Background: Non-perforated Polytetrafluoroethylene (PTFE) membranes are effectively utilized in
guided bone regeneration (GBR) but may hinder cell migration due to limited interaction with the
periosteum. This study compared bone regeneration using occlusive or perforated membranes
combined with acellular collagen sponge (ACS) and recombinant human bone morphogenic protein-2
(rhBMP-2) in a canine mandibular model.
Material and Methods: Male beagle dogs (n=3) received two mandibular defects each to compare
ACS/rhBMP-2 with experimental (perforated group) and control (non-perforated group) membranes
(n=3 defects/group). Tissue healing was assessed histomorphologically, histomorphometrically and
through volumetric reconstruction using microcomputed tomography.
Results: The perforated group showed increased bone formation and reduced soft tissue formation
compared to the non-perforated group. For the primary outcome, histomorphometric analysis revealed
significantly greater total regenerated bone in the perforated group (67.08 ± 6.86%) relative to the nonperforated
group (25.18 ± 22.44%) (p = 0.036). Perforated membranes had less soft tissue infiltration
(32.91 ± 6.86%) compared to non-perforated membranes (74.82 ± 22.44%) (p = 0.036).
Conclusion: The increased permeability of membranes in the perforated group potentially enabled
periosteal precursor cells greater accessibility to rhBMP-2. The availability may have accelerated their
differentiation into mature bone-forming cells, contributing to the stimulation of new bone production,
relative to the non-perforated group.
Keywords: Osteogenesis, periosteum, bone regeneration, polytetrafluoroethylene, implants