Collagen Barrier Membranes Research Articles

Evaluation of release kinetics and mitogenic capacity of collagen barrier membranes supplemented with the secretome of activated platelets

Evaluation of release kinetics and mitogenic capacity of collagen barrier membranes supplemented with the secretome of activated platelets

Marine-derived collagen biomaterials from echinoderm connective tissues

The use of marine collagens is a hot topic in the field of tissue engineering. Echinoderms possess unique connective tissues (Mutable Collagenous Tissues, MCTs) which can represent an innovative source of collagen to develop collagen barrier-membranes for Guided Tissue Regeneration (GTR). In the present work we used MCTs from different echinoderm models (sea urchin, starfish and sea cucumber) to produce echinoderm-derived collagen membranes (EDCMs). Commercial membranes for GTR or soluble/reassembled (fibrillar) bovine collagen substrates were used as controls. The three EDCMs were similar among each other in terms of structure and mechanical performances and were much thinner and mechanically more resistant than the commercial membranes. Number of fibroblasts seeded on sea-urchin membranes were comparable to the bovine collagen substrates. Cell morphology on all EDCMs was similar to that of structurally comparable (reassembled) bovine collagen substrates. Overall, echinoderms, and sea urchins particularly, are alternative collagen sources to produce efficient GTR membranes. Sea urchins display a further advantage in terms of eco-sustainability by recycling tissues from food wastes.

Horizontal Ridge Augmentation with a Novel Resorbable Collagen Membrane: A Retrospective Analysis of 36 Consecutive Patients.

The aim of this investigation was to evaluate a new resorbable, monolayer, noncross-linked collagen barrier membrane for immobilizing bone augmentation material during horizontal guided bone regeneration (GBR) procedures. GBR was performed on 36 consecutive patients in 49 sites, with 103 implants placed either simultaneously or after a healing period. Healing time, suture retention, postoperative complications, and functional outcome after GBR, implant placement, and prosthesis loading were assessed. A wound dehiscence rate of only 12% and a graft failure rate of 4% occurred. Mean healing time was 5.8 months for simultaneous placement and 7.9 + 4.8 months for two-stage procedures. The implant survival rate was 100% after a mean follow-up of 18.3 months from implantation. These early data demonstrate a low dehiscence rate and excellent potential of this new noncross-linked collagen membrane for use with horizontal ridge augmentation.

Collagen barrier membranes adsorb growth factors liberated from autogenous bone chips.

Collagen membranes serve as barriers to separate bone grafts from soft tissues. Bone grafts harvested with a bone scraper release growth factors activating transforming growth factor-β (TGF-β) signaling in mesenchymal cells. The aim of the present pilot study was to determine whether collagen membranes adsorb molecules from bone-conditioned medium (BCM) with the capacity to provoke the expression of TGF-β target genes invitro. Collagen membranes were soaked in aqueous extracts from fresh and demineralized bone chips placed in cell culture medium. Recombinant human TGF-β1 served as control. Gingival fibroblasts were seeded onto the washed collagen membranes and evaluated for the expression of adrenomedullin, pentraxin 3, interleukin 11, and proteoglycan 4. Cell viability and morphology with phalloidin staining were also determined. Incubation of collagen membranes with BCM for at least one minute caused fibroblasts to decrease the expression of adrenomedullin and pentraxin 3, and to increase the expression of interleukin 11 and proteoglycan 4. Four different membrane treatments - incubated with recombinant TGF-β1, pre-wetted with saline solution, exposed to UV light, and dry out and stored one week at room temperature - also provoked significant changes in gene expression. Likewise, conditioned medium from demineralized bone chips caused gene expression changes. BCM did not alter the viability or morphology of gingival fibroblasts. These findings demonstrate that collagen membranes rapidly adsorb the TGF-β activity released from bone chips, a molecular process that might contribute to guided bone regeneration.

Different bone regeneration patterns in periimplant circumferential gap defects grafted with two types of osteoconductive biomaterial.

This study aimed to determine healing patterns in periimplant gap defect grafted with demineralized bovine bone mineral (DBBM) and porous titanium granules (PTG), which are known to induce a minimal tissue reaction and to undergo minimal biodegradation in healing process. Experiments were performed using a standardized periimplant gap-defect model in dogs with two observational periods: 4 and 8 weeks. Circumferential defects were surgically induced around dental implants on unilateral mandibles in five dogs, and collagen barrier membranes were placed over the DBBM and PTG grafts at two experimental sites and over a nongrafted site. Four weeks later, the same procedures were performed on the contralateral mandible, and the animals allowed to heal for a further 4 weeks, after which they were sacrificed and their mandibles with graft/control sites harvested for histologic evaluation. Both types of grafted biomaterials significantly enhanced the defect fill with newly formed bone, but the bone-to-implant contact (BIC) was significantly increased only at sites that had been grafted with DBBM. The two experimental sites exhibited different healing patterns, with new bone formation being observed on the surface of the DBBM particles throughout the defect, while there was no de novo bone formation on the PTG surface, but rather appositional bone growth from the base and lateral walls of the defect. It has been suggested that gap-defect filling with DBBM around dental implants may enhance both BIC and defect fill; however, the present findings show that defect grafting with PTG enhances only defect fill and not BIC. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1202-1209, 2016.

Long-term stability of contour augmentation in the esthetic zone: histologic and histomorphometric evaluation of 12 human biopsies 14 to 80 months after augmentation.

Contour augmentation around early-placed implants (Type 2 placement) using autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) and a collagen barrier membrane has been documented to predictably provide esthetically satisfactory clinical outcomes. In addition, recent data from cone beam computed tomography studies have shown the augmented volume to be stable long-term. However, no human histologic data are available to document the tissue reactions to this bone augmentation procedure. Over an 8-year period, 12 biopsies were harvested 14 to 80 months after implant placement with simultaneous contour augmentation in 10 patients. The biopsies were subjected to histologic and histomorphometric analysis. The biopsies consisted of 32.0% ± 9.6% DBBM particles and 40.6% ± 14.6% mature bone. 70.3% ± 14.5% of the DBBM particle surfaces were covered with bone. On the remaining surface, multinucleated giant cells with varying intensity of tartrate-resistant acid phosphatase staining were regularly present. No signs of inflammation were visible, and no tendency toward a decreasing volume fraction of DBBM over time was observed. The present study confirms previous findings that osseointegrated DBBM particles do not tend to undergo substitution over time. This low substitution rate may be the reason behind the clinically and radiographically documented long-term stability of contour augmentation using a combination of autogenous bone chips, DBBM particles, and a collagen membrane.

Release kinetics of prolyl hydroxylase inhibitors from collagen barrier membranes.

Collagen barrier membranes are used in guided tissue regeneration to support healing. This strategy, however, relies on the healing capacity of the tissue. Pharmacological inhibitors of prolyl hydroxylases can support regeneration by enhancing angiogenesis and are therefore a promising tool for periodontology. Here we evaluate the release kinetics of the prolyl hydroxylase inhibitors dimethyloxalylglycine and L-mimosine from collagen barrier membranes. Dimethyloxalylglycine and L-mimosine were lyophilized onto the collagen barrier membranes. The morphology of the collagen barrier membranes was analysed using scanning electron microscopy. The release of prolyl hydroxylase inhibitors was assessed by colorimetric and spectroscopic methods. Their ability to induce a cellular response was assessed in bioassays with gingival and periodontal ligament fibroblasts based on vascular endothelial growth factor production, proliferation, and metabolic activity of the cells. We found that loading of collagen barrier membranes with prolyl hydroxylase inhibitors did not change the overall membrane morphology. Assessment of the release kinetics by direct measurements and based on vascular endothelial growth factor production showed that supernatants obtained from the collagen barrier membranes in the first 6 hours had a sufficient level of prolyl hydroxylase inhibitors to induce vascular endothelial growth factor production. A similar kinetic was found when cell proliferation was assessed. Changes in metabolic activity did not reach the level of significance in the MTT assay. In conclusion, collagen barrier membranes can release prolyl hydroxylase inhibitors thereby increasing the pro-angiogenic capacity of periodontal cells in vitro. These findings provide the basis for preclinical studies to evaluate the regenerative capacity of prolyl hydroxylase inhibitors in periodontology and oral surgery.

Release kinetic of prolyl hydroxylase inhibitors from collagen barrier membranes in vitro

Searchable abstracts of presentations at key conferences on calcified tissues ISSN 2052-1219 (online)

Histological Evaluation of Degradable Guided Bone Regeneration Membranes Prepared from Poly(trimethylene carbonate) and Biphasic Calcium Phosphate Composites

SummaryIn oral and maxillofacial surgery, guided bone regeneration using barrier membranes is an important strategy to treat bone defects. The currently used barrier membranes have important disadvantages. Barrier membranes prepared from resorbable poly(trimethylene carbonate) (PTMC) performed as well as collagen barrier membranes. We hypothesized that composite membranes prepared from surface‐eroding PTMC and osteoinductive biphasic calcium phosphate (BCP) would enhance bone formation even further. Bicortical critical size defects in the mandibular angle of rats were covered on both sides with the membranes. After 2, 4, and 12 weeks the extent of bone formation in the defects and the soft tissue reaction towards the membranes was examined histologically. At 2 and 4 weeks, the formation of new bone was observed in defects covered with PTMC, PTMC‐BCP and Biogide collagen membranes. At 12 weeks, bone defects that were covered with PTMC membranes and control Biogide collagen membranes were fully filled with new formed bone. However, at this time point, defects covered with PTMC‐BCP composite membranes had not led to new bone in the defects. Instead a significant tissue reaction, likely to remaining BCP particles, was observed.

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

Collagen barrier membranes are used in guided bone regeneration/guided tissue regeneration because of their excellent bio- and cytocompatibility. However, they are considered to have limitations in clinical outcome because of rapid and unpredictable degradation profiles. The aim of this study was to investigate the degradation behavior of two porcine-based, non-cross-linked collagen membranes in vitro and in vivo. Remaix™ (RX; Matricel GmbH, Herzogenrath, Germany) and Bio-Gide® (BG; Geistlich Pharma AG, Wolhusen, Switzerland) membranes were characterized by testing mechanical strength, denaturation temperature, enzymatic degradation and hydroxyproline content in vitro (n = 5 up to 16). Thereafter, both membranes were implanted subcutaneously in rats (n = 20) for up to 20 weeks to investigate tissue compatibility with respect to membrane thickness. BG contained a significant higher hydroxyproline content compared with RX, but RX showed a higher stress at break (dry: 11.4 (SD 2.9) vs. 5.5 (SD 1.5) N/mm(2)), higher suture retention (wet: 5.6 (SD 1.3) vs. 2.7 (SD 0.7) N), increased denaturation temperature (55.1 (SD 1) vs. 49.4 (SD 0.6)°C) and an almost twofold reduction in degradation rate (15.6% (SEM 1.3)/h vs. 24.8% (SEM 2.9)/h) in vitro. In the rat model, both membranes showed excellent tissue compatibility without signs of inflammatory reactions. Shortly after implantation, RX and BG showed moderate infiltration of mononuclear cells that appeared not to be influenced by the surface texture of the membranes. In the histomorphometric analysis, both membranes showed significant different thickness over the 20 weeks period (P = 0.0002). Although the thickness remained almost stable during the first 9 weeks after implantation, after 20 weeks, the thickness of RX decreased only slightly, whereas BG showed a thickness loss of around 50% and stronger degradation than RX. Therefore, the higher stability of RX against biodegradation found in vitro was confirmed in the animal study. 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.

Physicochemical, Pharmacologic, and in Vitro Cellular Effects of Loading Collagen Membranes with Zoledronic Acid

There is a need for improved methods of reducing peri-implant bone loss. This study evaluated the structural, drug loading, drug release, and in vitro characteristics of collagen membranes impregnated with zoledronic acid (ZA). Two commercially available collagen barrier membranes (Bio-Gide and BME-10X) were loaded with ZA. The physicochemical and pharmacologic properties of the membranes were characterized with scanning electron microscopy, energy dispersive spectroscopy, Fourier transform infrared spectroscopy, and high-performance liquid chromatography. The ZA-loaded membrane's inhibition of osteoclasts and promotion of osteoblast growth was evaluated in vitro at ZA concentrations of 0, 10(-4), 10(-3), and 10(-2) mol/L. The disappearance of micropores between Bio-Gide collagen fibers and the formation of crystalloids on the surface of BME-10X membranes following ZA loading was evident under the microscope. Phosphorus was detected on the membranes, and amide shifts were observed. Greater amounts of ZA loading and slower ZA release were evident for Bio-Gide membranes. Osteoclast numbers were reduced with ZA, and a corresponding decrease in bone resorption was evident at higher ZA concentrations (P < .05). After 7 days, at a ZA concentration of 10(-3) mol/L, Bio-Gide membranes had an increased osteoblast proliferation index, while both types of membranes displayed increased alkaline phosphatase expression. Collagen membranes loaded with ZA provided delayed drug release. This study may offer a novel therapeutic strategy for minimizing peri-implant bone resorption.

Evaluation of a bioresorbable collagen membrane of fish origin in the treatment of periodontal intrabony defects: A prospective clinical study.

Recently, there has been interest in non-mammalian collagen sources such as fish collagen in the development of biomatrices and scaffolds for periodontal regeneration. In the present study, a novel collagen barrier membrane of fish origin was assessed in the treatment of periodontal intra-bony defects. Ten systemically healthy chronic periodontitis patients having an osseous defect in the mandibular posterior teeth were selected and following the open flap debridement, a collagen membrane was placed over the defect and the flap was sutured with interrupted sutures. Clinical parameters such as Plaque Index, Gingival Bleeding Index, probing pocket depth (PPD), relative attachment level (RAL), and recession (R) were recorded at baseline, 6 and 9 months, whereas radiographic evaluation was done to assess alveolar crestal bone level and defect depth fill at 6 and 9 months using Auto-computer aided design (ACAD) 2007 software. Statistical significance was set at 5% level of significance. There was statistical significant differences with respect to periodontal clinical parameters such as Plaque Index, Gingival Bleeding Index, PPD, RAL, and gingival recession assessed at baseline, at 6 and 9 months respectively (P < 0.05), and radiographic evaluation showed a defect fill of 58.62 median % at 9 months. This preliminary study has shown predictable results in using fish collagen membrane, for treating periodontal intra-bony defects. Further, long-term clinical trials are needed to validate the effectiveness of this membrane.

Clinical and radiographical evaluation of a bioresorbable collagen membrane of fish origin in the treatment of periodontal intrabony defects: A preliminary study.

Background:Recently, there has been interest in non-mammalian collagen sources such as fish collagen in periodontal regeneration. In the present study, collagen barrier membrane of fish origin was assessed in the treatment of periodontal intrabony defects.Materials and Methods:Ten systemically healthy chronic periodontitis patients having a paired osseous defect in the mandibular posterior teeth were selected and randomly assigned to receive a collagen membrane (test) or open flap debridement (control) in a split mouth design. Clinical parameters such as Plaque index, Gingival bleeding index, Probing pocket depth, Relative attachment level, and Recession were recorded at baseline, 3, 6, and at 9 months, while radiographic evaluation was done to assess alveolar crestal bone level and percentage of defect fill at 6 and 9 months using autoCAD 2007 software. Student's t test (two-tailed, dependent) was used to find the significance of study parameters on continuous scale. Significance was set at 5% level of significance. Wilcoxon signed rank test was used to find the significance of percentage change of defect fill.Results:The comparison between the two groups did not show any statistically significant differences in the parameters assessed (P > 0.05) but, within each group, clinical parameters showed statistically significant differences from baseline to 9 months (P < 0.05).Conclusion:Within the limits of the study, it can be inferred that no significant differences were found either by using collagen membrane of fish origin or open flap debridement in the treatment of periodontal intrabony defects.

Osteoblast proliferation and differentiation on a barrier membrane in combination with BMP2 and TGFβ1

Bioresorbable collagen membranes are routinely utilized in guided bone regeneration to selectively direct the growth and repopulation of bone cells in areas of insufficient volume. However, the exact nature by which alveolar osteoblasts react to barrier membranes as well as the effects following the addition of growth factors to the membranes are still poorly understood. The objective of the present study was therefore to investigate the effect of a bioresorbable collagen membrane soak-loaded in growth factors bone morphogenetic protein 2 (BMP2) or transforming growth factor β1 (TGFβ1) on osteoblast adhesion, proliferation, and differentiation. Prior to experimental seeding, membranes were soaked in either BMP2 or TGFβ1 at a concentration of 10ng/ml for 5min. Human osteoblasts adhered to all soak-loaded membranes as assessed by scanning electron microscopy. Growth factors BMP2 and TGFβ1 increased osteoblast proliferation at 3 or 5days post-seeding when compared to control collagen membranes. Analysis of real-time PCR revealed that administration of BMP2 increased osteoblast differentiation markers such as osterix, collagen I, and osteocalcin. BMP2 also increased mineralization of primary osteoblasts as demonstrated by alizarin red staining when compared to control and TGFβ1 soak-loaded membranes. The combination of a collagen barrier membrane with growth factors TGFβ1 and BMP2 significantly influenced adhesion, proliferation, and differentiation of primary human osteoblasts. The described in vitro effects following the combination of collagen barrier membranes with growth factors TGFβ1 and BMP2 provide further biologic support for the clinical application of this treatment strategy in guided bone regeneration procedures.

Periosteal Distraction Osteogenesis and Barrier Membrane Application: An Experimental Study in the Rat Calvaria

Distraction of the periosteum results in the formation of new bone in the gap between the periosteum and the original bone. We postulate that the use of a barrier membrane would be beneficial for new bone formation in periosteal distraction. To selectively influence the contribution of the periosteum, a distraction plate with perforations was used alone or covered by a collagen barrier membrane. All animals were subjected to a 7-day latency period and a 10-day distraction period with a rate of 0.1 mm/day. Four animals per group with or without a barrier membrane were sacrificed at 2, 4, and 6 weeks after the end of the distraction. The height of new bone generated relative to the areas bound by the parent bone and the periosteum was determined by histomorphometric methods. New bone was found in all groups. At the periphery of the distraction plate, significant differences in bone height were found between the hinge and the distraction screw for the group without barrier membrane at 2 weeks (0.39 ± 0.19 mm) compared to 4 weeks (0.84 ± 0.44 mm; P = 0.002) and 6 weeks (1.06 ± 0.39 mm; P = 0.004). Differences in maximum bone height with and without a barrier membrane were observed laterally to the distraction plate at 2 weeks (1.22 ± 0.64 versus 0.55 ± 0.14 mm; P = 0.019) and 6 weeks (1.61 ± 0.56 versus 0.73 ± 0.33 mm; P = 0.003) of the consolidation period. Within the limitations of the present study, the application of a barrier membrane may be considered beneficial for new bone formation induced by periosteal distraction.

Radiographic alveolar bone changes following ridge preservation with two different biomaterials

The aim of this randomized controlled trial was to evaluate radiographical bone changes following alveolar ridge preservation with a synthetic bone substitute or a bovine xenograft. Alveolar ridge preservation was performed in 27 patients randomized in two groups. In the test group (n=14), the extraction socket was treated with Straumann bone ceramic(®) (SBC) and a collagen barrier membrane (Bio-Gide(®)), whereas in the control group (n=13) with deproteinized bovine bone mineral and the same barrier. Standardized periapical X-rays were taken at 4 time points, BL: after tooth extraction, GR: immediately after socket grafting, 4M: 16 weeks, 8M: 32 weeks post-operatively. The levels of the alveolar bone crest at the mesial (Mh), and distal (Dh) and central aspects of the socket were measured at all time points. All the radiographs obtained were subtracted from the follow-up images. The gain, loss and unchanged areas in terms of grey values were tested for significant difference between the two groups. In the test group, the Mh and Dh showed a mean difference (± standard deviation) of 0.9 ± 1.2 and 0.7 ± 1.8 mm, respectively, among BL-8M. In the control group, the Mh and Dh showed a mean difference of 0.4 ± 1.3 and 0.7 ± 1.3 mm, respectively (P>0.05). Both treatments presented similar gain in grey values between BL-GR, BL-4M and BL-8M. The SBC presented less loss in grey values between BL-4M and BL-8M (P<0.05). Radiographic assessment underestimated the intrasurgical measurements (mesial and distal) of an average 0.3 mm (95% CI, 0.02-0.6). Both types of bone grafts presented similar radiographic alveolar bone changes when used for alveolar ridge preservation.

Effect of bovine bone and collagen membranes on healing of mandibular bone blocks: a prospective randomized controlled study

The aim of the present study was to evaluate if the use of deprotenized bovine bone mineral (DBBM) and collagen barrier membranes (CM) in combination with mandibular bone block grafts could reduce bone block graft resorption during healing. A prospective randomized controlled study has been designed. Twenty-two ridges presenting horizontal alveolar deficiency (crest width <4 mm) and at least two adjacent missing teeth were included in the study. In the control group, one or multiple mandibular blocks were used to gain horizontal augmentation of the ridge. In the test group, DBBM granules were added at the periphery and over the graft. The reconstructions were covered by two layers of CM. Implants were placed 4 months after grafting. Direct measurements of crest width were performed before and immediately after bone augmentation, and immediately before implant placement. Statistical analysis showed no significant differences in crest width between test and control groups at baseline and immediately after grafting. Mean augmentation at first surgery in the test group was 4.18 vs. 4.57 mm in the control group. Final gain obtained at the time of implant placement was 3.93 mm in the test and 3.67 mm in the control groups. The difference in mean graft resorption between test and control sites was statistically significant (0.25 mm in the test group vs. 0.89 mm in the control group, P=0.03). Complications seem to occur more often in the test group (complications recorded in three cases in the test group vs. one complication recorded in the control group). In all cases, implants could be placed in the planned sites and a total of 55 implants were placed (28 in the test group and 27 in the control group). All implants could be considered successfully integrated at the 24-month follow-up visit. The results from this study showed that the addition of bovine bone mineral and a CM around and over a mandibular bone block graft could minimize graft resorption during healing. On the other hand, the use of bone substitutes and barrier membranes in combination with block grafts increased the frequency of complications and the difficulty of their management.

In vivo degradation of collagen barrier membranes exposed to the oral cavity

The purpose of this human clinical trial was to compare the degradation profiles of three different collagen membranes under conditions mimicking exposure to the oral cavity. Three collagen membranes, ribose cross-linked (RCL), glutaraldehyde cross-linked (GCL), and non-cross-linked (NCL) were tested. The membranes were placed over the buccal mucosa of 20 human volunteers, apical to the gingival margins in the maxillary premolar and molar region. A periodontal dressing was placed over the membranes and secured in the interproximal spaces. The dressing was removed after 10 days, and membrane integrity was evaluated by two examiners using a Likert-like grading scale (grades 1-5). Eight subjects withdrew from the study due to discomfort, pain, or dislodging of the pack. Of the three membranes tested, RCL appeared to be the most resistant to degradation (median grade 5), compared with GCL (2.25) and NCL (1.75). Marked differences in membrane integrity were found between the three tested membranes after 10 days in the oral cavity. These differences may be part of the important factors determining the outcome of the regenerative treatment modality in cases of premature membrane exposure.

Clinical evaluation of particulate allogeneic with and without autogenous bone grafts and resorbable collagen membranes for bone augmentation of atrophic alveolar ridges

The evaluate the clinical outcome of bone augmentation with the use of particulate mineralized freeze-dried bone allograft (FDBA) with or without the addition of autogeneous bone chips, applied in a bi-layered (BL) technique, covered by a resorbable cross-linked collagen membrane. Fifty patients presenting with a vertical and/or lateral ridge deficiency of at least 3 mm were included: Group FDBA, N=27 patients, particulate FDBA was the only graft; and Group BL, N=23 patients, a BL bone grafting procedure where autogenous bone chips were the inner layer and FDBA the outer. Bone graft was covered with a ribose cross-linked collagen barrier membrane. Ridge dimensions were clinically or radiographically (computerized tomography scan) measured at the time of the bone augmentation procedure and at implant placement or uncovering and the maximum linear vertical or horizontal calcified tissue gain was calculated. Statistical analysis consisted of linear regression analysis, with maximum bone gain being the dependent variable. In the FDBA group, mean vertical bone gain was 3.47 mm (SD 1.25) and the horizontal, 5 mm (SD 1.28), while in the BL values were 3.5 mm (SD 1.2) and 3.6 mm (SD 1.72), respectively. Addition of autogenous bone does not appear to statistically significantly enhance the results. Spontaneous membrane exposure occurred in 24% of the cases and was the only variant that significantly influenced results (P<0.001). Large vertical and/or horizontal ridge deficiencies may be treated with FDBA and ribose cross-linked collagen barrier membranes with good clinical outcome. No added effect of the application of a layer of autogenous bone in these bone augmentation procedures could be demonstrated. Spontaneous membrane exposure was the only parameter to affect the degree of new calcified tissue formation.

Collagen barrier membranes decrease osteoclastogenesis in murine bone marrow cultures

Collagen barrier membranes (CBM) are used for guided bone regeneration to support the process of graft consolidation. It remains, unknown however, whether CBM can affect the consolidation of bone grafts by controlling the differentiation of progenitor cells into bone-resorbing osteoclasts and bone-forming osteoblasts. To gain an insight into the underlying mechanisms, we performed in vitro bone marrow cultures on CBM (Bio-Gide under conditions that favor osteoclastogenesis and osteoblastogenesis, respectively. Measures of osteoclastogenesis were based on the number of tartrate-resistant acid-phosphatase-positive (TRAP+) multinucleated cells. Resorption assays revealed the activity of mature osteoclasts. Osteoblastogenesis was determined by alkaline-phosphatase activity. Viability was investigated utilizing the MTT assay. Cultivation of murine bone marrow on CBM reduced the number of TRAP+ multinucleated cells compared with cultures on tissue culture plates. Inhibition of osteoclastogenesis was observed on the porous and the dense CBM surfaces. The majority of TRAP+ cells were mononucleated and the decreased osteoclastogenesis was not due to changes in cell viability. Furthermore, CBM are inert regarding the resorptive activity of mature osteoclasts. Moreover, osteoblastogenesis was not reduced when bone marrow cells were grown on the surface of CBM. These in vitro findings demonstrate that CBM can reduce the formation but not the activity of multinucleated osteoclasts. Our data further reveal that the formation of osteogenic cells from their progenitors is not reduced by the CBM. Overall, our results suggest that the beneficial effects of CBM during graft consolidation may involve their direct impact on osteoclastogenesis.