Atelo-collagen type I bovine bone substitute and membrane in guided bone regeneration: a series of clinical cases and histopathological assessments
Ondine Lucaciu1*, Dragos Apostu2*, Alexandru Mester1, Radu Septimiu Campian1, Dan Gheban3 and Richard J. Miron4
1Department of Oral Rehabilitation, 2Department of Orthopedics and Traumatology, 3Department of Anatomic Pathology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania and 4Department of Periodontology, University of Bern, Switzerland
*Ondine Lucaciu and Dragos Apostu have equal contribution
Offprint requests to: Alexandru Mester, Department of Oral Rehabilitation, University of Medicine and Pharmacy "Iuliu Hatieganu", 15 Victor Babes Street, 400012, Cluj-Napoca, Romania. e-mail: alexandrumester@yahoo.com
Summary. Absorbable atelo-collagen type 1 represents a new approach for guided bone regeneration with several reported advantages such as: osteoblast attachment, proliferation, mineralization potential, absorption of growth factors and inhibition of bacterial pathogen colonization. The aim of this study was to assess the clinical, radiological (preoperative width, re-entry width, gain), Periotest measurements and histologic benefits of atelo-collagen-derived bovine bone grafts (ImploBone) in combination with an atelo-collagen type I barrier membrane (ImploSorb) for guided bone regeneration (GBR) of atrophic alveolar crest in thirteen patients.
Eleven patients underwent simultaneous GBR with implant insertion, two had initial GBR procedure followed by implant placement after 6 months of healing. Ridge augmentation was performed using an atelo-collagen membrane (ImploSorb, Bioimplon, Germany) and a combination of 50% ABBM (ImploBone, granule size 0.5-1mm, BioImplon Germany) mixed with 50% autologous bone.
It was found that simultaneous GBR with implant placement resulted in a 35% gain at bone defect level (preoperative width 5.03±1.25 mm, re-entry width 6.81±0.98 mm, gain 1.78±1.71 mm). Implant placement performed in a 2 stage surgery 6 months following GBR was linked with a 63.9% gain at bone defect level (preoperative width 3.79±1.10 mm, re-entry width 6.22±1.41 mm, gain 2.43±1.43 mm). The total gain in both groups was 41.9% utilizing these novel biomaterials (preoperative width 4.68±1.32 mm, re-entry width 6.65±1.12 mm, gain 1.96±1.64 mm).
This case series study presents a protocol where GBR can be performed either simultaneously to implant placement or delayed with this innovative biomaterial to favor bone regrowth. Future randomized controlled clinical trials are needed to further validate the bone-promoting potential of atelo-collagen-based biomaterials for bone regeneration. Histol Histopathol 34, 1061-1071 (2019)
Key words: Aatelo-collagen membrane, Guided bone regeneration, Osseointegration, Implant
DOI: 10.14670/HH-18-108