What is the benefit of using amniotic membrane in oral surgery? A comprehensive review of clinical studies

Clin Oral Investig. 2018 Jun;22(5):1881-1891. doi: 10.1007/s00784-018-2457-3. Epub 2018 Apr 22.

Abstract

Objectives: Since its first use for the reconstruction of tissue defects in the oral cavity in 1985, human amniotic membrane (hAM) has been widely studied in the field of oral surgery. Despite the growing number of publications in this field, there is no systematic review or meta-analysis concerning its clinical applications, outcome assessments, and relevance in oral surgery. The aim of this review is to provide a thorough understanding of the potential use of hAM for soft and hard tissue reconstruction in the oral cavity.

Materials and methods: A systematic electronic and a manual literature search of the MEDLINE-PubMed database and Scopus database was completed. Patient, Intervention, Comparison and Outcomes (PICO) technique was used to select the relevant articles to meet the objective. Studies using hAM for oral reconstruction, and conducted on human subjects, were included in this survey.

Results: A total of 17 articles were analyzed. Five areas of interest were identified as potential clinical application: periodontal surgery, cleft palate and tumor reconstruction, prosthodontics and peri-implant surgery. Overall, periodontal surgery was the only discipline to assess the efficacy of hAM with randomized clinical trials. The wide variability of preservation methods of hAM and the lack of objective measurements were observed in this study.

Conclusion: hAM is already used in the field of oral surgery. Despite this, there is weak clinical evidence demonstrating convincingly the benefit of hAM in this area compared to standard surgery.

Clinical relevance: Several studies now suggest the interest of hAM for periodontal tissue repair. Due to its biological and mechanical properties, hAM seems to be a promising treatment for wound healing in various areas of oral reconstruction. However, further randomized clinical trials are needed to confirm these preliminary results.

Keywords: Amniotic membrane; Guided bone regeneration; Guided tissue regeneration; Oral surgery.

Publication types

  • Review

MeSH terms

  • Amnion / transplantation*
  • Biological Dressings
  • Evidence-Based Medicine
  • Humans
  • Oral Surgical Procedures*