Oral Health and Dental Management

Characteristics and Classification of Barrier Membranes used in GBR Procedure

Kiyoshi Furuhashi^* Department of Oral Rehabilitation, Kyushu University, Higashi-ku, Fukuoka, Japan
^*Correspondence: Kiyoshi Furuhashi, Department of Oral Rehabilitation, Kyushu University, Higashi-ku, Fukuoka, Japan, Email:

Received: 29-Aug-2022, Manuscript No. OHDM-22-18217; Editor assigned: 01-Sep-2022, Pre QC No. OHDM-22-18217(PQ); Reviewed: 15-Sep-2022, QC No. OHDM-22-18217; Revised: 22-Sep-2022, Manuscript No. OHDM-22-18217(R); Published: 29-Sep-2022, DOI: 10.35248/2247-2452.22.21.1018

Description

Barrier membranes are of crucial part in Guided Bone Regeneration (GBR) procedure, which is the most popular method in implant dentistry for treating bony abnormalities. Today, the implant clinician can choose from a wide variety of membrane materials depending on the clinical scenario. As the idea of membrane barrier techniques and their clinical applications has grown, several types of membrane materials have also developed. In GBR operations, membranes serve as biological and mechanical barriers to prevent the invasion of cells that are not involved in bone formation, such as epithelial cells, also allowing the slower-moving bone-forming cells to migrate into the defect locations. Both soft-tissue and bone-forming cells compete to infiltrate the surgical site when bone abnormalities restore. In general, the migration of soft tissue cells is much faster than that of bone-forming cells. The main function of Barrier membranes is to control the proliferation of different tissues and enable selective cell repopulation throughout the healing process. The regeneration process, which includes angiogenesis and the migration of osteogenic cells, takes place below the membrane. After vascular ingrowth, the original blood clot is replaced by woven bone, which later develops into load-bearing lamellar bone. This ultimately promotes the regeneration of both hard and soft tissues. Lack of space maintenance will lead to poor bone growth and soft-tissue integration if a barrier membrane is not used. The characteristics of an ideal membrane include predictable resorption rate, space maintenance, cell occlusiveness, stabilisation of the blood clot, mechanical strength, tissue compatibility, and ease of modification and manipulation.

Classification

Membranes for GBR procedures can be categorised as either non-resorbable or resorbable. Non-resorbable membranes must be removed by the second surgery when bone regeneration is finished since they are bio-inert. Resorbable membranes have varied rates of resorption and are naturally biodegradable. All membranes, whether resorbable or not, differ in their biomaterial and physical properties, with corresponding benefits and drawbacks for diverse therapeutic circumstances.

Non-Resorbable Membranes

Non-resorbable membranes show tremendous biocompatibility, greater mechanical strength, higher stiffness, and usually attain more constructive space than resorbable membranes. Non-resorbable membranes, on the other hand require a second surgery, which raises morbidity, expenses, and patient pain. Non-resorbable membranes are most frequently made of Poly-Tetrafluoroethylene (PTFE) and titanium mesh. PTFE membranes further differentiated as expanded, high-density and titanium-reinforced forms. It has been demonstrated that titanium mesh is used in maintaining space from collapsing. Due to their flexibility the membranes can be bent and manipulated into shape by themselves around the bone defect. The titanium mesh’s has established ability to be biocompatible, and contains holes that provide continuous blood supply from the periosteum.

Non-resorbable membranes have the advantages of titanium reinforcement, staying in place until removed, being easily attached with either titanium or resorbable tacks, higher bone fill, and little tissue reaction if the membrane is not exposed. The drawbacks include need of second surgery to remove them, increasing patient morbidity, and need to be removed if they get exposed. Wound dehiscence is also more frequent with non-resorbable membranes.

Resorbable Membranes

The most common membranes used in implant dentistry today are resorbable membranes made of xenogeneic collagen for GBR operations. Collagen, pericardium, fibrin that is rich in platelets, and acellular dermal matrix are the various categories of resorbable membranes. Collagen barriers are further classified into collagen plugs, collagen tape, regular collagen membranes, and extended collagen membranes.

Resorbable membranes provide the benefits of avoiding a second surgical treatment, which lowers patient morbidity and costs, improving soft tissue recovery, and a tissue-friendly response to membrane exposure. The drawbacks include reduced bone filling, material exposure or flap dehiscence that might complicate postoperative tissue care, tissue inflammation that can delay healing and GBR, and unpredictable resorption time, which may adversely affect the amount of bone formation.

Conclusion

Membranes play a significant and common role in implant dentistry. They serve as a biological and mechanical barrier to prevent the invasion of cells that are not included in bone formation, allows slower-moving bone-forming cells to migrate into the areas of defects. It is crucial for implant doctors to choose the appropriate membrane based on a variety of clinical circumstances as well as elements like material composition and resorption rate. With a wide range of choices, considerate selection will support the regeneration of both hard and soft tissues and ultimately raise the success rate of GBR treatments.