Report: Guided bone regeneration membrane made of polycaprolactone/calcium

carbonate composite nano-fibers

Authors : K. Fujihara, M. Kotaki, S. Ramakrishna

This paper is about a particular composite nano-fiber used for the fabrication of a membrane for
Guided bone regeneration(GBR). A biodegradable composite material polycaprolactone(PCL)
and calcium carbonate was used to form the membrane which eliminates a second time surgery
for the removal of the membrane after the completion of the process as in the case of non-
degradable material. The fabrication of the membrane for GBR at the nano scale is being
explored, as the attachment and proliferation of the cell is much better at the nano scale rather
than the micro scale. Previously polycaprolactone had been used for the fabrication of the
membrane along with calcium carbonate which helps bone regeneration but this inclusion of
calcium carbonate reduced the mechanical strength of the membrane. Therefore the main aim of
this research was to fabricate membranes for GBR from polycaprolactone and calcium carbonate
without the compromise on the mechanical strength.

For this experiment two membranes were fabricated by changing the quantity of
polycaprolactone and calcium carbonate with respect to each other. One membrane had the ratio
75:25 and the other membrane 25:75 of polycaprolactone and calcium carbonate
respectively.The fabrication method used to form the membrane was electrospinning. First the
PCL nano-fiber layer was formed which is used to increase the mechanical strength of the
membrane and then the composite nano-fiber PCL/CaCO 3 layer was formed. By varying the
concentration of PCL, nano-fibers with fine surface were formed by electrospinning which
improve the mechanical strength of the membrane. Similarly the concentration of PCL was
varied for the two composite nano-fibers and granulated surface fibers were formed. A scanning
electron microscope(SEM) was used to view the nano-fibers. On performing energy disperse X-
ray(EDX) mapping CaCO3 nano particles were observed on the composite nano-fibers. The
nano-fibres were then treated with plasma which induces a change in the surface of polymers.
Thus the surface energy of the nano-fibers increases and the surface contact angle decreases
which was measured before and after plasma treatment. This results in the enhancement of the
wettability of the membrane.

After plasma treatment and contact angle measurement, osteoblast seeding was performed. To
assess the osteoblast seeding over a period of time MTS assay was performed and the
membranes were observed with the help of SEM. Seeding was also performed on tissue culture
polystyrene (TCPS) to compare it with the two membranes. It was observed that the absorbance
intensity of membrane with greater concentration of PCL and the TCPS increased during the
seeding duration. Even though the absorbance intensity of the membrane with lower PCL
concentration increased but the value was not as high as the other membrane. During the
observation under SEM it was noticed that the difference in cell attachment between the two
membranes was minimal. The osteoblast proliferation in the two membranes was not thoroughly
understood. Though experiments conducted previously did show that membranes with high
calcium concentration produce good results in bone regeneration. Thus further research on
osteoblast proliferation is required.

The paper also discusses the application of the GBR membrane for mandible and periodontal
defects and concludes that it is more suited for regeneration of bone in the periodontal region. It
also highlights that the degradation time of the biodegradable GBR membrane should be greater
than the time required for regeneration of the bone.

Overall the paper explores the ability of PCL/CaCO 3 composite nano fibers to be fabricated as
membranes for GBR and concludes that further research can make it feasible for GBR.

Review:
The main purpose of Guided Bone Regeneration is to repair the damage caused by periodontal
diseases in the mandible and alveolar region. For this purpose the above researchers have
fabricated two membranes using composite nano fibers PCL/CaCO 3. Previously they had
fabricated GBR membrane using PCL and CaCO 3 but they had used a different concentration
with respect to each other. The use of CaCO3 reduced the tensile strength of the membrane. But
since calcium carbonate has the property to enhance bone growth and also its use for bone
regeneration was approved at that time. Therefore they decided to pursue further research to
fabricate GBR membrane rich in calcium concentration.

They fabricated two membranes one with greater calcium concentration and the other with
greater PCL concentration to compare the absorbance intensity and osteoblast proliferation. Even
then the experiment did not produce conclusive results and further research was required.

An important consideration while selecting the material for the degradable GBR membrane is the
time period of the degradation and at the same time, the time required for the regeneration. The
former should be sufficiently higher than the latter. Even though in this case the degradation time
for PCL/CaCO3 is greater than the bone regeneration time but the hydrolysis behavior of the
membrane was not considered. Neither was it put into practice on a specimen to test it. Therefore
the completion of bone regeneration before the degradation of the membrane cannot be
confirmed.

The purpose of this experiment was to fabricate a calcium rich mechanically strong GBR
membrane. But it was inferred that it is only suitable for regeneration in the case of defects in the
alveolar region and not for mandible defects. Thus the purpose of the experiment was not
completely served.

Materials like Tricalcium phosphates have been successfully used for membranes for
regeneration of large bones like mandible within a short duration. When used with a copolymer it
has high mechanical stability which is one of the key requirements for GBR membrane. Also the
biodegradation rate of beta tricalcium phosphates can be varied. Therefore it can be considered
for the fabrication of GBR membranes.

In order to get a better understanding of osteoblast proliferation and the biodegradability of the
fabricated membrane, tests on animal specimens should have been pursued.