Dense-PTFE Membrane vs. Expanded-PTFE Membrane ?
Posted in Bone Grafting Ridge Augmentation Tissue Regeneration
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Subscribe to this PostGdoc, a dental student, asks:
I am a dental student and I am trying to figure out the difference between a dense-PTFE membrane and a expanded-PTFE membrane. What exactly is the difference? Is it the pore size? Or is it that one is meant to be left exposed and the other needs to be covered?Please clarify. Thanks
You are correct. The manufacturing process of high density PTFE decreases the pore size to .2 microns, making the material impervious to bacteria. Primary closure is not required, and not desired, making the membrane removal easy and painless. The studies in the past using e-PTFE yielded the best results in terms of bone regeneration compared with resorbable products(Buser), however the exposure rate was very high leading to biomaterial centered infections and complications. The d-PTFE yields comparable results. (Greenwell)
In my practice i have good results with cytoplast dense PTFE membrane. Much better bone preservation and tissue responce than to resorbable membranes. Price is better is better too.
remember when resorbable membranes resorb, they resorb with an inflammatory response, that leads to some resorption. Even through hydrolysis of polylactic acid (resorbable plates and membranes) there is evidence of inflammation in there resorption processes.
while on the topic ,can collatape be used as an effective barrier membrane? If not ,why not ?
Where does one buy the d- PTFE. Is this a membrane from gore-tex?
I am in real need of the dPTFE membrane for my thesis work. I would like to know where it may be available.Any guidance will be greatly appreciated
Hey Guys:
Even if I provide a tension free primary closure, there is flap die back and exposure of white d-PTFE (cytoplast)happens in 100% of the cases I have ever done. Why does not it remain submerged.
Dr Jain
center for Implant Dentistry
Fremont,CA
PTFE membranes are teflon. Not only is there no adhesion of cells, there is also no adhesion of fibrin and thrombin. Without a base for stabilization of a clot and attachment of filopodia from the cells, there is no angiogenesis. There is also no perfusion of gases and fluids from the underlying bone which prevents new tissue growth. PTFE is purely an occlusive material and, as such, limits our ability to regrow soft tissue. I prefer a type I bovine collagen membrane with a longer resorption time. There is excellent clot and cell adhesion which allows complete epithelialization of tissue over the graft in a few weeks. Additionally, there is no second surgery to remove the non-resorbable membranes which helps the maturation process of both soft and hard tissues.
RJM
Hi Robert, some good comment on clot stability which is vital for differiation to osteoblasts. We have only used (last 5 years ) graft materials that are their own cell occlusive membrane and stable thus providing the body the best possible platform for healing.these materials are nano porus for vascularisation to further aid the body, there is an interesting paper on pore size of membranes by Gutta R , Baker RA et al in J of Oral Maxillofac Surg Jun 09 67 (6) 1218-25 which also shows improved results with the use of non resorbable membranes.
Another interesting area are the “paint on” membranes which are bio absorbable , the polyethylene glycol (PEG) hydrogel show in the paper by Jung RE , Halg GA et al, A randomised , controlled clinical trial to evaluate a new membrane for GBR around implants pub in Clin Oral Implants Res 09 Feb 20 (2) 162-8 , which is soon to be released by one of he major implant companies.
Hi, can u tell me where can i find a cheaper PTFE membrane. From your experience, what do you use? I want a cheap, but a good membrane. Can you recommend something?
Thank you in advance for your help!
Kind regards,