Abstract
Polymer membranes have been widely used in guided tissue regeneration (GTR) and guided bone regeneration (GBR). In this review, various commercially available membranes are described. Much attention is paid to the recent development of biodegradable polymers applied in GTR and GBR, and the important issues of biodegradable polymeric membranes, including their classification, latest experimental research and clinical applications, as well as their main challenges are addressed. Herein, natural polymers, synthetic polymers and their blends are all introduced. Pure polymer membranes are biodegradable and biocompatible, but they lack special properties such as antibacterial properties, osteoconductivity, and thus polymer membranes loaded with functional materials such as antibacterial agents and growth factors show many more advantages and have also been introduced in this review. Despite there still being complaints about polymer membranes, such as their low mechanical properties, uncontrollable degradation speed and some other drawbacks, these problems will undoubtedly be conquered and biodegradable polymers will have more applications in GTR and GBR.
Highlights
Guided tissue regeneration (GTR) was first described in the 1950s by Hurley, who physically separated soft tissues from areas of active bone formation in the spine with a barrier membrane [1].In the 1980s, guided tissue regeneration (GTR) was introduced to periodontal tissue regeneration to stop cell migration from gingival connective tissue and epithelium to the periodontal defect, and has been adopted in treating periodontal lesions to generate new attachments [2,3]
The hydroxyapatite/chitosan/gelatin membranes promote human bone marrow mesenchymal stem cells proliferation, and enhance progression of osteogenic differentiation [95]. These results suggest that such gelatin/chitosan or collagen/chitosan membranes are promising candidate for guided tissue and bone regeneration applications which possess sufficient mechanical and structural properties to function as a barrier membrane, and that the proteins promoted osteogenic differentiation
A series of PDLLA/Polyglycolic Acid Copolymer (PLGA) electrospinning membrane system with appropriate degradation rate and excellent cell-occlusiveness were prepared for GTR, and the in vitro cytologic research revealed that PDLLA/PLGA composite membranes could efficiently inhibit the infiltration of human embryonic kidney 293T cells
Summary
Guided tissue regeneration (GTR) was first described in the 1950s by Hurley, who physically separated soft tissues from areas of active bone formation in the spine with a barrier membrane [1]. For GTR and GBR techniques, whether or not the graft material is filled, a special barrier membrane plays a key role to prevent epithelial or undesirable tissues migration into the defective area [9], and it allows sufficient time for bone, cementum, and periodontal ligament regeneration [10]. The ideal membrane for periodontal guided tissue and bone regeneration should have the following properties: biocompatibility, space maintenance ability, cell occlusiveness, integrated by the host tissues, and clinical manageability [11,12]. The structural integrity of the membrane should be maintained during the maturation of the newly formed tissue and it varies according to the application, i.e., 4–6 weeks for GTR for bone and periodontal ligament cells to fill the space but ě6 months for GBR to support new bone formation and maturation [15]. Ideal for ridge augmentation and grafting bony defects missing one or more walls
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