Research

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8 pages, 1800 KiB

Open AccessArticle

Effectiveness of Collagen Membrane in the Treatment of Schneiderian Membrane Perforation

by Jae-Yeol Lee, Jin-Ju Kwon, George K. Sándor and Yong-Deok Kim

Appl. Sci. 2019, 9(7), 1514; https://doi.org/10.3390/app9071514 - 11 Apr 2019

Cited by 3 | Viewed by 4529

Schneiderian membrane perforation (SMP) is the most common complication encountered during sinus lift procedures. SMPs should be managed to prevent loss of the valuable bone graft and bone substitute materials. A fast-resorbing collagen membrane (CM) is a soft, white, pliable, and nonfriable sponge [...] Read more.

Schneiderian membrane perforation (SMP) is the most common complication encountered during sinus lift procedures. SMPs should be managed to prevent loss of the valuable bone graft and bone substitute materials. A fast-resorbing collagen membrane (CM) is a soft, white, pliable, and nonfriable sponge used in dental surgery. The purpose of this study was to evaluate the clinical outcomes of SMP repair using CMs when an SMP had occurred during a sinus lifting procedure. The patients were divided into three groups according to the size of the SMPs during the sinus lift procedure. (A) Group 1: there was no perforation of the Schneiderian membrane but the membrane was weakened (or thinned) and repaired using CMs. (B) Group 2: the SMP was small to medium in size (< 10 mm) and repaired using CMs and fibrin adhesive (FA). (C) Group 3: the SMP was large in size (> 10 mm) and repaired using a collagen plug. The negative control group consisted of patients who did not have any SMP (Control) and these patients were randomly selected. Orthopantomographic X-rays taken before surgery, 2–3 days following surgery, and over 6 months after surgery (follow-up) were used to evaluate the acquired bone height according to groups. Bone heights were measured from the crestal bone at the planned implant placement sites. Clinical outcomes, including implant success and complications according to repair method, were also investigated. There was no significant difference in bone heights between the groups with the exception of group 3. The overall implant survival rate was 100% for implants placed in sinuses with frank SMPs or weakened sinus membranes. The CM is applicable for small-to-moderate perforations or sinus membranes which have been weakened or thinned during sinus lift procedures. Full article

(This article belongs to the Special Issue Development of Membranes for Oral and Maxillofacial Application)

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10 pages, 789 KiB

Open AccessArticle

Clinical Study for Silk Mat Application into Extraction Socket: A Split-Mouth, Randomized Clinical Trial

by Ju-Won Kim, You-Young Jo, Jwa-Young Kim, Ji-hyeon Oh, Byoung-Eun Yang and Seong-Gon Kim

Appl. Sci. 2019, 9(6), 1208; https://doi.org/10.3390/app9061208 - 22 Mar 2019

Cited by 6 | Viewed by 2406

Abstract

Silk mat originates from the cocoon of the silkworm and is prepared by a simple method. The material has been used for guided bone regeneration (GBR) in animal models. In this study, the silk mat used for a clinical application was compared with [...] Read more.

Silk mat originates from the cocoon of the silkworm and is prepared by a simple method. The material has been used for guided bone regeneration (GBR) in animal models. In this study, the silk mat used for a clinical application was compared with a commercially available membrane for GBR. A prospective split-mouth, randomized clinical trial was conducted with 25 patients who had bilaterally impacted lower third molars. High-density polytetrafluoroethylene (dPTFE) membrane or silk mat was applied in the extraction socket randomly. Probing depth (PD), clinical attachment level (CAL), and bone gain (BG) were measured at the time of extraction (T0) and then at three months (T1) and six months after extraction (T2). There was no missing case. GBR with silk mat was non-inferior to GBR with dPTFE for PD reduction at T1 and T2 (p_{non-inferiority} < 0.001). PD and CAL were significantly decreased at T1 and T2 when compared with those at T0 in both membrane groups (p < 0.001). BG at T2 was 3.61 ± 3.33 mm and 3.56 ± 3.30 mm in the silk mat group and dPTFE group, respectively. There was no significant complication from the use of silk mat for the patients. The results for patients undergoing GBR with silk mat for third-molar surgery were non-inferior to GBR with dPTFE for PD reduction. Full article

(This article belongs to the Special Issue Development of Membranes for Oral and Maxillofacial Application)

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15 pages, 5858 KiB

Open AccessArticle

PRGF-Modified Collagen Membranes for Guided Bone Regeneration: Spectroscopic, Microscopic and Nano-Mechanical Investigations

by Cristian Ratiu, Marcel Brocks, Traian Costea, Liviu Moldovan and Simona Cavalu

Appl. Sci. 2019, 9(5), 1035; https://doi.org/10.3390/app9051035 - 12 Mar 2019

Cited by 26 | Viewed by 4119

Abstract

The aim of our study was to evaluate the properties of different commercially available resorbable collagen membranes for guided bone regeneration, upon addition of plasma rich in growth factors (PRGF). The structural and morphological details, mechanical properties, and enzymatic degradation were investigated in [...] Read more.

The aim of our study was to evaluate the properties of different commercially available resorbable collagen membranes for guided bone regeneration, upon addition of plasma rich in growth factors (PRGF). The structural and morphological details, mechanical properties, and enzymatic degradation were investigated in a new approach, providing clinicians with new data in order to help them in a successful comparison and better selection of membranes with respect to their placement and working condition. Particular characteristics such as porosity, fiber density, and surface topography may influence the mechanical behavior and performances of the membranes, as revealed by SEM/AFM and nanoindentation measurements. The mechanical properties and enzymatic degradation of the membranes were analyzed in a comparative manner, before and after PRGF-modification. The changes in Young modulus values are correlated with the ultrastructural properties of each membrane type. The enzymatic (trypsin) degradation test also emphasized that PRGF-modified membranes exhibit a slower degradation compared to the native ones. Full article

(This article belongs to the Special Issue Development of Membranes for Oral and Maxillofacial Application)

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15 pages, 4309 KiB

Open AccessArticle

Angioplasty Using 4-Hexylresorcinol-Incorporated Silk Vascular Patch in Rat Carotid Defect Model

by Chan-Woo Kim, Min-Keun Kim, Seong-Gon Kim, Young-Wook Park, Yong-Tae Park, Dae-Won Kim and Hyun Seok

Appl. Sci. 2018, 8(12), 2388; https://doi.org/10.3390/app8122388 - 26 Nov 2018

Cited by 7 | Viewed by 2990

Abstract

The aim of this study was to evaluate and compare the efficacy of 4-hexylresorcinol (4-HR)-incorporated silk as a vascular patch scaffold to that of the commercial polytetrafluoroethylene (PTFE) vascular patch (GORE^® ACUSEAL). The expression of the vascular endothelial cell growth factor-A (VEGF-A) [...] Read more.

The aim of this study was to evaluate and compare the efficacy of 4-hexylresorcinol (4-HR)-incorporated silk as a vascular patch scaffold to that of the commercial polytetrafluoroethylene (PTFE) vascular patch (GORE^® ACUSEAL). The expression of the vascular endothelial cell growth factor-A (VEGF-A) after application of 4-HR was studied in RAW264.7 and HUVEC cells. In the animal study, a carotid artery defect was modeled in Sprague Dawley rats (n = 30). The defect was directly closed in the control group (n = 10), or repaired with the PTFE or 4-HR silk patch in the experimental groups (n = 10 per group). Following patch angioplasty, angiography was performed and the peak systolic velocity (PSV) was measured to evaluate the artery patency. The application of 4-HR was shown to increase the expression of VEGF-A in RAW264.7 and HUVEC cells. The successful artery patency rate was 80% for the 4-HR silk group, 30% for the PTFE group, and 60% for the control group. The PSV of the 4-HR silk group was significantly different from that of the control group at one week and three weeks post-angioplasty (p = 0.005 and 0.024). Histological examination revealed new regeneration of the arterial wall, and that the arterial diameter was well maintained in the 4-HR silk group in the absence of an immune reaction. In contrast, an overgrowth of endothelium was observed in the PTFE group. In this study, the 4-HR silk patch was successfully used as a vascular patch, and achieved a higher vessel patency rate and lower PSV than the PTFE patch. Full article

(This article belongs to the Special Issue Development of Membranes for Oral and Maxillofacial Application)

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8 pages, 1678 KiB

Open AccessArticle

Efficacy of Collagen-Based Membranes in Alveolar Bone Augmentation

by Na-Rae Choi, George K. Sándor and Yong-Deok Kim

Appl. Sci. 2018, 8(11), 2048; https://doi.org/10.3390/app8112048 - 25 Oct 2018

Cited by 5 | Viewed by 3629

Abstract

Collagen-based membranes (CBMs) have similar permissive bone formation capabilities when compared to non-absorbable membranes. CBMs have been classified as non-cross-linked membranes (NCLMs) and cross-linked membranes (CLMs) depending on whether the cross-linking between the collagen fibers was artificially increased. The purpose of this study [...] Read more.

Collagen-based membranes (CBMs) have similar permissive bone formation capabilities when compared to non-absorbable membranes. CBMs have been classified as non-cross-linked membranes (NCLMs) and cross-linked membranes (CLMs) depending on whether the cross-linking between the collagen fibers was artificially increased. The purpose of this study is to evaluate the bone maintenance capacity between NCLMs and CLMs by comparing resorption of regenerated bone. The inclusion criteria consisted of: (1) The use of a CBM, either being an NCLM or CLM for coverage of grafted bone; (2) follow-up for more than one year; (3) the presence of the patient's orthopantomographic X-ray (OPTG) immediately following the installation of implants and one year after. The bone resorption observed in the OPTG was determined by measuring the number of exposed threads of the implant. The number of thread exposures in the implant was compared according to CBM types. OPTGs taken immediately following the installation of implants and at one year after installation were compared. The subject of the measurement was always the implant in which the greatest number of exposed threads were present in each patient. A total of 56 subjects and 97 implants were used in this study. There was no significant difference between NCLM and CLM groups (p > 0.05). However, there was a statistically significant difference (p = 0.02) between the groups when a bone graft was applied to both the maxilla and the mandible. The average number of thread exposures was less than 1.5. In this study, no comparison was made between commonly known causes of bone loss and membrane types. Full article

(This article belongs to the Special Issue Development of Membranes for Oral and Maxillofacial Application)

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18 pages, 5307 KiB

Open AccessFeature PaperArticle

Volumetric, Radiographic, and Histologic Analyses of Demineralized Dentin Matrix Combined with Recombinant Human Bone Morphogenetic Protein-2 for Ridge Preservation: A Prospective Randomized Controlled Trial in Comparison with Xenograft

by Gyu-Un Jung, Tae-Hyun Jeon, Mong-Hun Kang, In-Woong Um, In-Seok Song, Jae-Jun Ryu and Sang-Ho Jun

Appl. Sci. 2018, 8(8), 1288; https://doi.org/10.3390/app8081288 - 02 Aug 2018

Cited by 21 | Viewed by 4897

Abstract

The aim of this study was to evaluate the clinical, volumetric, radiographic, and histologic aspects of autogenous demineralized dentin matrix (DDM) combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) used for ridge preservation, compared to those of deproteinized bovine bone with collagen (DBBC). [...] Read more.

The aim of this study was to evaluate the clinical, volumetric, radiographic, and histologic aspects of autogenous demineralized dentin matrix (DDM) combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) used for ridge preservation, compared to those of deproteinized bovine bone with collagen (DBBC). Following atraumatic extraction, the socket was filled with DBBC, DDM, or rhBMP-2/DDM. Scanned images of dental casts and cone beam computed tomographs (CBCT) were superimposed for the calculation of soft and hard tissue volume alteration. Preoperative and postoperative measurements of the height and width of the alveolar ridge were compared using CBCT images. After 4 months, bone specimens were harvested for histomorphometric assessment. Loss of hard and soft tissue volume occurred at 4 months after extraction and ridge preservation in all groups. No volumetric differences were detected among the three groups before and 4 months after ridge preservation. The reduction in the horizontal width at 5 mm was higher in the DBBC compared to the DDM. Histologically, approximately 40% newly formed bone was founded in rhBMP-2/DDM group. The autogenous dentin matrix used to fill the socket was as beneficial for ridge preservation as conventional xenografts. The combination of rhBMP-2 with dentin matrix also demonstrated appreciable volumetric stability and higher new bone formation compared to DDM alone and DBBC. Full article

(This article belongs to the Special Issue Development of Membranes for Oral and Maxillofacial Application)

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Review

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19 pages, 578 KiB

Open AccessReview

Past, Present, and Future of Regeneration Therapy in Oral and Periodontal Tissue: A Review

by Hwa-Sun Lee, Soo-Hwan Byun, Seoung-Won Cho and Byoung-Eun Yang

Appl. Sci. 2019, 9(6), 1046; https://doi.org/10.3390/app9061046 - 13 Mar 2019

Cited by 25 | Viewed by 5255

Abstract

Chronic periodontitis is the most common disease which induces oral tissue destruction. The goal of periodontal treatment is to reduce inflammation and regenerate the defects. As the structure of periodontium is composed of four types of different tissue (cementum, alveolar bone periodontal ligament, [...] Read more.

Chronic periodontitis is the most common disease which induces oral tissue destruction. The goal of periodontal treatment is to reduce inflammation and regenerate the defects. As the structure of periodontium is composed of four types of different tissue (cementum, alveolar bone periodontal ligament, and gingiva), the regeneration should allow different cell proliferation in the separated spaces. Guided tissue regeneration (GTR) and guided bone regeneration (GBR) were introduced to prevent epithelial growth into the alveolar bone space. In the past, non-absorbable membranes with basic functions such as space maintenance were used with bone graft materials. Due to several limitations of the non-absorbable membranes, membranes of the second and third generation equipped with controlled absorbability, and a functional layer releasing growth factors or antimicrobials were introduced. Moreover, tissue engineering using biomaterials enabled faster and more stable tissue regeneration. The scaffold with three-dimensional structures manufactured by computer-aided design and manufacturing (CAD/CAM) showed high biocompatibility, and promoted cell infiltration and revascularization. In the future, using the cell sheath, pre-vascularizing and bioprinting techniques will be applied to the membrane to mimic the original tissue itself. The aim of the review was not only to understand the past and the present trends of GTR and GBR, but also to be used as a guide for a proper future of regeneration therapy in the oral region. Full article

(This article belongs to the Special Issue Development of Membranes for Oral and Maxillofacial Application)

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10 pages, 842 KiB

Open AccessReview

New Resorbable Membrane Materials for Guided Bone Regeneration

by You-Young Jo and Ji-Hyeon Oh

Appl. Sci. 2018, 8(11), 2157; https://doi.org/10.3390/app8112157 - 04 Nov 2018

Cited by 16 | Viewed by 5016

Abstract

Membranes are used for guided bone regeneration (GBR) in bone defects. Resorbable membranes of collagen or aliphatic polyesters that do not require secondary surgery for removal, unlike non-resorbable membranes, have been marketed for GBR. Platelet rich fibrin membrane and silk-based membranes have recently [...] Read more.

Membranes are used for guided bone regeneration (GBR) in bone defects. Resorbable membranes of collagen or aliphatic polyesters that do not require secondary surgery for removal, unlike non-resorbable membranes, have been marketed for GBR. Platelet rich fibrin membrane and silk-based membranes have recently been assessed as membranes for GBR. Studies have been conducted on resorbable membranes with new materials to improve physical properties and bone regeneration without any adverse inflammatory reactions. However, clinical research data remain limited. More studies are needed to commercialize such membranes. Full article

(This article belongs to the Special Issue Development of Membranes for Oral and Maxillofacial Application)

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17 pages, 4685 KiB

Open AccessReview

Silk Protein-Based Membrane for Guided Bone Regeneration

by Kwang-Jun Kwon and Hyun Seok

Appl. Sci. 2018, 8(8), 1214; https://doi.org/10.3390/app8081214 - 24 Jul 2018

Cited by 31 | Viewed by 4750

Abstract

Silk derived from the silkworm is known for its excellent biological and mechanical properties. It has been used in various fields as a biomaterial, especially in bone tissue engineering scaffolding. Recently, silk protein-based biomaterial has been used as a barrier membrane scaffolding for [...] Read more.

Silk derived from the silkworm is known for its excellent biological and mechanical properties. It has been used in various fields as a biomaterial, especially in bone tissue engineering scaffolding. Recently, silk protein-based biomaterial has been used as a barrier membrane scaffolding for guided bone regeneration (GBR). GBR promotes bone regeneration in bone defect areas using special barrier membranes. GBR membranes should have biocompatibility, biodegradability, cell occlusion, the mechanical properties of space-making, and easy clinical handling. Silk-based biomaterial has excellent biologic and mechanical properties that make it a good candidate to be used as GBR membranes. Recently, various forms of silk protein-based membranes have been introduced, demonstrating excellent bone regeneration ability, including osteogenic cell proliferation and osteogenic gene expression, and promoting new bone regeneration in vivo. In this article, we introduced the characteristics of silk protein as bone tissue engineering scaffolding and the recent application of such silk material as a GBR membrane. We also suggested future studies exploring additional uses of silk-based materials as GBR membranes. Full article

(This article belongs to the Special Issue Development of Membranes for Oral and Maxillofacial Application)

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