Physical, mechanical, and biological properties of collagen membranes for guided bone regeneration: a comparative in vitro study

Guided tissue regeneration with a gelatin and polycaprolactone composite membrane for repairing oral soft tissue defects: A prospective, single-blinded, randomized trial

STATEMENT OF PROBLEM

Clinical trials comparing outcomes of the guided tissue regeneration membrane (TRM), fabricated from gelatin and polycaprolactone via electronspinning technology, with collagen membrane for repairing oral soft tissue defects are lacking.

PURPOSE

The purpose of this clinical trial was to evaluate the efficacy and safety of TRM compared with collagen membrane in reconstructing oral soft tissue defects.

MATERIAL AND METHODS

This prospective, single-blinded, randomized, noninferiority trial involved 48 participants with oral lesions who were randomized (1:1) into 2 groups: surgery + TRM or surgery + collagen membrane. The primary endpoint was to establish a noninferiority margin of -10% regarding Grade A healing rates 1 month ±7 days after surgery between groups. Secondary endpoints included instrument performance, Grade A healing rate at 10 ±3 days and 3 months ±7 days after surgery, time to achieve Grade A healing, surgical area satisfaction and wound contraction at 10 ±3 days, 1 month ±7 days, and 3 months ±7 days after surgery. Adverse events were assessed to evaluate the safety of TRM. The independent samples t test was used for continuous variables between groups, and the Fisher exact test or chi-squared test was used for categorical variables (α=.05).

RESULTS

The Grade A healing rate was 100% in both groups at 1 month ±7 days after surgery in the full-analysis and per-protocol sets. The 95% confidence interval of the rate difference (0%) was -5% to +5%, within the predefined noninferiority margin of -10%, indicating that TRM was not inferior to collagen membrane. No significant differences in secondary endpoints were found between groups (P>.05). Adverse events rates were also similar between groups (serious adverse events: 3 [12.50%] for TRM and 1 [4.17%] for collagen membrane, P=.609; overall adverse events: 7 [29.17%] for TRM and 4 [16.67%] for collagen membrane, P=.303).

CONCLUSIONS

TRM demonstrated noninferiority to collagen membrane for reconstructing oral soft tissue defects.

From Waste to Innovation: A Circular Economy Approach for Tissue Engineering by Transforming Human Bone Waste into Novel Collagen Membranes

The aim of the circular economy is to treat waste as a valuable raw material, reintegrating it into the industrial economy and extending the lifecycle of subsequent products. Efforts to reduce the production of hard-to-recycle waste are becoming increasingly important to manufacturers, not only of consumer goods but also of specialized items that are difficult to manufacture, such as medical supplies, which have now become a priority for the European Union. The purpose of the study is to manufacture a novel human-purified type I collagen membrane from bone remnants typically discarded during the processing of cortico-cancellous bones in tissue banks and to evaluate its mechanical properties and effectiveness in regenerating bone-critical mandibular defects in rabbits. To prepare the novel membrane, cortico-cancellous bone chip samples from a local tissue bank were processed to isolate collagen by demineralization under agitation in HCl, cast into a silicone mold, and air-dried at room temperature and UV irradiation. The average thickness of the four batches analyzed by SEM was 37.3 μm. The average value of Young's modulus and tensile strength obtained from the specimens was 2.56 GPa and 65.43 Mpa, respectively. The membrane's efficacy was tested by creating a critical bicortical and bilateral osteoperiosteal defect in rabbit mandibles. The right-side defects were covered with the collagen membrane, while the left-side defects were left untreated as a control. Nine weeks post-surgery, clinical, radiological, and histological analyses demonstrated new bone formation in the treated areas, whereas the control sites showed no bone regeneration. This innovative approach not only contributes to sustainability in healthcare by optimizing biological waste but also exemplifies efficient resource use in line with the circular economy, offering a cost-effective, biocompatible option that could benefit national health systems.

Tissue Sources Influence the Morphological and Morphometric Characteristics of Collagen Membranes for Guided Bone Regeneration

(1) Background: Collagen, a natural polymer, is widely used in the fabrication of membranes for guided bone regeneration (GBR). These membranes are sourced from various tissues, such as skin, pericardium, peritoneum, and tendons, which exhibit differences in regenerative outcomes. Therefore, this study aimed to evaluate the morphological and chemical properties of porcine collagen membranes from five different tissue sources: skin, pericardium, dermis, tendons, and peritoneum. (2) Methods: The membrane structure was analyzed using energy-dispersive X-ray spectrometry (EDX), variable pressure scanning electron microscopy (VP-SEM), Fourier transform infrared spectroscopy (FTIR), and thermal stability via thermogravimetric analysis (TGA). The absorption capacity of the membranes for GBR was also assessed using an analytical digital balance. (3) Results: The membranes displayed distinct microstructural features. Skin- and tendon-derived membranes had rough surfaces with nanopores (1.44 ± 1.24 µm and 0.46 ± 0.1 µm, respectively), while pericardium- and dermis-derived membranes exhibited rough surfaces with macropores (78.90 ± 75.89 µm and 64.89 ± 13.15 µm, respectively). The peritoneum-derived membrane featured a rough surface of compact longitudinal fibers with irregular macropores (9.02 ± 3.70 µm). The thickness varied significantly among the membranes, showing differences in absorption capacity. The pericardium membrane exhibited the highest absorption, increasing by more than 10 times its initial mass. In contrast, the skin-derived membrane demonstrated the lowest absorption, increasing by less than 4 times its initial mass. Chemical analysis revealed that all membranes were primarily composed of carbon, nitrogen, and oxygen. Thermogravimetric and differential scanning calorimetry analyses showed no significant compositional differences among the membranes. FTIR spectra confirmed the presence of collagen, with characteristic peaks corresponding to Amide A, B, I, II, and III. (4) Conclusions: The tissue origin of collagen membranes significantly influences their morphological characteristics, which may, in turn, affect their osteogenic properties. These findings provide valuable insights into the selection of collagen membranes for GBR applications.

Unveiling the consequences of early human saliva contamination on membranes for guided bone regeneration

AIMS

GBR membranes have various surface properties designed to elicit positive responses in regenerative clinical procedures; dental clinicians attempt to employ techniques to prevent the direct interaction of contaminated oral fluids with these biomaterials. However, saliva is uninterruptedly exhibited in oral surgical procedures applying GBR membranes, suggesting a persistent interaction with biomaterials and the surrounding oral tissues. This fundamental study aimed to investigate potential alterations in the physical, chemical, and key biological properties of membranes for guided bone regeneration (GBR) caused by isolated early interaction with human saliva.

METHODS

A reproducible step-by-step protocol for collecting and interacting human saliva with membranes was developed. Subsequently, membranes were evaluated for their physicochemical properties, protein quantification, DNA, and 16S rRNA levels viability of two different cell lines at 1 and 7 days, and ALP activity. Non-interacted membranes and pure saliva of donors were applied as controls.

RESULTS

Qualitative morphological alterations were noticed; DNA extraction and 16S quantification revealed significantly higher values. Furthermore, the viability of HGF-1 and MC3T3-E1 cells was significantly (p < .05) reduced following saliva interaction with biodegradable membranes. Saliva contamination did not prejudice PTFE membranes significantly in any biological assay.

CONCLUSIONS

These outcomes demonstrated a susceptible response of biodegradable membranes to isolated early human saliva interaction, suggesting impairment of structural morphology, reduced viability to HGF-1 and MC3T3-E1, and higher absorption/adherence of DNA/16S rRNA. As a result, clinical oral procedures may need corresponding refinements.

In Vitro Degradation of Collagen-Based Membranes for Guided Bone Regeneration After Zn-Ions or Doxycycline Functionalization

Collagen-based membrane is the most commonly used biomaterial for guided bone and tissue regeneration; however, its barrier function can be threatened by its rapid degradation pattern, affecting the success of the regeneration process. Differences in the origin and functionalization of the membrane to obtain better properties can alter the degradation rate. The objective of this study was to examine the biodegradation pattern of two commercially available collagen membranes (Jason® and Collprotect®) manufactured using porcine pericardium or dermis, doped or not with zinc-ions or doxycycline, in a period up to 21 days. The membrane specimens were subjected to hydrolytic and bacterial degradation tests. The different immersion times were carried out from 12 h up to 21 days. At each time point, quantitative measurements of thickness and weight were made using a digital caliper and an analytic microbalance, respectively. ANOVA and Student-Newman-Keuls tests were carried out for comparison purposes (p < 0.05). The differences between time-points within the same membranes and solutions were assessed by pairwise comparisons (p < 0.001). Unfunctionalized Jason membrane made of porcine pericardium attained the highest resistance to both degradation tests. The functionalization of the membranes did not alter the biodegradation patterns. All the membranes completely degraded before 48 h in the bacterial collagenase solution, which was the most aggressive test.

Complication rates of guided bone regeneration using titanium-reinforced PTFE membranes: a retrospective analysis

INTRODUCTION

This study analyzed complication rates of guided bone regeneration (GBR) using titanium-reinforced polytetrafluoroethylene (PTFE) membranes for alveolar ridge augmentation.

MATERIAL AND METHODS

84 patients treated with GBR using titanium-reinforced PTFE membranes (91 sites) were retrospectively analyzed. Complications such as membrane exposure and early removal were analyzed concerning patient age, defect site position, size, simultaneous vs. two-stage implant placement, smoking, and the use of bone grafts (BG) and substitutes (BS).

RESULTS

Early removal due to membrane exposure was necessary in 14/91 sites (15.4%). No correlation was found between early removal and patient age (p = 0.917). Analyzing early removal between the upper and lower jaw and between both jaws' anterior and posterior tooth regions revealed no correlations (p = 0.381 and 0.477, respectively). Defect sites sizes of 5-6 mm exhibited the highest rate of membrane exposure, requiring early removal, accounting for 57.1% of these sites (8/14). No correlation was observed between the defect sites size and early removal (p = 0.660). Comparison of simultaneous (74 sites) vs. two-stage implant placement (16 sites) showed no correlation with early removal (p = 0.706). Membrane exposure incidence was 42.9% among smokers (27 patients, 32.1%) and 57.1% among non-smokers (57 patients, 67.9%), without correlation. No correlation was found between the type of BG and BS and early removal (p = 0.500).

CONCLUSION

GBR using titanium-reinforced PTFE membranes is effective for alveolar ridge augmentation and has favorable long-term outcomes.

CLINICAL RELEVANCE

Careful surgical technique and postoperative care can minimize the notable risk of PTFE membrane exposure.

Proteomic Analysis of Human Serum Proteins Adsorbed onto Collagen Barrier Membranes

Collagen barrier membranes are frequently used in guided tissue and bone regeneration. The aim of this study was to analyze the signature of human serum proteins adsorbed onto collagen membranes using a novel protein extraction method combined with mass spectrometry. Native porcine-derived collagen membranes (Geistlich Bio-Gide®, Wolhusen, Switzerland) were exposed to pooled human serum in vitro and, after thorough washing, subjected to protein extraction either in conjunction with protein enrichment or via a conventional surfactant-based method. The extracted proteins were analyzed via liquid chromatography with tandem mass spectrometry. Bioinformatic analysis of global profiling, gene ontology, and functional enrichment of the identified proteins was performed. Overall, a total of 326 adsorbed serum proteins were identified. The enrichment and conventional methods yielded similar numbers of total (315 vs. 309), exclusive (17 vs. 11), and major bone-related proteins (18 vs. 14). Most of the adsorbed proteins (n = 298) were common to both extraction groups and included several growth factors, extracellular matrix (ECM) proteins, cell adhesion molecules, and angiogenesis mediators involved in bone regeneration. Functional analyses revealed significant enrichment of ECM, exosomes, immune response, and cell growth components. Key proteins [transforming growth factor-beta 1 (TGFβ1), insulin-like growth factor binding proteins (IGFBP-5, -6, -7)] were exclusively detected with the enrichment-based method. In summary, native collagen membranes exhibited a high protein adsorption capacity in vitro. While both extraction methods were effective, the enrichment-based method showed distinct advantages in detecting specific bone-related proteins. Therefore, the use of multiple extraction methods is advisable in studies investigating protein adsorption on biomaterials.

Assembled collagen films modified using polyacrylic acid with improved mechanical properties via mineralization

The imperative task of enforcing collagen materials holds paramount significance in the field of hard tissue repair. We hereby present mineralized collagen fiber films via mineralization with improved mechanical properties. Self-extracted collagen was assembled into an array with an aligned fibrous pattern and then modified with polyacrylic acid (PAA) followed by mineralization in cationic polyacrylamide (CPAM)-SBF. Biomineralization occurred at the inner and outer surface of the assembled collagen fiber films. A tensile strength of up to 40.38 ± 3.08 MPa of mineralized collagen was obtained, for the first time, which may be attributed to the synergistic effect of polyanion and polycation on the mineralization process of assembled intrafibrillar collagen fibers. It was argued that PAA may facilitate the intra-fiber interaction of collagen, which extends the elongation at break of collagen fibers. This study introduces a pioneering approach for the preparation of mineralized collagen materials with superior mechanical properties, which would be beneficial for hard tissue repair.

The design of an RGD in situ sustained delivery system utilizing scallop byssal protein through genetic engineering

Although bioactive peptides enhancing bone healing have demonstrated effectiveness in treating bone defects, in vivo instability poses a challenge to their clinical application. Currently reported peptide delivery systems do not meet the demands of bone tissue repair regarding stability and peptide release efficacy. Herein, the self-assembling recombinant chimeric protein (Sbp5-2RGD) is developed by genetic engineering with cell adhesion peptide RGD as the targeted peptide and a newly discovered scallop byssal-derived protein Sbp5-2 that can assemble into wet stable films as the structural domain. In vitro studies show that the Sbp5-2RGD film exhibits excellent extensibility and biocompatibility. In vitro and in vivo degradation experiments demonstrate that the film remains stable due to the layer-by-layer degradation mode, resulting in sustained delivery of RGD in situ for up to 4 weeks. Consequently, the film can effectively promote osteogenesis, which accelerates bone defect healing and the implants osseointegration. Cell-level studies further show that the film up-regulates the expression of genes and proteins (ALP, OCN, OSX, OPN, RUNX2, VEGF) associated with osteogenesis and angiogenesis. Overall, this novel protein film represents an intelligent platform for peptide immobilization, protection, and release through its self-assembly, dense structure, and degradation mode, providing a therapeutic strategy for bone repair.

Optimization of Polydimethylsiloxane-Modified Composite Synthesis and Its Impact on Collagen Interactions: Perspectives for Biomedical Applications

This research explores how silica composites modified with polydimethylsiloxane interact with collagen, aiming to enhance their application in the biomedical field. By adjusting the amount of polydimethylsiloxane in these composites, we evaluated their capacity to bind with collagen, an essential feature for biomaterials used in tissue engineering and drug delivery. Our findings reveal that incorporating polydimethylsiloxane into silica composites significantly boosts collagen attachment, indicating strong binding interactions. Notably, the collagen adhered to the composites maintains its natural structure, ensuring its functionality and compatibility with living tissues. This aspect is critical for biomaterials that support cell growth and regeneration in tissue scaffolds. Additionally, this study investigates how the viscosity of polydimethylsiloxane influences collagen binding, offering insights into the tailoring of composite properties for better biological performance. This work highlights the potential of polydimethylsiloxane-modified silica composites in creating innovative biomaterials for regenerative medicine and targeted therapeutic delivery.

Development, Characterization, and Antibacterial Analysis of the Selenium-Doped Bio-Glass-Collagen-Gelatin Composite Scaffold for Guided Bone Regeneration

Background Guided bone regeneration (GBR) is an often-used technique to aid the successful placement of dental implants in sites with deficient bone. The search for the ideal GBR membrane with bioactive components improving the regenerative outcomes is still on. In this study, a novel composite GBR membrane was developed using selenium-doped bio-glass, collagen, and gelatin. It was further characterized for surface, chemical, biocompatibility, and antibacterial properties. Methodology Selenium-doped bio-glass was prepared using the sol-gel method. The membrane was fabricated using an equal ratio of collagen and gelatin mixed with 1% selenium-doped bio-glass. The solution was poured to obtain a thin layer of the material which was lyophilized to obtain the final GBR membrane. The membrane was analyzed with scanning electron microscopy, energy dispersive X-ray (EDX) analysis, attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), zebrafish cytotoxicity test, and antibacterial assay. Results The membrane revealed good surface roughness with lamellar and fibrillar arrangement with a minute granular surface ideal for cell attachment and proliferation. The EDX analysis revealed the presence of carbon, oxygen, and nitrogen as predominant components with trace amounts of calcium, phosphorus, silica, and selenium. Fourier transform infrared spectroscopy analysis also proved the presence of collagen, gelatin, and bio-glass. The membrane revealed excellent biocompatibility with zebrafish growth at a normal rate with 90% viability maintained at 48, 72, and 96 hours and 95% viability at 120 hours. It also exhibited excellent antibacterial activity against Staphylococcus aureus and Escherichia coli with minimal growth of bacterial colonies. Conclusion The developed novel selenium bio-glass collagen and gelatin composite scaffold has a good surface and antibacterial properties along with excellent biocompatibility. Further cell line and in vivo studies should be conducted to explore its role in bone regeneration.