Membranes for Periodontal Regeneration

Abstract

U ovome su članku prikazane različite vrste membrana za vođenu regeneraciju parodontnih tkiva. One se upotrebljavaju za pokrivanje defekata i poticanje regeneracije koštanih stijenki u parodontnome džepu. Membrana treba biti biokompatibilna i omogućiti da se stanice isključe kako bi se odvojio gingivni režanj od fibrinskoga ugruška te očuvao prostor za novu alveolnu kost i periodontni ligament. Membrane mogu biti resorbirajuće i neresorbirajuće. Neresorbirajuće membrane zahtijevaju drugi kirurški zahvat kako bi ih se uklonilo, zbog čega se sve manje upotrebljavaju. Većina tih membrana izrađuje se od politetrafluoretilena, kao na primjer Gore-Tex membrane. Resorbirajuće membrane skraćuju vrijeme liječenja, jer ih ne treba odstraniti nakon zahvata. Mogu biti od prirodnih materijala, pretežito od kolagena, i sintetičkih resorbirajučih materijala, najčešće derivata organskih alifatskih termoplastičnih polimera. Upotrebljava se poliglikolna i polilaktična kiselina. U tu skupinu spada Atrisorb membrana koja se pripravlja intraoperativno. Danas se ispituje i upotreba poliuretanskih membrana. Idealnih membrana nema. Do sada se najviše rabe kolagene membrane koje imaju najbolju biokompatibilnost, iako im se vrijeme razgradnje teško može predvidjeti.This article reviews different types of membranes for guided tissue regeneration. They are used to cover defects and stimulate regeneration of osseous defects in periodontal pockets. A membrane should be biocompatible, enable cell exclusion separating the gingival flap from the fibrine clot and guard space for the new alveolar bone and the periodontal ligament. Membrane can be non-resorbable and resorbable. When non resorbable membranes are used, another surgical procedure for their extraction is needed. They are therefore used less frequently today. The majority of these membranes are made of polytetrafluoretylene, e.g. Gore-Tex membrane. Resorbable membranes shorten the treatment since there is no need for their removal. They can be made from natural materials like collagen, laminar bone, dura mater or connective tissue transplants and from synthetic resorbable materials, most frequently derivatives of organic aliphatic thermoplastic polymers. Polyglycolic and polylactic acids are mostly used. This group includes the Atrisorb membrane that has to be prepared intraoperatively. The use of polyurethane membranes is presently being tested. So far the perfect membrane has not been discovered. Collagen membranes are most popular due to their optimal biocompatibility, although their rate of resorption is difficult to predict