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P K, Selvarasu K, Murthykumar K, Krishnan M, Kumar SP, Lakshmanan S. Comparison of the Effectiveness of a Novel Matrix-Modified Bovine Collagen Membrane With a Conventional Bovine Collagen Membrane for Oral Mucosal Defects: A Single-Center Study. Cureus 2024; 16:e53696. [PMID: 38455829 PMCID: PMC10918302 DOI: 10.7759/cureus.53696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Background Surgical procedures such as excision of a growth or lesion lead to soft tissue or oral mucosal defects. These defects require a proper surgical dressing to promote better wound healing and to avoid infection and scarring. A collagen membrane is one of the most commonly used surgical dressings because of its ease of adaptability to defects and its inherent ability to promote epithelialization and inhibition of pain through the indirect mechanism of preventing infection of the surgical site. Collagen also serves as a reservoir of regenerative factors. The regenerative potential increases as porosity decreases. The novel bovine-derived collagen membrane used in this current study has an average porosity of 20 microns which increases the availability of regenerative factors. Objective The aim of this study was to compare the effectiveness between a novel matrix-modified bovine collagen membrane (SurgiColl) and a conventional bovine collagen membrane for promoting wound healing for oral mucosal or soft tissue defects. Materials and methods This clinical trial was conducted in the Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital. The sample size of the study was 20, divided into two groups: novel bovine collagen (Surgicoll-Mesh) (Group 1) and conventional bovine collagen (Group 2) with 10 participants in each group. The randomization process was adopted. The parameters assessed were epithelialization, granulation, and wound contraction at the end of two weeks. All the parameters were assessed using a standardized visual assessment scale. Statistical analysis was done using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States), and an independent sample t-test was done at 95% confidence interval. A p-value of less than 0.05 was considered statistically significant. Results The difference in epithelialization between the two groups was statistically significant with a p-value of 0.015 (<0.05). The difference in granulation tissue formation between the two groups was statistically significant with a p-value of 0.015 (<0.05). The difference in wound contraction at the end of two weeks between the two groups was also statistically significant with a p-value of 0.005 (<0.05). Group 1 showed superior results compared to Group 2 for all the outcomes assessed. Conclusion The novel bovine-derived collagen membrane (SurgiColl-Mesh) was superior in its properties of wound healing for oral mucosal or soft tissue defects than the conventional bovine collagen membrane.
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Affiliation(s)
- Kalyani P
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Kathiravan Selvarasu
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Karthikeyan Murthykumar
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Murugesan Krishnan
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Santhosh P Kumar
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Saravanan Lakshmanan
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Lindner C, Alkildani S, Stojanovic S, Najman S, Jung O, Barbeck M. In Vivo Biocompatibility Analysis of a Novel Barrier Membrane Based on Bovine Dermis-Derived Collagen for Guided Bone Regeneration (GBR). MEMBRANES 2022; 12:membranes12040378. [PMID: 35448348 PMCID: PMC9027842 DOI: 10.3390/membranes12040378] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 12/19/2022]
Abstract
Collagen-based barrier membranes are nowadays the prevalent option for Guided Bone Regeneration (GBR) procedures. Xenogeneic collagen is highly biocompatible as it shares a similar structure to native human collagen, which prevents it from eliciting an exaggerated host immune response. Most commercially available collagen barrier membranes are porcine-derived, while bovine-derived alternatives are still rarely available. The aim of the present study was to investigate the tissue responses and the barrier functionality of a novel GBR membrane composed of bovine collagen type I (BM). Therefore, the subcutaneous implantation model in Wistar rats was performed to compare the novel medical device with two already clinically used native porcine-based barrier membranes, i.e., Jason® membrane (JM) and Bio-Gide® (BG), at 10-, 30-, 60-, and 90-days post implantationem. Histochemical and immunohistochemical stains were used for histopathological evaluation including a biocompatibility scoring according to the DIN EN ISO 10993-6 norm as well as histomorphometrical analyses of the occurrence of M1 and M2 macrophages and the transmembraneous vascularization. The bovine membrane exhibited a host tissue reaction that was comparable to both control materials, which was verified by the scoring results and the histomorphometrical macrophage measurements. Moreover, the novel membrane exhibited an integration pattern without material fragmentation up to day 60. At day 90, material fragmentation was observable that allowed for “secondary porosity” including transmembrane vascularization. The results of this study suggest that the novel bovine barrier membrane is fully biocompatible and suitable for indications that require GBR as a suitable alternative to porcine-sourced barrier membranes.
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Affiliation(s)
| | - Said Alkildani
- BerlinAnalytix GmbH, 12109 Berlin, Germany; (C.L.); (S.A.)
| | - Sanja Stojanovic
- Department for Cell and Tissue Engineering, Faculty of Medicine, University of Niš, 18000 Nis, Serbia; (S.S.); (S.N.)
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18000 Nis, Serbia
| | - Stevo Najman
- Department for Cell and Tissue Engineering, Faculty of Medicine, University of Niš, 18000 Nis, Serbia; (S.S.); (S.N.)
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18000 Nis, Serbia
| | - Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany;
| | - Mike Barbeck
- BerlinAnalytix GmbH, 12109 Berlin, Germany; (C.L.); (S.A.)
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany;
- Correspondence: ; Tel.: +49-176-81022467
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Binlateh T, Thammanichanon P, Rittipakorn P, Thinsathid N, Jitprasertwong P. Collagen-Based Biomaterials in Periodontal Regeneration: Current Applications and Future Perspectives of Plant-Based Collagen. Biomimetics (Basel) 2022; 7:34. [PMID: 35466251 PMCID: PMC9036199 DOI: 10.3390/biomimetics7020034] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/09/2022] [Accepted: 03/23/2022] [Indexed: 01/27/2023] Open
Abstract
Collagen is the most widely distributed protein in human body. Within the field of tissue engineering and regenerative medical applications, collagen-based biomaterials have been extensively growing over the past decades. The focus of this review is mainly on periodontal regeneration. Currently, multiple innovations of collagen-based biomaterials have evolved, from hemostatic collagen sponges to bone/tissue regenerative scaffolds and injectable collagen matrices for gene or cell regenerative therapy. Collagen sources also differ from animal to marine and plant-extracted recombinant human type I collagen (rhCOL1). Animal-derived collagen has a number of substantiated concerns such as pathogenic contamination and transmission and immunogenicity, and rhCOL1 is a potential solution to those aforementioned issues. This review presents a brief overview of periodontal regeneration. Also, current applications of collagen-based biomaterials and their mechanisms for periodontal regeneration are provided. Finally, special attention is paid to mechanical, chemical, and biological properties of rhCOL1 in pre-clinical and clinical studies, and its future perspectives in periodontal regeneration are discussed.
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Affiliation(s)
- Thunwa Binlateh
- Institute of Research and Development, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand;
| | - Peungchaleoy Thammanichanon
- Institute of Dentistry, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand; (P.T.); (P.R.); (N.T.)
| | - Pawornwan Rittipakorn
- Institute of Dentistry, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand; (P.T.); (P.R.); (N.T.)
| | - Natthapol Thinsathid
- Institute of Dentistry, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand; (P.T.); (P.R.); (N.T.)
| | - Paiboon Jitprasertwong
- Institute of Dentistry, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand; (P.T.); (P.R.); (N.T.)
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Dasukil S, Jena AK, Boyina KK, Grover S, Arora G, Ahmed ZU. Functional outcome of two different grafting techniques in the surgical management of oral submucous fibrosis: a comparative evaluation. Oral Maxillofac Surg 2021; 26:477-483. [PMID: 34661770 DOI: 10.1007/s10006-021-01016-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/10/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the functional efficacy of two different grafting techniques following the fibrotomy among subjects with oral submucous fibrosis (OSMF). DESIGN Forty consecutively treated OSMF subjects between 20 and 40 years who had grades 3 and 4a OSMF and mouth opening < 15 mm were included in the present study. All the subjects were randomly divided into two groups. In Group I, all the subjects received a buccal pad of fat sandwiched with a nasolabial flap following fibrotomy. In contrast, Group II subjects received a buccal pad of fat combined with a collagen graft. The effect of two different surgical protocols on mouth opening was evaluated clinically before the surgery (T0) and 1 month (T1), 6 months (T2), and 12 months (T3) after the surgery. RESULTS In Group I subjects, the mouth opening increased significantly (P < 0.001) from 10.90 ± 1.971 mm at T0 to 34.25 ± 3.127 mm at T1, but reduced marginally to 32.15 ± 3.422 mm at T2, and 31.30 ± 3.358 mm at T3. In Group II, the mouth opening increased significantly (P < 0.001) from 10.85 ± 1.725 mm at T0 to 28.90 ± 3.059 mm, 29.10 ± 2.808 mm, and 28.20 ± 2.285 mm at T1, T2, and T3, respectively. At the end of 12 months of follow-up, the mean value improvement in the mouth opening (T0-T3) was 20.4 ± 3.5 mm and 17.3 ± 2.9 mm in Groups I and II, respectively, and the difference was statistically significant (P = 0.006). CONCLUSION The buccal pad of fat sandwiched with a nasolabial flap for the reconstruction following fibrotomy had a slightly better beneficial effect on the postoperative mouth opening among OSMF subjects.
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Affiliation(s)
- Saubhik Dasukil
- Department of Dentistry, All India Institute of Medical Sciences, Sijua, Bhubaneswar, Odisha, India
| | - Ashok Kumar Jena
- Department of Dentistry, All India Institute of Medical Sciences, Sijua, Bhubaneswar, Odisha, India
| | - Kiran Kumar Boyina
- Department of Trauma and Emergency, All India Institute of Medical Sciences, Sijua, Bhubaneswar, Odisha, India.
| | | | - Geetanjali Arora
- Department of Oral and Maxillofacial Surgery, SGT Dental College and Hospital, Gurugram, India
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Movaniya PN, Makwana TR, Desai NN, Makwana KG, Patel HB. Efficacy of Collagen Membrane Graft in Intraoral Surgery - An Evaluative Study. Ann Maxillofac Surg 2021; 11:42-48. [PMID: 34522653 PMCID: PMC8407641 DOI: 10.4103/ams.ams_192_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/04/2020] [Accepted: 12/14/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Bovine-derived collagen membrane is usually and regularly used as a temporary cover or dressing for extraoral wounds and burns. It has wide applications because of its usefulness and biocompatibility. This has provoked us to do a study with the use of collagen membrane even for minor intraoral surgical defects. The aim of this evaluative study was to evaluate the clinical efficacy of collagen membrane in intraoral wounds created by removal of various soft tissue lesions. Materials and Methods A total of 25 healthy patients (16 males and 9 females) were taken for this study. This study was confined to secondary defects of the oral mucosa, which occur after excision of premalignant lesions and other conditions, such as benign lesions, reactive proliferations, and incisional biopsy wounds. Only those lesions that were sufficiently large and could not be closed primarily were included in the study. Results The results were evaluated on the day of surgery and in the postoperative period. The usefulness of collagen membrane as an intraoral temporary wound dressing material to promote haemostasis, relieve pain, induce granulation, and assist in rapid epithelialization at the wound site and prevent infection, contracture, scarring, and donor-site morbidity was evaluated, and finally, the efficacy of collagen membrane was tested by the use of Chi-square test and P < 0.001, which is a statistically and clinically significant value. Discussion Collagen membrane was observed as both biological dressing material and drug carrier. It was found to be a suitable alternative to other graft materials mentioned for the repair of defects in the mucous membrane created by surgical excision of lesions. Therefore, when used judiciously in a controlled clinical situation, collagen membrane is biologically acceptable in nature. It is an alternative to autologous grafts rather than a replacement of other grafts used in the oral cavity.
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Affiliation(s)
- Pratap N Movaniya
- Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Tushar R Makwana
- Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Nimisha N Desai
- Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Kalpesh G Makwana
- Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Hirakben B Patel
- Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
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Efficacy of collagen-silicone bilayer membrane in the management of oral submucous fibrosis: a prospective case series. Oral Maxillofac Surg 2021; 26:73-79. [PMID: 33866454 DOI: 10.1007/s10006-021-00962-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Oral submucous fibrosis is a scourge of Southeastern Asia since a long time resulting in significant health and social problems. Mainstay of the treatment is concentrated on attempts to improve mouth opening and relieve the symptoms by medicinal or surgical means. In moderate to severe cases, release of fibrous bands is advocated followed by placement of graft. The present study was conducted to evaluate the use of collagen-silicone bilayer membrane as a mucosal substitute in its management. METHODOLOGY Study consisted of 12 clinically and histologically proven cases of OSMF. After the incision and release of fibrous bands, a collagen membrane was placed and secured over the raw area by placement of a silicone sheet of adequate thickness. Parameters were assessed pre-operatively, intra-operatively, and post-operatively at 1 week, 1 month, and 3 months. The data was recorded and statistical analysis was done. RESULTS Pre-operatively, the mean values of inter-incisal opening, cheek flexibility, and width of oral commissure were 16.92, 24.58, and 53.17 mm respectively whereas at 3 months post-operatively, it was 27.67, 26.58, and 55.00 mm, which was statistically significant. No incidence of infection was noted. CONCLUSION The study concludes that the use of collagen membrane along with silicone sheet can be an alternative to other graft materials in context of reduced donor site morbidity as well as significant increase in inter-incisal opening. However, study with more sample size is needed to assess the long-term efficiency and surgical outcome of this material.
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Birkelbach MA, Smeets R, Fiedler I, Kluwe L, Wehner M, Trebst T, Hartjen P. In Vitro Feasibility Analysis of a New Sutureless Wound-Closure System Based on a Temperature-Regulated Laser and a Transparent Collagen Membrane for Laser Tissue Soldering (LTS). Int J Mol Sci 2020; 21:ijms21197104. [PMID: 32993100 PMCID: PMC7582393 DOI: 10.3390/ijms21197104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 09/23/2020] [Indexed: 12/23/2022] Open
Abstract
For the post-surgical treatment of oral wounds and mucosal defects beyond a certain size, the gold standard is still an autologous skin or mucosal graft in combination with complex suturing techniques. A variety of techniques and biomaterials has been developed for sutureless wound closure including different tissue glues or collagen patches. However, no wound covering that enables for sutureless fixation has yet been introduced. Thus, a new system was developed that allows for sutureless wound covering including a transparent collagen membrane, which can be attached to the mucosa using a specially modified 2λ laser beam with integrated temperature sensors and serum albumin as bio-adhesive. The sutureless wound closure system was tested for its applicability and its cytocompatibility by an established in vitro model in the present study. The feasibility of the laser system was tested ex vivo on a porcine palate. The in vitro cytocompatibility tests excluded the potential release of toxic substances from the laser-irradiated collagen membrane and the bio-adhesive. The results of the ex vivo feasibility study using a porcine palate revealed satisfactory mean tensile strength of 1.2–1.5 N for the bonding of the membrane to the tissue fixed with laser of 980 nm. The results suggest that our newly developed laser-assisted wound closure system is a feasible approach and could be a first step on the way towards a laser based sutureless clinical application in tissue repair and oral surgery.
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Affiliation(s)
- Moritz Alexander Birkelbach
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.S.); (L.K.); (P.H.)
- Correspondence: ; Tel.: +49-40-74-105-3254
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.S.); (L.K.); (P.H.)
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Imke Fiedler
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Lan Kluwe
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.S.); (L.K.); (P.H.)
| | - Martin Wehner
- ILT, Fraunhofer-Institute for Laser Technology, 52074 Aachen, Germany;
| | | | - Philip Hartjen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (R.S.); (L.K.); (P.H.)
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Evaluation of Bovine-Derived Collagen Membrane in Oral Surgical Mucosal Defects. J Maxillofac Oral Surg 2019; 18:466-473. [PMID: 31371892 DOI: 10.1007/s12663-018-1172-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/11/2018] [Indexed: 10/27/2022] Open
Abstract
Background The overall purpose of this clinical study is to evaluate the effectiveness of bovine-derived collagen in surgical oral mucosal defects. Patients and methods The study model included thirty-two patients who underwent surgery for benign and malignant lesions of oral cavity in the Indira Gandhi Medical College and Research Institute, Puducherry, India-from 2012 to 2018. The surgical oral mucosal defects had been reconstructed with a commercially available bovine-derived type I collagen [Surgicoll-Mesh, 0.5 mm thick] membrane. The clinical effectiveness of this collagen membrane was evaluated using parameters like haemostasis, pain, epithelialisation, granulation tissue formation and mouth opening as the functional test parameter. Results The clinical outcome results documented proved that the bovine-derived collagen membrane showed excellent significant results with respect to haemostasis, pain relief, epithelialisation and granulation tissue formation.
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