Evaluation between Biodegradable Magnesium Metal GBR Membrane and Bovine Graft with or without Hyaluronate

Abstract

Bone substitutes and barrier membranes are widely used in dental regeneration procedures. New materials are constantly being developed to provide the most optimal surgical outcomes. One of these developments is the addition of hyaluronate (HA) to the bovine bone graft, which has beneficial wound healing and handling properties. However, an acidic environment that is potentially produced by the HA is known to increase the degradation of magnesium metal. The aim of this study was to evaluate the potential risk for the addition of HA to the bovine bone graft on the degradation rate and hence the efficacy of a new biodegradable magnesium metal GBR membrane. pH and conductivity measurements were made in vitro for samples placed in phosphate-buffered solutions. These in vitro tests showed that the combination of the bovine graft with HA resulted in an alkaline environment for the concentrations that were used. The combination was also tested in a clinical setting. The use of the magnesium metal membrane in combination with the tested grafting materials achieved successful treatment in these patients and no adverse effects were observed in vivo for regenerative treatments with or without HA. Magnesium based biodegradable GBR membranes can be safely used in combination with bovine graft with or without hyaluronate.

Horizontal and Vertical Defect Management with a Novel Degradable Pure Magnesium Guided Bone Regeneration (GBR) Membrane—A Clinical Case

“…Wound dehiscence was previously reported in an in vivo study using the membrane [16]. However, in this instance, and in concurrence with the published cases [24][25][26][27], there were no clinical observations associated with the release of hydrogen gas.…”

“…As it degrades, it releases magnesium ions, which are naturally prevalent within the body and are present in almost every cell [21]. Its initial mechanical strength provides a rigid three-dimensional volumetric maintenance to stabilize the underlying bone graft during the critical healing period, yet reabsorbs in the subsequent months following implantation in a complete and predictable way [14,16,[22][23][24][25][26][27]. The membrane has undergone substantial preclinical research [14,16], and since its CE approval, its clinical performance has been reported in several case studies [24][25][26][27].…”

Immediate implant placement by using natural bovine bone substitute with hyaluronate

“…Even though the patient's own bone is considered to be the gold standard grafting material, different synthetic or naturally-derived biomaterials are used to simplify the grafting procedure [12]. Especially the bovine derived xenograft granules in combination with hyaluronate provide better handling at the grafted site due to the sticky consistency [13]. This also leads to faster cells proliferation and vascularization compared to the xenograft granules alone [7], [8].…”

First Clinical Case Report of a Xenograft–Allograft Combination for Alveolar Ridge Augmentation Using a Bovine Bone Substitute Material with Hyaluronate (Cerabone® Plus) Combined with Allogeneic Bone Granules (Maxgraft®)

“…In vitro studies showed that hyaluronic acid biofunctionalization of the bovine bone substitute cerabone ® caused an increased activity of human osteoblasts, thus indicating the ability to accelerate and improve bone regeneration [24,27]. Based on the findings of the in vitro studies, the innovative bone graft substitute was tested in in vivo models.…”

“…Given the properties of cerabone ® plus, including osteoconductivity and volume stability, this relatively new bovine bone substitute material enables time-saving and efficient defect filling and easy defect contouring [30,31]. After hydration, cerabone ® plus is sticky and malleable, thereby minimizing displacement of single granules during application [24,27]. It can therefore be applied for horizontal and vertical augmentation [31], peri-implant defects [30], socket preservation and sinus lifts.…”