Demineralized Freeze-Dried Bovine Cortical Bone: Its Potential for Guided Bone Regeneration Membrane

Background. Bovine pericardium collagen membrane (BPCM) had been widely used in guided bone regeneration (GBR) whose manufacturing process usually required chemical cross-linking to prolong its biodegradation. However, cross-linking of collagen fibrils was associated with poorer tissue integration and delayed vascular invasion. Objective. This study evaluated the potential of bovine cortical bone collagen membrane for GBR by evaluating its antigenicity potential, cytotoxicity, immune and tissue response, and biodegradation behaviors. Material and Methods. Antigenicity potential of demineralized freeze-dried bovine cortical bone membrane (DFDBCBM) was done with histology-based anticellularity evaluation, while cytotoxicity was analyzed using MTT Assay. Evaluation of immune response, tissue response, and biodegradation was done by randomly implanting DFDBCBM and BPCM in rat’s subcutaneous dorsum. Samples were collected at 2, 5, and 7 days and 7, 14, 21, and 28 days for biocompatibility and tissue response-biodegradation study, respectively. Result. DFDBCBM, histologically, showed no retained cells; however, it showed some level of in vitro cytotoxicity. In vivo study exhibited increased immune response to DFDBCBM in early healing phase; however, normal tissue response and degradation rate were observed up to 4 weeks after DFDBCBM implantation. Conclusion. Demineralized freeze-dried bovine cortical bone membrane showed potential for clinical application; however, it needs to be optimized in its biocompatibility to fulfill all requirements for GBR membrane.

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Comparative In Vivo Analysis of the Integration Behavior and Immune Response of Collagen-Based Dental Barrier Membranes for Guided Bone Regeneration (GBR)

Membranes ◽

10.3390/membranes11090712 ◽

2021 ◽

Vol 11 (9) ◽

pp. 712

Author(s):

Milena Radenković ◽

Said Alkildani ◽

Ignacio Stoewe ◽

James Bielenstein ◽

Bernd Sundag ◽

...

Keyword(s):

Wound Healing ◽

Bone Regeneration ◽

Barrier Function ◽

Guided Bone Regeneration ◽

Collagen Membrane ◽

Cellular Infiltration ◽

Barrier Membranes ◽

Tissue Integration ◽

Tissue Reactions

Collagen-based resorbable barrier membranes have been increasingly utilized for Guided Bone Regeneration (GBR), as an alternative to non-resorbable synthetic membranes that require a second surgical intervention for removal. One of the most important characteristics of a resorbable barrier membrane is its mechanical integrity that is required for space maintenance and its tissue integration that plays a crucial role in wound healing and bone augmentation. This study compares a commercially available porcine-derived sugar-crosslinked collagen membrane with two non-crosslinked collagen barrier membranes. The material analysis provides an insight into the influence of manufacturing on the microstructure. In vivo subcutaneous implantation model provides further information on the host tissue reaction of the barrier membranes, as well as their tissue integration patterns that involve cellular infiltration, vascularization, and degradation. The obtained histochemical and immunohistochemical results over three time points (10, 30, and 60 days) showed that the tissue response to the sugar crosslinked collagen membrane involves inflammatory macrophages in a comparable manner to the macrophages observed in the surrounding tissue of the control collagen-based membranes, which were proven as biocompatible. The tissue reactions to the barrier membranes were additionally compared to wounds from a sham operation. Results suggest wound healing properties of all the investigated barrier membranes. However, the sugar-crosslinked membrane lacked in cellular infiltration and transmembraneous vascularization, providing an exclusive barrier function in GBR. Moreover, this membrane maintained a similar swelling ratio over examined timepoints, which suggests a very slow degradation pattern and supports its barrier function. Based on the study results, which showed biocompatibility of the sugar crosslinked membrane and its stability up to 60 days post-implantation, it can be concluded that this membrane may be suitable for application in GBR as a biomaterial with exclusive barrier functionality, similar to non-resorbable options.

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In Vivo Analysis of the Biocompatibility and Macrophage Response of a Non-Resorbable PTFE Membrane for Guided Bone Regeneration

International Journal of Molecular Sciences ◽

10.3390/ijms19102952 ◽

2018 ◽

Vol 19 (10) ◽

pp. 2952 ◽

Cited By ~ 9

Author(s):

Tadas Korzinskas ◽

Ole Jung ◽

Ralf Smeets ◽

Sanja Stojanovic ◽

Stevo Najman ◽

...

Keyword(s):

Bone Regeneration ◽

Guided Bone Regeneration ◽

Foreign Body Response ◽

Tissue Response ◽

Collagen Membrane ◽

Macrophage Response ◽

Barrier Membrane ◽

In Vivo Analysis ◽

Inflammatory Macrophages

The use of non-resorbable polytetrafluoroethylene (PTFE) membranes is indicated for the treatment of large, non-self-containing bone defects, or multi-walled defects in the case of vertical augmentations. However, less is known about the molecular basis of the foreign body response to PTFE membranes. In the present study, the inflammatory tissue responses to a novel high-density PTFE (dPTFE) barrier membrane have preclinically been evaluated using the subcutaneous implantation model in BALB/c mice by means of histopathological and histomorphometrical analysis methods and immunohistochemical detection of M1- and M2-macrophages. A collagen membrane was used as the control material. The results of the present study demonstrate that the tissue response to the dPTFE membrane involves inflammatory macrophages, but comparable cell numbers were also detected in the implant beds of the control collagen membrane, which is known to be biocompatible. Although these data indicate that the analyzed dPTFE membrane is not fully bioinert, but its biocompatibility is comparable to collagen-based membranes. Based on its optimal biocompatibility, the novel dPTFE barrier membrane may optimally support bone healing within the context of guided bone regeneration (GBR).

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Collagen Membrane and Immune Response in Guided Bone Regeneration: Recent Progress and Perspectives

Tissue Engineering Part B Reviews ◽

10.1089/ten.teb.2016.0463 ◽

2017 ◽

Vol 23 (5) ◽

pp. 421-435 ◽

Cited By ~ 41

Author(s):

Chenyu Chu ◽

Jia Deng ◽

Xianchang Sun ◽

Yili Qu ◽

Yi Man

Keyword(s):

Immune Response ◽

Bone Regeneration ◽

Recent Progress ◽

Guided Bone Regeneration ◽

Collagen Membrane

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Comparison of Guided Bone Regeneration using a Bovine Collagen Membrane vs a Calcium Sulfate Barrier

Journal of Contemporary Dentistry ◽

10.5005/jp-journals-10031-1053 ◽

2013 ◽

Vol 3 (3) ◽

pp. 138-143 ◽

Cited By ~ 1

Author(s):

Jeffrey A Rossmann ◽

Ibtisam Al-Hashimi ◽

Eric S Solomon ◽

Mira Ghaly ◽

David G Kerns ◽

...

Keyword(s):

Bone Regeneration ◽

Calcium Sulfate ◽

Guided Bone Regeneration ◽

Collagen Membrane ◽

Socket Preservation ◽

Ridge Augmentation ◽

Bovine Collagen ◽

Freeze Dried ◽

Significant Difference ◽

Tissue Reactions

ABSTRACT Resorbable membranes have eliminated the need for re-entry for removal and reduce the incidence of adverse soft tissue reactions that accompany membrane exposure. However, the lack of rigidity often makes these more prone to collapse. Calcium sulfate has shown promise as a regenerative material alternative in a socket preservation application. The purpose of this study was to compare calcium sulfate and bovine collagen as a barrier in guided bone regeneration. Materials and Methods Eighteen sites were treated in this randomized, blinded clinical study. Patients were divided into 2 groups, 9 sites each. Group 1, had bovine collagen membrane (OssixTM) and group 2 had calcium sulfate barrier (CalcigenOralTM) to cover the graft. All sites were augmented with autogenously bone and demineralized freeze-dried bone composite graft at 1:1 ratio. Implants were placed in the grafted area 4 to 6 months post grafting. Vertical and horizontal ridge measurements were made before and after grafting by two blinded examiners. Results The collagen membrane group had a mean bone gain of 1.06 ± 1.01 mm in width and 0.19 ± 1.11 mm in height. In comparison, the calcium sulfate group had a mean bone loss of –0.14 ± 0.74 mm in width and –0.19 ± 0.74 mm in height. Student t-test revealed a significant difference in width dimension between the two groups, p = 0.01. Conclusion Overall results of this study suggest that calcium sulfate might have limited use as barrier for ridge augmentation. How to cite this article Ghaly M, Kerns DG, Hallmon WW, Solomon ES, Nagy WW, Al-Hashimi I, Rossmann JA. Comparison of Guided Bone Regeneration using a Bovine Collagen Membrane vs a Calcium Sulfate Barrier. J Contemp Dent 2013;3(3):138-143.

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Contemporary guided bone regeneration therapy for unaesthetic anterior peri-implantitis case

Dental Journal (Majalah Kedokteran Gigi) ◽

10.20473/j.djmkg.v49.i4.p181-184 ◽

2016 ◽

Vol 49 (4) ◽

pp. 181

Author(s):

Benso Sulijaya ◽

Sandra Olivia Kuswandani ◽

Yuniarti Soeroso

Keyword(s):

Calcium Phosphate ◽

Bone Regeneration ◽

Dental Implant ◽

Bone Substitutes ◽

Initial Therapy ◽

Guided Bone Regeneration ◽

Collagen Membrane ◽

Sandwich Technique ◽

Bone Allografts ◽

Freeze Dried

Background: Dental implant is one of an alternative solutions reconstruction therapy for missing teeth. Complication of dental implant could occurs and leading to implant failure. In order to restore the complication, surgical treatment with guided bone regeneration (GBR) is indicated. The potential use of bone substitutes is widely known to be able to regenerate the bone surrounding the implant and maintain bone volume. Purpose: The study aimed to demonstrate the effectiveness of implant-bone fully coverage by using sandwich technique of biphasic calcium phosphate (BCP) and demineralized freeze-dried bone allografts (DFDBA) bone substitutes combined with collagen resorbable membrane. Case: A 24-year-old male came with diagnosis of peri-implantitis on implant #11. Clinical finding indicated that implant thread was exposed on the labial aspect. Case management: After initial therapy including oral hygiene improvement performed, an operator did a contemporary GBR to correct the defect. Bone graft materials used were 40% β-tri calcium phosphate (β-TCP)-60% hydroxyapatite (HA) on the outer layer and DFDBA on the inner layer of the defect. Resorbable collagen membrane was used to cover the graft. Conclusion: GBR with sandwich technique could serve as one of the treatment choices for correcting an exposed anterior implant that would enhance the successful aesthetic outcome.

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Collagen Membrane for Guided Cortical Bone Regeneration: Characterization, Preclinical and Proof of Concept Clinical Studies

10.21203/rs.3.rs-26801/v1 ◽

2020 ◽

Author(s):

Brent Allan ◽

Rui Ruan ◽

Euphemie Landao-Bassonga ◽

Nicholas Gillman ◽

Tao Wang ◽

...

Keyword(s):

Electron Microscopy ◽

Bone Regeneration ◽

Cortical Bone ◽

Dental Implants ◽

Bone Defect ◽

Bone Defects ◽

Guided Bone Regeneration ◽

Collagen Membrane ◽

Micro Ct ◽

Proof Of Concept

Abstract Background: Treatment of cortical bone defects is a clinical challenge. Guided bone regeneration (GBR), commonly used in oral in maxillofacial dental surgery, may show promise for orthopedic application in repair of cortical defects. However, a limitation in the use of GBR for cortical bone defects is the lack of an ideal scaffold that provides sufficient mechanical support to bridge the cortical bone with minimal interference in the repair process. We have developed a new collagen membrane, CelGroTM, for use in GBR. We report the material characterisation of CelGroTM, and evaluate the performance of CelGroTM in translational preclinical and clinical studies. Methods: Scanning electron microscopy (SEM), micro computed tomography (micro-CT) and transmission electron microscopy (TEM) were used to examine the structural morphology of CelGroTM. Purity and biochemical composition of CelGroTM was evaluated by Western-blot, immunohistochemistry and confocal microscopy. Physical and chemical properties of CelGroTM were examined and compared with another commercially available collagen membrane. The pre-clinical evaluation was conducted using a cortical bone defect model in the New Zealand white rabbit. Cortical bone regeneration in defects of the femoral diaphysis were evaluated at 30 days and 60 days after intervention, by micro-CT and histology. A clinical study to evaluate the performance of CelGroTM in GBR for treatment of bone augmentation surrounding dental implants was also performed. The clinical outcomes were evaluated by semi quantitative tissue condition assessments and cone-beam computed tomography (CBCT) scan. Results: CelGroTM has a bilayer structure of different fibre alignment and is composed almost exclusively of type I collagen. CelGroTM was found to be completely acellular and a clinically significant xenoantigen, α -gal, was not detected. CelGroTM displayed less deformity and better mechanical strength as compared to Bio-Gide ® . In the preclinical study, CelGroTM demonstrated enhanced bone-modelling activity and cortical bone healing. Micro-CT evaluation showed early bony bridging over the defect area 30 days post-operatively, and nearly complete restoration of mature cortical bone at the bone defect site 60 days post- operatively. Histological analysis at day 60 after surgery further confirmed that CelGroTM enables bridging of the cortical bone defect by induction of newly-formed cortical bone. It appears that CelGroTM showed better cortical alignment and reduced porosity at the defect interface compared to Bio-Gide®. Owning the fact that selection of orthopedic patients with cortical bone defects is complex, we conducted the proof of concept clinical study in a total of 16 dental implants which were placed in 10 participants receiving GBR. The results showed that there were with no complications or adverse events observed. CBCT evidenced efficiency of the CelGroTM scaffold for GBR for the dental implants, showing significantly decreased 2 distance from the implant shoulder to first bone/implant contact (DIB) and increased horizontal thickness of facial bone wall (HT). Conclusion: The findings of our study demonstrate that CelGroTM is an ideal membrane for GBR not only in oral maxillofacial reconstructive surgery but also in orthopedic applications. Details of clinical trial registration: “Single centre, open-label, pilot study of Celgro(tm) collagen membrane for guided bone regeneration around exposed implants in patients undergoing dental implant surgery”; Registration ID: ACTRN12615000027516; Date of registration: 19/01/2015; URL: https://anzctr.org.au/ACTRN12615000027516.aspx

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Dentin-Derived-Barrier Membrane in Guided Bone Regeneration: A Case Report

Materials ◽

10.3390/ma14092166 ◽

2021 ◽

Vol 14 (9) ◽

pp. 2166

Author(s):

Jeong-Kui Ku ◽

In-Woong Um ◽

Mi-Kyoung Jun ◽

Il-hyung Kim

Keyword(s):

Case Report ◽

Bone Regeneration ◽

Guided Bone Regeneration ◽

Successful Outcome ◽

Collagen Membrane ◽

Type I ◽

Barrier Membrane ◽

Dentin Matrix ◽

Demineralized Dentin Matrix ◽

Demineralized Dentin

An autogenous, demineralized, dentin matrix is a well-known osteo-inductive bone substitute that is mostly composed of type I collagen and is widely used in implant dentistry. This single case report describes a successful outcome in guided bone regeneration and dental implantation with a novel human-derived collagen membrane. The authors fabricated a dentin-derived-barrier membrane from a block-type autogenous demineralized dentin matrix to overcome the mechanical instability of the collagen membrane. The dentin-derived-barrier acted as an osteo-inductive collagen membrane with mechanical and clot stabilities, and it replaced the osteo-genetic function of the periosteum. Further research involving large numbers of patients should be conducted to evaluate bone forming capacity in comparison with other collagen membranes.

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