• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.58-67
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• 2006

In the recent studies, many authors have reported that the success rate of immediate implantation has no difference compared to conventional staged implantation. Although the immediate implantation has many advantages over conventional approach, many clinicians don't seem to practice because they think that most of the extraction sockets will have some bony gab with defects around implant and that this situation makes the result of immediate implantation unpredictable. We clinically analyzed 23 implanted sites of 18 patients treated with immediate implantation in our hospital from September 2003 to January 2004. The $ITI^{(R)}$. dental implant system was used and GBR procedure with $Bio-Oss^{(R)}$. and $Bio-Gide^{(R)}$. was done simultaneously. The pre & post-op. measurements were recorded such as alveolar crest-adjacent tooth CEJ distance, gingival crest-adjacent tooth CEJ distance, existence of periapical lesion, vertical defect around the extraction socket, horizontal defect around the extraction socket, probing depth, radiologic change of alveolar crest height. We report a positive outcome about immediate implantation with review of literatures.

• The Journal of Advanced Prosthodontics
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• v.6 no.6
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• pp.539-546
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• 2014

PURPOSE. Silk fibroin (SF) is a new degradable barrier membrane for guided bone regeneration (GBR) that can reduce the risk of pathogen transmission and the high costs associated with the use of collagen membranes. This study compared the efficacy of SF membranes on GBR with collagen membranes (Bio-$Gide^{(R)}$) using a rat calvarial defect model. MATERIALS AND METHODS. Thirty-six male Sprague Dawley rats with two 5 mm-sized circular defects in the calvarial bone were prepared (n=72). The study groups were divided into a control group (no membrane) and two experimental groups (SF membrane and Bio-$Gide^{(R)}$). Each group of 24 samples was subdivided at 2, 4, and 8 weeks after implantation. New bone formation was evaluated using microcomputerized tomography and histological examination. RESULTS. Bone regeneration was observed in the SF and Bio-$Gide^{(R)}$-treated groups to a greater extent than in the control group (mean volume of new bone was $5.49{\pm}1.48mm^3$ at 8 weeks). There were different patterns of bone regeneration between the SF membrane and the Bio-$Gide^{(R)}$ samples. However, the absolute volume of new bone in the SF membrane-treated group was not significantly different from that in the collagen membrane-treated group at 8 weeks ($8.75{\pm}0.80$ vs. $8.47{\pm}0.75mm^3$, respectively, P=.592). CONCLUSION. SF membranes successfully enhanced comparable volumes of bone regeneration in calvarial bone defects compared with collagen membranes. Considering the lower cost and lesser risk of infectious transmission from animal tissue, SF membranes are a viable alternative to collagen membranes for GBR.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.3
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• pp.325-341
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• 2003

Statement of problem: In cases where bony defects were present, guided bone regenerations have been performed to aid the placement of implants. Nowadays, the accepted concept is to isolate bone from soft tissue by using barrier membranes to allow room for generation of new bone. Nonresorbable membranes have been used extensively since the 1980's. However, this material has exhibited major shortcomings. To overcome these faults, efforts were made to develop resorbable membranes. Guided bone regenerations utilizing resorbable membranes were tried by a number of clinicians. $Bio-Gide^{(R)}$ is such a bioresorbable collagen that is easy to use and has shown fine clinical results. Purpose: The aim of this study was to evaluate the histological results of guided bone regenerations performed using resorbable collagen membrane($Bio-Gide^{(R)}$) with autogenous bone, bovine drived xenograft and combination of the two. Surface morphology and chemical composition was analyzed to understand the physical and chemical characteristics of bioresorbable collagen membrane and their effects on guided bone regeneration. Material and methods: Bioresorbable collagen membrane ($Bio-Gide^{(R)}$), Xenograft Bone(Bio-Oss), Two healthy, adult mongrel dogs were used. Results : 1. Bioresorbable collagen membrane is pure collagen containing large amounts of Glysine, Alanine, Proline and Hydroxyproline. 2. Bioresorbable collagen membrane is a membrane with collagen fibers arranged more loosely and porously compared to the inner surface of canine mucosa: This allows for easier attachment by bone-forming cells. Blood can seep into these spaces between fibers and form clots that help stabilize the membrane. The result is improved healing. 3. Bioresorbable collagen membrane has a bilayered structure: The side to come in contact with soft tissue is smooth and compact. This prevents soft tissue penetration into bony defects. As the side in contact with bone is rough and porous, it serves as a stabilizing structure for bone regeneration by allowing attachment of bone-forming cells. 4. Regardless of whether a membrane had been used or not, the group with autogenous bone and $Bio-Oss^{(R)}$ filling showed the greatest amount of bone fill inside a hole, followed by the group with autogenous bone filling, the group with blood and the group with $Bio-Oss^{(R)}$ Filling in order. 5. When a membrane was inserted, regardless of the type of bone substitute used, a lesser amount of resorption occurred compared to when a membrane was not inserted. 6. The border between bone substitute and surrounding bone was the most indistinct with the group with autogenous bone filling, followed by the group with autogenous bone and $Bio-Oss^{(R)}$ filling, the group with blood, and the group with $Bio-Oss^{(R)}$ filling. 7. Three months after surgery, $Bio-Gide^{(R)}$ and $Bio-Oss^{(R)}$ were distinguishable. Conclusion: The best results were obtained with the group with autogenous bone and $Bio-Oss^{(R)}$ filling used in conjunction with a membrane.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.3
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• pp.382-388
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• 2007

Statement of problem. The role of calcium sulfate in stimulating the growth of gingival soft tissue has been reported in few studies. Such a unique property of calcium sulfate could serve as a trouble-solving broker in compensating for the lack of soft tissues in various oral surgeries. Purpose. The purpose of this study was to compare the proliferating activities of human gingival fibroblasts seeded on various bone graft barrier materials of calcium sulfate, collagen, and polytetrafluorethylene (PTFE). Material and methods. Two calcium sulfates ($CAPSET^{(R)}$. and $CalForma^{(R)}$, Lifecore Biomedical Inc., St. Paul, Minnesota, USA), a resorbable natural collagen ($Bio-Gide^{(R)}$, Geistlich Pharma Ag., Wolhusen, Switzerland), and a non-resorbable PTFE ($TefGen-FD^{(R)}$, Lifecore Biomedical Inc., St. Paul, Minnesota, USA) served as the human gingival fibroblasts' substrates and comprised the four experimental groups, whereas the untreated floors of culture plastics were used in the control group, in this study. Cells were trypsinized, seeded, and incubated for 48 h. The proliferating activities of fibroblasts were determined by XTT and SRB assay and absorbance (optical density, OD) was measured. One-way ANOVA was used to analyze the differences in the mean OD values between the groups of CAPSET, CalForma, Bio-Gide, TefGen, and the control (p<0.05). Results. From the XTT assay, the mean OD value of the control group, the highest, was significantly greater than that of any of the four experimental groups followed by CalForma, CAPSET, TefGen, and Bio-Gide. Further, the mean OD value of CalForma, was significantly greater compared to that of Bio-Gide. From the SRB assay, Calforma showed the highest mean OD value, which was significantly greater than that of any other groups, followed by the control, CAPSET, Bio-Gide, and TefGen. The mean OD values of both the control and CAPSET were significantly greater compared to that of TefGen (p<0.05). Conclusion. Assessment of the viability and proliferation of cultured fibroblasts seeded and incubated for 48 h on various barrier-material substrates using XTT and SRB assay showed that calcium sulfate $CalForma^{(R)}$ promotes the proliferating activity of human gingival fibroblasts.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.2
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• pp.112-119
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• 2011

Purpose: Collagen membranes are used extensively as bioabsorbable barriers in guided bone regeneration. However, collagen has different effects on tissue restoration depending on the type, structure, degree of cross-linking and chemical treatment. The purpose of this study was to evaluate the inflammatory reaction, bone formation, and degradation of dehydrothermal treated porcine type I atelocollagen (CollaGuide$^{(R)}$) compared to of the non-crosslinked porcine type I, III collagen (BioGide$^{(R)}$) and the glutaldehyde cross-linked bovine type I collagen (BioMend$^{(R)}$) in surgically created bone defects in rat mandible. Methods: Bone defect model was based upon 3 mm sized full-thickness transcortical bone defects in the mandibular ramus of Sprague-Dawley rats. The defects were covered bucolingually with CollaGuide$^{(R)}$, BioMend$^{(R)}$, or BioGide$^{(R)}$ (n=12). For control, the defects were not covered by any membrane. Lymphocyte, multinucleated giant cell infiltration, bone formation over the defect area and membrane absorption were evaluated at 4 weeks postimplantation. For comparison of the membrane effect over the bone augmentation, rats received a bone graft plus different covering of membrane. A $3{\times}4$ mm sized block graft was harvested from the mandibular angle and was laid and stabilized with a microscrew on the naturally existing curvature of mandibular inferior border. After 10 weeks postimplantation, same histologic analysis were done. Results: In the defect model at 4 weeks post-implantation, the amount of new bone formed in defects was similar for all types of membrane. Bio-Gide$^{(R)}$ membranes induced significantly greater inflammatory response and membrane resorption than other two membranes; characterized by lymphocytes and multinucleated giant cells. At 10 weeks postoperatively, all membranes were completely resorbed. Conclusion: Dehydrotheramal treated cross-linked collagen was safe and effective in guiding bone regeneration in alveolar ridge defects and bone augmentation in rats, similar to BioGide$^{(R)}$ and BioMend$^{(R)}$, thus, could be clinically useful.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.2
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• pp.142-149
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• 2008

The purpose of this study was to evaluate histomorphometrically a toothash - plaster of Paris mixture associated with collagen membrane ($Bio-Gide^{(R)}$), regarding new bone formation in the peri-implantitis defects in dogs. Three mandibular molars were removed from 1-year-old mongrel dogs. After 2 months of healing, 2 titanium implants with sandblasted with large grit and acid etched (SLA) surface were installed in each side of the mandible. Experimental peri-implantitis was induced with ligatures after successful osseointegration. Ligatures were removed after identification of bone defect beneath the level of 5th thread of fixture on radiographic image. The mucoperiosteal flaps were elevated and the contaminated fixtures were treated with chlorhexidine and saline. The bone defects were assigned to one of the following treatments: no guided bone regeneration (GBR) procedure (group 1), GBR with Bio-$Oss^{(R)}$ and Bio-$Gide^{(R)}$ (group 2), or GBR with toothash - plaster of Paris mixture (TPM) and Bio-$Gide^{(R)}$ (group 3). The dogs were sacrificed after 8 or 16 months. The mean percentages of new bone formation within the limits of the 5 most coronal threads were $17.83{\pm}10.69$ (8 weeks) and $20.13{\pm}13.65$ (16 weeks) in group 1, $34.25{\pm}13.32$ (8 weeks) and $36.33{\pm}14.21$ (16 weeks) in group 2, and $46.33{\pm}18.39$ (8 weeks) and $48.00{\pm}17.78$ (16 weeks) in group 3, respectively. The present study confirmed statistically considerable new bone formation within the threads in group 3 compared with group 1 at 8 and 16 weeks (P<0.05). Although, data analysis did not reveal significant differences between group 2 and 3, the latter showed better results during the period of 8 or 16 weeks. Our findings support the effectiveness of TPM as a GBR material in the treatment of peri-implantitis bone defect.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.14.1-14.6
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• 2016

Background: In guided bone regeneration (GBR) technique, many materials have been used for improving biological effectiveness by adding on membranes. The new membrane which was constructed with chitin-fibroin-hydroxyapatite (CNF/HAP) was compared with a collagen membrane (Bio-$Gide^{(R)}$) by means of micro-computed tomography. Methods: Fifty-four rats were used in this study. A critical-sized (8 mm) bony defect was created in the calvaria with a trephine bur. The CNF/HAP membrane was prepared by thermally induced phase separation. In the experimental group (n = 18), the CNF/HAP membrane was used to cover the bony defect, and in the control group (n = 18), a resorbable collagen membrane (Bio-$Gide^{(R)}$) was used. In the negative control group (n = 18), no membrane was used. In each group, six animals were euthanized at 2, 4, and 8 weeks after surgery. The specimens were analyzed using micro-CT. Results: Bone volume (BV) and bone mineral density (BMD) of the new bone showed significant difference between the negative control group and membrane groups (P < 0.05). However, between two membranes, the difference was not significant. Conclusions: The CNF/HAP membrane has significant effect on the new bone formation and has the potential to be applied for guided bone regeneration.

• Journal of Periodontal and Implant Science
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• v.47 no.3
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• pp.165-173
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• 2017

Purpose: The aim of this study was to radiographically and clinically compare the effect of extracellular matrix (ECM) membranes on dimensional alterations following a ridge preservation procedure. Methods: One of 2 different ECM membranes was applied during a ridge preservation procedure. A widely used ECM membrane (WEM; Bio-Gide, Geistlich Biomaterials, Wolhusen, Switzerland) was applied in the treatment group and a newly developed ECM membrane (NEM; Lyso-Gide, Oscotec Inc., Seongnam, Korea) was applied in the control group. Cone-beam computed tomography (CBCT) scans and alginate impressions were obtained 1 week and 6 months after the ridge preservation procedure. Results were analyzed using the independent t-test and the nonparametric Mann-Whitney U test. Results: There were no significant differences between the ECM membranes in the changes in the dimension, width, and height of the extraction socket or the quantity of bone tissue. Conclusions: The NEM showed comparable clinical and radiographic results to the WEM following the ridge preservation procedure.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.15-26
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• 2006

흡수성 차페막을 이용한 조직 유도 재생술시 차폐막의 견고성으로 미루어 보아 재생을 위한 공간의 유지가 어려울 수 있다. 조직 유도 재생술과 함께 골이식술을 시행함으로써 공간 확보와 함께 적절한 혈병의 유지를 도모할 수 있고 이식된 골은 선생골 형성을 위한 핵으로 작용할 수도 있다. 최근에 사람의 치아회분말과 연석고를 혼합한 골이식재가 여러 연구를 통해 좋은 골이식재로 평가되었다. 본 연구에서는 성견 하악 소구치 2급 치근이개부위에 외과적으로 형성하여 흡수성 차폐막과 치아회분말-연석고 혼합 이식재를 이용한 조직유도재생 술을 시행하여 치주 조직 재생의 양상을 조직학적으로 관찰하고자 한다. 생후 12개월에서 16개윌 된 체중 15 Kg 내외의 성견 4마리를 이용하였다. 실험 재료로 생체흡수성 차폐막 (Biogide(R), Swiss) 를 사용하였고, 골이식재로 치아회분말-연석고를 혼합매식 하였다. 양측 상악 소구치 부위에 변연 치조골하방에 4 mm ${\times}$ 4 mm ${\times}$ 4 mm, (깊이 ${\times}$ 근원심 ${\times}$ 협설폭경) 깊이로 골내낭을 형성하였다. 형성된 골내낭의 기저부위 치근 표면에 1/4 round bur로 notch를 형성하여 참고점으로 하였다. 무작위로 선택된 한 쪽의 결손부를 대조군으로 오직 생체 흡수성 차폐막을 사용하였고, 실험군으로 치아회분말-연석고와 생체 흡수성 차폐막을 결손부로부터 2 mm 이상 덮을 수 있도록 다듬어 결손부 위에 위치시킨 후 협측 판막을 덮고 봉합하였다. 4주 후 2마리 ,8주 후 2마리를 희생시키고 통상의 방법으로 고정, 탈회, 포매의 과정을 거쳐 광학 현미경으로 검경하였다. 그 결과, 1. 4주 대조군에서 Bio-gide(R)는 완전한 흡수를 보였고, 치근이개부내에는 큰 공간이 존재하였다. 2. 4주 실험군에서 역시 Bio-gide(R)는 완전한 흡수를 보였고, 골 결손부내에 더 많은 신생골 관찰되었다. 그러나 아직까진 기존골과 신생골간에 명확한 차이가 있어서 쉽게 구분할 수 있었다. 또한 골이식재 주변으로 파골세포가 다수 관찰되며 이로 미루어 보아 활발한 골흡수가 일어남을 알 수 있었다. 3. 8주 대조군에서 결손부내에서는 기존골에 인접하여 신생골 형성이 부분적으로 일어났으나 연조직 침입이 관찰되었다. 4. 8주 실험군은 신생골이 기존골과 매우 유사한 형태로 관찰되었고, 신생골 형성 부위에 신생 혈관 증식이 관찰되었다. 또한 골내낭 기저부위에서는 백악질과, 치주인대가 재생됨이 관찰되었다. 이상의 결과에서 치아회분말-연석고 혼합매식은 골재생을 위한 골전도성이 있는 재료로 사료되며, 이를 이용히여 치주조직재생술시 흡수성 차폐막과 병행하여 사용한다면 더 많은 골재생이 있을 것으로 기대된다.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.1
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• pp.43-53
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• 2007

The purpose of this experimental study was to examine the effect of the decontamination of carbon dioxide ($CO_2$) laser in treatment of ligature-induced peri-implantitis in dogs. A total 24 implants with a sandblasted with large-grit and acid-etched (SLA) surface were inserted in six mongrel dogs. After a 3-month healing period, experimental peri-implantitis characterized by a bone loss of about 3mm was established by inducing with wires. And then wires were removed and plaque control was implemented. Surgical treatment involving flap procedure + debridement of implants surface with chlorhexidine and saline (group 1), flap procedure + GBR with absorbable collagen membrane (Bio-Gide) and mineralized bone graft (Bio-Oss) (group 2), and flap procedure + $CO_2$ laser application + GBR (group 3) was performed. The animals were killed 8 weeks and 16 weeks after treatment, respectively. A histomorphometric analysis confirmed statistically considerable new bone formation within the limit of the 5 most coronal threads in group 3 compared with group 1 at 16 weeks (P<0.05). And intragroup analysis showed considerable increase of new bone formation in group 3 at 16 weeks compared with 8 weeks (P<0.05). The present study demonstrates considerable new bone formation after treatment of experimental peri-implantitis with flap procedure, $CO_2$ laser application and GBR.