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Effect of isolating the periosteum with a resorbable barrier membrane on neovascularization in guided bone regeneration. An experimental study.
EAO Online Library. LEVENTIS M. Oct 9, 2018; 232604; P-BR-56
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In guided bone regeneration, the use of xenogeneic bone substitutes protected by barrier membranes is suggested for treatment of bone defects. Sprouting of vessels from surrounding local bone and periosteum into such regenerated areas is considered to be an important factor for osteogenesis. However, isolating the grafted area from the overlying periosteum with a barrier membrane may have an effect on neovascularization of the site. To perform a comparative histological and immunohistochemical evaluation of neovascularization in bone defects filed with deproteinized bovine bone mineral (DBBM) and covered with a resorbable barrier membrane or a collagen fleece. Twenty New Zealand white rabbits were used. Two circular bicortical bone defects (8 mm in diameter) were created in the calvaria of the animals and subsequently filled with a DBBM (Bio-Oss®, Geistlich Pharma AG, Wolhusen, Switzerland). One grafted defect, chosen randomly, was covered with a resorbable collagen barrier membrane (Bio-Guide®, Geistlich Pharma AG, Switzerland) – Group A, while the other site was covered by a fast resorbing collagen fleece (Jason® collagen fleece, botissdental GmbH, Berlin, Germany) – Group B. After 1, 2 and 4 weeks specimens were taken and histologic and immunohistologic analyses were carried out to assess the number of newly-formed vessels. Sections were stained with Hematoxylin-Eosin and subjected to microscopic examination, or immunostained with a monoclonal antibody against CD31, a marker for vascular endothelial cells. Histological examination showed that in all sites bone formation occurred uneventfully and showed progressive stages of bone regeneration and maturation. Regarding neovascularization, the microvessel density (MVD) was measured in all sites. Analysis of the data revealed that the number of blood vessels increased with time in all groups, and MVD was higher in the fleece group, compared to the resorbable collagen membrane group at all time points of observation. Differences between the 2 groups were found to be statistically significant in all time points. This study reported a negative effect of barrier membranes on neovascularization, compared to the use of a collage fleece, utilizing this experimental model. The results may be of clinical interest for bone regeneration using DBBM and collagen barrier membranes, but further studies are required to supplement the present findings and verify the results in humans.
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