Sinus floor elevation in sites with a perforated schneiderian membrane: What is the effect of placing a collagen membrane in a rabbit model?

Abstract

Objective To investigate the healing following sinus grafting in sites with a perforated schneiderian membrane repaired using a collagen membrane, compared to control sites without membrane perforation. Materials & Methods Following elevation of the sinus membrane in 16 rabbits, each sinus was assigned to one of the following groups: (a) intentional schneiderian membrane perforation, followed by the placement of a collagen membrane and bone grafting (group SMP) and (b) bone grafting without a perforation of the schneiderian membrane and without a collagen membrane placement (control group). At 2 and 4 weeks (n = 8 for each time‐point), microcomputed tomographic (micro‐CT) and histomorphometric analyses were performed. Results Overall new bone formation in group SMP was significantly delayed compared to the control group at 2 and 4 weeks (1.58 ± 1.25% vs. 9.23 ± 2.69% at 2 weeks, 10.43 ± 3.55 vs. 17.86 ± 4.11% at 4 weeks, p < 0.05). At 2 weeks, new bone formation for the areas close to lateral (1.19 ± 2.02%) and medial sinus bone walls (3.17 ± 1.98%) was markedly delayed in group SMP compared to the control group (13.08 ± 6.13% and 12.75 ± 5.63%, respectively, p < 0.05), but there was no statistical difference in those areas at 4 weeks (p > 0.05). The augmented volumes at 2 and 4 weeks were not statistically significantly different in both groups. Conclusion The perforation of the schneiderian membrane and the repair using a collagen membrane delayed new bone formation in the augmented sinuses. However, the extension of the collagen membrane on the sinus bone walls was also attributable to this delayed bone formation.

Tomographic evaluation of the influence of the placement of a collagen membrane subjacent to the sinus mucosa during maxillary sinus floor augmentation: a randomized clinical trial

“…The results from the present study are not in agreement with those from another experimental study in rabbits [18]. In that experiment, a perforation was intentionally produced in the sinus mucosa of the test sites and a collagen membrane was placed as protection subjacent to the sinus mucosa.…”

Volume stability of the augmented sinus using a collagenated bovine bone mineral grafted in case of a perforated Schneiderian membrane: An experimental study in rabbits

“…Applying a resorbable collagen membrane to a perforated SM has been demonstrated to achieve a physical sealing effect, but its effects on healing of the SM and new bone formation are still unclear. A previous study found delayed new bone formation when using a collagen membrane and particulate bone on a perforated SM in a rabbit sinus model (Lim et al, 2018). It is assumed that the collagen membrane may impair the natural healing process of the SM by delaying the migration of undifferentiated basal cells from the adjacent untraumatized area or obstructing the osteogenic potential of the SM.…”

Platelet‐rich fibrin and collagen membrane in the preservation of the alveolar bone: Feasibility of the elemental inorganic composition and scanning electron microscopy analysis

“…The use of PRF and CM for bone regeneration was analyzed in animal studies (Gavazzoni, Filho, & Hernandes, ; Horimizu et al, ; Lim et al, ; Oliveira et al, ; Padilha et al, ; Sun et al, ). In none of these cases, the combination of PRF and RCM was evaluated.…”

“…In none of these cases, the combination of PRF and RCM was evaluated. However, the PRF was analyzed combined with Bio‐Oss (Oliveira et al, ), human‐cultured alveolar bone‐derived periosteal sheet (Horimizu et al, ), and leucocytes (Padilha et al, ); the RCM was associated with sinusal membrane (Lim et al, ), calcium sulfate and deproteinized bovine bone mineral (Gavazzoni et al, ), and cap morphogenetic protrein‐2 (Sun et al, ). In these studies, in general, the use of PRF showed better results with increased bone area increased after 60 days (Oliveira et al, ); increased angiogenesis at the site of application (Horimizu et al, ), positive effect on the regenerative process of bone defects, reduction of inflammatory response, and greater bone neoformation (Padilha et al, ).…”

“…In these studies, in general, the use of PRF showed better results with increased bone area increased after 60 days (Oliveira et al, ); increased angiogenesis at the site of application (Horimizu et al, ), positive effect on the regenerative process of bone defects, reduction of inflammatory response, and greater bone neoformation (Padilha et al, ). On the other hand, the CM delayed bone formation (Lim et al, ) and did not improve bone formation even when associated with bone morphogenetic protein 2 (Sun et al, ). Analyzing these studies, we can suggest that the changes observed in the bone tissue in our clinical study are mainly due to the action of the PRF clot.…”