J Periodontal Implant Sci.  2015 Dec;45(6):229-237. 10.5051/jpis.2015.45.6.229.

Assessment of dehydrothermally cross-linked collagen membrane for guided bone regeneration around peri-implant dehiscence defects: a randomized single-blinded clinical trial

• Lee JH
• Lee JS
• Baek WS
• Lim HC
• Cha JK
• Choi SH
• Jung UW

• KMID: 2354941
• DOI: http://doi.org/10.5051/jpis.2015.45.6.229

Abstract

PURPOSE
The aim of this study was to determine the clinical feasibility of using dehydrothermally cross-linked collagen membrane (DCM) for bone regeneration around peri-implant dehiscence defects, and compare it with non-cross-linked native collagen membrane (NCM).
METHODS
Dehiscence defects were investigated in twenty-eight patients. Defect width and height were measured by periodontal probe immediately following implant placement (baseline) and 16 weeks afterward. Membrane manipulation and maintenance were clinically assessed by means of the visual analogue scale score at baseline. Changes in horizontal thickness at 1 mm, 2 mm, and 3 mm below the top of the implant platform and the average bone density were assessed by cone-beam computed tomography at 16 weeks. Degradation of membrane was histologically observed in the soft tissue around the implant prior to re-entry surgery.
RESULTS
Five defect sites (two sites in the NCM group and three sites in the DCM group) showed soft-tissue dehiscence defects and membrane exposure during the early healing period, but there were no symptoms or signs of severe complications during the experimental postoperative period. Significant clinical and radiological improvements were found in all parameters with both types of collagen membrane. Partially resorbed membrane leaflets were only observed histologically in the DCM group.
CONCLUSIONS
These findings suggest that, compared with NCM, DCM has a similar clinical expediency and possesses more stable maintenance properties. Therefore, it could be used effectively in guided bone regeneration around dehiscence-type defects.

Keyword

Augment bone graft; Controlled clinical trial; Cross-linking; Membrane

MeSH Terms

Bone Density
Bone Regeneration*
Collagen*
Cone-Beam Computed Tomography
Humans
Membranes*
Postoperative Period
Collagen

Figure

• 

  Figure 1 Mid-cross-sectional image of the implant placement site, showing measurement of horizontal thickness (HT) after augmentation and at the time of re-entry surgery. HT was calculated at three levels: 1, 2, and 3 mm below the top of the implant platform.

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  Figure 2 Flow chart of patient enrollment and reasons for exclusion. NCM: non-cross-linked native collagen membrane; DCM: dehydrothermally cross-linked collagen membrane; CBCT: cone-beam computed tomography.

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  Figure 3 Histological images from the DCM group at the time of re-entry surgery. (A, B) Partially resorbed collagen membrane leaflets exhibiting structural integrity and some blood vessels (BVs) were observed. Bone substitute materials (BM) were surrounded by collagen membranes and BVs. New bone (NB) formation was observed on the BM surface. (A: Masson's trichrome stains, ×100, Scale bars, 500 μm; B: Masson's trichrome stains, ×200, Scale bars, 200 μm).

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