Collagen based barrier membranes for periodontal guided bone regeneration applications

Abstract

Certain cell populations within periodontal tissues possess the ability to induce regeneration, provided they have the opportunity to populate the wound or defect. Guided regeneration techniques have been investigated for regenerating periodontal tissues and such therapies usually utilize barrier membranes. Various natural and synthetic barrier membranes have been fabricated and tested to prevent epithelial and connective tissue cells from invading while allowing periodontal cells to selectively migrate into the defect. This paper focuses on the literature relevant to the use and potential of resorbable collagen membranes in GBR procedures, sites of periodontal and intrabony defects, in cases of socket and alveolar ridge preservation and at implant sites. The results of their use in GBR procedures has shown them to be effective and comparable with non-resorbable membranes with regards to clinical attachment gain, probing depth reduction and defect bone filling. They have also shown to prevent epithelial ingrowth into the defect space during the initial wound healing phase postsurgically. Collagen membranes have also been used for root coverage and GBR procedures and have shown good success rates comparable to subepithelial connective tissue grafts and expanded-polytetrafluoroethylene (e-PTFE) membranes. The future for periodontal tissue engineering is very exciting with the use of barrier membranes expected to continue playing a critical role. However, long-term clinical trials are required to further evaluate and confirm the efficacy of the available collagen barrier membranes for periodontal and bone regeneration use.

Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: a 12-month randomized controlled trial

“…It may be achieved by placing barrier membrane over intrabony defect to prevent ingrowth of connective and epithelial cells during the initial wound healing phase [2]. Bioresorbable collagen membranes (CM) are frequently used for this purpose [3]. Albeit guided tissue regeneration (GTR) is a wellestablished procedure, the treatment of intrabony defects, especially in patients with AgP, remains a challenge and novel therapeutic strategies are very much needed.…”

Regenerative surgical treatment of peri‐implantitis using either a collagen membrane or concentrated growth factor: A 12‐month randomized clinical trial

“…[9][10][11][12] Barrier membranes are used in regenerative approaches to stabilize the graft and to prevent epithelial ingrowth and long junctional epithelium formation from the PBD, providing the population of bone cells in the defects. 14 While collagen membrane (CM) is successfully used in regenerative approaches, additional use or replacement with platelet concentrates can provide further regenerative advantages due to the acceleration of angiogenesis, stimulation of the activity of osteoblasts and fibroblasts, and the regeneration of hard and soft tissues, including stem cells and growth factors. 14 While collagen membrane (CM) is successfully used in regenerative approaches, additional use or replacement with platelet concentrates can provide further regenerative advantages due to the acceleration of angiogenesis, stimulation of the activity of osteoblasts and fibroblasts, and the regeneration of hard and soft tissues, including stem cells and growth factors.…”

Natural graft tissues and synthetic biomaterials for periodontal and alveolar bone reconstructive applications: a review

“…This also results in reducing the rate of graft resorption [143, 144]. There are a variety of degradable and non-degradable barrier membranes that have been synthesized for periodontal GTR and GBR applications [11, 12]. The general characteristics that must be considered when designing barrier membranes intended for periodontal regeneration are: 1) biocompatibility; 2) cell-occlusivity; 3) Space-making ability; 4) Tissue integration; 5) Degradability; 6) Mechanical properties; and 7) Clinical handling characteristics [145, 146].…”

“…They have no risk for cross infection/disease transmission, which might be a possibility with the use of allografts and xenografts [10]. To prevent the down-growth of the epithelial cells along the tooth-root surface and into the periodontal defect space, various barrier membranes have been developed and investigated [11]. Similar to the hard tissue replacement graft materials, these membranes can be manufactured using natural or synthetic materials [12].…”