OSSEOUS GUIDED TISSUE REGENERATION USING A COLLAGEN BARRIER MEMBRANE

The formation of mature, fibrous tissue in surgical osteotomy sites during the healing process can produce clinically undesirable results such as nonunion or encapsulation of alloplastic implants. The techniques of guided tissue regeneration have been used to ameliorate this problem by presenting a barrier to the invasion of fibrous tissue elements into the wound-site clot. The most frequently used barrier material, polytetrafluoroethylene is effective, but suffers the disadvantage of requiring surgical removal after clot organization is completed. A biocompatible, resorbable membrane that will effectively control the type of tissue that can invade and organize a clot would be advantageous, because it would not require surgical removal. In the present study, the efficacy of a collagen membrane to effect guided tissue regeneration in a rabbit zygomatic arch osteotomy model was tested. Complete, bilateral narrow (1 mm) or wide (5 mm) vertical osteotomies were created in eight adult New Zealand white male rabbits. On one side, the wound site was surrounded by a collagen barrier membrane prior to closure, while the other side was left uncovered (control side). Four animals were killed at 2 and 4 weeks postoperatively for gross radiologic and histologic examination of the wound site. The wide osteotomy sites without a barrier membrane showed invasion by fibroblasts resulting in fibrous nonunion, while the contralateral sides with the barrier membrane showed no fibrous tissue ingrowth and bony union by 4 weeks postoperatively. Although narrow wound sites without the barrier membrane showed fibrous tissue formation, the perimeter of the defects showed some new bone deposited at the periosteal surface, bridging the osteotomy site and producing osseous union. These results suggest that a collagen membrane can effectively prevent invasion of a clot by undesired cells, especially in large bony defects, and may be a useful adjunct in surgical cases requiring extensive repositioning of bony segments, where fibrous nonunion would be an undesired outcome. © 1993, American Association of Oral and Maxillofacial Surgeons. All rights reserved.