What are the difference between Pericardium membrane and other collagen membranes，like Bio-Oss?
I believe you mean, Bio-Gide.
A periodontist from UCLA once told me this
,"- I use pericardium only for Perio defects such as with osseous surgery ( around natural teeth).
- I use Collagen membranes with GBR for Implants."
Differences : - Collagen membranes are typically two layered and thicker around , 0.44mm.
- -Pericardium ( porcine or bovine ) is thinner around 0.15-0.2mm and still triple layered, histologically has more elastic fibers.
- Pericardium can take longer time to resorb than a collagen membrane
I think the difference is whatever we want to say is different. They both serve as a barrier and they both resorb be it at different rates. Interesting that one would opt to use the longer resorbing product around teeth rather than for GBR given that some of the original products were designed to be slower resorbing specifically for GBR procedures. At the end of the day collagen membranes have a ton of research/data backing them where Pericardium is possibly more of a gee wiz look at me product. I have used a number of the pericardium products and they have all done well but I will stick with non-cross linked collagen as they have the most documented success.
There seems to be some confusion here on what pericardium membranes are probably because it’s just a general term that can mean different things. You have pericardium membranes made from human allograft pericardium and you have collagen membranes made from porcine pericardium. I assume the question is related to the collagen membrane. An allograft pericardium membrane would be a separate discussion.
The fact of the matter is that many of the popular collagen membranes on the market are made from porcine pericardium, even though people will just call these collagen membranes, without knowing what they are actually made of. So comparing one to the other doesn’t make much sense, when they are the same thing!
The issue, I believe, is really between porcine-based collagen membranes vs bovine-based.
Briefly, there are 2 types of collagen membranes. One made from Bovine (the classic kind that was the first type of collagen membrane) and one from Porcine.
When it comes to porcine-based collagen membranes, you have Biogide (not Bio-oss, which is mistakenly reference in the question) , which is made from porcine peritoneum, and nearly all the others that are made from porcine pericardium.
Peritoneum is a material that lines organs in the abdominopelvic cavity, while pericardium surrounds the heart. I’m honestly not sure why many of the competitors to Biogide use porcine pericardium, but perhaps Geistlich, the manufacturer, initially had some sort of patent on peritoneum for dental membranes, so pericardium was a logical substitute, especially since human pericardium membranes were already in use. I’m sure there are other biological differences when you choose one source of the other, but I haven’t seen any clinical proof that one type of porcine-membrane is “better” than the other, and they seem to behave in a similar manner (at least the FDA considers them substantially equivalent).
Anyhow, the primary benefit of porcine collagen membranes, irregardless of the source, over bovine-membranes, is that porcine membranes are very flexible. Bovine membranes, tend to be stiffer.
The issue with porcine is that it resorbs very quickly as compared to bovine membranes. This is why some of the porcine-based collagen membranes are cross-linked (cross-linking is a chemical process the purpose of which prolong the resorption of the membrane). Some collagen membranes, by the way, have natural cross links. There is some debate over chemically-induced cross-linking, but as with much else in dentistry, there is no proven clinical data that shows one is “better” than other. There are actually some membranes that tout their particular type of cross-linking as making a better membrane. So who knows.
The bottom line is all the types of collagen membranes are proven in dentistry, in the sense that they have a long history of clinical use and do what they are supposed to do when used correctly. Which type of membrane you choose really depends on the clinical case. Sometimes you will want a tougher, longer-lasting collagen membrane, so you’ll probably go with the bovine-type. Sometimes you want something more flexible that drapes over the site, and you are not concerned with the faster resorption, so you would go with a porcine-type of collagen membrane.
Anecdotally, porcine-pericardium collagen membranes are currently much more popular with our customers, than the classic bovine membranes, which were the initial collagen membranes. That’s partially because people prefer more flexible membranes, but also probably due to the fact that nearly all bovine collagen membranes in the US market are made by the same manufacturer that is now owned by a private equity firm. So there is sort of a monopoly on bovine collagen membranes in the US market and a financial incentive for outsized profits, which has inevitably led to a very high price for the bovine membranes. Porcine membranes, on the other hand, have healthy competition, which keeps a lid on their prices.
Hope this helps.
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Thank you so much for this clarification. I was under the impression, based on the marketing material, that they were different materials with different properties designed for the same purpose. Essentially they are all collagen membranes differing only in the anatomical location that the collagen was derived… Thank You!!