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Resorbability and histological reaction of bioabsorbable membranes  

Suk, Hun-Joo (Department of Periodontology, College of Dentisty, Yonsei University, Research Institute for Periodontal Regeneration)
Kwon, Suk-Hoon (Department of Periodontology, College of Dentisty, Yonsei University, Research Institute for Periodontal Regeneration)
Kim, Chang-Sung (Department of Periodontology, College of Dentisty, Yonsei University, Research Institute for Periodontal Regeneration)
Choi, Seong-Ho (Department of Periodontology, College of Dentisty, Yonsei University, Research Institute for Periodontal Regeneration)
Jeon, Dong-Won (Department of Clothing & Textiles, Ewha Womans University)
Kim, Chong-Kwan (Department of Periodontology, College of Dentisty, Yonsei University, Research Institute for Periodontal Regeneration)
Publication Information
Journal of Periodontal and Implant Science / v.32, no.4, 2002 , pp. 781-800 More about this Journal
Abstract
The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. With the development of non-resorbable membrane, GTR has proved to be the representive technique of periodontal regeneration. However, due to various clinical problems of non-resorbable membrane, resorbable membrane was developed and it showed to be clinically effective. The newly developed Para-Dioxanone membrane has a characteristic of non-woven fabric structures which is different from the generally used membranes with structure of mesh form. In addition, Chitosan membrane has been developed to apply its adventage maximally in GTR. Although a number of different types of membranes had been clinically used, researches on absorption rate of membranes were inadequate and limited to subjective opinions. However, since long term period of resorption and space maintenance are required in implant or ridge augmentation, accurate verification of resorption rate is clinically important. In this study, we had implanted Resolut(R), Biomesh(R), Para-Dioxanone membrane and Chitosan membrane (Size : 4mm ${\times}$ 4mm) on dorsal side of Sprague Dawley rat, and sacrified them after 4 weeks, 8 weeks, 12 weeks respectively. Histologic observation was carried out, and the following results were obtained by calculating the objective resorption rate. 1. In case of Resolut(R), external resorption took place initially, followed by internal resorption. Surface area are 5.76${\pm}$2.37$mm^2$, 4.90${\pm}$l.06$mm^2$, 4.90${\pm}$0.98$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.6${\pm}$4.5%, 52.8${\pm}$9.4%, 56.4${\pm}$5.1% respectively. 2. Biomesh(R) showed a pattern of folding, relatively slow resorption rate with small size of membrane. Surface area are 3.62${\pm}$0.82$mm^2$, 3.63${\pm}$0.76$mm^2$, 4.07${\pm}$1.14$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 26.1${\pm}$5.8%, 30.9${\pm}$3.4%, 29.2${\pm}$3.6%, respectively. 3. Para-Dioxanone membrane was surrounded by fibrous conncetive tissue externally, and resorption took place internally and externally. Surface area are 5.96${\pm}$1.05$mm^2$, 4.77${\pm}$10.76$mm^2$, 3.86${\pm}$0.84$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 30.7${\pm}$5.1%, 53.3${\pm}$4.4%, 69.5${\pm}$3.1%, respectively. 4. Each fiber of Chitosan membrane was surrounded by connective tissue and showed external resorption pattern. It showed little invasion of inflammatory cells and excellent biocompatability. The resorption rate was relatively slow. Surface area are 6.01${\pm}$2.01$mm^2$, 5.49${\pm}$1.3$mm^2$, 5.06${\pm}$1.38$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.3${\pm}$3.6%, 38.4${\pm}$3.80%, 39.7${\pm}$5.6%, respectively. Consequently, Para-Dioxanone membrane and Chitosan membrane are found to be clinically effective for their excellent tissue reaction and biocompatibility. Futhermore, the advantage of bone regenerating ability as well as the relatively long resorption period of Chitosan membrane, it might be widely used in implant or ridge augmentation.
Keywords
GTR; resorbable membrane; chitosan membrane; resorption rate;
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1 Wikesjo UME, Nilveus RE, Selvig KA : Significanceof early healing events on periodontal repair. A review, J Periodontol, 1992;158-165
2 Becker W, Becker BE, Prichard JF, Caffesse R, Rosenberg E, Gian-Grasso J : Root isolation for new attachment procedures: A surgical and suturing method: Three case reports, J Clin Periodontol, 1987;58(12): 819-826   DOI
3 Pontoriero R, Lindhe J, Nyman S, Karring T, Rosenberg E, Sanavi F : Guided tissue regeneration in the treatment of furcation defects in mandibular molars. A clinical study of degree III involvernents. J Clin Periodontol, 1989;16(3):170-174   DOI
4 Simon M, Baldoni M, Rossi P, Zaffe D : A comparative study of the effectiveness of e-PTFE membranes with and without early exposure during the healing period, Int J Periodontics Restorative Dent, 1994;14: 167-180
5 Milella E, Ramires PA, Brescia E, La Sala G, Di Paola L, Bruno V: Physicochemical, mechanical, and biological properties of commercial membranes for GTR, J Biomedical Materials Res, 2001;58(4): 427-35   DOI   ScienceOn
6 Peleg M, Chaushu G, Blinder D, Taicher S : Use of lyodura for bone augmentation of osseous defects around dental implant, J Periodontol, 1999;70: 853-860   DOI
7 권석훈, 김종관, 문익상: 백서 두개골 실험적 결손부에서 Para-Dioxanone 차단막의 골조직 재생 효과, 대한 치주과학회지 계제 예정
8 서종진, 정예진, 최병갑, 최성호, 조규성: 골내 치주낭에 $Biomesh^{\circledR}$ 차단막과 자가골이식의 치료 효과에 대한 연구, 대한치주과학회지, 2000;30:779-792
9 Klokkevold PR, Fukayama H, Sung EC, Bertolami CN: The effect of chitosan (poly-Nacetyl glucosamine) on lingual hemostasis in heparinized rabbits, J Oral Maxillofac Surg, 1999;57: 49-52   DOI   ScienceOn
10 Muzzarelli RA, Baldassarre M, Conti F, Ferrara P, Biagini B: Biological activity of chitosan:Ultrastructural study, Biomaterials, 1988;9: 247-252   DOI   ScienceOn
11 Balassa LL, Prudden JF : Applications of chitin and chitosan in wound healing acceleration, In: Muzzarelli R.A., Pariser E.R., eds, Proceedings of the 1st International Conference on Chitin and Chitosan, Cambridge, MA: MIT Press, 1978
12 Muzzarelli RA, Biagini G, Pugnaloni A, Filippini O, Baldassarre V: Reconstruction of parodontal tissue with chitosan, Biomaterials, 1989;10: 598-603   DOI   ScienceOn
13 Nyman S, Gottlow J, Lindhe J , Karring T, Wennstrom J: New attachment formation by guided tissue regeneration, J Periodont Res, 1987;22(3): 252-254
14 Araujo MG, Berblundh T, Lindhe J : GTR treatment of degree III furcation defects with 2 different resorbable barriers. An experimental study in dogs, J Clin Periodontol, 1998;25: 253-259   DOI   ScienceOn
15 Muzzarelli RA, Biagini G, Bellardini M, Simonelli L, Castaldini C, Fratto G: Osteoconduction exerted by methylpyrrolidinone chitosan used in dental surgery, Biomaterials, 1993;14: 39-43   DOI   ScienceOn
16 Wang HL, O'Neal RH, Thomas CL, Shyr Y, MacNeil RL : Evaluation of an absorbable collagen membrane in treating class II furcation defect, J Periodontol, 1994;65 : 1029-1036   DOI   ScienceOn
17 Kind GM, Bind SD, Staren ED, Templeton AJ, Economou SG: Chitosan: Evaluation of a new hemostatic agent, Curr Surg, 1990;47: 37-39   PUBMED
18 Minabe M : Acritical review for the biologic rational for guided tissue regeneration, J Periodontol, 1991;62:171-179   DOI
19 Magnusson I, Batich C, Collins BR, : New attachment formation following controlled tissue regeneration using biodegradable membranes, J Periexlontol, 1988;59: 1-6   DOI
20 백정원, 이현정, 유윤정, 조규성, 김종관, 최성호 : 키토산이 치주인대 섬유아세포에 미치는 영향, 대한치주과학회지, 2001;31(4) : 823-832   과학기술학회마을
21 류인철, 구영. 정종평, 한수부, 최상묵 : Poly(alpha-hydroxy acid~)제 제 생분해성 차폐막의 치주조직 재생 유도 능력에 관한 조직학적 장기 관찰, 대한 치주과학회지, 1997;27(3) : 633-645
22 Melcher AH: On the repair potential of periodontal tissues, J Periodontol, 1976;47(5):256-260   DOI
23 Aukhil I, Iglhaut J : Periodontal ligament cell kinetics following experimental regeneration procedure, J Clin Periodontol, 1988;15: 374-382   DOI   PUBMED
24 이학철, 한승민, 설양조, 이철우, 엄홍식, 장범석, 정종평, 한수부: 2급 치근 분지부 병소에서의 생분해성 차폐막의 효과, 대한치주과학회지, 1999;29: 539-552
25 Aspinall GO : The polysaccharides. Chitin and chitosan. New York: Academic Press , Inc.1983;2: 386
26 Lee ML, Park YJ, Lee SJ, Ku Y, Han SB, Choi SM, Klokkevold PR, Chung CP : Tissue Engineered Bone formation Using chitosan/tricalcium phosphate sponges, J Periodontol, 2000;71(3): 410-417   DOI   ScienceOn
27 Simon M, Trisi P, Maglione M, Piatelli A : Bacterial penetration in vitro throuth GTAM membrane with and without topical chlorhexidine application. A light and scanning electron microscopic study. J Clin Periodontol, 1995;22: 321-331   DOI   ScienceOn
28 Takata T, Wang HL, Miyauchi M : Attachment, proliferation and differentiation of periodontal ligament cells on various guided tissue regeneration membranes, J Perio Res, 2001;36(5): 322-7   DOI   ScienceOn
29 Lee ML, Park YJ, Lee SJ, Ku Y, Han SB, Choi SM, Klokkevold PR, Chung CP : The Bone Regenerative effect of platalet-derived growth factor-BB delivered with a Chitosan/Tricalcium phosphate sponge carrier, J Periodontal, 2000;71(3): 418-424
30 Sapelli PL, Baldassare V, Muzzarelli RA, Emanuelli M: Chitosan in dentistry, Chitin in Nature and Technology, 1986;507-512
31 Donos N, Kostopoulos L, Karring T : Alveolar ridge augmentation using a resorbable copolymer membrane and autogenous bone grafts. An experimental study in the rat, Clin Oral Implants Res 2002;13(2): 203-13   DOI   ScienceOn
32 Sculean A, Donos N, Miliauskaite N, Arweiler N, Brecx M : Treatment of intrabony defects with enamel matrix proteins or bioabsorbable membranes. A 4-year follow-up split-mouth study, J Periodontol, 2001;72(12): 1695-1701   DOI   ScienceOn
33 Wang HL, Miyauchi M, Takata T : Initial attachment of osteoblasts to various guided bone regeneration membranes: an in vitro study, J Perio Res 2002;37(5): 340-4   DOI   ScienceOn
34 Sandford PA : Chitosan: Commercial uses and potential applications, In: Skjak-Braek G, Anthonsen T, Sandford P, eds, Chitin and Chitosan. London: Elsevier Applied Science, 1989;51-70
35 Nyman S, Lindhe J, Karring T, Rylander H: New attachment following surgical treatment of human periodontal disease, J Clin Periodontol, 1982;9(4): 290-296   DOI   PUBMED
36 Caffesse RG, Nasjleti CE., Morrison EC, Sanchez R : Guided tissue regeneration: Comparison of bioabsorbable and non-bioabsorbable membranes. Histologic and histometric study in dogs, J Periodontol, 1994;65: 583-591   DOI   ScienceOn
37 Klokkevold PR, Lew DS, Ellis DG, Bertolami CN: Effect of chitosan on lingual hemostasis in rabbits, J Oral Maxillofac Surg, 1991;49: 858-863   DOI   ScienceOn
38 Caffesse RG, Smith BA, Castelli WA, Nasjleti CE : New attachment achieved by guided tissue regeneration in beagle dogs, J Periodontol, 1988;59(9): 589-594   DOI
39 허지선, 김현영, 김창성, 최성호, 조규성, 채중규, 김종관 : Polylactic/polyglycolic copolymer 차단막의 이개부 병소의 치유 효과, 대한치주과학회지, 2001;31(2) : 345-356
40 Gottlow J, Karring T: Maintenance of new attachment gained through guided tissue regeneration. J Clin Periodontol, 1992;19(5):315-317   DOI
41 계승범, 손성희, 최상묵: Chitosan과 chitosan-cellulose를 이용한 차폐막의 골조직 재생유도능력에 관한 연구, 대한치주과학회지, 1998;28: 611-630
42 Reynolds BL: Wound healing III: Artificial maturation of arrested regenerate with an acetylated amino sugar, Am Surgeon, 1960;26: 113-117
43 Pontoriero R, Lindhe J, Nyman S, Karring T, Rosenberg E, Sanavi F : Guided tissue regeneration in degree II furcation-involved mandibular molars. A clinical study, J Clin Periodontol, 1988;15(4):247-254   DOI
44 Sculean A, Berakdar M, Pahl S, Windisch P, Brecx M, Reich E, Donos N : Patterns of cytokeratin expression in monkey and human periodontium following regenerative and conventional periodontal surgery, J Perio Res, 2001;36(4): 260-8   DOI   ScienceOn
45 Muzzarelli RA: In vivo biochemical significance of chitin-based medical items, Polymeric Materials for Biomedical ApplicationsfEds S. Dumitriu and M. Szycher), Marcel Dekker, New York, USA, 1992
46 Wikesjo ME, Claffey N, Nilveus R : Periodontal repair in dogs : Effect of root surface treatment with stannous fluoride or citric acid on root resorption, J Periodontol, 1991;62 : 180-184   DOI
47 Gottlow J, Nyman S, Karring T, Wennstrom J: New attachment formation in the human periodontium by guided tissue regeneration. Case reports, J Clin Periodontol, 1986;13(6): 604-616   DOI
48 Iglhaut J, Aukhil I, Simpson DM, Johnston MC, Koch G : Progenitor cell kinetics during guided tissue regeneration in experimental periodontal wounds, J Periodont Res, 1988; 23: 107-117   DOI   PUBMED
49 Caffesse G, Nasjlete E, Anderson B : Periodontal healing following guided tissue regeneration with citric acid and fibronectin application, J Periodontol, 1991;62: 21-29   DOI
50 Key SA, Lynch LW, Marxer M, Lynch SE : Guided bone regeneration : Integration of a resorbable membrane and a bone graft material, Prdct Periodont Aesthet Dent, 1997;9: 185-194
51 Simon M, Trisi P, Maglione M, Piatelli A: A preliminary report on a method for studying the permeability of expanded polytetrafluoroethylene membrane to bacteria in vitro ; A scanning electron microscopic and histologic study, J Periodontol, 1994;65 : 755-761   DOI   PUBMED   ScienceOn
52 Caton J, Nyman S, Zander H : Histometric evaluation of periodontal surgery . II. Connective tissue attachment levels after four regenerative procedure. J Periodontol, 1980;7: 223-231
53 Nyman S, Gottlow J, Karring T, Lindhe J: Healing following implantation of periodontitis-affected roots into gingival connective tissue, J Clin Periodontol, 1980;7: 394-401   DOI   PUBMED