![]() ![]() Studies using a barrier membrane for treatment of periodontal defects, peri-implantitis, and periapical lesions were excluded. The search strategy was limited to in vitro, in vivo, and human studies that reported data on GBR. Articles that were published before 16 June 2016 were included. ![]() The survey was supplemented by cross-checking the bibliographies of relevant review articles. Literature search and inclusion criteriaĪ survey of the literature, without limitation regarding the year of publication, was conducted using the medical databases MEDLINE/PubMed. The aims of this review were: (i) to provide a comprehensive overview of attempted modifications of membrane properties and the resulting biological effects and (ii) to provide a critical assessment of the biological mechanisms governing bone regeneration in defects covered by membranes. a predictable regeneration of bone, adequate soft-tissue reactions, and efficient handling of microbial adhesion and colonization during GBR treatment). Here, many of the future strategies involve modifications of the membrane to promote appropriate responses (e.g. The major components of the treatment with GBR are the membrane properties and the biological responses 6. Furthermore, the use of membranes in the defect, together with bone grafts and substitute materials, is now commonly used to provide structural support to the defect site and to promote the intrinsic regenerative potential of the host tissue. Recently, efforts have been made to develop a new generation of membranes by using naturally derived membranes or employing principles of tissue engineering during membrane preparation 17, 18. Subsequently, a second generation of membranes made of resorbable materials was developed and became widely used in different clinical situations. However, non-resorbable membranes need a second surgical intervention for membrane removal. In general, these types of membrane demonstrate biocompatibility and space-making capacity 16. Non-resorbable membranes, mainly polytetrafluoroethylene (PTFE) in its expanded form (e-PTFE), constituted the first generation of barrier membranes. The desirable characteristics of the membrane utilized for GBR therapy include biocompatibility, cell-occlusion properties, integration by the host tissues, clinical manageability, space-making ability, and adequate mechanical and physical properties. Different materials and modifications thereof have been used (Table 1). The membrane used for GBR is an essential component of the treatment. The survival rate of implants placed in augmented sites varied between 79% and 100%, with the majority of studies indicating a survival rate of more than 90% after at least 1 yr of function 15. Several reports have indicated that the survival rates of implants placed in the sites augmented by GBR are similar to those reported for implants placed in pristine sites 3, 13, 14. It has been estimated that up to 40% of osseointegrated implants require GBR as part of the patient's rehabilitation 12. Guided bone regeneration is presumed to be achieved when the osteoprogenitor cells are exclusively allowed to repopulate the bone defect site by preventing the entry of non-osteogenic tissues 10, 11. The optimization of membrane materials by systematically addressing both the barrier and the bioactive properties is an important strategy in this field of research. Novel experimental findings also suggest an active role of the membrane compartment per se in promoting the regenerative processes in the underlying defect during GBR, instead of being purely a passive barrier. ![]() ![]() Nevertheless, the precise role of membrane porosities for the barrier function of GBR membranes still awaits elucidation. Experimental data suggest that different modifications of the physicochemical and mechanical properties of membranes may promote bone regeneration. The relevant literature for this narrative review was assessed after a MEDLINE/PubMed database search. This prompts the need for an update on membrane properties and the biological outcomes, as well as a critical assessment of the biological mechanisms governing bone regeneration in defects covered by membranes. A large number of membranes have been introduced for experimental and clinical verification. Membrane materials possess a number of properties which are amenable to modification. The application of a membrane to exclude non-osteogenic tissues from interfering with bone regeneration is a key principle of GBR. Guided bone regeneration (GBR) is commonly used in combination with the installment of titanium implants. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |