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Han HS, Lee JT, Oh S, Cho YD, Kim S. Effectiveness of a collagen matrix seal and xenograft in alveolar ridge preservation: an experimental study in dogs. Sci Rep 2024; 14:163. [PMID: 38168516 PMCID: PMC10762190 DOI: 10.1038/s41598-023-50370-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
Majority of previous studies on alveolar ridge preservation (ARP) used collagen membranes as barrier membranes, and further evidence for ARP in dehiscent extraction sockets with a deproteinized bovine bone mineral (DBBM) and matrix is needed. The aim of this study is to assess the impact of non-cross linked collagen membranes (membrane) and crosslinked collagen matrices (matrix) on ARP using DBBM in extraction sockets with buccal dehiscence. In six mongrel dogs, the mesial roots of three mandibular premolars (P2, P3, and P4) were extracted 1 month after dehiscence defect induction. Two experimental groups were randomly assigned: (1) DBBM with a membrane (DBBM/membrane group) and (2) DBBM with a matrix (DBBM/matrix group). Three-dimensional (3D) volumetric, microcomputed tomography (μCT), and histologic analyses were performed to assess the ridge preservation. Both groups were effective to maintain the ridge width (p > 0.05), and the DBBM/matrix group showed more favorable soft tissue regeneration and bone quality in the histological analysis (p = 0.05). Based on these results, DBBM/matrix could be better choice for ARP in cases of buccal dehiscence defects.
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Affiliation(s)
- Hee-Seung Han
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jung-Tae Lee
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Seunghan Oh
- Department of Dental Biomaterials, The Institute of Biomaterial and Implant, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea.
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2
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Dogan Kaplan A, Cinar IC, Gultekin BA, Avci Kupeli Z, Ozfirat EC, Yalcin S. The Effect of Different Types of Collagen Membranes on Peri-Implant Dehiscence Defects. J Craniofac Surg 2023; 34:2479-2484. [PMID: 37431934 DOI: 10.1097/scs.0000000000009536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 05/20/2023] [Indexed: 07/12/2023] Open
Abstract
AIM This experimental study aimed to compare the bone-implant contact (BIC) following guided bone regeneration with 3 bioabsorbable collagen membranes on peri-implant dehiscence defects. METHODS Forty-eight standard dehiscence defects were created in the sheep iliac bone crest, and dental implants were placed into the defects. With the guided bone regeneration technique, the autogenous graft was placed into the defect and covered with different types of membranes: Geistlich Bio-Gide, Ossix Plus, and Symbios Prehydrated were covered. One group was left without a membrane as the control group (C) by applying only an autogenous graft. After recovery periods of 3 and 6 weeks, the experimental animals were sacrificed. Histologic sections were prepared by a nondecalcified method, and BIC was examined. RESULTS There was no statistically important difference between groups in the third week ( P >0.05). A statistically significant difference between groups was found in the sixth week ( P <0.01). Bone-implant contact values of the C group were significantly lower than those of the Geistlich Bio-Gide and Ossix Plus groups ( P <0.05). There was no statistically significant difference between control and Symbios Prehydrated groups ( P >0.05). In all sections, osseointegration was observed, with no signs of inflammation, necrosis, or foreign body reaction. CONCLUSION In our study, it has been concluded that the resorbable collagen membranes used in treating peri-implant dehiscence defects might affect the BIC, and the success varies according to the type of membrane used.
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Affiliation(s)
- Aylin Dogan Kaplan
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul
| | - Ihsan Caglar Cinar
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul
| | | | - Zehra Avci Kupeli
- Department of Pathology, Faculty of Veterinary Medicine, Bursa Uludag University
| | - Eren Can Ozfirat
- Department of Surgery, Faculty of Veterinary Medicine, Bursa Uludag University, Bursa, Turkey
| | - Serdar Yalcin
- Department of Oral Implantology, Istanbul University Faculty of Dentistry, Istanbul
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3
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Quan BD, Sadeghi R, Ikeda Y, Ganss B, Hamilton DW, McCulloch CA, Sone ED. Screening of functionalized collagen membranes with a porcine periodontal regeneration model. Oral Dis 2023; 29:2845-2853. [PMID: 36458549 DOI: 10.1111/odi.14445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/18/2022] [Accepted: 11/11/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Current methods for periodontal regeneration do not promote collagen fiber insertions into new bone and cementum. We used a pig wound model to screen different functionalized collagen membranes in promoting periodontal reattachment to root surfaces. METHODS Treatment groups included (1) control with no membranes, (2) collagen-coated membranes, (3) membranes with insulin-like growth factor-1 (IGF-1), (4) membranes with amelotin, or (5) membranes attached with calcium phosphate cement (CPC), or with CPC combined with IGF-1. Flap procedures were performed on mandibular and maxillary premolars of each pig. RESULTS Histomorphometric, micro-CT, and clinical measurements obtained at 4 and 12 weeks after surgery showed cementum formation on denuded roots and reformation of alveolar bone, indicating that the pig model can model healing responses in periodontal regeneration. Calcium phosphate cement simplified procedures by eliminating the need for sutures and improved regeneration of alveolar bone (p < 0.05) compared with other treatments. There was a reduction (p < 0.05) of PD only for the IGF group. Large observed variances between treatment groups indicated that a priori power analyses should be conducted to optimize statistical analysis. CONCLUSIONS Pigs can model discrete elements of periodontal healing using collagen-based, functionalized membranes. Screening indicates that membrane anchorage with calcium phosphate cements improve regeneration of alveolar bone.
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Affiliation(s)
- Bryan D Quan
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Rokhsareh Sadeghi
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Yuichi Ikeda
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Department of Periodontology, Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Bernhard Ganss
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Douglas W Hamilton
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | | | - Eli D Sone
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Department of Materials Science and Engineering, University of Toronto, Toronto, Ontario, Canada
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4
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Buser D, Urban I, Monje A, Kunrath MF, Dahlin C. Guided bone regeneration in implant dentistry: Basic principle, progress over 35 years, and recent research activities. Periodontol 2000 2023; 93:9-25. [PMID: 38194351 DOI: 10.1111/prd.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 01/10/2024]
Abstract
Bone augmentation procedures are frequent today in implant patients, since an implant should be circumferentially anchored in bone at completion of bone healing to have a good long-term stability. The best documented surgical technique to achieve this goal is guided bone regeneration (GBR) utilizing barrier membranes in combination with bone fillers. This clinical review paper reflects 35 years of development and progress with GBR. In the 1990s, GBR was developed by defining the indications for GBR, examining various barrier membranes, bone grafts, and bone substitutes. Complications were identified and reduced by modifications of the surgical technique. Today, the selection criteria for various surgical approaches are much better understood, in particular, in post-extraction implant placement. In the majority of patients, biodegradable collagen membranes are used, mainly for horizontal bone augmentation, whereas bioinert PTFE membranes are preferred for vertical ridge augmentation. The leading surgeons are using a composite graft with autogenous bone chips to accelerate bone formation, in combination with a low-substitution bone filer to better maintain the augmented bone volume over time. In addition, major efforts have been made since the millenium change to reduce surgical trauma and patient morbidity as much as possible. At the end, some open questions related to GBR are discussed.
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Affiliation(s)
- Daniel Buser
- School of Dental Medicine, University of Bern, Bern, Switzerland
- Centre for Implantology Buser and Frei, Bern, Switzerland
| | - Istvan Urban
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, UIC Barcelona, Barcelona, Spain
- Division of Periodontology, CICOM-Monje, Badajoz, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Marcel F Kunrath
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dentistry, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral, Maxillofacial Surgery and Research and Development, NU-Hospital Organisation, Trollhättan, Sweden
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5
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Shido R, Ohba S, Tominaga R, Sumita Y, Asahina I. A Prospective Study of the Assessment of the Efficacy of a Biodegradable Poly(l-lactic acid/ε-caprolactone) Membrane for Guided Bone Regeneration. J Clin Med 2023; 12:5994. [PMID: 37762935 PMCID: PMC10532217 DOI: 10.3390/jcm12185994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Biodegradable guided bone regeneration (GBR) membranes consist primarily of collagen and aliphatic polyesters. This study assessed the comparative efficacy of a poly(l-lactic-caprolactone) [P(LA/CL)] membrane versus that of a collagen membrane in GBR. Patients requiring GBR simultaneously or before dental implant placement in edentulous regions were randomly assigned to one of two membranes. Within each membrane, they were subdivided into 3 groups: dental implants were placed simultaneously with GBR in groups A and B, and 180 days post-GBR in group C. The augmented bone width was measured at 1, 3, and 6 mm from the implant's neck (groups A and B) or the reference line (group C), utilizing cone-beam computed tomography images, immediately and 150 days post-surgery. A histological study was performed to evaluate bone formation in group C. No adverse events were observed. In the collagen group, the absorbed ratios of the augmented bone were 40.9 ± 36.7%, 29.4 ± 30.1%, and 11.1 ± 22.0% at 1, 3, and 6 mm, respectively; the ratio at 6 mm was significantly lower than that at 1 mm (p = 0.0442). In the P(LA/CL) group, those were 26.2 ± 27.3%, 17.1 ± 19.7%, and 13.3 ± 16.4% at 1, 3, and 6 mm, respectively, with no significant difference at each point. No significant inter-membrane differences were observed. The bone augmentation potential of the P(LA/CL) membrane matched that of the collagen membrane. P(LA/CL) could be used as a safe and effective membrane in GBR.
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Affiliation(s)
- Rena Shido
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (R.S.); (R.T.); (I.A.)
- Center for Oral Implant, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan
| | - Seigo Ohba
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (R.S.); (R.T.); (I.A.)
- Center for Oral Implant, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan
| | - Risa Tominaga
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (R.S.); (R.T.); (I.A.)
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Tokyo 113-8510, Japan
| | - Yoshinori Sumita
- Department of Medical Research and Development for Oral Disease, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan;
| | - Izumi Asahina
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (R.S.); (R.T.); (I.A.)
- Department of Oral and Maxillofacial Surgery, School of Medicine, Juntendo University, 3-1-3 Hongo, Tokyo 113-8421, Japan
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6
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Sanz-Sánchez I, Sanz-Martín I, Ortiz-Vigón A, Molina A, Sanz M. Complications in bone-grafting procedures: Classification and management. Periodontol 2000 2022; 88:86-102. [PMID: 35103322 DOI: 10.1111/prd.12413] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bone-regenerative interventions aiming to restore deficient alveolar ridges, such as the use of block grafts or through the application of guided bone-regeneration principles, have reported positive outcomes in the published scientific literature. These interventions, however, are invasive, and hence, intraoperative and/or postoperative complications may occur. The types of complications and their severity may vary from the exposure of the biomaterial (membrane or graft) to postsurgical infections, neurosensorial disturbances, occurrence of hemorrhage, and pain, etc. The aim of the present narrative review was to search the available scientific evidence concerning the incidence of these complications, their effect on treatment outcomes, their clinical management and, finally, strategies aimed at prevention. Exposure of the barrier membrane or the block graft is the most common complication associated with oral regenerative interventions. To manage these complications, depending on the extent of the exposure and the presence or absence of concomitant infections, therapeutic measures may vary, from the topical application of antiseptics to the removal of the barrier membrane or the block graft. Regardless of their treatment, the occurrence of these complications has been associated with patient selection, with compliant patients (eg, nonsmokers) having a lower reported incidence of complications. Similarly, surgical factors such as correct flap elevation and a tensionless closure are of obvious importance. Finally, to prevent the incidence of complications, it appears prudent to utilize whenever possible less invasive surgical interventions.
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Affiliation(s)
- Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | | | | | - Ana Molina
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
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7
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Impact of Cross-Linking of Collagen Matrices on Tissue Regeneration in a Rabbit Calvarial Bone Defect. MATERIALS 2021; 14:ma14133740. [PMID: 34279311 PMCID: PMC8269870 DOI: 10.3390/ma14133740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 11/29/2022]
Abstract
The cross-linking of collagen matrices (Cl_CM) may provide volume-stable enhanced defect regeneration when compared to non-cross-linked matrices (Ncl_CM). The aim of the present study was to investigate the bone forming potential of collagen matrices (CMs) and the effects of cross-linking CMs in a rabbit calvaria defect model. (1) Empty controls (n = 6), (2) Ncl_CM (n = 8), and (3) Cl_CM (n = 8) were selected to be observed for the healing in 10 mm critical-sized calvarial bone defects. The potential for the bone as well as the connective tissue formation were evaluated by micro-CT and histomorphometry at three months post-surgery. There were no statistically significant differences in terms of new bone volume in the defects between the groups. However, the Cl_CM induced significantly greater fibrous tissue regeneration (5.29 ± 1.57 mm2) when compared to the controls (3.51 ± 0.93 mm2) by histomorphometry. The remnants of collagen fibers with immune cells, including macrophages and giant cells, were occasionally observed in the Cl_CM group but not in the Ncl_CM group. In conclusion, the cross-linking of collagen did not influence the potential for bone formation. Nevertheless, Cl_CM might be advantageous for the maintenance of fibrous tissue volume without disturbing bone formation in the defects.
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8
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Tien HK, Lee WH, Kim CS, Choi SH, Gruber R, Lee JS. Alveolar ridge regeneration in two-wall-damaged extraction sockets of an in vivo experimental model. Clin Oral Implants Res 2021; 32:971-979. [PMID: 34101908 PMCID: PMC8453892 DOI: 10.1111/clr.13791] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/24/2021] [Accepted: 05/22/2021] [Indexed: 12/24/2022]
Abstract
Aim To determine the healing outcome following grafting with deproteinized porcine bone mineral (DPBM) with or without collagen membrane coverage in two‐wall (both buccal and lingual)‐damaged extraction sockets. Materials and methods Distal roots of three mandibular premolars in six beagle dogs were extracted, and the whole buccal and lingual bony walls were surgically removed. Three treatment protocols were then applied according to the following group allocation: no graft (None), grafting DPBM (BG), and grafting DPBM with coverage by a collagen membrane (BG + M). Two observational periods (2 and 8 weeks) were used with the split‐mouth design, and quantitative and qualitative analyses were performed by microcomputed tomography and histology. Results The dimensions of the alveolar ridge at both grafted sites (BG and BG + M) remained similar to those of the pristine ridge in the histologic and radiographic analyses, whereas the ungrafted sites (None) collapsed both vertically and horizontally. Both grafting protocols produced substantial bony regeneration, but the addition of a covering membrane enhanced the proportion of mineralized tissue within the augmented area, and the BG + M group also showed a significantly larger area of regenerated ridge than the None group (p < .05). Conclusions Bone grafting with collagen membrane can maintain the alveolar ridge dimensions with substantial bone regeneration in a two‐wall‐damaged extraction socket.
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Affiliation(s)
- Hsu Kuo Tien
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Won-Ho Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
| | - Reinhard Gruber
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea.,Department of Oral Biology, School of Dentistry, Medical University of Vienna, Vienna, Austria
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9
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Harris M, Potgieter J, Ishfaq K, Shahzad M. Developments for Collagen Hydrolysate in Biological, Biochemical, and Biomedical Domains: A Comprehensive Review. MATERIALS (BASEL, SWITZERLAND) 2021; 14:2806. [PMID: 34070353 PMCID: PMC8197487 DOI: 10.3390/ma14112806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/19/2021] [Accepted: 05/19/2021] [Indexed: 01/11/2023]
Abstract
The collagen hydrolysate, a proteinic biopeptide, is used for various key functionalities in humans and animals. Numerous reviews explained either individually or a few of following aspects: types, processes, properties, and applications. In the recent developments, various biological, biochemical, and biomedical functionalities are achieved in five aspects: process, type, species, disease, receptors. The receptors are rarely addressed in the past which are an essential stimulus to activate various biomedical and biological activities in the metabolic system of humans and animals. Furthermore, a systematic segregation of the recent developments regarding the five main aspects is not yet reported. This review presents various biological, biochemical, and biomedical functionalities achieved for each of the beforementioned five aspects using a systematic approach. The review proposes a novel three-level hierarchy that aims to associate a specific functionality to a particular aspect and its subcategory. The hierarchy also highlights various key research novelties in a categorical manner that will contribute to future research.
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Affiliation(s)
- Muhammad Harris
- Massey Agrifood (MAF) Digital Labs, Massey University, Palmerston North 4410, New Zealand;
- Industrial and Manufacturing Engineering Department, Rachna College of Engineering and Technology, Gujranwala 52250, Pakistan;
| | - Johan Potgieter
- Massey Agrifood (MAF) Digital Labs, Massey University, Palmerston North 4410, New Zealand;
| | - Kashif Ishfaq
- Industrial and Manufacturing Engineering Department, University of Engineering and Technology, Lahore 54890, Pakistan;
| | - Muhammad Shahzad
- Industrial and Manufacturing Engineering Department, Rachna College of Engineering and Technology, Gujranwala 52250, Pakistan;
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Gueldenpfennig T, Houshmand A, Najman S, Stojanovic S, Korzinskas T, Smeets R, Gosau M, Pissarek J, Emmert S, Jung O, Barbeck M. The Condensation of Collagen Leads to an Extended Standing Time and a Decreased Pro-inflammatory Tissue Response to a Newly Developed Pericardium-based Barrier Membrane for Guided Bone Regeneration. In Vivo 2021; 34:985-1000. [PMID: 32354884 DOI: 10.21873/invivo.11867] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND/AIM A new manufacturing process has been established for the condensation of collagen derived from porcine pericardium to develop a new dental barrier membrane (CPM) that can provide a long barrier functionality. A native collagen membrane (PM) was used as control. MATERIALS AND METHODS Established in vitro procedures using L929 and MC3T3 cells were used for cytocompatibility analyses. For the in vivo study, subcutaneous implantation of both membrane types in 40 BALB/c mice and established histological, immuno histochemical and histomorphometrical methods were conducted. RESULTS Both the in vitro and in vivo results revealed that the CPM has a biocompatibility profile comparable to that of the control membrane. The new CPM induced a tissue reaction including more M2-macrophages. CONCLUSION The CPM is fully biocompatible and seems to support the early healing process. Moreover, the new biomaterial seems to prevent cell ingrowth for a longer period of time, making it ideally suited for GBR procedures.
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Affiliation(s)
- Tristan Gueldenpfennig
- University Hospital Hamburg-Eppendorf, Hamburg, Germany.,Werner Forßmann Hospital Eberswalde, Eberswalde, Germany
| | | | - Stevo Najman
- Department for Cell and Tissue Engineering Institute of Biology and Human Genetics, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Sanja Stojanovic
- Department for Cell and Tissue Engineering Institute of Biology and Human Genetics, Faculty of Medicine, University of Niš, Niš, Serbia
| | | | - Ralf Smeets
- University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Gosau
- University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Ole Jung
- University Hospital Hamburg-Eppendorf, Hamburg, Germany.,Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Mike Barbeck
- University Hospital Hamburg-Eppendorf, Hamburg, Germany .,BerlinAnalytix GmbH, Berlin, Germany
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11
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Katagiri H, El Tawil Y, Lang NP, Imber JC, Sculean A, Fujioka-Kobayashi M, Saulacic N. Collagen-Based Matrices for Osteoconduction: A Preclinical In Vivo Study. Biomedicines 2021; 9:biomedicines9020143. [PMID: 33540647 PMCID: PMC7913003 DOI: 10.3390/biomedicines9020143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/27/2021] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to evaluate the influence of additional hydroxyapatite (HA) in collagen-based matrices (CM) and membrane placement on bone formation in calvarial defects. Critical size defects in the calvaria of 16 New Zealand White Rabbits were randomly treated with CM or mineralized collagen-based matrices (mCM). Half of the sites were covered with a collagen membrane. Animals were euthanized after 12 weeks of healing. The samples were studied by micro-CT and histology. Newly formed lamellar bone was observed in all samples at the periphery of the defect. In the central areas, however, new bone composed of both woven and lamellar bone was embedded in the soft tissue. Samples treated with mCM showed more residual biomaterial and induced more small bony islands in the central areas of the defects than samples with CM. Nevertheless, a complete defect closure was not observed in any of the samples at 12 weeks. Membrane placement resulted in a decrease in bone density and height. Significant differences between the groups were revealed only between CM groups with and without membrane coverage for bone height in the central area of the defect. Neither mineralization of CM nor membrane placement improved the osteogenic capacity in this particular defect. Nevertheless, mineralisation influenced bone density without a membrane placement and bone volume underneath a membrane. CM may be used as a scaffold in bone regeneration procedures, without the need of a membrane coverage. Further preclinical studies are warrant to optimise the potential of mCM.
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Affiliation(s)
- Hiroki Katagiri
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, Faculty of Medicine, University of Berne, CH-3010 Berne, Switzerland; (H.K.); (Y.E.T.); (N.P.L.); (M.F.-K.)
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan
| | - Yacine El Tawil
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, Faculty of Medicine, University of Berne, CH-3010 Berne, Switzerland; (H.K.); (Y.E.T.); (N.P.L.); (M.F.-K.)
| | - Niklaus P. Lang
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, Faculty of Medicine, University of Berne, CH-3010 Berne, Switzerland; (H.K.); (Y.E.T.); (N.P.L.); (M.F.-K.)
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Berne, CH-3010 Berne, Switzerland; (J.-C.I.); (A.S.)
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Berne, CH-3010 Berne, Switzerland; (J.-C.I.); (A.S.)
| | - Masako Fujioka-Kobayashi
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, Faculty of Medicine, University of Berne, CH-3010 Berne, Switzerland; (H.K.); (Y.E.T.); (N.P.L.); (M.F.-K.)
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, Faculty of Medicine, University of Berne, CH-3010 Berne, Switzerland; (H.K.); (Y.E.T.); (N.P.L.); (M.F.-K.)
- Correspondence: ; Tel.: +41-31-632-8764
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12
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Tay JRH, Lu XJ, Lai WMC, Fu JH. Clinical and histological sequelae of surgical complications in horizontal guided bone regeneration: a systematic review and proposal for management. Int J Implant Dent 2020; 6:76. [PMID: 33241468 PMCID: PMC7688776 DOI: 10.1186/s40729-020-00274-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
It is not uncommon to encounter post-surgical complications after horizontal guided bone regeneration (GBR). The primary aim of this review was to evaluate the incidence and types of complications that occur after horizontal GBR and propose management strategies to deal with these clinical situations. A secondary aim was to conduct a histomorphometric review of the wound healing process at sites that experienced post-surgical complications after GBR. A keyword search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published in English from January 2015 to January 2020 was conducted for the primary aim and 23 studies were selected. A second search addressing the secondary aim was conducted, and five studies were included. Site-level analysis showed that the weighted mean incidence proportion of minor wound dehiscence and minor infections occurring at the augmented site was 9.9% [95% CI 6.4, 13.9, P < 0.01] and 1.5% [95% CI 0.4, 3.1, P = 0.21) respectively. Patient-level analysis showed minor and major complications occurring at a weighted mean incidence proportion of 16.1% [95% CI 11.9, 20.8, P = 0.01] and 1.6% [95% CI 0.0, 4.7, P < 0.01] respectively, while neurosensory alterations at the donor site was 7.0% [95% CI 1.3, 15.5, P < 0.01]. Subgroup analysis also revealed that the use of block grafts increased the incidence proportion of minor post-surgical complications, whereas a staged GBR procedure increased the incidence proportion of both minor and major post-surgical complications. Although exposure of the barrier membrane is often associated with less bone regeneration and graft resorption, the type of membrane used (resorbable or non-resorbable) had no statistically significant influence on any post-surgical complication. Histologically, a layer of fibrous connective tissue instead of bone is commonly observed at the interface between the native bone at the recipient site and the regenerated bone in cases with membrane exposure after GBR procedure. Minor wound dehiscence was the highest incidence proportion of post-surgical complications. Methods ranging from daily application of antiseptics, use of systemic antimicrobials, regular reviews, and total removal of the non-integrated biomaterials are commonly prescribed to manage these post-surgical complications in attempt to minimise the loss of tissue at the surgical site.
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Affiliation(s)
- John Rong Hao Tay
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.,Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, Singapore, 168938, Singapore
| | - Xiaotong Jacinta Lu
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Wei Ming Clement Lai
- Statistics Unit, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Jia-Hui Fu
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.
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13
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Song YW, Rafikov K, Paeng KW, Kim MJ, Cha JK, Thoma DS, Jung RE, Jung UW. Dimensional changes of the maxillary sinus augmented with a collagenated synthetic bone block or synthetic bone particulates: A pre-clinical study in rabbits. J Clin Periodontol 2020; 47:1416-1426. [PMID: 32888335 DOI: 10.1111/jcpe.13363] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/08/2020] [Accepted: 08/27/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To compare the efficacy of a collagenated synthetic bone substitute (C-SBS) to a particulated synthetic bone substitute (P-SBS) in volume maintenance and new bone formations in a rabbit sinus model. MATERIALS AND METHODS Either C-SBS or P-SBS was grafted in both sinuses of 16 rabbits. Four (N = 8) or 12 (N = 8) weeks after the surgery, total augmented volume (TAV) and area (TAA), as well as new bone volume (NBV) and area (NBA), were statistically compared by radiographic and histomorphometric analyses (p < .05). RESULTS The differences in TAV, NBV, TAA and NBA between C-SBS and P-SBS groups at 4 weeks were not statistically significant. The TAV (267.13 ± 62.08 vs. 200.18 ± 40.32 mm3 ) and NBV (103.26 ± 10.50 vs. 71.10 ± 7.58 mm3 ) in group C-SBS were significantly higher than in group P-SBS at 12 weeks (p < .05). The TAA (19.36 ± 2.88 vs. 14.48 ± 2.08 mm2 ) and NBA (5.43 ± 1.20 vs. 3.76 ± 0.78 mm2 ) in group C-SBS were significantly higher than in group P-SBS at 12 weeks (p < .05). CONCLUSIONS Collagenated synthetic bone substitute grafted in rabbit sinuses demonstrated more favourable outcomes across all outcome measures compared to P-SBS at 12 weeks.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Komoliddin Rafikov
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea.,Department of Oral Surgery and Dental Implantology, Tashkent State Dental Institute, Tashkent, Uzbekistan
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Myong Ji Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Daniel S Thoma
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
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14
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Di Raimondo R, Sanz-Esporrín J, Plá R, Sanz-Martín I, Luengo F, Vignoletti F, Nuñez J, Sanz M. Alveolar crest contour changes after guided bone regeneration using different biomaterials: an experimental in vivo investigation. Clin Oral Investig 2019; 24:2351-2361. [PMID: 31707629 DOI: 10.1007/s00784-019-03092-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 09/22/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the changes in alveolar contour after guided bone regeneration (GBR) with two different combinations of biomaterials in dehiscence defects around implants. MATERIAL AND METHODS Chronic alveolar ridge defects were created bilaterally in the mandible of eight Beagle dogs. Once implants were placed, three treatment groups were randomly allocated to each peri-implant dehiscence defect: (i) test group received a bone substitute composed of hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) covered by a cross-linked collagen membrane, (ii) positive control group with placement of deproteinized bovine bone mineral (DBBM) plus a porcine natural collagen membrane, and (iii) a negative control with no treatment. Two healing periods (8 and 16 weeks) were evaluated. Dental casts were optically scanned, the obtained files were uploaded into an image analysis software and superimposed to evaluate the linear changes. RESULTS In both healing periods, the gains in linear contours were higher in the test group and at the intermediate level (3 mm below the gingival margin). While at 8 weeks, no significant differences were found between the groups; at 16 weeks, the test and positive control groups demonstrated significant gains in contour compared with negative control. CONCLUSIONS GBR using different biomaterials significantly increased the buccal contours of the alveolar crest when used at dehiscence defects around dental implants. CLINICAL RELEVANCE Particulate highly porous synthetic bone substitute and a cross-linked collagen membrane demonstrated similar outcomes in terms of contour augmentation when compared to bovine xenograft (DBBM) and a collagen membrane.
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Affiliation(s)
- R Di Raimondo
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - J Sanz-Esporrín
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - R Plá
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - I Sanz-Martín
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - F Luengo
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - F Vignoletti
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - J Nuñez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
- Facultad de Odontología, Plaza Ramón y Cajal s/n (Ciudad Universitaria), 28040, Madrid, Spain.
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15
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Caballé-Serrano J, Munar-Frau A, Delgado L, Pérez R, Hernández-Alfaro F. Physicochemical characterization of barrier membranes for bone regeneration. J Mech Behav Biomed Mater 2019; 97:13-20. [PMID: 31085456 DOI: 10.1016/j.jmbbm.2019.04.053] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/10/2019] [Accepted: 04/27/2019] [Indexed: 11/19/2022]
Abstract
Barrier membranes are essential biomaterials for guided bone regeneration. Due to different origin and structure of barrier membranes, singular mechanical properties and clinical behaviors can be expected. It is important to understand the physic and chemical properties of barrier membranes to select the needed biomaterial for each clinical situation. To date, no study has evaluated and compared the physicochemical properties of various families of barrier membranes. The aim of this study is to evaluate the physicochemical properties of various barrier membranes. Fifteen membranes of different origin were tested in this study. Membranes were divided into biological or synthetic origin and grouped in natural allogenic collagen, natural xenogenic collagen, cross-linked collagen and synthetic membranes. Physicochemical properties were evaluated in terms of tension, stiffness, absorption ability, pH and wettability. For the tension tests, all membranes showed similar low tension and low stiffness, especially after a 4-min hydration, except for bone laminas that showed a greater stiffness particularly in a dry status. Regarding wettability and hydration of the barrier membranes, porcine origin membranes had greater hydration; wettability was also superior in porcine derived barrier membranes and showed a faster absorption of the drop on the rough surfaces. All membranes had a stable pH, having the synthetic membranes the most stable pH when compared to physiologic. The wide variety of barrier membranes opens a debate in which the practitioner should select the adequate barrier membrane for each clinical situation. Different materials show singular potentials depending on their tissue origin making them suitable for specific clinical indications. More studies regarding adsorption, integration and degradation of barrier membranes are needed to understand their behavior.
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Affiliation(s)
- Jordi Caballé-Serrano
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Universitat Internacional de Catalunya, Barcelona, Spain; Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Switzerland; Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Switzerland.
| | - Antonio Munar-Frau
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Luis Delgado
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Roman Pérez
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Federico Hernández-Alfaro
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
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16
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Song YW, Kim S, Waller T, Cha JK, Cho SW, Jung UW, Thoma DS. Soft tissue substitutes to increase gingival thickness: Histologic and volumetric analyses in dogs. J Clin Periodontol 2018; 46:96-104. [PMID: 30372547 DOI: 10.1111/jcpe.13034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 08/29/2018] [Accepted: 10/23/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To evaluate the histologic and volumetric changes of gingival tissues following grafting with collagen-based matrices at labial aspect of teeth in canines. MATERIALS AND METHODS Gingival augmentation was performed in the mandibular incisor area using two types of xenogeneic cross-linked collagen matrices (CCMs), bovine CCM for BCCM group and porcine CCM for PCCM group, whereas the contralateral sides remained untreated (B-control group and P-control group). Descriptive histology, histometric and volumetric analyses were performed after 12 weeks. For statistical comparison between each test group and respective control group, paired t test was used for histometric analysis, and repeated-measured analysis of variance was used for volumetric analysis (p < 0.05). RESULTS An increased number of rete pegs and an enhanced formation of new blood vessels were observed at both grafted sites compared to the corresponding control sites. There was statistically significant gain of horizontal thickness only in BCCM group (1.36 ± 0.27 mm vs. 1.26 ± 0.34 mm; p < 0.05) compared to the B-control groups. CONCLUSION BCCM was effective for gingival augmentation in terms of horizontal thickness at the labial aspect of teeth at 12 weeks post-surgery.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Korea
| | - Tobias Waller
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Sung-Won Cho
- Division of Anatomy and Developmental Biology, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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17
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Wang Y, Papagerakis S, Faulk D, Badylak SF, Zhao Y, Ge L, Qin M, Papagerakis P. Extracellular Matrix Membrane Induces Cementoblastic/Osteogenic Properties of Human Periodontal Ligament Stem Cells. Front Physiol 2018; 9:942. [PMID: 30072915 PMCID: PMC6058254 DOI: 10.3389/fphys.2018.00942] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 06/26/2018] [Indexed: 01/09/2023] Open
Abstract
Objective: Periodontitis affects nearly 90% of adults over the age of 70, resulting to periodontal tissue infection, destruction, and ultimately tooth loss. Guided tissue regeneration (GTR) is a method widely used to treat severe periodontal disease, and involves placement of an occlusive barrier to facilitate regeneration of the damaged area by periodontal ligament stem cells (PDLSCs). In this study, we evaluate natural extracellular matrix (ECM) as a scaffold material to provide a suitable microenvironment to support the proliferation, differentiation, and tissue-regenerating properties of PDLSCs. Design: The viability, proliferation, apoptosis, and migration of PDLSCs cultured on ECM membrane, that was isolated from porcine urinary bladders, were compared with those cultured on type I collagen membrane, a commonly used scaffold in GTR. To evaluate the effects of ECM vs. type I collagen on the tissue-regenerating properties of PDLSCs, the bio-attachment and cementoblastic/osteogenic differentiation of PDLSCs were evaluated. Results: Incubation of PDLSCs with ECM resulted in increased viability, proliferation, and reduced apoptosis, compared with type I collagen treated PDLSCs. Co-culture with ECM membrane also increased the migration and bio-attachment of PDLSCs. Incubation of PDLSCs with ECM membrane increased expression of the cementoblastic/osteogenic differentiation markers BSP, RUNX2, ALP, OPN, OCN, and periostin. Conclusion: ECM membrane enhances the proliferation and regenerative properties of PDLSCs, indicating that ECM membrane can serve as a suitable scaffold in the application of GTR to treat periodontal disease.
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Affiliation(s)
- Yuanyuan Wang
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China
| | - Silvana Papagerakis
- Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Otolaryngology, Medical School, University of Michigan, Ann Arbor, MI, United States
| | - Denver Faulk
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Stephen F Badylak
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Surgery, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yuming Zhao
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China
| | - Lihong Ge
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China
| | - Man Qin
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China
| | - Petros Papagerakis
- Colleges of Dentistry and Biomedical Engineering, Toxicology, Pharmacy, Nutrition, Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
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18
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Abstract
This review is focused on the use of membranes for the specific application of bone regeneration. The first section focuses on the relevance of membranes in this context and what are the specifications that they should possess to improve the regeneration of bone. Afterward, several techniques to engineer bone membranes by using "bulk"-like methods are discussed, where different parameters to induce bone formation are disclosed in a way to have desirable structural and functional properties. Subsequently, the production of nanostructured membranes using a bottom-up approach is discussed by highlighting the main advances in the field of bone regeneration. Primordial importance is given to the promotion of osteoconductive and osteoinductive capability during the membrane design. Whenever possible, the films prepared using different techniques are compared in terms of handability, bone guiding ability, osteoinductivity, adequate mechanical properties, or biodegradability. A last chapter contemplates membranes only composed by cells, disclosing their potential to regenerate bone.
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Affiliation(s)
- Sofia G Caridade
- Department of Chemistry CICECO, Aveiro Institute of Materials, University of Aveiro , Aveiro, Portugal
| | - João F Mano
- Department of Chemistry CICECO, Aveiro Institute of Materials, University of Aveiro , Aveiro, Portugal
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19
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Dehydrothermally Cross-Linked Collagen Membrane with a Bone Graft Improves Bone Regeneration in a Rat Calvarial Defect Model. MATERIALS 2017; 10:ma10080927. [PMID: 28796152 PMCID: PMC5578293 DOI: 10.3390/ma10080927] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 07/29/2017] [Accepted: 08/05/2017] [Indexed: 11/17/2022]
Abstract
In this study, the bone regeneration efficacy of dehydrothermally (DHT) cross-linked collagen membrane with or without a bone graft (BG) material was evaluated in a critical-sized rat model. An 8-mm-diameter defect was created in the calvaria of 40 rats, which were randomized into four groups: (1) control; (2) DHT; (3) BG; and, (4) DHT + BG. Evaluations were made at 2 and 8 weeks after surgery using micro-computed tomographic (micro-CT), histological, and histomorphometric analyses. Micro-CT analysis showed an increase in the new bone volume (NBV) of the BG and DHT + BG groups at 2 weeks after surgery, representing a significant difference (p < 0.05). At 8 weeks after surgery, the NBV increased in all four groups. However, larger NBVs were observed in the BG and DHT + BG groups, and a significant difference was no longer observed between the two groups. Histologic analysis demonstrated that the graft materials sustained the center of the defect in the BG and DHT + BG groups, which was shown in histomorphometric analysis as well. These results suggest that DHT membrane is a safe biomaterial with adequate tissue integration, and has a positive effect on new bone formation. Moreover, the best effects were achieved when DHT was used in conjunction with BG materials.
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20
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Jiménez Garcia J, Berghezan S, Caramês JMM, Dard MM, Marques DNS. Effect of cross-linked vs non-cross-linked collagen membranes on bone: A systematic review. J Periodontal Res 2017; 52:955-964. [PMID: 28617950 DOI: 10.1111/jre.12470] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2017] [Indexed: 12/29/2022]
Abstract
The aim of this study was to conduct a systematic review to compare the clinical outcomes of two different resorbable collagen membranes in terms of regenerated bone volume, postoperative complications and membrane degradation during bone regeneration procedures. Randomized controlled trials (RCT) or controlled trials (CT) that compared both techniques were reviewed on four electronic databases up to December 2015, a manual search was performed on the bibliography of the collected articles and the authors were contacted for additional references if undetected on the electronic and manual search. Membrane exposure was evaluated as a dichotomous outcome and the statistical unit was the membrane. The results were presented as relative risk (RR) with a 95% confidence interval. Eight RCTs and one CT were included in this study. The majority of the studies depicted a bone augmentation area, which ranged from 46.15% to 94.6% for the non-cross-link membranes and from 44% to 92.6% for the cross-link membranes at the 4-6 month re-entry surgery. From a total of 289 patients, a forest plot concerning the membrane exposure was constructed using the obtained RR of the included studies. The overall RR was 1.43 (95% CI: 0.85-2.39) with no statistically significant differences between the two groups, although with a marginal tendency towards higher exposure in the cross-link membrane group. This systematic review suggests the different membranes present themselves as appropriate for bone regeneration procedures, although cross-link membranes present higher rates of postoperative complications. However, more RCT with higher sample sizes are needed to evaluate the different membranes. The suggested lack of clinical differences between the compared membranes suggest that further cost-benefit ratio, tissue integration and postoperative complication oriented studies should be performed so that clinicians can take a patient-centred, evidence-based decision.
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Affiliation(s)
- J Jiménez Garcia
- Implant Department, Universidad Europea de Madrid, Madrid, Spain.,Periodontology and Implant Dentistry Department, New York University College of Dentistry, New York, NY, USA.,CIRO, Madrid, Spain
| | - S Berghezan
- Máster Universitário en Implantología Oral, Universidad Europea de Madrid, Madrid, Spain
| | - J M M Caramês
- Periodontology and Implant Dentistry Department, New York University College of Dentistry, New York, NY, USA.,Oral Surgery and Implant Department, LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal.,Implantology Institute, Lisbon, Portugal
| | - M M Dard
- Periodontology and Implant Dentistry Department, New York University College of Dentistry, New York, NY, USA.,Institut Straumann AG, Basel, Switzerland
| | - D N S Marques
- Máster Universitário en Implantología Oral, Universidad Europea de Madrid, Madrid, Spain.,Implantology Institute, Lisbon, Portugal.,Centro de Estudos de Medicina Dentária Baseada na Evidência and LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
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21
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Scheyer ET, Heard R, Janakievski J, Mandelaris G, Nevins ML, Pickering SR, Richardson CR, Pope B, Toback G, Velásquez D, Nagursky H. A randomized, controlled, multicentre clinical trial of post-extraction alveolar ridge preservation. J Clin Periodontol 2016; 43:1188-1199. [PMID: 27617409 PMCID: PMC5132058 DOI: 10.1111/jcpe.12623] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2016] [Indexed: 11/29/2022]
Abstract
AIM To compare the effectiveness of two-ridge preservation treatments. MATERIALS AND METHODS Forty subjects with extraction sockets exhibiting substantial buccal dehiscences were enrolled and randomized across 10 standardized centres. Treatments were demineralized allograft plus reconstituted and cross-linked collagen membrane (DFDBA + RECXC) or deproteinized bovine bone mineral with collagen plus native, bilayer collagen membrane (DBBMC + NBCM). Socket dimensions were recorded at baseline and 6 months. Wound closure and soft tissue inflammation were followed post-operatively, and biopsies were retrieved for histomorphometric analysis at 6 months. RESULTS Primary endpoint: at 6 months, extraction socket horizontal measures were significantly greater for DBBMC + NBCM (average 1.76 mm greater, p = 0.0256). Secondary and Exploratory endpoints: (1) lingual and buccal vertical bone changes were not significantly different between the two treatment modalities, (2) histomorphometric % new bone and % new bone + graft were not significantly different, but significantly more graft remnants remained for DBBMC; (3) at 1 month, incision line gaps were significantly greater and more incision lines remained open for DFDBA + RECXC; (4) higher inflammation at 1 week tended to correlate with lower ridge preservation results; and (5) deeper socket morphologies with thinner bony walls correlated with better ridge preservation. Thirty-seven of 40 sites had sufficient ridge dimension for implant placement at 6 months; the remainder were DFDBA + RECXC sites. CONCLUSION DBBMC + NBCM provided better soft tissue healing and ridge preservation for implant placement. Deeper extraction sockets with higher and more intact bony walls responded more favourably to ridge preservation therapy.
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Affiliation(s)
- Eric Todd Scheyer
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Houston, TX, USA
| | - Rick Heard
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Victoria, TX, USA
| | - Jim Janakievski
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Tacoma, WA, USA.,Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - George Mandelaris
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Oakbrook Terrace, IL, USA.,Department of Graduate Periodontics, College of Dentistry, University of Illinois, Chicago, IL, USA
| | - Marc L Nevins
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Boston, MA, USA.,Department of Oral Medicine, Infection and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Stephen R Pickering
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, San Mateo, CA, USA
| | - Christopher R Richardson
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Richmond, VA, USA.,Department of Graduate Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA, USA
| | - Bryan Pope
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, San Mateo, CA, USA
| | - Gregory Toback
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, New London, CT, USA
| | - Diego Velásquez
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Fenton, MI, USA.,University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Heiner Nagursky
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Center - University of Freiburg, Freiburg im Breisgau, Germany
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Fujioka-Kobayashi M, Caballé-Serrano J, Bosshardt DD, Gruber R, Buser D, Miron RJ. Bone conditioned media (BCM) improves osteoblast adhesion and differentiation on collagen barrier membranes. BMC Oral Health 2016; 17:7. [PMID: 27430310 PMCID: PMC4948089 DOI: 10.1186/s12903-016-0230-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 06/11/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The use of autogenous bone chips during guided bone regeneration procedures has remained the gold standard for bone grafting due to its excellent combination of osteoconduction, osteoinduction and osteogenesis. Recent protocols established by our group have characterized specific growth factors and cytokines released from autogenous bone that have the potential to be harvested and isolated into bone conditioned media (BCM). Due to the advantageous osteo-promotive properties of BCM, the aims of the present study was to pre-coat collagen barrier membranes with BCM and investigate its effect on osteoblast adhesion, proliferation and differentiation for possible future clinical use. METHODS Scanning electron microscopy (SEM) was first used to qualitative assess BCM protein accumulation on the surface of collagen membranes. Thereafter, undifferentiated mouse ST2 stromal bone marrow cells were seeded onto BioGide porcine derived collagen barrier membranes (control) or barrier membranes pre-coated with BCM (test group). Control and BCM samples were compared for cell adhesion at 8 h, cell proliferation at 1, 3 and 5 days and real-time PCR at 5 days for osteoblast differentiation markers including Runx2, alkaline phosphatase (ALP), osteocalcin (OCN) and bone sialoprotein (BSP). Mineralization was further assessed with alizarin red staining at 14 days post seeding. RESULTS SEM images demonstrated evidence of accumulated proteins found on the surface of collagen membranes following coating with BCM. Analysis of total cell numbers revealed that the additional pre-coating with BCM markedly increased cell attachment over 4 fold when compared to cells seeded on barrier membranes alone. No significant difference could be observed for cell proliferation at all time points. BCM significantly increased mRNA levels of osteoblast differentiation markers including ALP, OCN and BSP at 5 days post seeding. Furthermore, barrier membranes pre-coated with BCM demonstrated a 5-fold increase in alizarin red staining at 14 days. CONCLUSION The results from the present study suggest that the osteoconductive properties of porcine-derived barrier membranes could be further improved by BCM by significantly increasing cell attachment, differentiation and mineralization of osteoblasts in vitro. Future animal testing is required to fully characterize the additional benefits of BCM for guided bone regeneration.
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Affiliation(s)
| | - Jordi Caballé-Serrano
- />Department of Oral Surgery and Stomatology, Laboratory of Oral Cell Biology, University of Bern, Freiburgstrasse 7, Bern, 3010 Switzerland
| | - Dieter D. Bosshardt
- />Robert K. Schenk Laboratory of Oral Histology, University of Bern, Bern, Switzerland
| | - Reinhard Gruber
- />Department of Oral Biology, University of Vienna, Vienna, Austria
| | - Daniel Buser
- />Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
| | - Richard J. Miron
- />Department of Oral Surgery and Stomatology, Laboratory of Oral Cell Biology, University of Bern, Freiburgstrasse 7, Bern, 3010 Switzerland
- />Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida USA
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Caballé-Serrano J, Sawada K, Miron RJ, Bosshardt DD, Buser D, Gruber R. Collagen barrier membranes adsorb growth factors liberated from autogenous bone chips. Clin Oral Implants Res 2016; 28:236-241. [PMID: 26818588 DOI: 10.1111/clr.12789] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Collagen membranes serve as barriers to separate bone grafts from soft tissues. Bone grafts harvested with a bone scraper release growth factors activating transforming growth factor-β (TGF-β) signaling in mesenchymal cells. The aim of the present pilot study was to determine whether collagen membranes adsorb molecules from bone-conditioned medium (BCM) with the capacity to provoke the expression of TGF-β target genes in vitro. MATERIALS AND METHODS Collagen membranes were soaked in aqueous extracts from fresh and demineralized bone chips placed in cell culture medium. Recombinant human TGF-β1 served as control. Gingival fibroblasts were seeded onto the washed collagen membranes and evaluated for the expression of adrenomedullin, pentraxin 3, interleukin 11, and proteoglycan 4. Cell viability and morphology with phalloidin staining were also determined. RESULTS Incubation of collagen membranes with BCM for at least one minute caused fibroblasts to decrease the expression of adrenomedullin and pentraxin 3, and to increase the expression of interleukin 11 and proteoglycan 4. Four different membrane treatments - incubated with recombinant TGF-β1, pre-wetted with saline solution, exposed to UV light, and dry out and stored one week at room temperature - also provoked significant changes in gene expression. Likewise, conditioned medium from demineralized bone chips caused gene expression changes. BCM did not alter the viability or morphology of gingival fibroblasts. CONCLUSIONS These findings demonstrate that collagen membranes rapidly adsorb the TGF-β activity released from bone chips, a molecular process that might contribute to guided bone regeneration.
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Affiliation(s)
- Jordi Caballé-Serrano
- Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Kosaku Sawada
- Department of Cranio-Maxillofacial Surgery, Bern University Hospital, Inselspital, Bern, Switzerland
| | - Richard J Miron
- Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Dieter D Bosshardt
- Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Reinhard Gruber
- Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral Biology, Medical University of Vienna, Vienna, Austria
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Lee DW, Kim KT, Joo YS, Yoo MK, Yu JA, Ryu JJ. The Role of Two Different Collagen Membranes for Dehiscence Defect Around Implants in Humans. J ORAL IMPLANTOL 2015; 41:445-8. [DOI: 10.1563/aaid-joi-d-13-00214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to elucidate the role of 2 types of collagen membranes (cross-linked vs noncross-linked) used in conjunction with autogenous or allogenic bone followed by xenogeneic bone particles for dehiscence defect around implants in humans. Experimental groups were divided into 2 groups: Group CL (cross-linked, Ossix Plus, n = 24 implants, 16 patients) and Group NCL (noncross-linked, Bio-Gide, n = 25 implants, 18 patients). At the time of implant insertion and uncovery surgery, measurements of the dehiscence bony height, width, and surface area were made. Before applying the membrane to defects, guided bone regeneration was performed. Because it is difficult to measure the degree of exposure, early exposed cases were excluded from the result analysis. The mean percentage gain of the dehiscence defect and the mean marginal bone reduction value of follow-up radiograph did not show statistically significant differences between the 2 groups. Both membranes exhibited satisfactory results on dehiscence defects. As a result, our authors concluded the success of guided bone regeneration was performed simultaneously for dehiscence defects around the implant, regardless whether collagen membranes were cross-linked or noncross-linked.
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Affiliation(s)
- Dong-Woon Lee
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Korea
- Department of Dentistry, Colleage of Medicine, Korea University, Seoul, Korea
| | - Kyeong-Taek Kim
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Korea
| | - Yon-Soo Joo
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Korea
| | - Mi-Kyung Yoo
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Korea
| | - Jeoung-A Yu
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Korea
| | - Jae-Jun Ryu
- Department of Dentistry, Colleage of Medicine, Korea University, Seoul, Korea
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Park JY, Jung IH, Kim YK, Lim HC, Lee JS, Jung UW, Choi SH. Guided bone regeneration using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC)-cross-linked type-I collagen membrane with biphasic calcium phosphate at rabbit calvarial defects. Biomater Res 2015; 19:15. [PMID: 26331084 PMCID: PMC4552459 DOI: 10.1186/s40824-015-0038-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 06/15/2015] [Indexed: 12/05/2022] Open
Abstract
Background In-vitro and animal studies using EDC cross-linked membranes have shown great resistance to enzymatic digestion as well as low cytotoxicity, and indicated its potential expediency as a barrier membrane for guided bone regeneration (GBR). The purpose of this study was to evaluate the efficacy, biocompatibility and degradation kinetics of a novel 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC)-cross-linked type I collagen membrane for regeneration of rabbit calvarial defects. EDC cross-linked type I collagen membrane and macroporous biphasic calcium phosphate (MBCP) consisting of 60 % hydroxyapatite and 40 % β-tricalcium phosphate were used in this study. Four circular defects (ø = 8 mm) were created in each calvarium of 12 male white rabbits. The experimental groups randomly allocated to the defects were as follows – (1) sham control, (2) EDC-cross-linked collagen membrane (EDC membrane), (3) bone graft (BG), and (4) bone graft with collagen membrane (B-EDC membrane). Specimens were harvested at 2 weeks (n = 6) and 8 weeks (n = 6) postoperatively for observational histology and histometrical analysis. Result The histologic observation showed close adaptation of the EDC membrane to the defect perimeters along with vascularization of the membrane at 2 weeks. Direct apposition of new bone on to the collagen matrix could be observed displaying adequate tissue integration. Collapsing of the central portion of the membrane could be seen in the EDC membrane group, and both BG and B-EDC membrane groups showed greater total augmented area and new bone area than the EDC membrane group. The membrane was largely unresorbed at 2 weeks; and at 8 weeks the overall shape of the membrane was still maintained suggesting sustained barrier function at 8 weeks. Conclusion Within the limits of this study, it may be concluded that EDC-cross-linked collagen membrane is a safe biomaterial with adequate tissue integration and resorption kinetics to support bone regeneration when used in conjunction with bone filler.
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Affiliation(s)
- Jin-Young Park
- Department of periodontology, Research institute of periodontal regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Republic of Korea
| | - Im-Hee Jung
- Department of Dental hygiene, College of Health Sciences, Eulji University, Seong-nam, Republic of Korea
| | - You-Kyoung Kim
- Department of periodontology, Research institute of periodontal regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Republic of Korea
| | - Hyun-Chang Lim
- Department of periodontology, Research institute of periodontal regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Republic of Korea
| | - Jung-Seok Lee
- Department of periodontology, Research institute of periodontal regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Republic of Korea
| | - Ui-Won Jung
- Department of periodontology, Research institute of periodontal regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Republic of Korea
| | - Seong-Ho Choi
- Department of periodontology, Research institute of periodontal regeneration, Yonsei University College of Dentistry, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752 Republic of Korea
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Donos N, Dereka X, Mardas N. Experimental models for guided bone regeneration in healthy and medically compromised conditions. Periodontol 2000 2015; 68:99-121. [DOI: 10.1111/prd.12077] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2014] [Indexed: 02/06/2023]
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27
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Lee SW, Kim SG. Membranes for the Guided Bone Regeneration. Maxillofac Plast Reconstr Surg 2014; 36:239-46. [PMID: 27489841 PMCID: PMC4283533 DOI: 10.14402/jkamprs.2014.36.6.239] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/07/2014] [Accepted: 10/17/2014] [Indexed: 11/17/2022] Open
Abstract
Many kinds of membrane have been used for the guided bone regeneration (GBR) technique. However, most membranes do not fulfill all requirements for the ideal membrane for the GBR technique. Among them, collagen membrane has been most widely used. However, its high price and weak tensile strength in wet condition are limitations for wide clinical application. Synthetic polymers have also been used for the GBR technique. Recently, silk based membrane has been considered as a membrane for the GBR technique. Despite many promising preclinical data for use of a silk membrane, clinical data regarding the silk membrane has been limited. However, silk based material has been used clinically as vessel-tie material and an electrospun silk membrane was applied successfully to patients. No adverse effect related to the silk suture has been reported. Considering that silk membrane can be provided to patients at a cheap price, its clinical application should be encouraged.
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Affiliation(s)
- Sang-Woon Lee
- Correspondence to Seong-Gon Kim, Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung 210-702, Korea, Tel: 82-33-640-2468, Fax: 82-33-641-2477, E-mail:
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Roman A, Cioban C, Stratul SI, Schwarz F, Muste A, Petrutiu SA, Zaganescu R, Mihatovic I. Ridge preservation using a new 3D collagen matrix: a preclinical study. Clin Oral Investig 2014; 19:1527-36. [DOI: 10.1007/s00784-014-1368-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 11/13/2014] [Indexed: 12/24/2022]
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Chou J, Komuro M, Hao J, Kuroda S, Hattori Y, Ben-Nissan B, Milthorpe B, Otsuka M. Bioresorbable zinc hydroxyapatite guided bone regeneration membrane for bone regeneration. Clin Oral Implants Res 2014; 27:354-60. [PMID: 25363210 DOI: 10.1111/clr.12520] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the bone regenerative properties of a heat treated cross-linked GBR membrane with zinc hydroxyapatite powders in the rat calvarial defect model over a 6-week period. MATERIAL AND METHODS In vitro physio-chemical characterization involved X-ray diffraction analysis, surface topology by scanning electron microscopy, and zinc release studies in physiological buffers. Bilateral rat calvarial defects were used to compare the Zn-HAp membranes against the commercially available collagen membranes and the unfilled defect group through radiological and histological evaluation. RESULTS The synthesized Zn-MEM (100 μm thick) showed no zinc ions released in the phosphate buffer solution (PBS) buffer, but zinc was observed under acidic conditions. At 6 weeks, both the micro-CT and histological analyses revealed that the Zn-MEM group yielded significantly greater bone formation with 80 ± 2% of bone filled, as compared with 60 ± 5% in the collagen membrane and 40 ± 2% in the unfilled control group. CONCLUSION This study demonstrated the use of heat treatment as an alternative method to cross-linking the Zn-MEM to be applied as a GBR membrane. Its synthesis and production are relatively simple to fabricate, and the membrane had rough surface features on one side, which might be beneficial for cellular activities. In a rat calvarial defect model, it was shown that new bone formation was accelerated in comparison with the collagen membrane and the unfilled defect groups. These results would suggest that Zn-MEM has the potential for further development in dental applications.
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Affiliation(s)
- Joshua Chou
- Advanced Tissue Regeneration and Drug Delivery Group, Faculty of Science, P.O.Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Maki Komuro
- Research Institute of Pharmaceutical Sciences, Faculty of Pharmacy, Musashino University, Tokyo, Japan
| | - Jia Hao
- Oral Implantology and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinji Kuroda
- Oral Implantology and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Hattori
- Research Institute of Pharmaceutical Sciences, Faculty of Pharmacy, Musashino University, Tokyo, Japan
| | - Besim Ben-Nissan
- Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Bruce Milthorpe
- Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Makoto Otsuka
- Research Institute of Pharmaceutical Sciences, Faculty of Pharmacy, Musashino University, Tokyo, Japan
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30
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Benic GI, Hämmerle CHF. Horizontal bone augmentation by means of guided bone regeneration. Periodontol 2000 2014; 66:13-40. [DOI: 10.1111/prd.12039] [Citation(s) in RCA: 214] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 12/18/2022]
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31
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Calvo-Guirado JL, Ramírez-Fernández MP, Maté-Sánchez JE, Bruno N, Velasquez P, de Aza PN. Enhanced bone regeneration with a novel synthetic bone substitute in combination with a new natural cross-linked collagen membrane: radiographic and histomorphometric study. Clin Oral Implants Res 2014; 26:454-464. [PMID: 24720519 DOI: 10.1111/clr.12399] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES 4Bone is a fully synthetic bioactive bone substitute composed of 60% hydroxyapatite (HA) and 40% beta-tricalcium phosphate (ß-TCP). This study aimed to investigate the effect of resorbable collagen membranes (RCM) on critical size defects in rabbit tibiae filled with this novel biphasic calcium phosphate at 15, 30, 45, and 60 days by radiological and histomorphometric analysis. MATERIAL AND METHODS Three critical size defects of 6 mm diameter were created in both tibiae of 20 New Zealand rabbits and divided into three groups according to the filling material: Group A (4Bone), Group B (4Bone plus RCM), and Group C (unfilled control group). At each of the four study periods, five rabbits were sacrificed. Anteroposterior and lateral radiographs were taken. Samples were processed for observation under light microscopy. RESULTS At the end of treatment, radiological analysis found that cortical defect closure was greater in Group B than Group A, and radiopacity was clearly lower and more heterogeneous in Group A cortical defects than in Group B. There was no cortical defect closure in Group C. Histomorphometric evaluation showed significant differences in newly formed bone and cortical closure in Group B compared with Groups A and C, with the presence of higher density newly formed bone in cortical and medullar zones. CONCLUSIONS Biphasic calcium phosphate functioned well as a scaffolding material allowing bone ingrowth and mineralization. The addition of absorbable collagen membranes enhanced bone gain compared with non-membrane-treated sites. This rabbit study provides radiological and histological evidence confirming the suitability of this new material for guided tissue regeneration of critical defects.
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Affiliation(s)
- José Luis Calvo-Guirado
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Maria P Ramírez-Fernández
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Jose E Maté-Sánchez
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Negri Bruno
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Pablo Velasquez
- Bioengineering Institute, Miguel Hernandez University, Elche, Spain
| | - Piedad N de Aza
- Bioengineering Institute, Miguel Hernandez University, Elche, Spain
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Bavariya AJ, Andrew Norowski P, Mark Anderson K, Adatrow PC, Garcia-Godoy F, Stein SH, Bumgardner JD. Evaluation of biocompatibility and degradation of chitosan nanofiber membrane crosslinked with genipin. J Biomed Mater Res B Appl Biomater 2013; 102:1084-92. [PMID: 24323703 DOI: 10.1002/jbm.b.33090] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 09/17/2013] [Accepted: 11/16/2013] [Indexed: 11/08/2022]
Abstract
Chitosan, a natural polysaccharide, has demonstrated potential as a degradable biocompatible guided bone regeneration membrane. This study aimed to evaluate the in vivo biocompatibility and degradation of chitosan nanofiber membranes, with and without genipin crosslinking as compared with a commercial collagen membrane in rat model. Chitosan nanofiber membranes, with and without genipin crosslinking, and collagen membrane (control) were implanted subcutaneously in the backs of 30 rats. The membranes were analyzed histologically at 2, 4, 8, 12, 16, and 20 weeks. Sections were viewed and graded by a blinded pathologist using a 4-point scoring system (0 = absent, 1 = mild, 2 = moderate, and 3 = severe) to determine the tissue reaction to the membranes and to observe membrane degradation. There was no statistically significant difference in histological scores among chitosan and collagen membranes at different time points. Absence or minimal inflammation was observed in 57-74% of the membranes across all groups. Most chitosan membranes persisted for 16-20 weeks, whereas most collagen membranes disappeared by resorption at 12-16 weeks. The general tissue response to chitosan nanofiber membranes with and without genipin crosslinking, was similar to that of control commercial collagen membrane. However, the chitosan membranes exhibited slower degradation rates than collagen membranes.
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Affiliation(s)
- Ankit J Bavariya
- Department of Periodontology, University of Tennessee Health Science Center, College of Dentistry, Memphis, Tennessee
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Calvo-Guirado JL, Ramírez-Fernández MP, Delgado-Ruíz RA, Maté-Sánchez JE, Velasquez P, de Aza PN. Influence of biphasic β-TCP with and without the use of collagen membranes on bone healing of surgically critical size defects. A radiological, histological, and histomorphometric study. Clin Oral Implants Res 2013; 25:1228-1238. [PMID: 24025159 DOI: 10.1111/clr.12258] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to investigate, by means of radiological and histomorphometric analysis, the effect of resorbable collagen membranes on critical size defects (CSD) in rabbit tibiae filled with biphasic calcium phosphate. MATERIALS AND METHODS Three CSD of 6 mm diameter were created in both tibiae of 20 New Zealand rabbits and divided into three groups according to the filling material: Group A (Ossceram), Group B (Ossceram plus Alveoprotect membrane), and Group C (unfilled control group). Five animals from each group were sacrificed after 15, 30, 45, and 60 days. Anteroposterior and lateral radiographs were taken. Samples were processed for observation under light microscopy. RESULTS At the end of treatment, radiological analysis found that cortical defect closure was greater in Group B than Group A, and radiopacity was clearly lower and more heterogeneous in the Group A cortical defects than in Group B. There was no cortical defect closure in Group C. Histomorphometric evaluation showed significant differences in newly formed bone and cortical closure in Group B compared with Groups A and C, with the presence of higher density newly formed bone in cortical and medullar zones. There was no cortical defect closure or medullar bone formation in Group C. CONCLUSIONS Biphasic calcium phosphate functioned well as a scaffolding material allowing mineralized tissue formation. Furthermore, the addiction of absorbable collagen membranes enhanced bone gain compared with non-membrane-treated sites.
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Affiliation(s)
- Jose L Calvo-Guirado
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Maria P Ramírez-Fernández
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | | | - Jose E Maté-Sánchez
- Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Pablo Velasquez
- Bioengineering Institute, Miguel Hernandez University, Elche, Spain
| | - Piedad N de Aza
- Bioengineering Institute, Miguel Hernandez University, Elche, Spain
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Schwarz F, Hegewald A, Sahm N, Becker J. Long-term follow-up of simultaneous guided bone regeneration using native and cross-linked collagen membranes over 6 years. Clin Oral Implants Res 2013; 25:1010-5. [PMID: 23822141 DOI: 10.1111/clr.12220] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the impact of a cross-linked- (VN) collagen membrane on the long-term stability of peri-implant health over 6 years. MATERIAL AND METHODS Vestibular dehiscence-type defects at titanium implants (19 patients, 19 implants) were augmented using a natural bone mineral and randomly allocated to either VN or a native collagen membrane (CM) and left to heal in a submerged position for 4 months. Clinical parameters (i.e. Bleeding on Probing-BOP, probing pocket depth-PD, mucosal recession-MR) were recorded at 4 and 6 years after prosthesis installation. RESULTS At 4 and 6 years, both VN and CM revealed comparable mean BOP, PD and MR values at both vestibular and oral aspects. Changes in these parameters from 4 to 6 years were minimal (vestibular aspect-VN: -3.3 ± 48.2%, -0.1 ± 0.5 mm, -0.1 ± 0.3 mm; CM: -1.8 ± 33.7%, 0.0 ± 0.4 mm, -0.1 ± 0.7 mm) and not significantly different between groups. At 6 years, the incidence of mucositis and peri-implantitis was comparable in both groups (VN: 60.0% and 20.0%; CM: 33.3% and 33.3%). CONCLUSION In conclusion, the present follow-up observation failed to identify any beneficial impact of VN over CM on peri-implant health at 4 and 6 years.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany
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Immunohistochemical analysis of staged guided bone regeneration and osseointegration of titanium implants using a polyethylene glycol membrane. Clin Oral Investig 2013; 18:429-35. [PMID: 23657747 DOI: 10.1007/s00784-013-0995-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 04/23/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study aimed to immunohistochemically evaluate staged guided bone regeneration and osseointegration of titanium implants using two bone graft substitutes in combination with a polyethylene glycol (PEG) membrane in a dog model. MATERIALS AND METHODS Saddle-type alveolar ridge defects were prepared in the lower jaws of 12 foxhounds and randomly filled with a natural bone mineral (NBM) or a biphasic calcium phosphate (SBC) and covered with an in situ gelling PEG membrane. After a healing period of 8 and 12 weeks (six animals each), modSLA titanium implants were inserted to heal in a submerged position. At 8 + 2 and 12 + 2 weeks, respectively, dissected blocks were processed for immunohistochemical analysis [osteocalcin (OC)]. RESULTS After 8 + 2 weeks, mean OC values (%) tended to be higher in the NBM group (NBM, 32.7 ± 8.9%), but failed to reach statistical significance over the SBC group (SBC, 24.4 ± 6.6%). After 12 + 2 weeks, mean OC values decreased in both groups and was almost identical in both groups (NBM 1.6 ± 1.2%/SBC 2.1 ± 1.4%). CONCLUSION It was concluded that all augmentation procedures investigated were characterised by a comparable OC activity during the process of bone regeneration and osseointegration of modSLA titanium implants.
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Behfarnia P, Khorasani MM, Birang R, Abbas FM. Histological and histomorphometric analysis of animal experimental dehiscence defect treated with three bio absorbable GTR collagen membrane. Dent Res J (Isfahan) 2013; 9:574-81. [PMID: 23559922 PMCID: PMC3612194 DOI: 10.4103/1735-3327.104876] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Guided tissue regeneration (GTR) allows mesenchymal cells to repopulate the defects. However, there is limited information regarding the efficacy of different membranes. The present study was designed to histologically and histomorphometrically compare three collagen membranes in regenerative treatment of dehiscence defects in dogs. MATERIALS AND METHODS This 8 weeks experimental animal study comprised 4 healthy dogs. 5 × 5 mm periodontal dehiscences were created in each side of the mandible (4 dehiscences in each side of dogs' mandible). In each side, one dehiscence defect was left uncovered as a control site and three other sites were randomly covered with different collagen membranes (Biogide (BG), Biomend (BM), and Cytoplast (CYT)). Histomorphometric and histologic analysis were conducted at 4 and 8 weeks. Data were analyzed using ANOVA, Mann-Withney, Kruskal-Wallis and Fisher 's exact tests (α = 0.05). RESULTS According to histomorphometric analysis there was a significant difference between treatment and control groups regarding the bone formation and the distance between the reference point and apical end of junctional epithelium (DJE) (P < 0.05). At 4 weeks, the maximum amount of bone thickness and height was observed in BG and CYT respectively, and this maximum rate was seen with the use of BG at 8 weeks. It was shown that DJE reached its highest rate in BM and CYT at 4 and 8 weeks, respectively. Organized PDL was formed in treatment groups. CONCLUSION The membrane-treated groups had a statistically significant increase in bone formation and connective tissue attachment compared to control groups. However, there are some differences among experimental groups, which should be considered in GTR treatments.
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Affiliation(s)
- Parichehr Behfarnia
- Dental Implants Research Centre, Department of Periodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Iglhaut G, Schwarz F, Gründel M, Mihatovic I, Becker J, Schliephake H. Shell technique using a rigid resorbable barrier system for localized alveolar ridge augmentation. Clin Oral Implants Res 2012; 25:e149-54. [PMID: 23278408 DOI: 10.1111/clr.12078] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the safety and efficacy of a rigid synthetic barrier system in a shell technique for localized alveolar ridge augmentation. MATERIALS AND METHODS Saddle-type defects (n = 4 each) were prepared in the lower jaws of six fox hounds. At two defects, the outer contours were reconstructed using polylactic acid (D and L isomers) (PDDL) pins welded to PDDL plates by ultrasound vibration and the defect area filled using either a natural bone mineral (NBM) or NBM + autogenous bone (AB) and covered by a native collagen membrane (CM). While the third defect was augmented using NBM+AB+CM, the fourth site was left untreated. At 14 weeks, dissected blocks were processed for histomorphometrical analysis [e.g., augmented area (AA)]. RESULTS AA values (median in mm(2)) were significantly increased in all guided bone regeneration (GBR) groups [NBM+PDDL+CM (19.74) > NBM+AB+PDDL+CM (16.98) > NBM+AB+CM (16.66)] when compared with the untreated control sites (7.34). Histological analysis has pointed, in the absence of any foreign-body reactions, to biodegradation of both PDDL plates/pins and CM. CONCLUSIONS (i) All GBR procedures investigated equally supported bone regeneration, (ii) the application of PDDL+CM may be associated with increased mineralized tissue MT and subsequently AA values than CM alone, and (iii) AB may not improve healing at NBM+PDDL+CM-treated sites.
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Affiliation(s)
- Gerhard Iglhaut
- Department of Oral and Maxillofacial Surgery, George-Augusta-University, Göttingen, Germany
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Norowski PA, Fujiwara T, Clem WC, Adatrow PC, Eckstein EC, Haggard WO, Bumgardner JD. Novel naturally crosslinked electrospun nanofibrous chitosan mats for guided bone regeneration membranes: material characterization and cytocompatibility. J Tissue Eng Regen Med 2012; 9:577-83. [DOI: 10.1002/term.1648] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Revised: 07/22/2012] [Accepted: 10/17/2012] [Indexed: 11/11/2022]
Affiliation(s)
- Peter A. Norowski
- University of Memphis; Department of Biomedical Engineering; Memphis TN USA
| | - Tomoko Fujiwara
- University of Memphis; Department of Chemistry; Memphis TN USA
| | | | - Pradeep C. Adatrow
- University of Tennessee Health Science Centre; Department of Periodontology; Memphis TN USA
| | - Eugene C. Eckstein
- University of Memphis; Department of Biomedical Engineering; Memphis TN USA
| | - Warren O. Haggard
- University of Memphis; Department of Biomedical Engineering; Memphis TN USA
| | - Joel D. Bumgardner
- University of Memphis; Department of Biomedical Engineering; Memphis TN USA
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Dimitriou R, Mataliotakis GI, Calori GM, Giannoudis PV. The role of barrier membranes for guided bone regeneration and restoration of large bone defects: current experimental and clinical evidence. BMC Med 2012; 10:81. [PMID: 22834465 PMCID: PMC3423057 DOI: 10.1186/1741-7015-10-81] [Citation(s) in RCA: 227] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 07/26/2012] [Indexed: 12/27/2022] Open
Abstract
Treatment of large bone defects represents a great challenge in orthopedic and craniomaxillofacial surgery. Although there are several methods for bone reconstruction, they all have specific indications and limitations. The concept of using barrier membranes for restoration of bone defects has been developed in an effort to simplify their treatment by offering a single-staged procedure. Research on this field of bone regeneration is ongoing, with evidence being mainly attained from preclinical studies. The purpose of this review is to summarize the current experimental and clinical evidence on the use of barrier membranes for restoration of bone defects in maxillofacial and orthopedic surgery. Although there are a few promising preliminary human studies, before clinical applications can be recommended, future research should aim to establish the 'ideal' barrier membrane and delineate the need for additional bone grafting materials aiming to 'mimic' or even accelerate the normal process of bone formation. Reproducible results and long-term observations with barrier membranes in animal studies, and particularly in large animal models, are required as well as well-designed clinical studies to evaluate their safety, efficacy and cost-effectiveness.
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Affiliation(s)
- Rozalia Dimitriou
- Department of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK
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Miron RJ, Saulacic N, Buser D, Iizuka T, Sculean A. Osteoblast proliferation and differentiation on a barrier membrane in combination with BMP2 and TGFβ1. Clin Oral Investig 2012; 17:981-8. [DOI: 10.1007/s00784-012-0764-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Accepted: 05/25/2012] [Indexed: 02/06/2023]
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Matsubara FB, Zanicotti DG, Zielak JC, Giovanini AF, Gonzaga CC, de Andrade Urban C, Deliberador TM. Nonprocessed Adipose Tissue Graft in the Treatment of Dehiscence Bone Defects in Rabbit Tibiae. IMPLANT DENT 2012; 21:236-41. [DOI: 10.1097/id.0b013e3182563e0d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Saulacic N, Schaller B, Bosshardt DD, Buser D, Jaun P, Haeniwa H, Iizuka T. Periosteal Distraction Osteogenesis and Barrier Membrane Application: An Experimental Study in the Rat Calvaria. J Periodontol 2012; 83:757-65. [DOI: 10.1902/jop.2011.110418] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Thoma DS, Villar CC, Cochran DL, Hämmerle CHF, Jung RE. Tissue integration of collagen-based matrices: an experimental study in mice. Clin Oral Implants Res 2011; 23:1333-9. [PMID: 22093051 DOI: 10.1111/j.1600-0501.2011.02356.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To test whether or not tissue integration, biodegradation, and new blood vessel formation in two collagen-based matrices depend on the level of chemical cross-linking. MATERIAL AND METHODS Two collagen matrices with high (CM1) and low (CM2) levels of chemical cross-linking were randomly implanted in two pouches in 14 athymic nude mice. Three and 6 weeks later, the animals were euthanized. Histologic and histomorphometric measurements were performed on paraffin-embedded sections. RESULTS Both collagen matrices integrated well into the surrounding soft tissues. The level of cross-linking and duration of implantation had an effect on the formation of new blood vessels. More blood vessels (n = in absolute numbers) were found in outer compartments compared to the central compartments of the matrices, reaching 5.6 (CM2) vs. 4.3 (CM1) at 3 weeks, and 5.3 (CM2) vs. 7.3 (CM1) at 6 weeks. Similarly, connective tissue formation increased for both matrices between 3 and 6 weeks, whereas the amount of remaining collagen network gradually decreased over time being more pronounced for CM1 (-50%) compared to CM2 (-15%). CONCLUSIONS The degree of cross-linking was negatively correlated for all outcome measures resulting in improved tissue integration, superior matrix stability and enhanced angiogenic patterns for the less cross-linked collagen matrix (CM2) in this experimental study in mice.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Mihatovic I, Becker J, Golubovic V, Hegewald A, Schwarz F. Influence of two barrier membranes on staged guided bone regeneration and osseointegration of titanium implants in dogs. Part 2: augmentation using bone graft substitutes. Clin Oral Implants Res 2011; 23:308-15. [DOI: 10.1111/j.1600-0501.2011.02238.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Thoma DS, Hämmerle CHF, Cochran DL, Jones AA, Görlach C, Uebersax L, Mathes S, Graf-Hausner U, Jung RE. Soft tissue volume augmentation by the use of collagen-based matrices in the dog mandible -- a histological analysis. J Clin Periodontol 2011; 38:1063-70. [PMID: 22092478 DOI: 10.1111/j.1600-051x.2011.01786.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim was to test, whether or not soft tissue volume augmentation with a specifically designed collagen matrix (CM), leads to ridge width gain in chronic ridge defects similar to those obtained by an autogenous subepithelial connective tissue graft (SCTG). MATERIAL AND METHODS In six dogs, soft tissue volume augmentation was performed by randomly allocating three treatment modalities to chronic ridge defects [CM, SCTG and sham-operated control (Control)]. Dogs were sacrificed at 28 (n = 3) and 84 days (n = 3). Descriptive histology and histomorphometric measurements were performed on non-decalcified sections. RESULTS SCTG and CM demonstrated favourable tissue integration, and subsequent re-modelling over 84 days. The overall mean amount of newly formed soft tissue (NMT) plus bone (NB) amounted to 3.8 ± 1.2 mm (Control), 6.4 ± 0.9 mm (CM) and 7.2 ± 1.2 mm (SCTG) at 28 days. At 84 days, the mean NMT plus NB reached 2.4 ± 0.9 mm (Control), 5.6 ± 1.5 mm (CM) and 6.0 ± 2.1 mm (SCTG). Statistically significant differences were observed between CM/SCTG and Control at both time-points (p < 0.05). CONCLUSION Within the limits of this animal model, the CM performed similar to the SCTG, based on histomorphometric outcomes combining NB and NMT.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Friedmann A, Gissel K, Soudan M, Kleber BM, Pitaru S, Dietrich T. Randomized controlled trial on lateral augmentation using two collagen membranes: morphometric results on mineralized tissue compound. J Clin Periodontol 2011; 38:677-85. [PMID: 21557757 DOI: 10.1111/j.1600-051x.2011.01738.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Guided bone regeneration is considered an effective tool for gaining mineralized tissue either at exposed implant surface or in deficient alveolar ridge areas before implant placement. MATERIAL AND METHODS Customized casts obtained following impression taking at surgery and re-entry allowed for morphometric assessment of alveolar ridge alterations 6 months after one-stage augmentation of bone dehiscences. In a randomized pilot study using biphasic calcium phosphate tests (n=17) received treatment with ribose cross-linked collagen membranes (RCLM), whereas controls (n=20) received non-cross-linked membranes. The primary endpoint was to quantify the effect of membrane type on dimensional changes in bone margins at crestal level of endosseous implants. RESULTS Soft tissue dehiscencies occurred at 70.5% and 55% frequency for tests and controls, respectively. Gain in clinically hard newly mineralized tissue at the crestal level was significantly higher in test group in lateral (1.8 versus 0.7 mm; p=.046) and in vertical dimensions (1.1 versus 0.2 mm; p=.035) compared with controls. Second measurement obtained at the border of reflected flap revealed no significant difference between groups (3.0 versus 2.1 mm; p=0.57) for lateral dimension. CONCLUSIONS Both collagen devices were effective in bone augmentation. RCLMs supported mineralization process and remodelling even in sites showing compromised healing as indicated by morphometric outcome.
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Affiliation(s)
- Anton Friedmann
- Department of Periodontology, School of Dentistry, Faculty of Health, University of Witten, Witten, Germany.
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Schwarz F, Mihatovic I, Golubovic V, Hegewald A, Becker J. Influence of two barrier membranes on staged guided bone regeneration and osseointegration of titanium implants in dogs: part 1. Augmentation using bone graft substitutes and autogenous bone. Clin Oral Implants Res 2011; 23:83-9. [DOI: 10.1111/j.1600-0501.2011.02187.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Thoma DS, Subramani K, Weber FE, Luder HU, Hämmerle CHF, Jung RE. Biodegradation, soft and hard tissue integration of various polyethylene glycol hydrogels: a histomorphometric study in rabbits. Clin Oral Implants Res 2011; 22:1247-54. [DOI: 10.1111/j.1600-0501.2010.02075.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bernabé PFE, Melo LGN, Cintra LTA, Gomes-Filho JE, Dezan Jr E, Nagata MJH. Bone healing in critical-size defects treated with either bone graft, membrane, or a combination of both materials: a histological and histometric study in rat tibiae. Clin Oral Implants Res 2011; 23:384-8. [DOI: 10.1111/j.1600-0501.2011.02166.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Thoma DS, Jung RE, Schneider D, Cochran DL, Ender A, Jones AA, Görlach C, Uebersax L, Graf-Hausner U, Hämmerle CHF. Soft tissue volume augmentation by the use of collagen-based matrices: a volumetric analysis. J Clin Periodontol 2010; 37:659-66. [PMID: 20642631 DOI: 10.1111/j.1600-051x.2010.01581.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim was to test whether or not soft tissue augmentation with a newly developed collagen matrix (CM) leads to volume gain in chronic ridge defects similar to those obtained by an autogenous subepithelial connective tissue graft (SCTG). MATERIAL AND METHODS In six dogs, soft tissue volume augmentation was performed by randomly allocating three treatment modalities to chronic ridge defects (CM, SCTG, sham-operated control). Impressions were taken before augmentation (baseline), at 28, and 84 days. The obtained casts were optically scanned and the images were digitally analysed. A defined region of interest was measured in all sites and the volume differences between the time points were calculated. RESULTS The mean volume differences per area between baseline and 28 days amounted to a gain of 1.6 mm (CM; SD+/-0.9), 1.5 mm (SCTG; +/-0.1), and a loss of 0.003 mm (control; +/-0.3). At 84 days, the mean volume differences per area to baseline measured a gain of 1.4 mm (CM; +/-1.1), 1.4 mm (SCTG; +/-0.4), and a loss of 0.3 mm (control; +/-0.3). The differences between CM and SCTG were statistically significant compared with control at 28 and 84 days (p<0.001). CONCLUSION Within the limits of this animal study, the CM may serve as a replacement for autogenous connective tissue.
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Affiliation(s)
- Daniel S Thoma
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
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