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Guided bone regeneration: materials and biological mechanisms revisited

Review article
Authors Ibrahim Elgali
Omar Omar
Christer Dahlin
Peter Thomsen
Published in European Journal of Oral Sciences
Volume 125
Issue 5
Pages 315-337
ISSN 0909-8836
Publication year 2017
Published at Institute of Clinical Sciences, Department of Biomaterials
Pages 315-337
Language en
Links doi.org/10.1111/eos.12364
Keywords biocompatible materials, growth factors, guided bone regeneration, membrane, osseointegration, alveolar ridge augmentation, platelet-rich fibrin, anorganic bovine, bone, resorbable polymeric membranes, controlled clinical-trial, calcium-sulfate barrier, randomized controlled-trial, asymmetric porous, structure, occlusive titanium barrier, beta-tricalcium phosphate
Subject categories Dentistry, Biomaterials Science

Abstract

Guided bone regeneration (GBR) is commonly used in combination with the installment of titanium implants. The application of a membrane to exclude non-osteogenic tissues from interfering with bone regeneration is a key principle of GBR. Membrane materials possess a number of properties which are amenable to modification. A large number of membranes have been introduced for experimental and clinical verification. This prompts the need for an update on membrane properties and the biological outcomes, as well as a critical assessment of the biological mechanisms governing bone regeneration in defects covered by membranes. The relevant literature for this narrative review was assessed after a MEDLINE/PubMed database search. Experimental data suggest that different modifications of the physicochemical and mechanical properties of membranes may promote bone regeneration. Nevertheless, the precise role of membrane porosities for the barrier function of GBR membranes still awaits elucidation. Novel experimental findings also suggest an active role of the membrane compartment per se in promoting the regenerative processes in the underlying defect during GBR, instead of being purely a passive barrier. The optimization of membrane materials by systematically addressing both the barrier and the bioactive properties is an important strategy in this field of research.

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