Abstract
Collagen-based resorbable barrier membranes have been increasingly utilized for Guided Bone Regeneration (GBR), as an alternative to non-resorbable synthetic membranes that require a second surgical intervention for removal. One of the most important characteristics of a resorbable barrier membrane is its mechanical integrity that is required for space maintenance and its tissue integration that plays a crucial role in wound healing and bone augmentation. This study compares a commercially available porcine-derived sugar-crosslinked collagen membrane with two non-crosslinked collagen barrier membranes. The material analysis provides an insight into the influence of manufacturing on the microstructure. In vivo subcutaneous implantation model provides further information on the host tissue reaction of the barrier membranes, as well as their tissue integration patterns that involve cellular infiltration, vascularization, and degradation. The obtained histochemical and immunohistochemical results over three time points (10, 30, and 60 days) showed that the tissue response to the sugar crosslinked collagen membrane involves inflammatory macrophages in a comparable manner to the macrophages observed in the surrounding tissue of the control collagen-based membranes, which were proven as biocompatible. The tissue reactions to the barrier membranes were additionally compared to wounds from a sham operation. Results suggest wound healing properties of all the investigated barrier membranes. However, the sugar-crosslinked membrane lacked in cellular infiltration and transmembraneous vascularization, providing an exclusive barrier function in GBR. Moreover, this membrane maintained a similar swelling ratio over examined timepoints, which suggests a very slow degradation pattern and supports its barrier function. Based on the study results, which showed biocompatibility of the sugar crosslinked membrane and its stability up to 60 days post-implantation, it can be concluded that this membrane may be suitable for application in GBR as a biomaterial with exclusive barrier functionality, similar to non-resorbable options.
Highlights
The so-called Guided Bone Regeneration (GBR) approach represents procedures in ridge augmentation or bone regeneration [1]
The aim of this study was to examine the integration behavior and immune responses to a porcine-derived sugar crosslinked collagen membrane compared with native collagen membranes of the same animal species
Ossix® Plus Membrane Ossix® Plus (Datum Dental Biotech, Lod, Israel) is a collagen membrane of porcine origin containing collagen type I, obtained from the tendon. This membrane is created from repolymerized collagen monomers, sugar crosslinked in a physiological process involving natural sugar ribose, and sterilized with ethylene oxide
Summary
The so-called Guided Bone Regeneration (GBR) approach represents procedures in ridge augmentation or bone regeneration [1]. Barrier membranes should act as a barrier in the course of GBR, preventing the collapse of surrounding soft tissue into the bony defects and to ensure the fixation of the implanted bone substitute material (BSM), creating a microenvironment suitable for bone remodeling support [1]. Thereby, this membrane class, as well as other biodegradable polymeric membranes, eliminates the need for a second surgical procedure for biomaterial extraction even compared to non-resorbable materials such as membranes based on polytetrafluoroethylene (PTFE) [2]. The M1 phenotype has shown to be predominantly present in the early phase, typically, at 3–4 days after injury, and participate in material degradation, and change their polarization to M2 phenotype leading to tissue healing [10,11,12]
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