tr?id=735770906937422&ev=PageView&noscript=1 Dental Barrier Membranes
6-thumb Dental Barrier Membranes

DSI Barrier Membranes 


Introduction:

As of today, it is a well-known fact that barrier membranes improve bone regeneration around implants. There are two types of barrier membranes that serve in the realms of GTR (Guided Tissue Regeneration) and GBR (Guided Bone Regeneration) procedures.

Resorbable membranes, either collagen (Type I, II or III) or synthetic (Aliphatic Polyesters) which are bio-compatible and are metabolized by hydrolysis or enzymatic activity over the course of time.

Non-Resorbable PTFE Membranes, made of Titanium and Polytetrafluoroethylene.
Although requiring a second surgery for removal, PTFE membranes are biologically inert and chemically stable, maintaining their form and integrity, preventing collapse and providing structural rigidity over the entire healing process. Available in different combinations: Pure Teflon, ePTFE reinforced with titanium micro-threads, and titanium mesh rigid membrane.

Barrier Membranes General Overview:

Barrier Membranes have been introduced into the Oral & Maxilofacial surgery field to support GBR and GTR treatment plans in the preservation of the alveolar socket or augmentation of the dental ridge.

After the supporting material is placed (Bone graft) in the socket to promote bone growth, the Barrier membrane plays an integral role, as it is placed sub-gingivaly over the alveolar ridge to protect the bone growth within the socket, prevent gingival in-growth and maintain height and width of the newly formed bone tissue.

Failing to apply a barrier membrane in a GTR or GBR procedures, may lead to an extensive epithelial cells migration into the socket, causing insufficient bone growth that will eventually lead to further ridge augmentation or to a potential inability for new implant placement.

 

Comparison of Resorbable and Non-Resorbable Membranes:

It has been indicated by studies, that Non-Resorbable membranes (PTFE) have a slight to moderate cytotoxic reaction while the Resorbable membrane has shown a high cytocompatibility and a great potential to be integrated into the connective tissue, surrounding the newly formed bone.
Studies have also concluded that in comparison to Non-Resorbable membranes, Resorbable membranes possess an ability to stimulate cellular proliferation allowing for better tissue regeneration.
On the other hand, Non-Resorbable membranes offer superb mechanical properties for GBR and bone sculpting which allows reconstruction of a narrow dental ridge, a procedure which is not possible to accomplish with a Resorbable membrane due to its soft texture.
The enormous advantage of the PTFE Resorbable membrane is that its surface has a less open structure, preventing bacterial products from penetrating it.

Barrier Membrane Anti-Infective Properties:

The success or failure of the barrier membrane integration into the patient's connective tissue,
is largely dependent on whether the barrier membrane is able to resist various infections, that may occur post-surgery or the bodies intolerance and recognition of the barrier membrane as a foreign body, that needs to be removed by means of the subgingival tissue inflammation, where it resides.

As infections are unavoidable and present the most common reason for barrier membrane failure, as of today, the solution is the incorporation of anti-infective agents or bio-active molecules which keep the wound from being affected by different pathogens, thus avoiding the infection and inflammation of the tissues. 
It has also been observed that drugs incorporated into the barrier membrane, accelerate the healing
process of the post-op tissue.

 

Properties, Characteristics and Requirements of Collagen Membranes:

Collagen is the most abundant protein in mammals, comprising 25-35% of the whole-body protein content, and can be found in all of the bodies tissues and organs in various arrangements and quantities.
Collagen proteins are found in the extra-cellular matrix in the form of elongated fibres and provide the tissue with very important properties such as elasticity and rigidity. Playing an important biological role in tissue morphogenesis and repair, as well as in cell adhesion and migration.
Offering a high level of homology and given this information, Collagen Barrier Membranes are to meet with certain criteria:

  • High Bio-Compatibility allowing further integration into the hosts tissue,
  • Rapid vascularization of the underlying wound bed,
  • Cell occlusiveness
  • Wound stabilization (Hemostatic behaviour) and
  • Disinfection properties provided by the incorporated drugs.

 

Properties, Characteristics and Requirements of PTFE Membranes:

Made of microporous high-density polytetrafluoroethylene (dPTFE) material, characterized by softness, flexibility, biologically-inertness and chemical non-reactivity. The Non-Resorbable membrane must uphold the following clinical standards:

  • Superb mechanical rigidity,
  • Space maintenance,
  • Easy separation and removal,
  • Prevention of bacteria migration and
  • Easy fixation to the alveolar ridge.

 

Collagen Membranes Manufacturing & Application in GBR/GTR/Periodontal procedures:

Collagen membranes used in dental procedures are mostly derived from a bovine origin.
And even though they originate from the same animal, collagen membranes differ in their mechanical properties and resorption behaviour since they originate from different tissues: Tendon, Dermis (Skin CT) and Pericardium (Outer fibrous layer of the heart).
A collagen barrier membrane is produced by different techniques.
In general, the collagen fraction is first isolated, then purified and precipitated by changing the ionic strength, the PH value or by increasing the temperature followed by air evaporation.
The final step is freeze-drying & sterilization of the purified collagen.

Resorbable Type II Collagen Membrane Cross-Linked:

Usually derived from a bovine collagen origin type II, which interfiber structure was reconstructed by cross-linking the polypeptide chains.
Biodegradable and provides 5 weeks of resorption time.

Layer-8-DSI-Syntoss-Resorbable Dental Barrier Membranes
DSI Syntoss Resorbable Collagen Membrane Type II

 

Resorbable type I Collagen Conforming Barrier Membrane:

Mostly derived from a bovine origin, engineered from collagen type I, obtains a significantly higher pull-out strength due to its unique fibrillar matrix structure.

Reliable, biodegradable, with excellent tensile strength, barrier type I membrane is suitable for a wide range of osseous regenerative indications.

Fitted for a healing time of most GBR procedures, increased resorption period is up to 16 weeks.

biomatrix Dental Barrier Membranes
DSI Zenoss Matrix Bio+ (Resorbable) - Collagen Type I Left Image: Collagen matrix adapted to the site and placed over the bone crest and implants.
Right Image: Anterior Maxilla - 4 months after. The tissue appears voluminous, healthy and aesthetically satisfying. No scar tissue is present.

 

PTFE Non-Resorbable Membrane:

Made of Polytetrafluoroethylene, is a soft, flexible and easy to trim non-resorbable membrane.

The membrane is impervious to bacteria while allowing the exchange of gasses and nutrients due to the elimination of the node expansion.

Great for ridge & socket preservation and is a perfect solution for vegan patients who abstain from being treated by an animal-derived tissue.

Also available with titanium reinforcement for procedures where regeneration free space is required.

The embedded titanium framework allows the membrane to be shaped and sculpted to fit any kind of defect without rebounding.

Useful in large, non-space making osseous defects.

 

 

 

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The regulatory status of different devices in the DSI Dental Implant System is not the same in all regions.
Please check with us to find out which devices are available in your country