Immunohistochemical characterization of guided bone regeneration at a dehiscence-type defect using different barrier membranes: an experimental study in dogs.
OBJECTIVE
The aim of the present study was to evaluate immunohistochemically the pattern of guided bone regeneration (GBR) using different types of barrier membranes.


METHODS
Standardized buccal dehiscence defects were surgically created following implant bed preparation in 12 beagle dogs. Defects were randomly assigned to six different GBR procedures: a collagen-coated bone grafting material (BOC) in combination with either a native, three cross-linked, a titanium-reinforced collagen membrane, or expanded polytetrafluorethylene (ePTFE), or BOC alone. After 1, 2, 4, 6, 9, and 12 weeks of submerged healing, dissected blocks were processed for immunohistochemical (osteocalcin - OC, transglutaminase II - angiogenesis) and histomorphometrical analysis [e.g., bone-to-implant contact (BIC), area of new bone fill (BF)].


RESULTS
In general, angiogenesis, OC antigen reactivity, and new bone formation mainly arose from open bone marrow spaces at the bottom of the defect and invaded the dehiscence areas along the implant surface and BOC. At 4 weeks, membranes supporting an early transmembraneous angiogenesis also exhibited some localized peripheral areas of new bone formation. However, significantly increasing BIC and BF values over time were observed in all groups. Membrane exposure after 10-12 weeks was associated with a loss of the supporting alveolar bone in the ePTFE group.


CONCLUSIONS
Within the limits of the present study, it was concluded that (i) angiogenesis plays a crucial role in GBR and (ii) all membranes investigated supported bone regeneration on an equivalent level.
Schwarz
Frank
F
Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany. Frank.Schwarz@med.uni-duesseldorf.de
Rothamel
Daniel
D
Herten
Monika
M
Wüstefeld
Martin
M
Sager
Martin
M
Ferrari
Daniel
D
Becker
Jürgen
J
D016301:Alveolar Bone Loss / Q000601:surgery*; D000818:Animals; D001861:Bone Regeneration / Q000502:physiology*; D018786:Bone Substitutes; D003094:Collagen; D024042:Collagen Type I; D024061:Collagen Type III; D003758:Dental Implantation, Endosseous; D004285:Dogs; D019204:GTP-Binding Proteins / Q000032:analysis; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D007124:Immunoenzyme Techniques; D008567:Membranes, Artificial; D008903:Minerals; D018919:Neovascularization, Physiologic / Q000502:physiology; D011138:Polytetrafluoroethylene; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011897:Random Allocation; D018709:Statistics, Nonparametric; D013526:Surgical Mesh; D013529:Surgical Wound Dehiscence / Q000503:physiopathology; D011503:Transglutaminases / Q000032:analysis
C106416:Bio-Gide; C077540:Bio-Oss; D018786:Bone Substitutes; D024042:Collagen Type I; D024061:Collagen Type III; D008567:Membranes, Artificial; D008903:Minerals; D011138:Polytetrafluoroethylene; D003094:Collagen; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins