Advances in Modification Methods Based on Biodegradable Membranes in Guided Bone/Tissue Regeneration: A Review

Abstract

Guided tissue/bone regeneration (GTR/GBR) is commonly applied in dentistry to aid in the regeneration of bone/tissue at a defective location, where the assistive material eventually degrades to be substituted with newly produced tissue. Membranes separate the rapidly propagating soft tissue from the slow-growing bone tissue for optimal tissue regeneration results. A broad membrane exposure area, biocompatibility, hardness, ductility, cell occlusion, membrane void ratio, tissue integration, and clinical manageability are essential functional properties of a GTR/GBR membrane, although no single modern membrane conforms to all of the necessary characteristics. This review considers ongoing bone/tissue regeneration engineering research and the GTR/GBR materials described in this review fulfill all of the basic ISO requirements for human use, as determined through risk analysis and rigorous testing. Novel modified materials are in the early stages of development and could be classified as synthetic polymer membranes, biological extraction synthetic polymer membranes, or metal membranes. Cell attachment, proliferation, and subsequent tissue development are influenced by the physical features of GTR/GBR membrane materials, including pore size, porosity, and mechanical strength. According to the latest advances, key attributes of nanofillers introduced into a polymer matrix include suitable surface area, better mechanical capacity, and stability, which enhances cell adhesion, proliferation, and differentiation. Therefore, it is essential to construct a bionic membrane that satisfies the requirements for the mechanical barrier, the degradation rate, osteogenesis, and clinical operability.

Barrier Membranes for Guided Bone Regeneration (GBR): A Focus on Recent Advances in Collagen Membranes

“…To enhance durability and mechanical strength, crosslinking as an efficient method has attracted extensive studies. In principle, crosslinking inhibits sliding between collagen molecules under pressure by introducing intramolecular and intermolecular covalent or non-covalent bonds, which increases the stiffness, tensile strength, compressive modulus, and reduced extensibility of collagen fibers [ 19 ]. At the same time, intermolecular crosslinking also improves the resistance of collagen against enzymatic degradation by masking the cleavage site of collagen [ 104 ].…”

“…However, the rapid degradation rates and the poor volume stability properties of most collagen barrier membranes are still important limiting factors [ 18 ]. Another important disadvantage of this material class is the rapid fragmentation and degradation after gingival dehiscence with membrane exposure and related decreased bone regeneration [ 2 ].Thus, various methods such as physical/chemical/enzymatic and crosslinking strategies such as ultraviolet (UV) radiation, genipin (Gp), and glutaraldehyde treatments have been analyzed, to extend both the degradation time and mechanical properties of collagen membranes for overcoming the current material deficiencies [ 19 , 20 ]. In addition, collagen membranes are often combined with different agents such as bone grafts or resorbable stabilizing structures such as magnesium meshes to increase their regenerative capacities and to prevent membrane collapse and volume stability [ 21 , 22 ].…”

“…In addition, collagen membranes are often combined with different agents such as bone grafts or resorbable stabilizing structures such as magnesium meshes to increase their regenerative capacities and to prevent membrane collapse and volume stability [ 21 , 22 ]. A further focus for improvement of the performance of a resorbable barrier membrane is to have influence on their “bioactivity”, including factors such as transmembraneous vascularization or different approaches for “immunomodulating” properties such as influence on macrophage phenotypization [ 19 , 23 ]. In this context, an increasing number of preclinical studies are focusing on the loading of active compounds such as growth factors, cytokines, inorganic compounds, and anti-inflammatory agents among different others [ 3 , 24 , 25 ].…”

Preparation, physicochemical characterization, and in vitro and in vivo osteogenic evaluation of a bioresorbable, moldable, hydroxyapatite/poly(caprolactone‐co‐lactide) bone substitute

“…Balancing the rate of degradation and strength of bioresorbable materials is a critical problem for researchers who aim to expand their clinical applicability. PLA and its stereoisomers are the most widely used and researched types of aliphatic polyester materials because of their mechanical strength, modulus, and biocompatibility 19,20 . Nevertheless, drawbacks of PLA including its poor strength, limited elongation, and low heat deflection temperature limit its use as a bone substitute in clinical settings 21 .…”

Recent advances in biofunctional guided bone regeneration materials for repairing defective alveolar and maxillofacial bone: A review

“…From the perspective of material, GBR materials in clinical trial were almost derived Ti or collagen meshes. However, Ti meshes needs to be removed in most cases and degradation of collagen membranes are difficult to handle [119] . In contrast, abundant new synthetic materials and processing technologies have been applied in fabricating GBR materials those in research stage [14] .…”