The substitute materials of autologous tissue graft for periodontal soft tissue augmentation surgery develop rapidly. The use of substitute material can avoid the second operation area, shorten the operation time, reduce the postoperative reaction and pain, and is not limited by the quantity, suitable for a wide range of cases. In this paper, the characteristics, histological study, clinical application and therapeutic effect of acellular dermal matrix as a substitute material for autologous tissue transplantation were introduced to provide reference for clinical work.
Acellular Dermis ; Wound Healing

No abstract available.
Acellular Dermis* ; Animals ; Dogs* ; Transplants*

OBJECTIVETo study the microstructue of acellular dermal matrix (ADM) and the attachment and proliferation of MG63 osteoblast-like cells on the membrane.

METHODSADM was experimental group and expanded polytetrafluoroethylene (e-PTFE) membrane was control group. Light microscope and scanning electronic microscope (SEM) were used to observe the microstructure of the two kinds of membrane. MG63 osteoblast-like cells were cultured on the two kinds of membrane and the blank group. The cell viability was checked by cell viability analyzer (CVA) and alkaline phosphatase (ALP) activity was detected by ELISA. SEM was used to observe the adhesion and proliferation of the MG63 osteoblast-like cells on the two kinds of membrane.

RESULTSThe ADM was composed of the tissular side and basal lamina side. The tissue side showed scale-shaped structure and the basal lamina side demonstrated many digitations and some pores of folliculus pili. The e-PTFE showed many tiny lined cracks in elliptic structure. The viability of the MG63 osteoblast-like cells on the two kinds of membranes and ALP measurement showed that there was no significant difference between each of the two membrane groups and the blank. The adhesion and proliferation of osteoblast-like cells on the two kinks of membranes were both well.

CONCLUSIONADM has no negative effects on the growth of osteoblast-like cells. ADM is biocompatibile and its microstructure is appropriate for guided bone regeneration materials.

Acellular Dermis ; Bone Regeneration ; Osteoblasts

No abstract available.
Acellular Dermis ; Ulcer ; Wounds and Injuries

A full-thickness skin defect was made on the back of rabbits to evaluate the characteristics of commonly used artificial dermis. The artificial dermis used in this experiment was Alloderm , Integra and Terudermis . The Integra and Terudermis are bilayer membranes composed of bovine collagen matrix and silastic membrane which functions as the epidermis. Alloderm is acellular dermal matrix obtained from human cadaveric skin. These artificial dermis were applied to the full-thickness skin defect on the back of rabbits and the histologic changes were evaluated 3 days, 1 week, 10 days, 2 weeks and 4 weeks after its application. Thin split-thickness skin graft taken from the abdomen was applied on the artificial dermis immediate after Alloderm graft and 2 weeks after Terudermis and Integra graft. The process of skin graft "take" was evaluated on the 3 rd, 5 th, and 7 th day after split-thickness skin graft. The formation of new collagen and capillaries, and infiltration of fibroblasts were found earliest and most remarkably in case of Alloderm , latest and least remarkably in case pf Integra . The arrangement of collagen fibers was most regular in Alloderm but there was no significant difference between Terudermis and Integra . The original structure of the artificial dermis disappeared 1 week after Terudermis graft but the structure remained until 4 th week after Integra graft, which means the cross-link of Integra is stronger than the other artificial dermis. The thickness of artificial dermis decreased from initial 0.43 mm to 0.34 mm(79.7% of initial thickness) on the 4 th week in Alloderm , from 1.22 mm to 0.89 mm(73.0%) in Terudermis , from 1.34 mm to 1.13 mm(84.3%) in Integra . The decrease of thickness was statistically significant in all artificial dermis. In conclusion, Alloderm has best cellular affinity to the host: the skin graft over the Alloderm turns out to be the best, but Alloderm is the thinnest among artificial dermis. Terudermis has better cellular affinity to the host than Integra , which means better vascularity and more collagen fibers in Terudermis . However, Intra keeps thicker volume than Terudermis . Best artificial dermis will be chosen according to the clinical conditions.
Abdomen ; Acellular Dermis ; Cadaver ; Capillaries ; Collagen ; Dermis* ; Epidermis ; Fibroblasts ; Humans ; Membranes ; Rabbits ; Skin ; Transplants*

The use of artificial skins for full thickness wounds is an accepted technique, but unfortunately the take rate is low and the aesthetical result is not acceptable. The freeze-drying treatment of allogenic tissues can destroy cells with preserving the structural organization of extracellular matrices, permitting allogenic transplantation. In this study we investigated a new method to process the allogenic skin for transplantable allogenic dermis and this dermis was evaluated in a full thickness wound model. The results are as followings; 1. After treatment with NaCl and SDS solution and then with freeze-drying method, the allogenic dermis shows acellular dermal matrix with preserved normal extracellular matrix. 2. This allogenic dermis became completely incorporated into the wound without evidence of rejection or replacement by scar tissue. 3. The take rate of thin autografts overlying the allogenic dermis that were applied simultaneously was comparable to take rate of autograft alone. 4. The reduction in secondary contraction by allogenic dermis treated wounds was significant. 5. After grafting with cultured keratinocytes, the degree of epithelial coverage was 70% at 2 weeks. In conclusion, the allogenic dermis processed with our method displayed lack of antigenicity, and rapid revascularization. This allogenic dermis can permit simultaneous engraftment of an overlying STSG or cultured kerationocytes, reduce secondary contraction and improve cosmesis of full thickness wounds.
Acellular Dermis ; Autografts ; Cicatrix ; Dermis* ; Extracellular Matrix ; Keratinocytes ; Skin ; Skin, Artificial ; Transplants ; Wounds and Injuries*

OBJECTIVETo observe the changes in the structure and cytocompatibility of porcine acellular dermal matrix, which was prepared with dermal reticular layer, treated with matrix metalloproteinase 7 (MMP-7), genipin, and vacuum freeze-drying.

METHODSFifty-four pieces of porcine dermal reticular layer, prepared with lateral abdominal skin were obtained from healthy large Yorkshire pig with mechanical method under sanitary condition, each 10.0 mm×5.0 mm in size and 0.5 - 0.6 mm in thickness. They were divided into normal control group (A(1), without treatment, n = 6), decellularization group (B, decellularized, n = 12), decellularization + MMP-7 group (C, treated with MMP-7 after decellularization, n = 12), decellularization + MMP-7 + genipin group (D, treated with MMP-7 and genipin after decellularization, n = 12), and decellularization + MMP-7 + genipin + vacuum freeze-drying group (E, treated with MMP-7, genipin, and vacuum freeze-drying after decellularization, n = 12) according to the random number table. Meanwhile, 6 pieces of human acellular dermal matrix, with the same size and thickness as listed above, were taken as control group (A(2), without treatment) in the cytocompatibility tests. HE staining and scanning electron microscope were used to detect the cell number and the change in tissue structure in dermal scaffold in groups A(1) and B-E. Immunohistochemical staining was used to determine residual vimentin, laminin and collagen IV in groups A(1), B, and C. Cytotoxicity tests were employed to test the cytotoxicity of the leaching solutions of groups B-E. Human fibroblasts were seeded on the surface of dermal scaffold in groups A(2) and B-E. The proliferation of fibroblasts were determined on post culture day (PCD) 3, 7, and 14, and the content of IL-6 and IL-8 in the supernatant were determined on PCD 3 and 7 with enzyme-linked immunosorbent assay. Data were processed with two-way analysis of variance and LSD- t test.

RESULTSGranular structure with hair follicle in pale yellow color was observed in group A(1). Small amount of hair, epithelial root sheath, nuclei, cell debris-like structure, vimentin, laminin, and collagen IV were observed in group B but not in group C, D, or E, which had been treated with MMP-7. The toughness of dermal scaffold was stronger in groups D, E than in groups B and C as observed in gross condition observation. The collagen fibers of dermal scaffold in groups C-E maintained their structural integrity with similar arrange as that of group A(1). The interspaces among collagen fibers in groups C-E were all increased, while those of groups C and D were similar but larger than that in group B; the interspace in group E was the largest. Groups B-E scored level 0 or 1 in the cytotoxicity test. Fibroblasts could proliferate on the surface of dermal scaffold in groups A(2) and B-E. Furthermore, with the extension of culture time, fibroblasts gradually became to be stratified to form multiple layers, and they proliferated toward the dermis. High density of fibroblasts was observed on the surface in groups D and E and in the deep layer in groups A(2) and C. On PCD 7, the contents of IL-6 [(132 ± 14), (104 ± 9), (122 ± 14), (120 ± 12), (128 ± 17) pg/mL] and IL-8 [(135 ± 18), (102 ± 17), (127 ± 18), (134 ± 23), (141 ± 24) pg/mL] in the supernatant in groups A(2) and B-E were significantly higher than those on PCD 3 [(55 ± 13), (34 ± 8), (48 ± 8), (50 ± 13), (49 ± 12) pg/mL] and [(93 ± 19), (63 ± 11), (82 ± 15), (82 ± 16), (89 ± 16) pg/mL], with F values respectively 98.869, 184.038, 125.531, 93.237, 87.265 and 15.694, 23.451, 22.801, 19.607, 18.808, P values below 0.05. The differences among groups A(2) and B-E in the levels of IL-6 and IL-8 at each time point were statistically significant (with F values respectively 2.809, 3.301 and 3.757, 3.266, P values below 0.05). The differences among groups A(2), C, D, and E in amount of IL-6 and IL-8 at each time point were not statistically significant (with t values respectively 0.058 - 1.905 and 0.034 - 1.295, P values above 0.05), but they were all higher than those in group B (with t values respectively 3.707 - 5.612 and 2.785 - 4.079, P values below 0.05).

CONCLUSIONSThe low immunogenic porcine dermal scaffold treated with MMP-7, genipin, and vacuum freeze-drying after decellularization, has good cytocompatibility. The growth of only a few fibroblasts in the dermal scaffold may be correlated with genipin, which increases tissue toughness.

Acellular Dermis ; Animals ; Cells, Cultured ; Dermis ; transplantation ; Histocompatibility ; Humans ; Skin Transplantation ; Swine ; Tissue Scaffolds ; Wound Healing

PURPOSE: Deficiencies of the abdominal wall can be the a result of infection, surgery, trauma, or primary herniation. For abdominal wall reconstruction, synthetic materials have been shown to provide a better long-term success rate than primary fascial repair. But, synthetic materials cannot elicit angiogenesis or produce growth factor and are therefore plagued by an inability to clear infection. As a result of the inherent drawbacks of synthetic, significant effort has been spent on the identification of new bioprosthetic materials. The aim of our study is to evaluate the effectiveness of a synthetic material(PROCEED(R)) and an ADM(SureDerm(TM)) to repair abdominal wall defects in a rabbit models. METHODS: We measured the tensile strength of the SureDerm(TM) and PROCEED(R) by a Tension meter(Instron 4482). 16 Rabbit models were assigned to this study for abdominal wall reconstruction. Abdominal defect of 8 rabbits were reconstructed by PROCEED(R) and the rest were reconstructed by SureDerm(TM). We assessed gross and histologic examinations for the reconstructed abdominal wall. RESULTS: The tensile strenth of SureDerm(TM) and Gore Tex(R) is 14.64+/-0.51 Mpa, 8.54+/-0.45 Mpa. PROCEED(R) was estimated above the limits of measurement. Inflammatory reaction of PROCEED(R) persisted for 32weeks, but SureDerm(TM) decreased after 16weeks. Vascular ingrowth into the SureDerm(TM) was seen after 32 weeks. The basement membrane of SureDerm(TM) changed into a form of pseudoperitoneum. In PROCEED(R), it seemed like pseudoepithelial lining was made from the fibrosis around the mesh. CONCLUSION: In our study, the SureDerm(TM) not only have less inflammatory reaction and presented more angiogenesis than the PROCEED(R), but also have pseudoperitoneum formation. It is expected that SureDerm(TM) is useful for abdominal wall reconstruction. However, a long-term study of its usage consequences are thought to be needed.
Abdominal Wall ; Acellular Dermis ; Basement Membrane ; Fibrosis ; Rabbits ; Tensile Strength

PURPOSE: Gingival recession is a major esthetic concern and may lead to root sensitivity during periodontal treatment. Coronally advanced flaps (CAFs) with and without acellular dermal matrix (ADM) are widely used in root coverage procedures. The aim of this study was to analyze the efficacy of CAF in combination with ADM in the treatment of gingival recession. METHODS: PubMed, The Cochrane Library, and Embase were used to identify relevant articles. The articles were screened, data were extracted, and the quality of the studies was assessed by three reviewers with expertise in clinical practice, trials, statistics, and biomedical editing. The clinical endpoints of interest included changes in recession, probing depth (PD), clinical attachment level (CAL), and keratinized tissue (KT). RESULTS: Ten randomized controlled trials were identified, including six studies that compared CAFs with ADM and CAFs using connective tissue grafting (CTG) and four studies that compared CAFs with or without ADM. No statistically significant differences were found between the use of ADM and CTG, whereas statistically significant differences were found between groups in which ADM and CAF were combined and groups that underwent CAF alone with regard to recession coverage, CAL, and KT. The combination of CAF with an ADM allograft achieved more favorable recession coverage and recovery of CAL and KT than CAF alone. CONCLUSIONS: The results from the ADM and CTG groups suggest that both procedures may be equally effective in clinical practice. Given the limitations of this study, further investigation is needed to clarify the effectiveness of ADM and CAF in clinical practice.
Acellular Dermis* ; Allografts ; Connective Tissue ; Gingival Recession ; Transplants

Acellular Dermis ; Female ; Humans ; Mammaplasty ; methods ; Nipples ; surgery