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Finding the Perfect Membrane: Current Knowledge on Barrier Membranes in Regenerative Procedures: A Descriptive Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031042] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Guided tissue regeneration (GTR) and guided bone regeneration (GBR) became common procedures in the corrective phase of periodontal treatment. In order to obtain good quality tissue neo-formation, most techniques require the use of a membrane that will act as a barrier, having as a main purpose the blocking of cell invasion from the gingival epithelium and connective tissue into the newly formed bone structure. Different techniques and materials have been developed, aiming to obtain the perfect barrier membrane. The membranes can be divided according to the biodegradability of the base material into absorbable membranes and non-absorbable membranes. The use of absorbable membranes is extremely widespread due to their advantages, but in clinical situations of significant tissue loss, the use of non-absorbable membranes is often still preferred. This descriptive review presents a synthesis of the types of barrier membranes available and their characteristics, as well as future trends in the development of barrier membranes along with some allergological aspects of membrane use.
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Solomon SM, Sufaru IG, Teslaru S, Ghiciuc CM, Stafie CS. Finding the Perfect Membrane: Current Knowledge on Barrier Membranes in Regenerative Procedures: A Descriptive Review. APPLIED SCIENCES-BASEL 2022. [DOI: https://doi.org/10.3390/app12031042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Guided tissue regeneration (GTR) and guided bone regeneration (GBR) became common procedures in the corrective phase of periodontal treatment. In order to obtain good quality tissue neo-formation, most techniques require the use of a membrane that will act as a barrier, having as a main purpose the blocking of cell invasion from the gingival epithelium and connective tissue into the newly formed bone structure. Different techniques and materials have been developed, aiming to obtain the perfect barrier membrane. The membranes can be divided according to the biodegradability of the base material into absorbable membranes and non-absorbable membranes. The use of absorbable membranes is extremely widespread due to their advantages, but in clinical situations of significant tissue loss, the use of non-absorbable membranes is often still preferred. This descriptive review presents a synthesis of the types of barrier membranes available and their characteristics, as well as future trends in the development of barrier membranes along with some allergological aspects of membrane use.
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Dhawan S, Takiar M, Manocha A, Dhawan R, Malhotra R, Gupta J. Functionally graded membrane: A novel approach in the treatment of gingival recession defects. J Indian Soc Periodontol 2021; 25:411-417. [PMID: 34667384 PMCID: PMC8452168 DOI: 10.4103/jisp.jisp_583_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 04/02/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Guided tissue regeneration has recently been advocated in re-constructing soft-tissue dimensions in recession defects. Advancement in nanotechnology has led to increased zest for approaches such as electrospinning of biologically active; nanofibrous functionally graded regenerative membranes for periodontal tissue engineering. A functionally graded membrane (FGM) had been tailored by incorporating chitosan and nano-hydroxyapatite over Amnion membrane and used in gingival recession defects. Study Design: It was single-blind, randomized controlled study. Split-mouth study was conducted in nine patients and 22 sites with recession defects were selected. Sites were divided into Group A (Amnion membrane with coronal advanced flap) and Group B (FGM with coronal advanced flap). Materials and Methods: Sites were assessed clinically by recording plaque index (PI), gingival index (GI), vertical recession defect depth (VRDD), relative clinical attachment level (CAL), and width of keratinized tissue at baseline, 3–6 months; and radiographically by recording linear bone growth by dentascan at baseline and 6 months. Result: Both groups showed statistically significant reduction in PI, GI and VRDD, and CAL and nonsignificant reduction in width of keratinized tissue at 3 and 6 months postoperatively. Group A showed statistically significant linear bone growth at 6 months. Group B also showed gain in linear bone growth at 6 months; however, result was statistically nonsignificant. Conclusion: FGM had shown favorable results by enhancing bone growth while preventing the gingival tissue downgrowth.
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Affiliation(s)
- Shivani Dhawan
- Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar Deemed to be University, Ambala, Haryana, India
| | - Megha Takiar
- Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar Deemed to be University, Ambala, Haryana, India
| | - Anish Manocha
- Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar Deemed to be University, Ambala, Haryana, India
| | - Rajan Dhawan
- Department of Conservative Dentistry and Endodontics, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar University, Ambala, Haryana, India
| | - Ranjan Malhotra
- Department of Periodontology and Oral Implantology, Himachal Dental College, Sunder Nagar, Himachal Pradesh University, Shimla, India
| | - Jyoti Gupta
- Department of Periodontology and Oral Implantology, Harvansh Singh Judge Institute of Dental Sciences, Chandigarh, India
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Jayash SN, Hashim NM, Misran M, Ibrahim N, AL-Namnam NM, Baharuddin NA. Analysis on Efficacy of Chitosan-Based Gel on Bone Quality and Quantity. FRONTIERS IN MATERIALS 2021; 8. [DOI: 10.3389/fmats.2021.640950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Objectives: To assess and compare the quantity and the quality of the newly bone generated when using chitosan-based gel scaffold and osteoprotegerin-chitosan gel scaffold.Methods: A total of 18 critical-sized defects on New Zealand white rabbit craniums were created. In 12 defects, either chitosan gel or osteoprotegerin-chitosan gel was implanted the last six defects were kept unfilled as a control. Bone formation was examined at 6 and 12 weeks. Bone’s specimens were scanned using the High-resolution peripheral quantitative computed tomography. Histological and histomorphometric analysis were carried out to compare the volume and area of regenerated bone.Results: The results of the HR-pQCT showed that bone volume and densities in the osteoprotegerin-chitosan gel group were significantly higher than the chitosan gel and control groups whereas, the bone volume density in the chitosan gel group was significantly higher than the control group in both intervals time (p = 0.01, p = 000). No significant difference in bone volume between the chitosan gel and control groups (p = 0.506, p = 0.640) was observed. However, similar findings were shown in the histomorphometric analysis, with the highest new bone formation was observed in the OPG-chitosan gel group followed by the chitosan group. The mean percentage of new bone was greater at 12 weeks compared to 6 weeks in all groups.Conclusions: Chitosan-based gel demonstrated a significant bone quantity and quality compared to unfilled surgical defects. Consistently, osteoprotegerin enhanced the chitosan gel in bone regeneration.
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Di Raimondo R, Sanz-Esporrín J, Sanz-Martin I, Plá R, Luengo F, Vignoletti F, Nuñez J, Sanz M. Hard and soft tissue changes after guided bone regeneration using two different barrier membranes: an experimental in vivo investigation. Clin Oral Investig 2020; 25:2213-2227. [PMID: 32851532 DOI: 10.1007/s00784-020-03537-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the contour and volumetric changes of hard and soft tissues after guided bone regeneration (GBR) using two types of barrier membranes together with a xenogeneic bone substitute in dehiscence-type defects around dental implants. MATERIAL AND METHODS In 8 Beagle dogs, after tooth extraction, two-wall chronified bone defects were developed. Then, implants were placed with a buccal dehiscence defect that was treated with GBR using randomly: (i) deproteinized bovine bone mineral (DBBM) covered by a synthetic polylactic membrane (test group), (ii) DBBM plus a porcine natural collagen membrane (positive control) and (iii) defect only covered by the synthetic membrane (negative control group). Outcomes were evaluated at 4 and 12 weeks. Micro-CT was used to evaluate the hard tissue volumetric changes and STL files from digitized cast models were used to measure the soft tissues contour linear changes. RESULTS Test and positive control groups were superior in terms of volume gain and contour changes when compared with the negative control. Soft tissue changes showed at 4 weeks statistically significant superiority for test and positive control groups compared with negative control. After 12 weeks, the results were superior for test and positive control groups but not statistically significant, although, with a lesser magnitude, the negative control group exhibited gains in both, soft and hard tissues. CONCLUSIONS Both types of membranes (collagen and synthetic) attained similar outcomes, in terms of hard tissue volume gain and soft tissue contours when used in combination with DBBM CLINICAL RELEVANCE: Synthetic membranes were a valid alternative to the "gold standard" natural collagen membrane for treating dehiscence-type defects around dental implants when used with a xenogeneic bone substitute scaffold.
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Affiliation(s)
- Riccardo Di Raimondo
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Javier Sanz-Esporrín
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Periimplant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Ignacio Sanz-Martin
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Rafael Plá
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Fernando Luengo
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Fabio Vignoletti
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Periimplant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Javier Nuñez
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain. .,ETEP (Etiology and Therapy of Periodontal and Periimplant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.
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Abstract
4-hexylresorcinol (4-HR), as a derivative of phenolic lipids, has biological and pharmacological properties that are beneficial when used with a biomaterial. It has antimicrobial and antiseptic activity and can thus prevent contamination and infection of biomaterials. 4-HR suppresses the nuclear factor kappa B (NF-κB) signaling pathway related to osteoclast differentiation. The suppression of NF-κB increases the bone formation marker and contributes to new bone formation. The tumor necrosis factor-α (TNF-α) is a pro-inflammatory cytokine produced by macrophages and suppressed by 4-HR. Suppression of TNF-α decreases osteoclast activity and promotes wound healing. 4-HR increases the vascular endothelial growth factor and has an anti-thrombotic effect. When incorporated into silk vascular patches, it promotes endothelium wound healing. Recently, 4-HR has exhibited biological properties and has been successfully incorporated into various biomaterials. Consequently, it is a useful pharmacological chemical that can be used with biomaterials in the field of tissue engineering.
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Abstract
Silk derived from the silkworm is known for its excellent biological and mechanical properties. It has been used in various fields as a biomaterial, especially in bone tissue engineering scaffolding. Recently, silk protein-based biomaterial has been used as a barrier membrane scaffolding for guided bone regeneration (GBR). GBR promotes bone regeneration in bone defect areas using special barrier membranes. GBR membranes should have biocompatibility, biodegradability, cell occlusion, the mechanical properties of space-making, and easy clinical handling. Silk-based biomaterial has excellent biologic and mechanical properties that make it a good candidate to be used as GBR membranes. Recently, various forms of silk protein-based membranes have been introduced, demonstrating excellent bone regeneration ability, including osteogenic cell proliferation and osteogenic gene expression, and promoting new bone regeneration in vivo. In this article, we introduced the characteristics of silk protein as bone tissue engineering scaffolding and the recent application of such silk material as a GBR membrane. We also suggested future studies exploring additional uses of silk-based materials as GBR membranes.
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Sivashanmugam A, Charoenlarp P, Deepthi S, Rajendran A, Nair SV, Iseki S, Jayakumar R. Injectable Shear-Thinning CaSO 4/FGF-18-Incorporated Chitin-PLGA Hydrogel Enhances Bone Regeneration in Mice Cranial Bone Defect Model. ACS APPLIED MATERIALS & INTERFACES 2017; 9:42639-42652. [PMID: 29143524 DOI: 10.1021/acsami.7b15845] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
For craniofacial bone regeneration, shear-thinning injectable hydrogels are favored over conventional scaffolds because of their improved defect margin adaptability, easier handling, and ability to be injected manually into deeper tissues. The most accepted method, after autografting, is the use of recombinant human bone morphogenetic protein-2 (BMP-2); however, complications such as interindividual variations, edema, and poor cost-efficiency in supraphysiological doses have been reported. The endogenous synthesis of BMP-2 is desirable, and a molecule which induces this is fibroblast growth factor-18 (FGF-18) because it can upregulate the BMP-2 expression by supressing noggin. We developed a chitin-poly(lactide-co-glycolide) (PLGA) composite hydrogel by regeneration chemistry and then incorporated CaSO4 and FGF-18 for this purpose. Rheologically, a 7-fold increase in the elastic modulus was observed in the CaSO4-incorporated chitin-PLGA hydrogels as compared to the chitin-PLGA hydrogel. Shear-thinning Herschel-Bulkley fluid nature was observed for both hydrogels. Chitin-PLGA/CaSO4 gel showed sustained release of FGF-18. In vitro osteogenic differentiation showed an enhanced alkaline phosphatase (ALP) expression in the FGF-18-containing chitin-PLGA/CaSO4 gel when compared to cells alone. Further, it was confirmed by studying the expression of osteogenic genes [RUNX2, ALP, BMP-2, osteocalcin (OCN), and osteopontin (OPN)], immunofluorescence staining of BMP-2, OCN, and OPN, and alizarin red S staining. Incorporation of FGF-18 in the hydrogel increased the endothelial cell migration. Further, the regeneration potential of the prepared hydrogels was tested in vivo, and longitudinal live animal μ-CT was performed. FGF-18-loaded chitin-PLGA/CaSO4 showed early and almost complete bone healing in comparison with chitin-PLGA/CaSO4, chitin-PLGA/FGF-18, chitin-PLGA, and sham control systems, as confirmed by hematoxylin and eosin and osteoid tetrachrome stainings. This shows that the CaSO4 and FGF-18-incorporated hydrogel is a potential candidate for craniofacial bone defect regeneration.
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Affiliation(s)
- A Sivashanmugam
- Center for Nanosciences and Molecular Medicine, Amrita University , Kochi 682041, India
| | - Pornkawee Charoenlarp
- Section of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo 113 8510, Japan
| | - S Deepthi
- Center for Nanosciences and Molecular Medicine, Amrita University , Kochi 682041, India
| | - Arunkumar Rajendran
- Center for Nanosciences and Molecular Medicine, Amrita University , Kochi 682041, India
| | - Shantikumar V Nair
- Center for Nanosciences and Molecular Medicine, Amrita University , Kochi 682041, India
| | - Sachiko Iseki
- Section of Molecular Craniofacial Embryology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo 113 8510, Japan
| | - R Jayakumar
- Center for Nanosciences and Molecular Medicine, Amrita University , Kochi 682041, India
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Kweon H, Jo YY, Seok H, Kim SG, Chae WS, Sapru S, Kundu SC, Kim DW, Park NR, Che X, Choi JY. In vivo bone regeneration ability of different layers of natural silk cocoon processed using an eco-friendly method. Macromol Res 2017. [DOI: 10.1007/s13233-017-5085-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jo YY, Kim SG, Kwon KJ, Kweon H, Chae WS, Yang WG, Lee EY, Seok H. Silk Fibroin-Alginate-Hydroxyapatite Composite Particles in Bone Tissue Engineering Applications In Vivo. Int J Mol Sci 2017; 18:ijms18040858. [PMID: 28420224 PMCID: PMC5412440 DOI: 10.3390/ijms18040858] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 03/28/2017] [Accepted: 04/13/2017] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to evaluate the in vivo bone regeneration capability of alginate (AL), AL/hydroxyapatite (HA), and AL/HA/silk fibroin (SF) composites. Forty Sprague Dawley rats were used for the animal experiments. Central calvarial bone (diameter: 8.0 mm) defects were grafted with AL, AL/HA, or AL/HA/SF. New bone formation was evaluated by histomorphometric analysis. To demonstrate the immunocompatibility of each group, the level of tumor necrosis factor (TNF)-α expression was studied by immunohistochemistry (IHC) and quantitative reverse transcription polymerase chain reaction (qRT-PCR) at eight weeks post implantation. Additionally, osteogenic markers, such as fibroblast growth factor (FGF)-23, osteoprotegerin (OPG), and Runt-related transcription factor (Runx2) were evaluated by qPCR or IHC at eight weeks post implantation. The AL/HA/SF group showed significantly higher new bone formation than did the control group (p = 0.044) and the AL group (p = 0.035) at four weeks post implantation. Additionally, the AL/HA/SF group showed lower relative TNF-α mRNA levels and higher FGF-23 mRNA levels than the other groups did at eight weeks post implantation. IHC results demonstrated that the AL/HA/SF group had lower TNF-α expression and higher OPG and Runx2 expression at eight weeks post implantation. Additionally, no evidence of the inflammatory reaction or giant cell formation was observed around the residual graft material. We concluded that the AL/HA/SF composite could be effective as a scaffold for bone tissue engineering.
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Affiliation(s)
- You-Young Jo
- Sericultural & Apicultural Materials Division, National Institute of Agricultural Science, Wanju 55365, Korea.
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung 25457, Korea.
| | - Kwang-Jun Kwon
- Department of Oral and Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung 25457, Korea.
| | - HaeYong Kweon
- Sericultural & Apicultural Materials Division, National Institute of Agricultural Science, Wanju 55365, Korea.
| | - Weon-Sik Chae
- Analysis Research Division, Daegu Center, Korea Basic Science Institute, Daegu 41566, Korea.
| | - Won-Geun Yang
- Analysis Research Division, Daegu Center, Korea Basic Science Institute, Daegu 41566, Korea.
| | - Eun-Young Lee
- Department of Oral and Maxillofacial Surgery, Chungbuk National University College of Medicine, Cheongju 28644, Korea.
- Department of Oral and Maxillofacial Surgery, Chungbuk National University Hospital, Cheongju 28644, Korea.
| | - Hyun Seok
- Department of Oral and Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung 25457, Korea.
- Department of Oral and Maxillofacial Surgery, Chungbuk National University Hospital, Cheongju 28644, Korea.
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