The Effect of Barrier Membranes on Regeneration of Bony Defects in Human and Animal Models: A Systematic Review

Barrier membranes have been extensively used for bone regeneration. However their effectiveness is still under investigation. This review was designed to answer the following question: "Do barrier membranes affect the successfulness of bone graft/ bone substitute materials?" Published articles were collected through hand and electronic searching in MEDLINE, EMBASE and CENTRAL databases. Controlled animal and human studies which had evaluated efficacy of membranes in defects other than periodontal lesion, extraction socket preservation and maxillary sinus graft, and had more than 4 weeks follow-up period were considered. Articles which had assessed membrane effect on oseointegration of implants, or had used osteoinductive materials in the bony defect were excluded. Meta-analysis was performed in the following groups: vertical bone augmentation, horizontal bone augmentation and eventful healing. Due to different outcome measurement, analysis was not done for horizontal bone augmentation. A total of 34 studies were selected. Meta-analysis of studies for vertical bone augmentation revealed that membranes may increase the amount of augmented bone (mean difference= 0.32 mm; P=0.006). No statistically significant differences were observed among groups in case of eventful healing both in human (odds ratio= 5.67; P=0.32) and animal studies (odds ratio= 3.35; P=0.12). Available evidence suggested that membranes might be useful for vertical bone augmentation. There was not strong evidence that membranes have an adverse effect on the healing process of the wound. More randomized clinical trials are necessary for applicable results.