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Concept
Barrier membrane
Résumé
A barrier membrane is a device used in oral surgery and periodontal surgery to prevent epithelium, which regenerates relatively quickly, from growing into an area in which another, more slowly growing tissue type, such as bone, is desired. Such a method of preventing epithelial migration into a specific area is known as guided tissue regeneration (GTR).
The first membranes developed were nonresorbable and required a second surgery for membrane removal some weeks later. The need for a second surgical procedure hindered the utilization of the original barrier membranes, which led to the development of resorbable membranes; research indicates no statistically significant difference in surgical success between the two types.
The purpose of a membrane is to prohibit the penetration of cells, primarily epithelial, through its structure. The bone tissue grows slower than soft tissue. Hence, if a bone defect needs to heal, the membrane separates it from the soft tissue, giving time for the bone cells to fill the defect. In absence of a barrier membrane, the defect would be occupied by soft tissue cells.
When barrier membranes are utilized, the superficial soft tissue flap remains separated from the underlying bone for the primary healing period and must survive on the vascular supply of the flap; it cannot rely on granulation tissue derived from the underlying bone.
Two types of bony defects exist that may require the use of a membrane:
Space-making defect
Non-space-making defect
Space-making defects, such as extraction sockets with intact bony walls, are not as demanding as non-space-making defects, such as sites of ridge augmentation, where there may be no support for the membrane and the soft tissue cover may cause collapse of the membrane during healing.
Barrier membranes have been derived from a variety of sources, both natural and synthetic, and are marketed under various trade names. Membranes used in guided bone regeneration (GBR) and grafting may be of two principal varieties:
non-resorbable
resorbable.
Source officielle
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