Guided tissue regeneration (GTR) has become an essential therapeutic procedure today, not only for the treatment of periodontal bone defects but also for bone and peri-implant defects. It is also used in augmentation procedures prior to implant placement, which is sometimes termed Guided Bone Regeneration (GBR).

Hypro-Sorb® F has a natural collagen structure (of bovine origin). The bilayer membrane presents an excellent collagen type I matrix for bone integration on the rough porous side, as well as for soft tissue adhesion and healing on the smooth membrane side.

Bone defect distal of the tooth 22	X-ray before treatment
Preparation of the bone defect	Graphical demonstration of the membrane application (GTR)
Situation after treatment	X-ray after treatment

Courtesy of: Prof. Dr. J. Bill, Cranio-maxillofacial Surgeon & Prof. Dr. N. Watted, Orthodontist

• High degree of tissue compatibility with excellent wound healing characteristics
• Quickly adaptable to the defect due to it is hydrophilic property
• Reduced risk of dehiscence formation
• Can be attached with pins and suturing material
• Barrier function is sufficiently long and is completely bioresorbed within 6 months
• Bioabsorbable; therefore, a second operation for membrane removal is not necessary
• Well documented and proven by many years of clinical experience

Properties
The membrane consists of collagen type I. A special method of preparation results in a “bilayer” structure with one smooth layer and one rough layer. The smooth membrane layer, which has a compact surface, is cell occlusive to guarantee protection against connective tissue. The properties of collagen favour cell attachment. This side of the membrane is turned towards the soft tissue.

The rough layer of the membrane consists of collagen fibers in a loose porous arrangement to enable cell invasion. This side is turned toward the bone defect in order to enhance the integration of bone forming cells and to stabilize the blood clot.

Hypro-Sorb® F is composed of highly purified bovine collagen type I, free of the antigenic immunogenic telopeptides, and therefore possesses a high degree of biocompatibility. Good cell adhesion at the surface promotes wound healing.

Investigations have revealed the development of a layer of fibroblasts on the smooth, compact surface of the membrane after 3 weeks. Single cells can invade the layer, however, without being able to form a new tissue structure inside the membrane. On the rough surface the osteoblasts use the collagen fibers to attach themselves and invade this loose porous structure.
The arrangement of the fibers results in great tensile strength and resistance to tearing. It can therefore be held in position by sutures or pins, which prevent the membrane mobilizationunder mechanical loading.  

Hypro-Sorb® F The smooth layer side turned towards the soft tissue	OSSAPLAST® predictable and reliable bone regeneration	Hypro-Sorb® F The rough layer side turned towards the bone defect

Situation before and after bone augmentation (OSSAPLAST®) in combination with membrane (Hypro-Sorb® F)

Courtesy of: Prof. Dr. N. Watted, Orthodontist & Prof. Dr. J. Bill, Cranio-maxillofacial Surgeon

Advantages
• Tear-proof fibrous tissue structure
• Highly purified collagen fibers free of the immunogenic telopeptides
• Physiological membrane resorption
• Bilayer structure enables it to be cut to size and fixated
• The smooth cell-occlusive layer forms a natural barrier against the soft tissue cells
• The porous layer favours bone tissue integration
• Accelerates cell adherence and blood clot formation
• Easy handling and perfect adaptation to the defect
• Favorable soft tissue healing
• Hypro-Sorb® F is supplied in sterile format in two-layer packaging.
• Hypro-Sorb® F bilayer is available in sterile format in three sizes:

Handling
1. Hypro-Sorb® F is trimmed to the desired size by using scissors.
2. The membrane should overlap the walls of the defect by at least 2-3 mm, in order to achieve complete coverage of the bone and thus prevent a lateral ingrowth of gingival tissue.
3. The defect cavity is then filled loosely with bone substitute material such as Ossaplast®.
4. Hypro-Sorb® F is applied over the defect with its smooth side uppermost and held in place with moderate pressure. The saturation of the membrane with blood and exsudate permits perfect adaptation to the bone surface. Additional stabilization by means of pins may be indicated for complex defects.
5. The flaps are closely sutured over the membrane and should be free of tension (e.g., using single sutures, mattress sutures). The wound should, whenever possible, be completely closed.
6. During the healing phase stress in the wound area from prosthetic pressure or palpation should be avoided. Intensive mechanical oral hygiene should be replaced by antibacterial rinsing (e.g., with chlorhexidine) for the first 3 weeks. Antibiotic therapy is prescribed at the discretion of the clinician.

Postoperative Care
In case of wound dehiscence with membrane exposure, the usual antimicrobial precautions are recommended. Removal of the membrane is not necessary. The resorption time may be accelerated by external influences such as saliva, etc. The properties of collagen may favour rapid healing of the wound dehiscence.

Exclusive Distribution
Hypro-Sorb® F is a medical device class III clinically tested and certified by the Notified Body No.1023, EC