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Micro-porous Cytoflex® Resorb membranes consist of three integral layers. The embossed gingival interface layer is designed to promote gingival tissue attachment. The middle layer is constructed of long lasting fabric filament to prevent fibroblast down growth. The defect interface layer is made to enhance adherence to the surrounding defect surface and to prevent fibroblasts from reaching the wound. All three micro-porous layers are structurally integrated, resulting in a flexible membrane with superb handling properties and high nutrient permeability.
Made of biocompatible poly (lactide-co-glycolide) copolymers, Cytoflex® Resorb membrane is non-pyrogenic, non-immunogenic and maintains a barrier framework for up to 4 months after implantation. The material is completely dissolved within 6 months. The resorbable membrane does not require a second retrieval procedure.
Cytoflex Resorb Study
The regenerative capacity of Cytoflex® Resorb barriers was evaluated in a beagle dog model. Bilateral infrabony defects were surgically created at the distal aspects of both mandibles in eight beagle dogs. Subsequently, the defects were treated with a GTR procedure using Cytoflex® Resorb barriers. The animals were euthanized at 4, 8, 16 and 24 weeks post-operation. Histotological analysis (below) demonstrates that Cytoflex® Resorb membranes are effective at regenerating new cementum, periodontal ligament and alveolar bone tissue in the protected infrabony defect. Over time, the regenerated tissues remodeled and organized into matured tissue. Post-operation, wound healing was calm and uneventful. The barrier frame remains largely intact up to 16 weeks and is completely resorbed at 24 weeks after implantation.
|Questions and Answers|
The side with the distinct diamond pattern embossing (large grating) should face the gingival tissue. The smoother side should face the bony defect or bone graft site. Note: In the inner package, the embossed layer faces the dentist.
The Box Technique was invented in November 2008 by Dr. Andrea Menoni; it is the first prosthetically guided bone regeneration technique aimed at fully restoring the lost bone volume by using resorbable polylactid acid absorbable materials.
The Cytoflex Resorb membrane is chemically similar to the materials used in the Box technique, however, Cytoflex Resorb is thinner and more flexible than the material used in the Box technique.
Cytoflex® Resorb was cleared by FDA for use as a space making barrier in the treatment of periodontal defects, including two or three wall bone defects, class II furcations, recession type defects, circumferential defects, and dehiscence defects associated with dental implants.
Primary closure is achieved when you are able to bring the tissue together and suture. When this is impossible after a large extraction, the practitioner needs to approximate the tissue as much as possible. Whether a barrier membrane can be left exposed is highly dependent upon the practitioner’s skills, experience with the barrier material, the construct of the barrier membrane and the treatment protocol.
Cytoflex Resorb is cleared for use in conjunction with primary closure. No clinical studies have been performed as if the membrane can be left exposed. If an early exposure does occur after primary closure, the barrier properties of this material can be much more forgiving due to its long resorption duration.
Cytoflex Resorb is slightly stiffer than regular paper yet can be easily folded without any pre-soaking.
In general, a double layer closure, with a deep layer of horizontal mattress suture followed by a standard wound closure with interrupted suture is recommended. During primary closure, adequate flap release must be accomplished in order to achieve a tension-free closure. Closure should be maintained for at least two weeks after surgery. The use of long lasting monofilament suture is recommended to prevent premature loss of suture strength, which may lead to early membrane exposure during the initial 2-week healing period.
The membrane may be cut to the desired configuration with scissors. To enhance stability and adequate protection of the space over the bony defect, the membrane should be trimmed to extend 2-3mm beyond the defect margins and to remain at least 1 mm from adjacent, uninvolved teeth.
Cytoflex® Resorb can be fixated with surgical screws or tacks. Proper fixation may be used to prevent membrane perforation and/or early exposure.
Cytoflex® Resorb can be trimmed, shaped and administered without pre-soaking. Doctors may wet the membrane either with sterile saline or patient’s blood prior to administration.
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