Comparison of resorbable membranes for guided bone regeneration of human and bovine origin

Abstract

The properties of membranes for guided bone regeneration have been described by a number of authors. These involve biocompatibility, appropriate barrier features (mechanical prevention of soft tissue proliferation), tissue integration, immunologic neutrality, preservation of the space for new alveolar bone, and simplicity of application. Such membrane must hold out against the masticatory forces and tissue tension of the flap, and prevent the collapse of soft tissues and wound space reduction. The property of integration into the tissue guarantees wound stabilization and inhibits epithelial migration. The aim of this study was to compare and evaluate the influence of human resorbable demineralized membrane (RHDM) and bovine resorbable demineralized membrane (RBDM) on bone regeneration. The experiment, approved by the Ethical Committee, was performed on six dogs and conducted into three phases. Bone defects were created in all six dogs on the left side of the mandible, 8 weeks after extraction of the second, third and fourth premolar. One defect was covered with 200 μm thick RHDM, one with 200 μm thick RBDM, and the third defect was left empty (control defect). The pathohistological analysis was done two, four and six months after the surgery. In the third phase samples of bone tissue were taken and subjected to patohistological analysis. In all six dogs the defects treated with RHDM 200μm thick showed a higher level of bone regeneration in comparison with the defect treated with RBDM 200 μm thick and especially with the control defect. Our results demonstrated that the human membrane showed the least soft tissue ingrowth and promoted better bone formation at 6 months compared with a bovine one.

Svojstva membrane za vođenu koštanu regeneraciju opisali su brojni autori. Ona uključuju biokompatibilnost, odgovarajuću barijernu moć (mehaničko sprečavanje proliferacije mekog tkiva), tkivnu integraciju, imunološku inertnost, očuvanje prostora za novu alveolarnu kost i jednostavnost primene. Membrana mora da izdrži sile žvakanja i tkivne tenzije režnja, da spreči kolaps mekih tkiva i smanjenje prostora rane. Svojstvo tkivne integracije omogućava stabilizaciju rane i inhibiciju epitelne migracije. Cilj studije je bio da ispita uticaj humane resorptivne demineralizovane membrane (RHDM) i bovine resorptivne demineralizovane membrane (RBDM) na koštanu regeneraciju i da ih međusobno uporedi. Eksperimentalna studija rađena na 6 pasa rase nemački ovčar, sprovedena je u tri faze. U prvoj fazi izvršena je ekstrakcija drugog, trećeg i četvrtog premolara sa leve strane. Osam nedelja nakon ekstrakcije, formirana su tri defekta na levoj strani mandibule i prekrivena humanom membranom debljine 200μm, bovinom membranom debljine 200 μm a treći defekt je ostavljen prazan (kontrolni defekt). Patohistološka analiza rađena je nakon dva, četiri i šest meseci posle hirurške intervencije. U trećoj fazi uzorci koštanog tkiva podvrgnuti su patohistološkoj analizi. Kod svih 6 pasa, defekti prekriveni humanom membranom debljine 200 μm, pokazali su patohistološkom analizom znatno veći stepen koštane regeneracije u poređenju sa defektima prekrivenim sa bovinom membranom i naročito sa kontrolnim defektom. Naši rezultati su pokazali da je humana membrana pokazala najmanje prorastanje mekim tkivom i bolju koštanu regeneraciju nakon 6 meseci u poređenju sa bovinom.