The effect of acellular dermal matrix therapy on biphasic calsium sulfate bone graft

Angga Febriharta(1), Kwartarini Murdiastuti(2*)

(1) Periodontics Specialty Program, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta
(2) Department of Periodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author


Infrabony pocket therapy is needed to eliminate pocket wall, creating easy to clean conditions for new attachment, and bone regeneration. Biphasic calcium sulfate (BCS) bone grafts combined with collagen membranes are known to regenerate bone tissue and have good osteoconductive effects. The addition of collagen membranes promotes migration and proliferation of fibroblast cells, osteoblasts, and homeostasis. However, the collagen membrane is a rapid
bioresynthesis and may cause disease transmission from animal. Acellular dermal matrix (ADMA) membrane contains a bioactive matrix that has the ability to support normal revascularization, cell repopulation, and tissue remodeling. Combination of BCS with ADMA membrane are proven to induce bone and tissue regeneration. The objective of this study is to determine the therapeutic effect of BSC and ADMA combination to eradicate pocket, gingival recession, bone recession and attachment loss. The samples were taken from 20 infrabony pocket sites divided into 2 groups. The first was treated by combination of BCS and ADMA, while the second group was treated by the combination of BCS and collagen membrane. After 1 and 3 months of flap surgery, the result was observed by probing depth
(PD), relative attachment loss (RAL), gingival recession, alveolar bone height and radiological examination. The result showed the decrease of PD, RAL, gingival recession, and alveolar bone height in both two groups. However, there were
no significant differences between those two groups. In conclusion, the combination of BCS and ADMA or BCS and collagen decreased the PD, RAL, gingival recession and alveolar bone height.


ADMA membrane; BCS; collagen membrane; infrabony pocket

Full Text:



1. Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, Taylor
R. Periodontitis and diabetes: a two-way relationship. 2012; 55(1): 21-31.
doi: 10.1007/s00125-011-2342-y

2. Kaushal S, Kumar A, Khan MA, Lal N. Comparative study of nonabsorbable and
absorbable barrier membranes in periodontal osseous defects by guided tissue regeneration. J Oral Bio Craniofac Res. 2016; 6(2): 111-117.
doi: 10.1016/j.jobcr.2015.12.001

3. Newman MG, Takei HH, Carranza FA, Klokkevold PR. Carranza‘s clinical
periodontology 11th ed. Philadelphia: W.B.Saunders Co; 2012. 50-51, 550-555, 587.

4. Reynolds MA, Kao RT, Nares S, Camargo PM, Caton JG, Clem DS, Fiorellini JP,
Geisinger ML, Mills MP, Nevins ML, Rosen PS. Periodontal regeneration – intrabony
defects: practical applications from the AAP regeneration workshop. Clinical Advances in Periodontics. 2015; 5(1): 21-29. doi: 10.1902/cap.2015.140062

5. Pietrzak WS, Ronk R. Calcium sulfate bone void filler: a review and a look ahead.
J Craniofac Surg. 2000; 11(4): 327‐334. doi: 10.1097/00001665-200011040-00009

6. Baranes D, Kurtzman GM. Biphasic calcium sulfate as an alternative grafting material in various dental applications. J Oral Implantol. 2019; 45(3): 247‐255.
doi: 10.1563/aaid-joi-D-18-00306

7. Sculean A, Pietruska M, Schwarz F, Willershausen B, Arweiler NB, Auschill TM.
Healing of human intrabony defects following regenerative periodontal therapy with an enamel matrix protein derivative alone or combined with a bioactive glass. A controlled clinical study. J Clin Periodontol. 2005; 32(1): 111‑117.
doi: 10.1111/j.1600-051X.2004.00635.x

8. Mengel R, Schreiber D, Jacoby LF. Bioabsorbable membrane and bioactive glass
in the treatment of intrabony defects in patients with generalized aggressive periodontitis: results of a 5 years clinical and radiological study. J Periodontol. 2006; 77(10): 1781‑1787. doi: 10.1902/jop.2006.060029

9. Chung Y, Lee J, Jeong S. Comparative study of two collagen membranes for guided tissue regeneration theraphy in periodontal intrabony defects: a randomized clinical trial. J Periodontal Implant Sci. 2014; 44(4): 194-200.
doi: 10.5051/jpis.2014.44.4.194

10. Wang J, Wang L, Zhou Z, Lai H, Xu P, Liao L, Wei J. Biodegradable polymer membranes applied in guided bone/tissue regeneration: a review. Polymers (Basel). 2016; 8(4): 115. doi: 10.3390/polym8040115

11. Jayavel K, Swaminathan M, Kumar S. Ridge augmentation and root coverage using acellular dermal matrix: a case report. Dent Res J. 2010; 7(2): 88-91.

12. Esfahanian V, Farhad S, Sadighi Shamami M. Comparison of ADM and connective tissue graft as the membrane in class II furcation defect regeneration: randomized clinical trial. J Dent Res Dent Clin Dent Prospects. 2014; 8(2): 101-106.
doi: 10.5681/joddd.2014.018

13. Taib H, Abidin KZ, Ali TBT, Yunus N. Socket preservation using acellular dermal matrix allograft in combination with xenograft for dental implant placement in anterior maxilla: a case report. Sains Malaysiana. 2014; 43(5): 745-750.

14. Reza KM, Babak I, Niloofar N. Comparison of the effect of exposed (semi-covered) technique of ADMA (Acellular Dermal Matrix Allograft) in increasing the width of attached gingiva. J Appl Environ Biol Sci. 2015; 5(12): 253-261.

15. Susanto A, Susanah S, Pontjo B, Satari MH. Membran guided tissue regeneration untuk regenerasi periodontal. J Dentika Dent. 2015; 18(2): 300-304.

16. Larjava H. Oral wound healing. Canada: John Wiley and Sons; 2012.

17. Eickholz P, Krigar DM, Kim TS, Reitmer P, Rawlinson A. Stability of clinical and
radiographic results after guided tissue regeneration in infrabony defects.
J Periodontol. 2007; 78(1): 37-46. doi: 10.1902/jop.2007.060097

18. Horowitz RA, Rohres MD, Prasad HS, Tovar N, Mazor Z. Enhancing extraction socket therapy with a biphasic calcium sulfate. Compend Contin Educ Dent. 2012; 33(6): 420‐428.

19. Groeneveld EH, Burger EH. Bone morphogenetic proteins in human bone
regeneration. Eur J Endocrinol, 2000; 142(1): 9‐21.
doi: 10.1530/eje.0.1420009

20. Hallman M, Ludgren S, Seneby L. Histologic analysis of clinical biopsies taken 6 months and 3 years after maxillary sinus floor augmentation with 80% bovine hydoxyapatite and 20% autogenous bone mixed with fibrin glue. Clint Implant Dent Relat. Res. 2001; 3(2): 87-96.
doi: 10.1111/j.1708-8208.2001.tb00236.x


Article Metrics

Abstract views : 1157 | views : 1328


  • There are currently no refbacks.

Copyright (c) 2020 Majalah Kedokteran Gigi Indonesia

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Currently, Majalah Kedokteran Gigi Indonesia indexed by:







 View My Stats

time web analytics