ABSTRACT
Objective:
To compare the antimicrobial efficacy of three commercially available membranes (Jason®, Biogide®, and Lumina PTFE®) in inhibiting the growth of Enterococcus faecalis in vitro.
Material and Methods:
Thirty blood-agar petri plates were inoculated with E. faecalis and divided into three groups (n = 10) based on the barrier membrane tested: Group I (Jason®), Group II (Biogide®), and Group III (Lumina PTFE®). After 48–72 hours of incubation, the zones of inhibition surrounding the membranes on the plates were measured. At a significance level of P < 0.01 ANOVA was used for statistical analysis.
Results:
Biogide® (Group II) demonstrated the highest antimicrobial activity with a mean zone of inhibition of 12.0 mm, followed by Jason® (Group I) with 10.5 mm. Lumina PTFE® (Group III) showed the least antimicrobial efficacy with a mean of 8.2 mm (P = 0.023).
Conclusion:
Biogide® exhibited the highest antimicrobial effectiveness, while Lumina PTFE® showed the least. Structural properties, such as membrane pore size and material composition, significantly influence bacterial adherence and effectiveness in GTR/GBR procedures, highlighting the need for optimized properties.
KEYWORDS: Bacteria, biofilm, biological membranes, guided bone regeneration, guided tissue regeneration
INTRODUCTION
The principles of guided tissue and bone regeneration (GTR/GBR) rely on the use of biological membranes to protect blood clots and prevent non-osteogenic cells from infiltrating the surgical site, promoting organized bone repair.[1] While both resorbable (e.g., collagen) and non-resorbable (e.g., polytetrafluoroethylene, PTFE) membranes are commonly used, there is no consensus on the optimal choice of biomaterial.[2,3] Resorbable membranes, like collagen, offer the advantage of not requiring removal surgery and reducing patient morbidity, but they may degrade too quickly, impairing bone formation. Non-resorbable membranes, such as dense PTFE, are impermeable to bacteria and can remain exposed to the oral environment, but they require additional surgery for removal. Failures in regenerative procedures often occur due to premature exposure of membranes, leading to inflammation and poor healing.[4] The success of GTR/GBR depends on infection-free healing, and bacterial colonization on membranes, including pathogens like Streptococcus mutans and Porphyromonas gingivalis, can hinder the process.[5] Studies have investigated antimicrobial coatings and agents to reduce bacterial contamination, but consensus on protocols is lacking. The purpose of this study is to specifically compare the abilities of Jason®, Biogide®, and Lumina PTFE® barrier materials to inhibit the growth of E. faecalis.
MATERIALS AND METHODS
The antibacterial efficacy of Jason® (Group I), Biogide® (Group II), and Lumina PTFE® (Group III) barrier membranes was assessed against Enterococcus faecalis (ATCC 29212). To prepare the bacterial cultures, brain-heart infusion (BHI) broth was autoclaved and pre-reduced, followed by the inoculation of pure isolates of bacterium. The E. faecalis cultures were incubated for 24 hours. A total of 30 blood-agar petri plates were divided into three groups and then placed with the barrier membranes according to the manufacturer’s instructions. The plates inoculated with E. faecalis were incubated for 48–72 hours at 37°C. After incubation, the plates were examined for zones of inhibition around the barrier membranes. The most uniform segment of the inhibition zone was measured, and the mean zone of inhibition for each barrier was calculated. The data were statistically analyzed using ANOVA, Tukey HSD, and Student’s t-test with a significance level set at P ≤ 0.01 to compare the antimicrobial effectiveness of the different barrier membranes against both bacterial species.
RESULTS
The results show a statistically significant difference in antimicrobial activity, with Group II (12.0 mm) demonstrating the highest efficacy, followed by Group I (10.5 mm), and Group III (8.2 mm) showing the least antimicrobial activity (P = 0.023) [Table 1 and Figure 1].
Table 1.
Zone of inhibition in various barrier membranes
| Group I | Group II | Group III | |
|---|---|---|---|
| Mean | 10.5 | 12.0 | 8.2 |
| Median | 10 | 12 | 8 |
| Standard Deviation (SD) | 1.17 | 1.83 | 1.55 |
| Range | 4 | 5 | 5 |
Figure 1.
Zone of inhibition in various barrier membranes
DISCUSSION
Biogide® shows the highest antimicrobial activity following Jason® and Lumina PTFE® is the least effective. These findings align with previous research, which suggests that the structural properties of resorbable membranes, such as Biogide® and Jason®, which are collagen-based, tend to facilitate greater bacterial adherence due to their hydrophilic nature.[6,7] The smaller pore size of Lumina PTFE® may contribute to its lower antimicrobial activity, as smaller pores generally result in lower permeability, potentially limiting bacterial passage but not necessarily preventing microbial colonization on the surface.[5,6,8] However, the increased bacterial adherence to collagen-based membranes like Biogide® and Jason® raises concerns about microbial contamination in clinical settings, especially when membranes are exposed. Despite its lower antimicrobial effectiveness, Lumina PTFE®’s dense, non-resorbable structure theoretically offers better protection against microbial invasion and degradation. A similar study evaluated bacterial adherence and passage through four types of commercially available GTR/GBR membranes using a multispecies biofilm model.[4] Results showed that Lumina Coat® and Lumina PTFE® exhibited significantly lower bacterial adhesion compared to Jason® and Biogide® (P < 0.05), with all membranes being permeable to bacterial cells, and no significant difference observed between the 2-hour and 7-day time points. Scanning electron microscopy confirmed increased bacterial adherence over time, highlighting the challenge of microbial contamination in regenerative procedures. The findings highlight the importance of optimizing pore size and material composition to improve the antimicrobial properties of membranes, ensuring both their functional integrity and clinical success in GTR/GBR procedures.
The strength of this study includes its controlled in vitro design, providing precise antimicrobial activity comparisons between barrier membranes. It’s relevant to clinical practice and offers insights into material selection for GTR/GBR procedures. However, it’s limited by its focus on a single pathogen, lack of replication of the clinical environment, and short incubation period.
CONCLUSION
Our study evaluated the antimicrobial efficacy of Jason®, Biogide®, and Lumina PTFE® barrier membranes against E. faecalis. Biogide® showed the highest activity, followed by Jason®. The study emphasizes the need to balance membrane characteristics for successful regenerative procedures.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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