J Periodontal Implant Sci.  2013 Apr;43(2):64-71.

Role of collagen membrane in lateral onlay grafting with bovine hydroxyapatite incorporated with collagen matrix in dogs

• Jung UW
• Lee JS
• Lee G
• Lee IK
• Hwang JW
• Kim MS
• Choi SH
• Chai JK

Abstract

PURPOSE
The objective of this study was to elucidate the role of collagen membranes (CMs) when used in conjunction with bovine hydroxyapatite particles incorporated with collagen matrix (BHC) for lateral onlay grafts in dogs.
METHODS
The first, second, and third premolars in the right maxilla of mongrel dogs (n=5) were extracted. After 2 months of healing, two BHC blocks (4 mmx4 mmx5 mm) were placed on the buccal ridge, one with and one without the coverage by a CM. The animals were sacrificed after 8 weeks for histometric analysis.
RESULTS
The collagen network of the membranes remained and served as a barrier. The quantity and quality of bone regeneration were all significantly greater in the membrane group than in the no-membrane group (P<0.05).
CONCLUSIONS
The use of barrier membranes in lateral onlay grafts leads to superior new bone formation and bone quality compared with bone graft alone.

Keyword

Alveolar ridge augmentation; Bone substitutes; Collagen; Guided tissue regeneration; Membranes

MeSH Terms

Alveolar Ridge Augmentation
Animals
Bicuspid
Bone Regeneration
Bone Substitutes
Collagen
Dogs
Durapatite
Guided Tissue Regeneration
Inlays
Maxilla
Membranes
Osteogenesis
Transplants
Bone Substitutes
Collagen
Durapatite

Figure

• 

  Figure 1 Representative photograph of the surgical procedure (A), including the graft sites of the no-membrane-cover group (left; bovine hydroxyapatite [BH] particles incorporated with collagen matrix [BHC] alone) and the membrane-cover group (right; BHC covered with a collagen membrane). Descriptive photomicrograph (B: H&E, ×40) showing the different areas used for histometric analysis. The augmented area (AA, b) is bounded by an inferred baseline and augmentation line; the resorption area (RA, a) is bounded by an inferred baseline and resorption line; the total area includes both the AA (b) and RA (a). The inferred baseline is an imaginary line drawn as an extension of the external surface of the native alveolar bone. Black dotted line: inferred baseline, red dotted line: resorption line, blue dotted line: augmentation line, black asterisk: residual BH particle.

• 

  Figure 2 Representative photomicrographs (Masson's trichrome stain, scale bars=1 mm) of the membrane-cover (A) and no-membrane-cover (B) groups. A periosteum-like dense connective tissue layer (white asterisks) was evident over the residual collagen membrane (black asterisks) in Fig. 2A, but beneath the grafted bovine hydroxyapatite (BH) particles in the site that received BH particles incorporated with collagen matrix only. At the graft sites of the membrane-cover group (A), extensive new bone formation was evident around and between the clusters of BH particles; however, the BH particles were encapsulated by collagen fibers at the no-membrane-cover site (B), and there was limited bone formation.

• 

  Figure 3 High-magnification photomicrographs of a graft site from the membrane-cover group (A) and of the no-membrane-cover group (B). Residual bovine hydroxyapatite particles (white asterisk) within the space protected by the barrier membrane had many multinucleated osteoclast-like cells (arrows) on their surface, simultaneously with linearly arranged osteoblasts (arrowheads). In the no-membrane-cover group, multinucleated osteoclast-like cells and osteoblasts were evident on the resorbed surface of the existing bone rather than around the residual particles. V: newly formed vessels (H&E, scale bars=100 µm).

• 

  Figure 4 Periosteum-like dense connective tissue layers (black asterisk) around the residual collagen membrane (CM) (white asterisk) in a graft site of the membrane-cover group (A) and between the grafted biomaterials and existing bone in the no-membrane-cover group (B). Most sites of the membrane-cover group exhibited a dense connective tissue layer beneath the residual CM (arrowheads), and newly formed vessels within it. In a graft site of the no-membrane-cover group, individual bovine hydroxyapatite particles were encapsulated by dense collagen fibers separately (without multinucleated osteoclast-like cells) over the newly formed periosteum (Masson's trichrome stain, scale bars=500 µm).

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  Figure 5 Results of histometric analysis: proportions of newly formed bone (%NB), residual biomaterials (%RB), and fibrovascular connective tissue (%FV). All of the measured values differed significantly between the membrane-cover and no-membrane-cover groups (★P<0.05).

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  Figure 6 A high-magnification photomicrograph of a graft site of the membrane-cover group, showing many newly formed vessels (V) within the residual collagen membrane (white asterisk). Black asterisk: periosteum-like dense connective tissue layer (Masson's trichrome stain, scale bar=500 µm).

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