Dental membranes

Lists and uses of different kinds of dental membranes

Dental membranes have many uses in our field and the variety of types can be overwhelming.

Why use a dental membrane?

There are many types of membranes that we use in many different ways.  Different doctors have different preferences and that is typically why one gets use over the other.

  • Need them to help contain graft material. A membrane may be all we need to exclude the soft tissue and let bone form, especially in the case of socket preservation post extraction.

 the barriers alone produced better clinical results than grafts+barriers or grafts alone. It could be argued that the protective, space-making effect of the barriers on the blood clot inside the socket and on the remaining bone walls outside the socket is responsible; ie, the barrier, acting as a shield, could enhance the physiologic healing process, minimizing bone loss and maximizing bone repair, with a resulting net effect of improvement versus untreated extraction sockets in terms of bone height and width.

it could be argued that socket preservation techniques are effective regardless of whether primary flap closure is achieved

Flap elevation and soft tissue primary closure seem to have little effect on horizontal and vertical bone loss at extraction sites. Orgeas JOMI 2013

Allograft dental membrane

Allograft dental membranes are those that are of human origin.

Alloderm by Biohorizons – regenerative tissue matrix
Perioderm  by Dentsply – acellular dermal allograft that is derived from donated human skin
Puros Dermis by Zimmer – assume same above
Puros Pericardium by Zimmer – allograft

BioXclude by Snoasis – allograft amnion and chorion tissue. This membrane can tolerate some exposure and has growth factors. If there is some exposure needs a collagen membrane underneath. It is great for socket grafting and sinus perforations.

Pericardium membrane

CopiOs by Zimmer – bovine pericardium
Puros Pericardium by Zimmer – allograft

Metal and metal reinforced membranes

Dentoalveolar Bone Fixation System by Synthes Dento – Ti mesh with fixation screws

Stryker by Medpor – Ti with polyethylene mesh

Cytoplast Ti reinforced – Although primary closure in ridge augmentation procedures is recommended, Cytoplast® Ti-250 membranes incorporate a high-density PTFE base that is engineered to withstand exposure as long as soft tissue has 360° coverage around the edges of the membrane. The textured Regentex™ surface increases the surface area available for cellular attachment, thereby assisting in stabilization of the membrane and prevention of soft tissue retraction.

Pro-fix by Osteogenics – Tenting and retention screws

Printed custom Ti shell

Reference

Collagen membrane

Biomend and Biomend Extended by Zimmer – purest bovine Type 1 collagen
CurV Presahped Collagen Membrane by Zimmer –  type 1 collagen derived from bovine Achilles tendon
Socket Repair Membrane by Zimmer – Type I Collagen

Bio-Gide by Geistlich – bilayer pure collagen membrane composed of both a smooth and rough layer. The smooth upper layer is a catalyst for the attachment of fibroblasts that lead to favorable healing of the gingival tissue. The dense porous layer acts as a guide for osteoblasts. So smooth layer goes up.
Mem-Lok by Biohorizons – highly purified type I collagen fibers

Vitala by Osteogenics – porcine derived collagen membrane

ConForm™ Membrane by Ace Surgical – Type I bovine collagen
RCM6™ by Ace Surgical –  highly purified Type I Collagen

Mucograft by Osteohealth – collagen matrix

Ossix Plus by OraPharma – Porcine-derived collagen 4-6 months

Ez Cure by Biomatlante – porcine epidermis derived collagen

Genoss Collagen membrane by Dentium – bovine type 1 collagen .3mm thick

Renovix by Salvin – type 1 porcine

Synthetic dental membranes – PLA and PTFE

Guidor by Sunstar- bilayer polylactic acid (PLA) = PLLA?
Gore Resolut by Gore – PLA discontinued
Atrisorb by Citagenix – PLA flowable 9-12 months
Epi-Guide by Kensey Nash – D, D-L, L polylactic acid – barrier for up to 20 weeks with complete bioresorption between 6-12 months
PLGC – poly L-lactide-co-glycolide-coepsilon- caprolactone = poly(lactic acid-co-glycolic acid-co-ε-caprolactone)
PLGA – same PLGC without the C, poly(lactic acid-co-glycolic acid

Cytoplast by Osteogenics – dPTFE membrane
PTFE Barrier Membrane by ACE through Henry Schein – dPTFE membrane
TR-PTFE  by Osteogenics – titanium reinforced dPTFE membrane (Henry Schein is cheaper)

PEG polyethylene gel – experimental synthetic hydrogel (Not any more – see below)
Membragel by Straumann – polyethylene glycol (PEG). Its gelification is activated by the combination of PEG A (containing acrylate as terminal functional group), PEG B (containing thiol as terminal functional group) and activators A (viscosity modifier) and B (isotonic chemical solution creating an optimal pH to start the chemical reaction).
The chemical components of PEG A and PEG B create a molecular network of PEG, that acts as a barrier and avoids the migration of soft tissue cells; in the meanwhile it remains permeable to nutritional substances.

Research
TR-PTFE more bone but less dense than PLGC for lateral defects

 

Collagen Plug

OraPlug by Salvin- collagen absorbs in 10-14 days
Foundation by JMorita- collagen based

Zimmer products all 10-14 days
CollaCote by Zimmer – Palatal donor sites and Mucosal flaps
CollaPlug by Zimmer – Biopsy sites and Extraction sites
CollaTape by Zimmer – Closure of grafted sites, Repair of Schneiderian Membranes and Minor oral wounds

Osteophealth products all 10-14 days,HeliPLUG®, HeliTAPE® and HeliCOTE® are absorbable collagen wound dressing
HeliPLUG – Biopsy sites and Extraction sites
HeliTAPE –  Repair of Schneiderian Membranes
HeliCOTE –  Palatal donor sites and control bleeding

 

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