The clinical ridge dimensions were measured after extraction and at the time of delayed implant placement. No significant difference was observed in the mean vital bone formation between the experimental (51.72 ± 8.46%) and control (49.96 ± 8.31%; P > 0.05) groups. The bone height and width did not differ, as determined by clinical measurements (P > 0.05). Using either a human amnion-chorion membrane or type 1 bovine collagen as the open barrier did not change healing, compromise ridge dimensions, or affect bone vitality between the two groups.
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Affiliation(s)
| | - Ahmad Kutkut
- University of Kentucky College of Dentistry Faculty Restorative Dentistry 800 Rose St UNITED STATES Lexington KY 40536 6465524667 University of Kentucky College of Dentistry
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Theodoridis K, Aggelidou E, Manthou M, Demiri E, Bakopoulou A, Kritis A. Assessment of cartilage regeneration on 3D collagen-polycaprolactone scaffolds: Evaluation of growth media in static and in perfusion bioreactor dynamic culture. Colloids Surf B Biointerfaces 2019; 183:110403. [PMID: 31400614 DOI: 10.1016/j.colsurfb.2019.110403] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 12/22/2022]
Abstract
Efforts on bioengineering are directed towards the construction of biocompatible scaffolds and the determination of the most favorable microenvironment, which will better support cell proliferation and differentiation. Perfusion bioreactors are attracting growing attention as an effective, modern tool in tissue engineering. A natural biomaterial extensively used in regenerative medicine with outstanding biocompatibility, biodegradability and non-toxic characteristics, is collagen, a structural protein with undisputed beneficial characteristics. This is a study designed according to the above considerations. 3D printed polycaprolactone (PCL) scaffolds with rectangular pores were coated with collagen either as a coating on the scaffold's trabeculae, or as a gel-cell solution penetrating scaffolds' pores. We employed histological, molecular and imaging techniques to analyze colonization, proliferation and chondrogenic differentiation of Adipose Derived Mesenchymal Stem Cells (ADMSCs). Two different differentiation culture media were employed to test chondrogenic differentiation on gelated and non gelated PCL scaffolds in static and in perfusion bioreactors dynamic culture conditions. In dynamic culture, non gelated scaffolds combined with our in house TGF-β2 based medium, augmented chondrogenic differentiation performance, which overall was significantly less favorable compared to StemPro™ propriety medium. The beneficial mechanical stimulus of dynamic culture, appears to outgrow the disadvantage of the "weaker" TGF-β2 medium used for chondrogenic differentiation. Even though cells in static culture grew well on the scaffold, there was limited penetration inside the construct, so the purpose of the 3D culture was not fully served. In contrast dynamic culture achieved better penetration and uniform distribution of the cells within the scaffold.
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Affiliation(s)
- Konstantinos Theodoridis
- Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Eleni Aggelidou
- Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Marilena Manthou
- cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; Laboratory of Histology, Embryology and Anthropology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Efterpi Demiri
- Department of Plastic Surgery, Medical School, Papageorgiou Hospital, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece
| | - Athina Bakopoulou
- cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), GR-54124, Thessaloniki, Greece
| | - Aristeidis Kritis
- Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece; cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece.
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Sheftel Y, Ruddiman F, Schmidlin P, Duncan W. Biphasic calcium phosphate and polymer-coated bovine bone matrix for sinus grafting in an animal model. J Biomed Mater Res B Appl Biomater 2019; 108:750-759. [PMID: 31199055 DOI: 10.1002/jbm.b.34429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 04/25/2019] [Accepted: 05/17/2019] [Indexed: 11/09/2022]
Abstract
Autogenous bone grafting requires a donor site and may lose substantial volume during remodeling. Several bone replacement materials (BRMs) are under development to overcome these limitations, especially for indications for minimally intervention surgeries. The objective of our study was to assess the potential of an equine collagen cone reinforced with biphasic calcium phosphate (CC-BCP) particles and deproteinized bovine bone matrix (BBM) coated with polylactic acid, and poly-ε-caprolactone copolymer (BBM-PCC) and then to compare the outcomes with a deproteinized BBM and an equine CC without a filler in a sheep sinus grafting model in the Elleven female sheep were selected. Two experimental sites on each side of the animals were prepared using an extraoral approach for maxillary sinus wall. The four treatments were performed in each animal through a standardized 10-mm access window. While the BBM access was covered with a collagen membrane, all other sites were closed with an equine collagen membrane. All animals were euthanized after 16 weeks. New bone (NB), residual graft particles, and connective tissue were measured in undemineralized resin-embedded sections. As a result, one sheep did not survive the surgery. All sites in the remaining 10 sheep healed uneventfully. All CC and BBM-PCC grafts resorbed and failed to augment the sinuses. BBM and CC-BCP, in contrast, showed some histologic evidence of NB and surgical site augmentation. The NB fraction in the latter two groups accounted for 10 ± 9 and 4 ± 5%, respectively (p > 0.05). In conclusion, BBM-PCC and collagen cone performed poorly for sinus floor augmentation, while deproteinised BBM and reinforced collagen cone demonstrated comparable outcomes.
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Affiliation(s)
- Yevgeny Sheftel
- Division of Periodontology, Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - Frances Ruddiman
- Division of Periodontology, Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - Patrick Schmidlin
- Division of Periodontology and Peri-implant Diseases, Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Warwick Duncan
- Division of Periodontology, Department of Oral Sciences, University of Otago, Dunedin, New Zealand
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Mehta DB, Deshpande NC, Dandekar SA. Comparative evaluation of platelet-rich fibrin membrane and collagen membrane along with demineralized freeze-dried bone allograft in Grade II furcation defects: A randomized controlled study. J Indian Soc Periodontol 2018; 22:322-327. [PMID: 30131624 PMCID: PMC6077968 DOI: 10.4103/jisp.jisp_310_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: The management of the furcation areas in multirooted teeth is often challenging due to difficulty in access. Platelet-rich fibrin (PRF), a second-generation platelet concentrate, has shown to accelerate the healing of soft and hard tissues. This study was designed to evaluate the efficacy of autologous PRF as a membrane in treatment of Grade II furcation defects in molars as compared to collagen membrane along with demineralized freeze-dried bone allograft in both the groups. Materials and Methods: A split-mouth study was planned with 18 patients having 2 sites of Grade II furcation defects each. Random allocation of the defect site was done for the test and control group. Plaque index, probing depth (PD), relative vertical clinical attachment level (RVCAL), gingival marginal level, and radiographic bone levels were recorded at baseline, 3 months, and 6 months postoperatively. Results: Both the groups showed statistically significant outcomes in intragroup comparison from baseline to 3 and 6 months. However, there was no statistical difference between PRF membrane and collagen membrane groups on intergroup comparison. Conclusion: There was a significant reduction of PD, improvement in RVCAL, and defect fill with autogenous PRF as membrane. This indicates its role as a regenerative material in treating furcation defects, which can be used as alternative to other expensive membranes.
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Affiliation(s)
- Dhruv Bipinchandra Mehta
- Department of Periodontology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Neeraj Chandrahas Deshpande
- Department of Periodontology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Shivani Ashwinikumar Dandekar
- Department of Periodontology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
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Periodontal responses to augmented corticotomy with collagen membrane application during orthodontic buccal tipping in dogs. BIOMED RESEARCH INTERNATIONAL 2014; 2014:873918. [PMID: 25276824 PMCID: PMC4174977 DOI: 10.1155/2014/873918] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 05/27/2014] [Accepted: 06/10/2014] [Indexed: 11/18/2022]
Abstract
This prospective randomized split-mouth study was performed to examine the effects of absorbable collagen membrane (ACM) application in augmented corticotomy using deproteinized bovine bone mineral (DBBM), during orthodontic buccal tipping movement in the dog. After buccal circumscribing corticotomy and DBBM grafting into the decorticated area, flaps were repositioned and sutured on control sides. ACM was overlaid and secured with membrane tacks, on test sides only, and the flaps were repositioned and sutured. Closed coil springs were used to apply 200 g orthodontic force in the buccolingual direction on the second and third premolars, immediately after primary flap closure. The buccal tipping angles were 31.19 ± 14.60° and 28.12 ± 11.48° on the control and test sides, respectively. A mean of 79.5 ± 16.0% of the buccal bone wall was replaced by new bone on the control side, and on the test side 78.9 ± 19.5% was replaced. ACM application promoted an even bone surface. In conclusion, ACM application in augmented corticotomy using DBBM might stimulate periodontal tissue reestablishment, which is useful for rapid orthodontic treatment or guided bone regeneration. In particular, ACM could control the formation of mesenchymal matrix, facilitating an even bone surface.
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Embroidered polymer-collagen hybrid scaffold variants for ligament tissue engineering. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 43:290-9. [PMID: 25175216 DOI: 10.1016/j.msec.2014.07.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 05/03/2014] [Accepted: 07/02/2014] [Indexed: 01/14/2023]
Abstract
Embroidery techniques and patterns used for scaffold production allow the adaption of biomechanical scaffold properties. The integration of collagen into embroidered polylactide-co-caprolactone [P(LA-CL)] and polydioxanone (PDS) scaffolds could stimulate neo-tissue formation by anterior cruciate ligament (ACL) cells. Therefore, the aim of this study was to test embroidered P(LA-CL) and PDS scaffolds as hybrid scaffolds in combination with collagen hydrogel, sponge or foam for ligament tissue engineering. ACL cells were cultured on embroidered P(LA-CL) and PDS scaffolds without or with collagen supplementation. Cell adherence, vitality, morphology and ECM synthesis were analyzed. Irrespective of thread size, ACL cells seeded on P(LA-CL) scaffolds without collagen adhered and spread over the threads, whereas the cells formed clusters on PDS and larger areas remained cell-free. Using the collagen hydrogel, the scaffold colonization was limited by the gel instability. The collagen sponge layers integrated into the scaffolds were hardly penetrated by the cells. Collagen foams increased scaffold colonization in P(LA-CL) but did not facilitate direct cell-thread contacts in the PDS scaffolds. The results suggest embroidered P(LA-CL) scaffolds as a more promising basis for tissue engineering an ACL substitute than PDS due to superior cell attachment. Supplementation with a collagen foam presents a promising functionalization strategy.
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Prathap S, Hegde S, Kashyap R, Prathap MS, Arunkumar MS. Clinical evaluation of porous hydroxyapatite bone graft (Periobone G) with and without collagen membrane (Periocol) in the treatment of bilateral grade II furcation defects in mandibular first permanent molars. J Indian Soc Periodontol 2013; 17:228-34. [PMID: 23869132 PMCID: PMC3713757 DOI: 10.4103/0972-124x.113083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Accepted: 01/24/2013] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Furcation invasions represent one of the most demanding therapeutic challenges in periodontics. This investigation assessed and compared the clinical efficacy of hydroxyapatite bone graft material when used alone and with collagen membrane in the treatment of grade II furcation defects. MATERIALS AND METHODS Ten patients with comparable bilateral furcation defects in relation to mandibular first molars were selected and treated in a split-mouth design. After the hygiene phase of therapy was completed, the groups were selected randomly either for treatment with hydroxyapatite bone graft (Periobone G) alone or with a combination of bone graft and guided tissue regeneration (GTR) membrane (Periocol). Clinical parameters like plaque index, gingival index, vertical probing depth, horizontal probing depth, clinical attachment level, position of marginal gingiva, and the amount of bone fill were used at baseline and at 3 and 6 months postoperatively. RESULTS At 6 months, both surgical procedures resulted in statistically significant reduction in vertical and horizontal probing depths and gain in the clinical attachment level. CONCLUSION The use of combination technique yielded superior results compared to sites treated with bone graft alone. However, the difference was not statistically significant.
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Affiliation(s)
- Sruthy Prathap
- Department of Periodontics, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Shashikanth Hegde
- Department of Periodontics, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Rajesh Kashyap
- Department of Periodontics, Yenepoya Dental College, Mangalore, Karnataka, India
| | - M. S. Prathap
- Department of Periodontics, Yenepoya Dental College, Mangalore, Karnataka, India
| | - M. S. Arunkumar
- Department of Periodontics, Yenepoya Dental College, Mangalore, Karnataka, India
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Doostmohammadi A, Monshi A, Fathi MH, Karbasi S, Braissant O, Daniels AU. Direct cytotoxicity evaluation of 63S bioactive glass and bone-derived hydroxyapatite particles using yeast model and human chondrocyte cells by microcalorimetry. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2011; 22:2293-2300. [PMID: 21786131 DOI: 10.1007/s10856-011-4400-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 07/14/2011] [Indexed: 05/31/2023]
Abstract
In this study, the cytotoxicity evaluation of prepared 63S bioactive glass and bone-derived hydroxyapatite particles with yeast and human chondrocyte cells was carried out using isothermal micro-nano calorimetry (IMNC), which is a new method for studying cell/biomaterial interactions. Bioactive glass particles were made via sol-gel method and hydroxyapatite was obtained from bovine bone. Elemental analysis was carried out by XRF and EDXRF. Amorphous structure of the glass and completely crystalline structure of HA were detected by XRD analysis. Finally, the cytotoxicity of bioactive glass and bone-derived HA particles with yeast and cultured human chondrocyte cells was evaluated using IMNC. The results confirmed the viability, growth and proliferation of human chondrocyte cells in contact with 63S bioactive glass, and bone-derived HA particles. Also the results indicated that yeast model which is much easier to handle, can be considered as a good proxy and can provide a rapid primary estimate of the ranges to be used in assays involving human cells. All of these results confirmed that IMNC is a convenient method which caters to measuring the cell-biomaterial interactions alongside the current methods.
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Affiliation(s)
- A Doostmohammadi
- Biomaterials Group, Materials Engineering Department, Isfahan University of Technology, Isfahan, 84156-83111, Iran.
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Wang CC, Wu WY, Chen CC. Antibacterial and swelling properties of N-isopropyl acrylamide grafted and collagen/chitosan-immobilized polypropylene nonwoven fabrics. J Biomed Mater Res B Appl Biomater 2010; 96:16-24. [DOI: 10.1002/jbm.b.31709] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lee CK, Koo KT, Kim TI, Seol YJ, Lee YM, Rhyu IC, Ku Y, Chung CP, Park YJ, Lee JY. Biological effects of a porcine-derived collagen membrane on intrabony defects. J Periodontal Implant Sci 2010; 40:232-8. [PMID: 21072220 PMCID: PMC2967811 DOI: 10.5051/jpis.2010.40.5.232] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 09/09/2010] [Indexed: 11/13/2022] Open
Abstract
Purpose To prolong the degradation time of collagen membranes, various cross-linking techniques have been developed. For cross-linking, chemicals such as formaldehyde and glutaraldehyde are added to collagen membranes, but these chemicals could adversely affect surrounding tissues. The aim of this study is to evaluate the ability of porous non-chemical cross-linking porcine-derived collagen nanofibrous membrane to enhance bone and associated tissue regeneration in one-wall intrabony defects in beagle dogs. Methods The second and third mandibular premolars and the first molars of 2 adult beagles were extracted bilaterally and the extraction sites were allowed to heal for 10 weeks. One-wall intrabony defects were prepared bilaterally on the mesial and distal side of the fourth mandibular premolars. Among eight defects, four defects were not covered with membrane as controls and the other four defects were covered with membrane as the experimental group. The animals were sacrificed 10 weeks after surgery. Results Wound healing was generally uneventful. For all parameters evaluating bone regeneration, the experimental group showed significantly superior results compared to the control. In new bone height (NBh), the experimental group exhibited a greater mean value than the control (3.04 ± 0.23 mm/1.57 ± 0.59, P = 0.003). Also, in new bone area (NBa) and new bone volume (NBv), the experimental group showed superior results compared to the control (NBa, 34.48 ± 10.21% vs. 5.09 ± 5.76%, P = 0.014; and NBv, 28.04 ± 12.96 vs. 1.55 ± 0.57, P = 0.041). On the other hand, for parameters evaluating periodontal tissue regeneration, including junctional epithelium migration and new cementum height, there were no statistically significant differences between two groups. Conclusions Within the limitations of this study, this collagen membrane enhanced bone regeneration at one-wall intrabony defects. On the other hand, no influence of this membrane on periodontal tissue regeneration could be ascertained in this study.
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Affiliation(s)
- Chang-Kyun Lee
- Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
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Rastogi S, Modi M, Sathian B. The Efficacy of Collagen Membrane as a Biodegradable Wound Dressing Material for Surgical Defects of Oral Mucosa: A Prospective Study. J Oral Maxillofac Surg 2009; 67:1600-6. [DOI: 10.1016/j.joms.2008.12.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2008] [Revised: 10/19/2008] [Accepted: 12/07/2008] [Indexed: 10/20/2022]
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Wang CC, Su CH, Chen JP, Chen CC. An enhancement on healing effect of wound dressing: Acrylic acid grafted and gamma-polyglutamic acid/chitosan immobilized polypropylene non-woven. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2009. [DOI: 10.1016/j.msec.2009.01.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Moses O, Frenkel T, Tal H, Weinreb M, Bornstein MM, Nemcovsky CE. Effect of systemic tetracycline on the degradation of tetracycline-impregnated bilayered collagen membranes: an animal study. Clin Implant Dent Relat Res 2009; 12:331-7. [PMID: 19438957 DOI: 10.1111/j.1708-8208.2009.00173.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Premature collagen membrane degradation may compromise the outcome of osseous regenerative procedures. Tetracyclines (TTCs) inhibit the catalytic activities of human metalloproteinases. Preprocedural immersion of collagen membranes in TTC and systemic administration of TTC may be possible alternatives to reduce the biodegradation of native collagen membranes. AIM To evaluate the in vivo degradation of collagen membranes treated by combined TTC immersion and systemic administration. MATERIALS AND METHODS Seventy-eight bilayered porcine collagen membrane disks were divided into three groups and were immersed in 0, 50, or 100 mg/mL TTC solution. Three disks, one of each of the three groups, were implanted on the calvaria of each of 26 Wistar rats. Thirteen (study group) were administered with systemic TTC (10 mg/kg), while the remaining 13 received saline injections (control group). Calvarial tissues were retrieved after 3 weeks, and histological sections were analyzed by image analysis software. RESULTS Percentage of remaining collagen area within nonimpregnated membranes was 52.26 ± 20.67% in the study group, and 32.74 ± 13.81% in the control group. Immersion of membranes in 100 mg/mL TTC increased the amount of residual collagen to 63.46 ± 18.19% and 42.82 ± 12.99% (study and control groups, respectively). Immersion in 50 mg/mL TTC yielded maximal residual collagen values: 80.75 ± 14.86% and 59.15 ± 8.01% (study and control groups, respectively). Differences between the TTC concentrations, and between the control and the study groups were statistically significant. CONCLUSIONS Immersion of collagen membranes in TTC solution prior to their implantation and systemic administration of TTC significantly decreased the membranes' degradation.
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Affiliation(s)
- Ofer Moses
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
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Wang CC, Chen JP, Chen CC. An enhancement on water absorbing and permeating abilities of acrylic acid grafted and chitosan/collagen immobilized polypropylene non-woven fabric: Chitosan obtained from Mucor. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2009. [DOI: 10.1016/j.msec.2008.09.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Behring J, Junker R, Walboomers XF, Chessnut B, Jansen JA. Toward guided tissue and bone regeneration: morphology, attachment, proliferation, and migration of cells cultured on collagen barrier membranes. A systematic review. Odontology 2008; 96:1-11. [DOI: 10.1007/s10266-008-0087-y] [Citation(s) in RCA: 153] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2008] [Accepted: 04/23/2008] [Indexed: 11/24/2022]
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Wang CC, Su CH, Chen CC. Water absorbing and antibacterial properties ofN-isopropyl acrylamide grafted and collagen/chitosan immobilized polypropylene nonwoven fabric and its application on wound healing enhancement. J Biomed Mater Res A 2008; 84:1006-17. [PMID: 17647243 DOI: 10.1002/jbm.a.31482] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A durable sandwich wound dressing system with high liquid absorbing, biocompatibility, and antibacterial properties was designed. Various solution weight ratios of collagen to chitosan were used to immobilize on the polypropylene nonwoven fabric, which were pregrafted with acrylic acid (AA) or N-isopropyl acrylamide (NIPAAm) to construct a durable sandwich wound dressing membrane with high water absorbing, easy removal, and antibacterial activity. Swelling properties and antibacterial activity of the membranes were measured, and wound healing enhancement by skin full-thickness excision on animal model was examined. The results indicated that NIPAAm-grafted and collagen/chitosan-immobilized polypropylene nonwoven fabric (PP-NIPAAm-collagen-chitosan) showed a better healing effect than AA-grafted and collagen/chitosan-immobilized polypropylene nonwoven fabric (PP-AA-collagen-chitosan). The wound treated with PP-NIPAAm-collagen-chitosan demonstrated the excellent remodeling effect in histological examination with respect to the construction of vein, epidermis, and dermis at 21 days after skin injury. The values of water uptake and water diffusion coefficient for PP-NIPAAm-collagen-chitosan were higher than that for PP-AA-collagen-chitosan under a given solution weight ratio of collagen/chitosan. Both PP-NIPAAm-collagen-chitosan and PP-AA-collagen-chitosan demonstrated antibacterial activity.
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Affiliation(s)
- Chyung-Chyung Wang
- Department of Textile Engineering, Chinese Culture University, Taipei, Taiwan 11114, Republic of China
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Wang CC, Chen CC, Chen FL, Lin NS. An improvement on water absorbing and permeating properties: Heparin immobilizing on acrylic acid-grafted and collagen/chitosan-immobilized wound dressing. J Appl Polym Sci 2008. [DOI: 10.1002/app.28206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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19
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Wang CC, Chen CC. Anti-bacterial and swelling properties of acrylic acid grafted and collagen/chitosan immobilized polypropylene non-woven fabrics. J Appl Polym Sci 2005. [DOI: 10.1002/app.22224] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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20
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Zahedi CS, Miremadi SA, Brunel G, Rompen E, Bernard JP, Benque E. Guided tissue regeneration in human Class II furcation defects using a diphenylphosphorylazide-cross-linked collagen membrane: a consecutive case series. J Periodontol 2003; 74:1071-9. [PMID: 12931772 DOI: 10.1902/jop.2003.74.7.1071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Several bioabsorbable collagen membranes are either currently available or under investigation for use in guided tissue regeneration (GTR) procedures. The aim of this 12-month reentry study was to evaluate a diphenylphosphorylazide (DPPA)-cross-linked bovine type I collagen membrane in the healing of mandibular Class II furcation defects. The DPPA technique prevents the inclusion of foreign cytotoxic cross-linking substances in the reticulated molecules, thus providing a more biocompatible product. METHODS Forty non-smoking periodontally compromised adult subjects volunteered for this study, and one defect was randomly selected in each patient. At baseline, plaque index (PI), gingival index (GI), probing depth (PD), gingival margin location (GML), clinical attachment level (CAL), and width of the attached gingiva (AG) were measured. Intrasurgical hard tissue measurements consisted of the vertical open probing attachment level (V-OPAL) and horizontal open probing attachment level (H-OPAL), as well as furcation entrance width (FW) and height (FH) and subclassification of defects according to vertical bone loss. All soft tissue measurements were repeated 12 months after membrane placement using conservative flap reentry surgeries; hard tissue parameters were also assessed at this time. RESULTS DPPA-cross-linked collagen membranes demonstrated good handling characteristics, and no postoperative adverse tissue reactions or clinically detectable localized allergic responses were observed. GI and PI remained low during the entire study period. When the one year reentry values were compared to the baseline measurements, a significant reduction in PD (1.9 +/- 1.4), FW (2.1 +/- 1.7), FH (2.9 +/- 1.6), and gain in CAL (1.7 +/- 1.5), V-OPAL (2.1 +/- 1.9), and H-OPAL (4.7 +/- 1.4) were observed (P < or = 0.05). However, there were no significant differences in GML or AG. Hard tissue improvements resulted in the complete closure of 30% (12) of the defects, and transformation of 67.5% (27) of the defects to Class I, while one defect remained a Class II (2.5%). CONCLUSIONS Based on this 12-month clinical reentry study, a DPPA-cross-linked collagen membrane could be beneficial in GTR treatment of Class II mandibular furcation involvements, both in terms of soft and hard tissue improvements.
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Affiliation(s)
- Charles S Zahedi
- Department of Advanced Periodontics and Implant Surgery, School of Dentistry, Loma Linda University, Loma Linda, CA 92354, USA.
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21
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Abstract
Guided tissue barriers using materials such as collagen are used in the hope of excluding epithelium and the gingival corium from the root surface or alveolar bone to facilitate regeneration. Convention suggests that the longer a membrane remains intact, the better the regeneration results. The purpose of this study was to determine the resorption rates of various collagen membranes in the oral cavity of dogs. Twelve adult mongrel dogs had three different collagen membranes (BioGide, AlloDerm porcine-derived, and AlloDerm human-derived) randomly inserted and secured into surgical pouches made in their palates. Full-thickness tissue punch biopsy specimens taken at 1, 2, 3, or 4 months after surgery were evaluated histologically for membrane intactness and other associated changes. At 1 month, all membranes had slight to moderate degradation. At 2 months, all membranes had moderate to severe degradation with the exception of one AlloDerm human-derived membrane that was intact. At 3 months, all membranes had severe degradation to not identifiable. At 4 months, all membranes had severe degradation to completely absent. Blood vessel penetration varied from none to moderate. Inflammation was found in only two samples. In the dog, all three tested collagen membranes showed slight to moderate degradation at 1 month and were severely degraded to completely absent at 4 months. Within the limits of transferring animal data to humans, clinicians need to be aware of these resorption rates when selecting membranes for guided tissue and bone regeneration.
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Affiliation(s)
- K W Owens
- Dept. of Periodontics, Louisiana State University School of Dentistry, New Orleans, LA, USA
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22
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Abstract
Collagen materials have been utilized in medicine and dentistry because of their proven biocompatability and capability of promoting wound healing. For guided tissue regeneration (GTR) procedures, collagen membranes have been shown to be comparable to non-absorbable membranes with regard to probing depth reduction, clinical attachment gain, and percent of bone fill. Although these membranes are absorbable, collagen membranes have been demonstrated to prevent epithelial down-growth along the root surfaces during the early phase of wound healing. The use of grafting material in combination with collagen membranes seems to improve clinical outcomes for furcation, but not intrabony, defects when compared to the use of membranes alone. Recently, collagen materials have also been applied in guided bone regeneration (GBR) and root coverage procedures with comparable success rates to non-absorbable expanded polytetrafluoroethylene (ePTFE) membranes and conventional subepithelial connective tissue grafts, respectively. Long-term clinical trials are still needed to further evaluate the benefits of collagen membranes in periodontal and peri-implant defects. This article will review the rationale for each indication and its related literature, both in vitro and in vivo studies. The properties that make collagen membranes attractive for use in regenerative therapy will be addressed. In addition, varieties of cross-linking techniques utilized to retard the degradation rate of collagen membranes will be discussed.
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Affiliation(s)
- P Bunyaratavej
- Department of Periodontics/Prevention/Geriatrics, School of Dentistry, University of Michigan, Ann Arbor 48109-1078, USA
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Piattelli M, Scarano A, Piattelli A. Histological evaluation of freeze-dried dura mater (FDDMA) used in guided bone regeneration (GBR): a time course study in man. Biomaterials 1996; 17:2319-23. [PMID: 8982471 DOI: 10.1016/s0142-9612(96)00068-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In 26 patients freeze-dried dura mater (FDDMA) membranes were used in fenestrations and dehiscences around dental implants, in implants inserted into postextraction sockets, in vertical ridge augmentation and in sinus lifting procedures. A re-entry procedure was carried out after 6, 9 and 12 months. In all patients a small portion of the membrane was removed and examined. No inflammatory infiltrate was present in the tissues around the membranes. No cells were present inside the membranes and only in the most peripheral portions was it possible to observe a few cells positive to acid phosphatase. The FDDMA membranes appeared to resorb slowly, did not seem to elicit an inflammatory reaction, and at 12 months they still appeared to play a role in cell occlusion.
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Yukna CN, Yukna RA. Multi-center evaluation of bioabsorbable collagen membrane for guided tissue regeneration in human Class II furcations. J Periodontol 1996; 67:650-7. [PMID: 8832475 DOI: 10.1902/jop.1996.67.7.650] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Clinical data related to GTR therapy for Class II furcations were analyzed from 7 treatment centers that evaluated one of two possible treatment pairs, either bioabsorbable collagen membrane (Type I bovine tendon collagen) (COLL) versus control surgical debridement (DEBR) or COLL versus expanded polytetrafluoroethylene (ePTFE). After initial preparation and re-evaluation, full thickness flaps were reflected, the defects debrided, and the roots planed. Furcations and associated bony defects in each patient were randomly assigned to one of the 2 treatments in each pair, and the flaps closed. Patients received quarterly periodontal maintenance until surgical re-entry at 6 to 12 (mean 11.1) months. Data from 59 pairs of Class II furcations were analyzed via paired t, Wilcoxon signed rank, and RM ANOVA tests. COLL showed better results than DEBR for vertical defect fill, percent defect resolution, and horizontal furcation fill. When COLL was compared to ePTFE in furcations across patients, no differences were found. Both COLL and ePTFE resulted in an improvement in clinical furcation Class about 50% of the time (compared to 7% frequency with DEBR). COLL use yielded 8 and ePTFE yielded 1 clinically-complete furcation closures. COLL barriers resulted in generally favorable clinical results in furcation defects, appeared to be better than DEBR alone, and were at least similar to and often better than ePTFE. COLL of the type used in this study appears to be a useful and beneficial material for regenerative therapy in Class II furcation type periodontal defects.
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Affiliation(s)
- C N Yukna
- Creative Dental Concepts, New Orleans, LA, USA
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25
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Chen CC, Wang HL, Smith F, Glickman GN, Shyr Y, O'Neal RB. Evaluation of a collagen membrane with and without bone grafts in treating periodontal intrabony defects. J Periodontol 1995; 66:838-47. [PMID: 8537865 DOI: 10.1902/jop.1995.66.10.838] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The aim of this study was to compare the clinical regenerative capacity of collagen membrane with and without demineralized freeze-dried bone allografts (DFDBA) in treating periodontal intrabony defects. Ten systemically healthy patients with similar bilateral periodontal defects were scheduled for surgery. Each patient had at least > or = 6 mm clinical probing depth and loss of attachment at selected sites. Baseline measurements included gingival index (GI), plaque index (PI), gingival recession (GR), clinical attachment level (CAL), probing depth (PD), and mobility. At the time of surgery, the defects were randomly assigned to either test (collagen membrane plus DFDBA) or control group (collagen membrane only). Stent to base of the defects, stent to crest bone, crest of bone to base of the defect, and width of the defects were recorded at the time of surgery and reentry. Eight patients returned after 6 months for reentry surgery. Statistical analysis with a paired t test was used to evaluate the treatment effect and comparison between test and control groups. In addition, a McNemar test was used to analyze the significance of GI, PI, and mobility at different times. The result of this study indicated that both the collagen plus DFDBA and the collagen alone treatment groups had a significant decrease of PD (3.4 +/- 0.4 and 3.2 +/- 0.4 mm), gain of CAL (2.3 +/- 0.5 and 2.0 +/- 0.4 mm), and defect fill (1.7 +/- 0.3 and 1.9 +/- 0.9 mm) (P < 0.05) when compared to the presurgery status. However, there was no significant difference in PD, AL, GR, defect fill, crestal bone resorption, GI, PI, or mobility between the test group and control group. No adverse tissue reaction, infection, or delayed wound healing was noted throughout the treatment in either group. This study suggests that the collagen membrane is well tolerated by the human tissues. Both treatments, either collagen membrane plus DFDBA or collagen membrane alone, promoted significant resolution of periodontal intrabony defects. The addition of a bone graft (DFDBA) with a collagen membrane appears to add no extra benefit to the collagen membrane treatment.
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Affiliation(s)
- C C Chen
- Department of Periodontics/Prevention/Geriatrics, School of Dentistry, University of Michigan, Ann Arbor, USA
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Romanos GE, Hotz ST, Schröter-Kermani C, Strub JR. Extracellular matrix interactions during the in vivo degradation of collagen membranes in the rat skin: immunohistochemical distribution of collagen types IV, V, and VI. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 1995; 29:1121-7. [PMID: 8567710 DOI: 10.1002/jbm.820290912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The role of collagen implant material (CIM) in periodontology is of considerable interest to the clinical dentist because of the capacity of connective tissue (CT) regeneration and partial prevention of epithelial cell migration onto the root surface. The aim of this study was to demonstrate alterations of the CT matrix after the use of CIM in subcutaneous pockets in the rat skin. We used 15 rats in this study. After sedation, two subcutaneous pockets (2 cm in length) were surgically made in the animals' backs. Collagen membranes were implanted in one of the two pockets (test site). The other pocket served as control. Then, 4, 7, 14, 21, and 28 days after implantation, the animals were sacrificed and biopsies preserved for histologic and immunohistochemical examination. Incubation with antibodies against CT matrix components (collagen type IV, V, and VI) were used for immunostaining. Histologically, the CIM was migrated by inflammatory cells in the first 7 days. Newly formed fibroblasts and blood vessels (BV) were present 14 days postimplantation. Collagen type IV was localized in the basement membranes of the epithelium, BV, and nerves. An increase in the BV amount was demonstrated around (and later in) the implant material. Collagen type V was found in a filament pattern of distribution and was inserted into the implant after 4 weeks of healing. Collagen type VI showed a microfibrillar pattern of distribution with a delayed formation in the graft mass. The data showed the alterations of the matrix after implantation of collagen type I membranes in the rat skin.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- G E Romanos
- Johann Wolfgang Goethe-University, Dental School Frankfurt (Carolinum), Department of Oral Surgery, FRG
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27
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Mattson JS, McLey LL, Jabro MH. Treatment of intrabony defects with collagen membrane barriers. Case reports. J Periodontol 1995; 66:635-45. [PMID: 7562356 DOI: 10.1902/jop.1995.66.7.635] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Two separate investigations were undertaken to assess the clinical characteristics and the safety, and to determine whether an absorbable type 1 bovine collagen barrier membrane would result in the improvement of clinical parameters during guided tissue regeneration in humans. The collagen membrane barrier was placed over a total of 21 interdental intrabony periodontal defects in 18 patients. The surgical procedures and postsurgical regimen were similar in both components of the investigation. Sulcular incisions were used and the sites were surgically exposed by reflection of full thickness mucoperiosteal flaps. The intrabony defects were debrided and the root surfaces prepared with automatic scalers and curets. Four 1-minute applications of tetracycline HCl 50 mg/ml were applied to the root surface. The collagen membrane barrier was hydrated in sterile saline until pliable, then trimmed so it covered the osseous defect and extended 2 to 3 mm beyond the defect. In both investigations, the collagen barrier membrane was not sutured, but retained by "pouching" or undermining the flap. Healing occurred without complications. There were no untoward or adverse reactions to the material in either phase of the study. In the initial investigation, 13 intrabony defects with probing depths of > or = 5 mm were treated in 9 patients having a mean age of 50.6 years. No controls defects were treated. Soft and hard tissue measurements were taken at the time of initial surgery and at 2, 4, and 6 months. In the second phase, 9 patients were enrolled with a mean age of 49.7 years. They had similar bilateral interdental intrabony defects with probing depths > or = 6 mm. One defect received the collagen membrane barrier, while the other was treated by flap debridement alone. The collagen membrane had undergone modification since the initial investigation, and was more highly cross-linked to retard absorption. After initial therapy, and prior to the surgical procedure, a series of 3 dermal patch tests were used to determine whether the patient would elicit a reaction to the collagen. Venous blood was drawn at baseline, 7 to 10 days, 18 to 21 days and at 8 weeks for analysis by ELISA for comparison of test and control sites relative to baseline. There were no allergic response to the dermal tests, and the ELISA tests indicated no significant differences between test and control sites. An automated probe was used to record soft and hard tissue measurements. These included the probing depths and clinical attachment levels.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- J S Mattson
- Creighton University School of Dentistry, Department of Periodontics, Omaha, NE, USA
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28
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Wang HL, O'Neal RB, Thomas CL, Shyr Y, MacNeil RL. Evaluation of an absorbable collagen membrane in treating Class II furcation defects. J Periodontol 1994; 65:1029-36. [PMID: 7853126 DOI: 10.1902/jop.1994.65.11.1029] [Citation(s) in RCA: 97] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Recent research has focused upon the utilization of an absorbable collagen membrane in guided tissue regeneration (GTR). Concern exists as to whether this type of membrane is beneficial in the treatment of periodontal defects. The purpose of this study was to evaluate the effect of a type I bovine collagen membrane on treatment of Class II furcation defects. Twelve systemically healthy patients (six male and six female, ages 32 to 68) were treated. Each had bilateral mandibular furcation defects with attachment loss > or = 6 mm. Prior to surgery all patients completed initial therapy including scaling and root planing. At the time of the surgery, teeth were randomly assigned to either a control (flap debridement alone) or test (flap debridement plus collagen membrane) group. Data were collected on the day of surgery, and 2, 4, and 6 months post-surgery and at the 12 month re-entry surgery. Clinical measurements included probing depth (PD), clinical attachment level (CAL), gingival recession (GR), stent to base of defect (SB), crestal bone to base of defect (CB), width of defect, and mobility. Statistical analysis was performed utilizing the paired t test. Both control and test groups demonstrated significant (P < 0.05) improvement at 12 months re-entry in PD, CAL, SB, and CB when compared to the presurgery status. While there is no significant difference in PD, CAL, GR, width of defect, and mobility between control and test groups, sites treated with the collagen membrane had significantly higher bone fill (SB and CB) at re-entry.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- H L Wang
- Department of Periodontics/Prevention/Geritrics, School of Dentistry, University of Michigan, Ann Arbor
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29
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Fontana E, Trisi P, Piattelli A. Freeze-dried dura mater for guided tissue regeneration in post-extraction dental implants: a clinical and histologic study. J Periodontol 1994; 65:658-65. [PMID: 7608841 DOI: 10.1902/jop.1994.65.7.658] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Soft membranes were used in 69 patients for bone regeneration around implants (blades and screws, submerged and non-submerged) placed into extraction sockets. In about 10% of the patients a prosthetic restoration was completed immediately, while in the remaining patients the prostheses were connected after a healing period of 3 to 6 months; follow-up ranged from 6 to 30 months. In 22 patients a re-entry procedure was done to evaluate the membrane and in 4 patients a bone biopsy was taken from 3 to 6 months after the placement of the membrane. In all cases the peri-implant tissues appeared clinically healthy and it was possible to see radiographically that the newly formed bone closely adapted to the implants. In most cases it was possible at 6 months re-entry to see the membrane and detach it from the underlying tissues. There was a partial dehiscence of the membrane in only 4% of the cases. After 3 months the tissue under the membrane presented macroscopical features similar to mature bone, and bone biopsies in all cases showed a spongious lamellar bone with a high level of activity and a wide band of osteoid tissue.
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Affiliation(s)
- E Fontana
- Dental School, University of Chieti, Italy
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Quteish D, Dolby AE. The use of irradiated-crosslinked human collagen membrane in guided tissue regeneration. J Clin Periodontol 1992; 19:476-84. [PMID: 1430283 DOI: 10.1111/j.1600-051x.1992.tb01160.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Irradiated glutaraldehyde-crosslinked human collagen membrane was evaluated for its effects on new attachment formation in clinical trials, using the principle of guided tissue regeneration (GTR). 19 adult periodontitis patients with 52 matched bilateral periodontal defects received scaling and polishing with oral hygiene instruction. The bilateral periodontal defects were treated by reflecting a flap with collagen membrane (test) or flap reflection alone (control). Plaque (P1I) and gingival index (GI) scorings, probing pocket depth (PPD) and probing attachment level (PAL) along with classification of furcation involvement (FI) and bony defects were made at pre- and post surgery (6 weeks, 3 and 6 months). Improvement of P1I and GI scores was seen in both test and control sites following the surgical therapy. Reductions in PPD and PAL were significantly (p less than 0.001) more pronounced at 6 months in the test sites compared to the controls. The 2 Class I furcations in the graft-treated teeth showed complete resolution, while the corresponding furcations in the control teeth showed incomplete closure. The use of human collagen membrane based on the GTR technique for treatment of human periodontal defects provided greater gain of clinical attachment than when flap surgery alone was undertaken.
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Affiliation(s)
- D Quteish
- Department of Periodontology, University of Wales College of Medicine, Heath Park, UK
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