Differences in degradation behavior of two non‐cross‐linked collagen barrier membranes: an <i>in vitro</i> and <i>in vivo</i> study

Bozkurt, Ahmet; Apel, Christian; Sellhaus, Bernd; Neerven, Sabien van; Wessing, Bastian; Hilgers, Ralf-Dieter; Pallua, Norbert

doi:10.1111/clr.12284

Cited by 48 publications

(45 citation statements)

References 30 publications

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“…This stain allows aligned (red) fibers to be distinguished from nonaligned (green) collagen fibers General and specific tissue reactions in three regions of interest (one at one end, one at the opposite end and one in the middle) according to Bozkurt et al . Details of the parameters evaluated and of the scoring system are presented in Table .…”

Section: Methodsmentioning

confidence: 99%

“…Details of the parameters evaluated and of the scoring system are presented in Table .

General and specific tissue reaction scores according to Bozkurt et al Parameters 7 days 14 days 30 days General tissue reactionFibrosis−−+Fatty infiltrate−++Hemorrhage+++++Necrosis−−−Degeneration−−−Foreign debris−−−Number of blood vessels (SE)1.13 (1.55)7.50 (3.42)11 (11.38)Specific tissue reaction (score 0‐3 and SE)Polymorphonuclear leukocytes0.38 (0.58)0.25 (0.44)0.25 (0.53)Lympocytes0.17 (0.38)0.58 (0.65)0.42 (0.58)Eosinophils0.04 (0.20)−−Plasma cells−−−Macrophages0.04 (0.20)0.08 (0.28)0.04 (0.20)Multinucleated giant cells−−−

The general tissue reaction was evaluated using the following scoring system: −, not present; +, present in ≥10% of the viewed area; ++, present in ≥20% of the viewed area; and +++, present in ≥50% of the viewed area. The number of blood vessels (and SE) in the extracranial and intracranial membranes of each sample was counted. The specific tissue reaction was evaluated using the following scoring system: 0, no cells; 0.5, <10 cells; 1, 10‐50 cells; 2, 50‐90 cells; and 3, >100 cells.…”

Section: Methodsmentioning

confidence: 99%

“…Although the clinical application of collagen membranes in guided bone/tissue regeneration is well established, surprisingly only a limited number of studies have investigated their resorption pattern and they have shown that the degradation of collagen membranes might start within 4 days to 6 weeks after surgical placement . However, in most of the published studies, resorption of collagen membrane was evaluated after subcutaneous implantation, which does not resemble the clinical milieu, in which the membrane is in direct contact with the pristine bone, the graft and the soft tissues within the context of a surgical osseous wound. Moreover, the available data mainly consist of qualitative histologic observations and/or the measurement of membrane thickness, with little characterization of the enzymatic degradation process …”

Section: Introductionmentioning

confidence: 99%

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Degradation pattern of a porcine collagen membrane in an in vivo model of guided bone regeneration

Calciolari

Ravanetti

Strange

et al. 2018

J of Periodontal Research

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The collagen membrane investigated was biocompatible and able to promote bone regeneration. However, pronounced signs of degradation were observed starting from day 30. Since successful regeneration is obtained only when cell occlusion and space maintenance exist for the healing time needed by the bone progenitor cells to repopulate the defect, the suitability of collagen membranes in cases where long-lasting barriers are needed needs to be further reviewed.

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Section: Methodsmentioning

confidence: 99%

“…Details of the parameters evaluated and of the scoring system are presented in Table .

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Degradation pattern of a porcine collagen membrane in an in vivo model of guided bone regeneration

Calciolari

Ravanetti

Strange

et al. 2018

J of Periodontal Research

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“…Premature exposure to the oral cavity is leading to early degradation and bacterial colonization compromising the beneficial effects of GTR or GBR procedures . The degradation rate may be influenced by various parameters such as the composition, structure, and dimensions of the membrane but also by systemic diseases, such as uncontrolled diabetes . In recent studies, CM degradation was found to be accelerated in uncontrolled diabetic rats .…”

Section: Introductionmentioning

confidence: 99%

Hyaluronic acid slows down collagen membrane degradation in uncontrolled diabetic rats

Eliezer

Sculean

Miron

et al. 2019

J of Periodontal Research

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Aim To examine the in vitro biokinetics of hyaluronic acid (HA) from a collagen membrane (CM) and to evaluate the in vivo effect of immersion of the CM in HA solution on its degradation in streptozotocin (STZ)‐induced diabetes conditions in a rat calvaria subcutaneous model. Background CM degradation is accelerated in uncontrolled diabetic rats. Immersion of CM in HA has been suggested to decrease their resorption rate without interfering with their tissue integration and structural degradation. However, it is unknown to what extent CM degradation may be influenced by its immersion in HA solution under a condition mimicking a medically compromised situation with an increased inflammatory level such as diabetes. Materials and Methods CMs were soaked in cross‐linked HA. Protein adsorption and the HA release were quantified by ELISA. Diabetes was induced in sixteen rats, while 16 healthy rats served as control. CM was prepared and labeled prior to implantation with Biotin. Seventeen CM were immersed in HA and 17 CM in PBS. In each animal, one test or one control disk was implanted. In order to compare the collagen content, two similar non‐implanted CM were used as baseline. Fourteen days after surgery, thirty‐two animals were sacrificed. The entire calvaria including the skin above, was chemically fixed, decalcified, and embedded in paraffin. Five‐μm‐thick sections were analyzed histologically and histomorphometrically using H&E and avidin‐peroxidase staining. Results The in vitro results demonstrated that the CM adsorbed roughly 80% of the total HA content. After 10 days, 36.3% of the initial HA remained on the CM. The in vivo results demonstrated that diabetes significantly reduced the thickness of the CM, while HA had a significant effect on keeping the membrane thickness. HA increased the residual collagen content in the diabetic group (P < 0.0001) but no such effect was observed in the healthy group. Conclusion Immersion of CM in HA prior to the implantation delays membrane degradation in uncontrolled diabetic compared with normoglycemic rats.

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“…Recently, a native collagen membrane with a significantly longer degradation time and increased mechanical properties, such as higher tensile and suture pull‐out strength, has been developed (Bozkurt et al. ). This membrane had a low membrane exposure rate (12%) in a retrospective analysis of 36 patients with simultaneous or subsequent implant placement (Wessing et al.…”

mentioning

confidence: 99%

A multicenter randomized controlled clinical trial using a new resorbable non‐cross‐linked collagen membrane for guided bone regeneration at dehisced single implant sites: interim results of a bone augmentation procedure

Wessing¹,

Urban²,

Montero

et al. 2016

Clinical Oral Implants Res

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ObjectiveTo compare clinical performance of a new resorbable non‐cross‐linked collagen membrane, creos xenoprotect (CXP), with a reference membrane (BG) for guided bone regeneration at dehisced implant sites.Materials and methodsThis randomized controlled clinical trial enrolled patients with expected dehiscence defects following implant placement to restore single teeth in the maxillary and mandibular esthetic zone and premolar area. Implants were placed using a two‐stage surgical protocol with delayed loading. Bone augmentation material placed at the implant surface was immobilized with CXP or BG membrane. Soft tissue health was followed during the healing period, and the defect size was measured at reentry and 6 months after implant placement.ResultsOf the 49 included patients, 24 were treated with CXP and 25 with BG. Patient characteristics did not differ between the two arms. In the CXP arm, the defect height at implant insertion was (mean ± SD) 5.1 ± 2.1 mm (n = 24) and reduced at reentry by 81% to 1.0 ± 1.3 mm (n = 23). In the BG arm, the defect height at implant insertion was 4.9 ± 1.9 mm (n = 25) and reduced at reentry by 62% to 1.7 ± 2.1 mm (n = 24). Assuming a margin of non‐inferiority of 1 mm, CXP was non‐inferior to BG. Membrane exposure rate was highest at week 3 in both arms, reaching 16.7% for BG and 8.7% for CXP.ConclusionsThe new resorbable non‐cross‐linked collagen membrane facilitates bone gain to support implant placement in expected dehiscence defects. The observed trend toward higher mean bone gain and lower exposure rate with CXP compared to BG should be further investigated.

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Differences in degradation behavior of two non‐cross‐linked collagen barrier membranes: an in vitro and in vivo study

Abstract: This study shows differences in the biodegradation characteristics of two non-cross-linked collagen membranes in vitro and in vivo. Whether the higher stability of RX is of clinical relevance should be analyzed in future clinical investigations.

Cited by 48 publications

References 30 publications

Degradation pattern of a porcine collagen membrane in an in vivo model of guided bone regeneration

Degradation pattern of a porcine collagen membrane in an in vivo model of guided bone regeneration

Hyaluronic acid slows down collagen membrane degradation in uncontrolled diabetic rats

A multicenter randomized controlled clinical trial using a new resorbable non‐cross‐linked collagen membrane for guided bone regeneration at dehisced single implant sites: interim results of a bone augmentation procedure

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