Aliquota IVA applicata: 22%
Features
Derived from heterologous mesenchymal tissue, the Evolution membrane is gradually resorbable1. Its structure is made of dense collagen fibers with high consistency and extraordinary resistance, offering the surgeon: - maximum adaptability to bone and soft tissue - easy and secure suturing to adjacent soft tissues - excellent membrane-bone and membrane-periosteum interface - prolonged stability and protection of the underlying graft2.
Usage
The membrane can be shaped with sterile scissors to the desired form. Unless the graft site is already bleeding, the membrane should be hydrated with saline solution. Once the desired plasticity is achieved, it must be adapted to the graft site. NB in case of accidental exposure, the dense collagen matrix of Evolution protects the graft from infection; in this case the membrane does not become infected and the wound heals by secondary intention3,4.
Clinical indications
Evolution is derived from heterologous mesenchymal tissue and is completely resorbable. Experimental studies show histological evidence of the prolonged barrier effect of this membrane, which lasts at least 8 weeks1, protecting the graft from external agents. The dense collagen matrix of Evolution protects the graft from infections in case of accidental exposure: the membrane itself does not become infected, allowing healing by secondary intention3,4.
This property is particularly important in the case of flapless regeneration of posterior alveoli5: in these cases, the standard model is recommended. In sinus lift with lateral access, Evolution membranes are indicated to cover the antrostomy (standard model)6,7,8 and to protect the sinus membrane from the risk of perforation due to graft pressure (thin model or OsteoBiol® Special)9.
Evolution is also ideal for protecting peri-implant regeneration10 and periodontal grafts. Furthermore, Evolution has been successfully tested in combination with OsteoBiol® Gel 40 for the treatment of gingival recession2 and for protecting Sp-Block in vertical augmentations using the inlay technique11.
Bibliography
1. NANNMARK U, SENNERBY L. THE BONE TISSUE RESPONSES TO PREHYDRATED AND COLLAGENATED CORTICO-CANCELLOUS PORCINE BONE GRAFTS. A STUDY IN RABBIT MAXILLARY DEFECTS. CLIN IMPLANT DENT RELAT RES, 2008 DEC;10(4):264-70.
2 CARDAROPOLI D, CARDAROPOLI G. Healing of gingival recessions using a collagen membrane with a demineralized xenograft: A randomized controlled clinical trial. Int J Periodontics Restorative Dent, 2009 Feb; 29(1):59-67.
3 BARONE A, BORGIA V, COVANI U, RICCI M, PIATTELLI A, IEZZI G. Flap versus flapless procedure for ridge preservation in alveolar extraction sockets: a histological evaluation in a randomized clinical trial. Clin Oral Implants Res, 2014 Mar 1. Epub ahead of print.
4 BARONE A, RICCI M, TONELLI P, SANTINI S, COVANI U TISSUE CHANGES OF EXTRACTION Sockets IN HUMANS: A COMPARISON OF SPONTANEOUS HEALING VS. RIDGE PRESERVATION WITH SECONDARY SOFT TISSUE HEALING CLIN ORAL IMPLANTS RES, 2012 JUL 12, EPUB AHEAD OF PRINT
5. CARDAROPOLI D, CARDAROPOLI G. Preservation of the postextraction alveolar ridge: A clinical and histologic study. Int J Periodontics Restorative Dent, 2008 Oct; 28(5):469-77.
6 RAMIREZ FERNANDEZ MP, CALVO GUIRADO JL, MATÉ SANCHEZ DE VAL JE, DELGADO RUIZ RA, NEGRI B, BARONA DORADO C. Ultrastructural study by backscattered electron imaging and elemental microanalysis of the bone-biomaterial interface and mineral degradation of porcine xenografts used in maxillary sinus floor elevation. Clin Oral Implants Res, 2012 Jan 26; Epub ahead of print.
7. Barone A, Ricci M, Grassi RF, Nannmark U, Quaranta A, Covani UA. 6-month histological analysis on maxillary sinus augmentation with and without use of collagen membranes over the osteotomy window: randomized clinical trial. Clin Oral Implants Res, 2013 Jan;24(1):1-6. Epub 2011 Dec 12.
8 SCARANO A, PIATTELLI A, PERROTTI V, MANZON L, IEZZI G. Maxillary sinus augmentation in humans using cortical porcine bone: a histological and histomorphometrical evaluation after 4 and 6 months. Clin Implant Dent Relat Res, 2011 Mar; 13(1):13-18.
9 CASSETTA M, RICCI L, IEZZI G, CALASSO S, PIATTELLI A, PERROTTI V. Use of piezosurgery during maxillary sinus elevation: clinical results of 40 consecutive cases. Int J Periodontics Restorative Dent, 2012 Dec;32(6):E182-8.
10 COVANI U, MARCONCINI S, CRESPI R, BARONE A. Immediate implant placement after removal of a failed implant: a clinical and histological case report. J Oral Implantol, 2009; 35(4):189-95.
11 FELICE P, PIANA L, CHECCHI L, CORVINO V, NANNMARK U, PIATTELLI M VERTICAL RIDGE AUGMENTATION OF ATROPHIC POSTERIOR MANDIBLE WITH AN INLAY TECHNIQUE AND CANCELLOUS EQUINE BONE BLOCK: A CASE REPORT INT J PERIODONTICS RESTORATIVE DENT, 2013 MAR;33(2):159-66