Bone Regenerative Potential of Cross-Linked Collagen Membrane in Peri-Implant Osseous Defect: Case Series with Histologic/Micro-Computed Tomographic Findings

The role of a barrier membrane is crucial in guided bone regeneration (GBR) for space creation and cell occlusiveness. Those properties of the membrane should be sustained for a sufficient period. For such purpose, several cross-linked collagen membranes were introduced and demonstrated favorable clinical outcomes. However, histologic data were not sufficient to support the effect of cross-linked collagen membranes. In the present case series, healing after GBR using a cross-linked collagen membrane was investigated in-depth via histologic and micro-computed tomographic (micro-CT) analyses. 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide cross-linked collagen membrane was used in GBR for treating various peri-implant bone defects in seven patients. After 4-7 months of healing, newly formed tissue of hard consistency was observed over the implant platform. This tissue was carefully harvested and assessed. In micro-CT and histological analyses, evident new bone formation was revealed, especially in the vicinity of the collagen membrane. Moreover, it was histologically found that some newly formed bone was in intimate contact with the membrane. Although the exact mechanism of bone regeneration in the present cases was not clearly elucidated, the cross-linked collagen membrane appeared to contribute to ossification in GBR. Further studies are needed to confirm the findings of the present case series.