Placement Techniques for OsseoSeal Porcine Collagen Membrane

OsseoSeal Membrane has become a popular membrane, due to its excellent flexibility, which allows you to easily adapt the membrane to a defect area. However, because of its flexibility, it also requires some changes in handling procedures, as described more fully below.

Two General Types of Collagen Membranes: Bovine and Porcine

Before getting to the placement technique, for OsseoSeal, we wanted to briefly review the various types of collagen membranes. There are many kinds of commercially available collagen membranes, and it can be confusing for the clinician to know which membrane to choose. Without getting too technical, we find it useful to simply differentiate between bovine and porcine collagen membranes.

Bovine is Stiffer, Porcine is more Adaptable: Choice Depends on Clinical Situation

In general, the bovine collagen membranes are stiffer than porcine collagen membranes. Therefore, when additional stress is inevitable and you need more rigidity, such as when you are placing a membrane thru a tunnel/pouch or inside a socket wall, and there is a risk that the membrane may collapse on itself, a bovine membrane is usually preferred. However, in other cases, you might require excellent adaptation of the membrane to the graft material and the surrounding native bone, in order to help maintain the space and exclude the soft tissue progenitor cells. In these situations, a porcine collagen membrane maybe a better choice, simply because it is more flexible and will adhere better to the site.

The Different Types of Porcine

When it comes to porcine collagen membranes, there are also many types depending on the source of the collagen and depending on whether the final membrane is native (i.e. non-cross linked), or cross-linked, and then if cross-linked, what is the method of cross-linking. Cross-linking is a process used to improve the properties of the collagen and overcome the limitations of non cross-linked membranes which have a shorter functional period and greater susceptibility to degradation by periodontal bacteria.

Uniqueness of OsseoSeal

When it comes specifically to OsseoSeal, the membrane is derived from porcine pericardium-derived type I collagen and it is enhanced via Dehydrothermal (DHT) treatment, which is a physical crosslinking method, as opposed to the chemical cross linking used in other membranes. DHT treatment basically entails exposing the collagen to a high temperature for a period in a vacuum, which removes water to form the crosslinks. Numerous studies have shown that the DHT method improves the mechanical properties of the membrane, reduces its biodegradation rate, and ultimately promotes soft-tissue healing

Handling and Placing OsseoSeal: Dry to Place, Wet to Hydrate and Tuck

Now with all the intro out of the way, how do use OsseoSeal? The key thing to remember is that when wet OsseoSeal will basically "suck down" over the area to create a type of seal over the graft and surrounding bone. So when placing OsseoSeal adhere to these guidelines:

• Make sure you are using it for the correct indication. As noted above, if the case requires a stiffer membrane, you should use a bovine membrane rather than OsseoSeal.

• Use a 2-instrument method when placing the membrane: dry instrument (e.g. plier/forcep) to place and anchor, and a wet instrument (e.g. periosteal elevator) to hydrate and tuck the membrane.

  The specific technique is as follows:

• Hold the membrane when its dry by the site of application (with a dry instrument).

• Slowly drop small droplets of saline or anesthetic solution. The membrane soaks the liquid and immediately adapts.

• Once fully wet and in place, you can proceed to advance the flap without any concern of the membrane moving during suturing.

• Use a “wet” instrument after positioning OsseoSeal, so the membrane does not stick to the instrument when it drapes