• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.1
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• pp.1-12
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• 1999

The purpose of this study was to evaluate the healing process of the calvarial defect filled with hydroxylapatite(HA) and $TGF-{\beta}$ in Rat. 72 Sprague-Dawly rats were divided into 3 groups, control and two experimental groups. Bony defect were artificially prepared in the calvaria of all 72 rats and followed by implantation of HA (experimental group of 24 rats) and HA+$TGF-{\beta}$(another experimental group of 24 rats) into the defects. Sequential sacrifice was performed at 1, 2, 4, 6, 8, 12 weeks of experiment. Obtained specimen was stained with Hematoxylin and Eosin, Masson's Trichrome and Immunohistochemistry. The results were as follows, 1. Granulation tissue was prominent on control group in 1 and 2 weeks. Bony defects were filled with dense fibrous tissue through the whole experimental period and osteoinduction could not be observed in all groups. 2. Inflammatory cell infiltration was prominent on control group in 1 and 2 weeks and osteoclastic activity was high in HA implanted experimental group at 1 and 2 weeks. 3. Inflammatory cell infiltration was less and maturation of fibrous tissue could be found on HA+$TGF-{\beta}$ implanted experimental group at 1 and 2 weeks. 4. Osteoconduction activity was high in HA+$TGF-{\beta}$ implanted experimental group at 2 and 4 weeks but there was no difference after 6 weeks among 3 groups. 5. In grafted site of HA+$TGF-{\beta}$ implanted group, osteonectin expression was slightly increased from 1 week to 6 weeks. In the host site, it was increased from 1 to 4weeks. 6. In grafted site of HA+$TGF-{\beta}$ implanted group, osteocalcin expression was high at 4 weeks. In the host site, we could find the difference among 3 groups. From above results, the HA with mixture of $TGF-{\beta}$ has the potentiality of promoting bone formation in the bony defect area in the rat.

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.229-237
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• 2015

Purpose: The aim of this study was to determine the clinical feasibility of using dehydrothermally cross-linked collagen membrane (DCM) for bone regeneration around peri-implant dehiscence defects, and compare it with non-cross-linked native collagen membrane (NCM). Methods: Dehiscence defects were investigated in twenty-eight patients. Defect width and height were measured by periodontal probe immediately following implant placement (baseline) and 16 weeks afterward. Membrane manipulation and maintenance were clinically assessed by means of the visual analogue scale score at baseline. Changes in horizontal thickness at 1 mm, 2 mm, and 3 mm below the top of the implant platform and the average bone density were assessed by cone-beam computed tomography at 16 weeks. Degradation of membrane was histologically observed in the soft tissue around the implant prior to re-entry surgery. Results: Five defect sites (two sites in the NCM group and three sites in the DCM group) showed soft-tissue dehiscence defects and membrane exposure during the early healing period, but there were no symptoms or signs of severe complications during the experimental postoperative period. Significant clinical and radiological improvements were found in all parameters with both types of collagen membrane. Partially resorbed membrane leaflets were only observed histologically in the DCM group. Conclusions: These findings suggest that, compared with NCM, DCM has a similar clinical expediency and possesses more stable maintenance properties. Therefore, it could be used effectively in guided bone regeneration around dehiscence-type defects.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.153-171
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• 1999

The purpose of this study was to evaluate the effect of modified calcium sulfate paste on periodontal regeneration. l-wall intrabony defect(mesio-distal width: 4mm, depth: 4mm) was surgically created on the distal side of P2 and mesial side of p4 in four dogs. The control group(GFS) was treated with conventional flap operation alone, and the experimental group(CS) was treated with conventional flap operation with modified calcium sulfate paste application. Both control and experimental groups were sacrificed after 8weeks of healing period, The results of histological and histometric observations were as follows. 1. The length of the junctional epithelium was 0.41${\pm}$0.01mm in the control groups, 0.47${\pm}$0.01mm in the experimental group. 2. The connective tissue attachment was 0.28${\pm}$0.02mm(6.15${\pm}$0.28%) in the control group, 0.18${\pm}$0.01mm(3.41${\pm}$0.14%) in the experimental group. The control group showed more connective tissue attachment. 3. The new cementum formation was 3.80${\pm}$0.06mm(84.80${\pm}$0.33%) in the control group, 4.49${\pm}$0.06mm(87.57${\pm}$0.15%) in the experimental group. Both groups showed a lot of new cementum formation. 4. The new bone formation was 1.43${\pm}$0.03mm(32.37%) in the control group, 2.04${\pm}$O.09mm(40.94%) in the experimental group. 5. The inflamatory cells were observed partially around resorbed calcium sulfate in the connective tissue of the experimental group. 6. Partially resorbed calcium sulfate were found within the connective tissue, around alveolar bone, and in the newly formed alveolar bone, On the basis of these results, newly formed calcium sulfate paste enhanced new bone formation and new cementum formation. The resorption rate of calcium sulfate seems to be controlled by the add-in compounds. Thus research about biocompatibility and adequate resorptionrate is required to develop a improved material.

• Journal of Periodontal and Implant Science
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• v.30 no.4
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• pp.803-814
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• 2000

Current acceptable methods of promoting periodontal regeneration are basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet Rich Plasma have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purpose of this study is to evaluate the possibility of using the Platelet Rich Plasma as a regeneration promoting agent for furcation involvement defect. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree II furcation defect was made on mandibular third(P3), forth(P4) and fifth(P5) premolar. 2 month later experimental group were PRP plus bovine bone and bovine bone only. After 4, 8 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. At 4 weeks after surgery, there were rapid osteogenesis phenomenon on the defected area of the Platelet Rich Plasma plus bovine bone group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 4 weeks after surgery. In conclusion, Platelet Rich Plasma can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

• Archives of Reconstructive Microsurgery
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• v.2 no.1
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• pp.29-41
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• 1993

Recent advances in microsurgery have made it possible to provide a continued circulation of blood to the grafted bone so as to ensure viability. With the nutrient blood supply preserved, healing of the graft to the recipient bone is facilitated without the usual replacement of the graft by creeping substitution. We reviewed 34 cases of vascularized osteocutaneous fibular transfers to the infected tibial defect complicated with skin defect, which were performed from May, 1982 to January, 1992, and the following results were obtained: 1. Despite of uncontrolled bone infection with skin defect, the vascularized osteocutaneous fibular flap transfer could be performed. 2. In the vascularized osteocutaneous fibula transfer, the patency of anastomoses could be indirectly monitored by observing the color of the skin flap. 3. The vascularized fibula had been hypertrophied with bony union during the follow-up period of 13 months to 6 years and 4 months(average, 30 months) and there was no resorption of the grafted fibula. 4. There was no fracture of the grafted fibula in parti resection of involved tibia. 5. The hypertrophic potentiality of grafted fibula could be inhibited by the infection status as operation site.

• The Journal of the Korean dental association
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• v.54 no.4
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• pp.274-283
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• 2016

Bisphosphonates are widely used mainly for the treatment of osteoporosis and bone metastasis of malignancy. Since the first report of MRONJ, there have been many studies associated, however the pathogenesis of MRONJ is not yet clear. Medication-related osteonecrosis of the jaws (MRONJ) is a serious complication associated with long-term medication therapy. It is characterized by exposed necrotic bonein the jaw, which has persisted for more than 8weeks despite continuous treatment by dentist. The mechanism of development of MRONJ is still unclear and there is no definitive standard treatment for MRONJ. The purpose of this study is to investigate the jaw bone destruction mechanism of accumulated bisphosphonates, so that we can develop therapeutic method to repair the defect and stop the destruction process. The authors performed simultaneous application of PRF(Platelet rich fibrin) and BMP-2(Bone morphogenetic protein-2) to stimulate not only soft tissue healing but also osseous regeneration. Our case series demonstrate that simultaneous application of platelet rich fibrin and bone morphogenetic protein-2 can be a treatment of choice for MRONJ.

• Journal of Periodontal and Implant Science
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• v.46 no.3
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• pp.176-196
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• 2016

Purpose: We sought to evaluate the effectiveness of bone substitutes in circumferential periimplant defects created in the rabbit tibia. Methods: Thirty rabbits received 45 implants in their left and right tibia. A circumferential bone defect (6.1 mm in diameter/4 mm depth) was created in each rabbit tibia using a trephine bur. A dental implant ($4.1mm{\times}8.5mm$) was installed after the creation of the defect, providing a 2-mm gap. The bone defect gaps between the implant and the bone were randomly filled according to the following groups: blood clot (CO), particulate Bio-Oss$^{(R)}$ (BI), and Bio-Oss$^{(R)}$ Collagen (BC). Ten animals were euthanized after periods of 15, 30, and 60 days. Biomechanical analysis by means of the removal torque of the implants, as well as histologic and immunohistochemical analyses for protein expression of osteocalcin (OC), Runx2, OPG, RANKL, and TRAP were evaluated. Results: For biomechanics, BC showed a better biological response ($61.00{\pm}15.28Ncm$) than CO ($31.60{\pm}14.38Ncm$) at 30 days. Immunohistochemical analysis showed significantly different OC expression in CO and BC at 15 days, and also between the CO and BI groups, and between the CO and BC groups at 60 days. After 15 days, Runx2 expression was significantly different in the BI group compared to the CO and BC groups. RANKL expression was significantly different in the BI and CO groups and between the BI and BC groups at 15 days, and also between the BI and CO groups at 60 days. OPG expression was significantly higher at 60 days postoperatively in the BI group than the CO group. Conclusions: Collectively, our data indicate that, compared to CO and BI, BC offered better bone healing, which was characterized by greater RUNX2, OC, and OPG immunolabeling, and required greater reversal torque for implant removal. Indeed, along with BI, BC presents promising biomechanical and biological properties supporting its possible use in osteoconductive grafts for filling peri-implant gaps.

• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.769-786
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• 1998

The purpose of the present study is to examine the effect of cell proliferation and alkaline phosphatase activity in osteoblastic cells and to compare the bone healing ability of rat calvarial defects between the control group and the safflower seed extract treated group. Osteoblastic cells were obtained from calvariae of a fetal rat. Cells were cultured containing DMEM and safflower seed extract ($10^{-6}g/ml$, $10^{-3}g/ml$) at $37^{\circ}$ with 5% $CO_2$ in 100% humidity for 3 days. MTT was performed to examine the viability of the cells, and alkaline phosphatase activity was analyzed to examine the mineralization in vitro. Rat calvarial defects($5{\times}5mm$) in 250g Sprague-Dawly were made using round bur. Rats were administrated with safflower seed extract(0.35g/kg/day) for experimental periods. Calvarial defects were studied histopathologically and immunohistochemically at 1,4, and 8 weeks. High concentration group($10^{-3}g/ml$) of safflower seed extract significantly increased in the cell proliferation and alkaline phos phatase synthesis in osteoblastic cells. The infiltration of inflammatory cells and osteoclastic activities were decreased in the safflower seed extract treated group as compared with control group. Bone maturation was accelerated in the safflower seed extract treated group as compared to control group. No difference in osteoinductive process was observed between the control and the safflower seed extract treated group. Immunohistochemical observation revealed that protein expression of TGF-$\beta$and osteonectin during early healing phase in the safflower seed extract treated group was slightly increased as compared to control group. These results indicate that safflower seed extract promotes the healing process in bony defect of rat calvariae, and retains a potential applicability as an adjuvant therapeutic modality for regeneration of periodontal bony defect.

• Journal of Periodontal and Implant Science
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• v.32 no.4
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• pp.769-779
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• 2002

This present study was carried out to find the effects of calcium aluminate cement($CaO\;{\cdot}\;Al_2O_3$, CAC), which has been developed with bio-compatibility and mechanical properties, in biological environments. Two different particle sizes of CAC - 3.5${\mu}m$ vs. 212${\sim}$250${\mu}m$ which is recommended in periodontal bone grafting procedures-were filled in 8mm calvarial defect in Sprague-Dawley rat. The specimens were examined histologically, especially the bone-cement interface and the response of surrounding tissues. The results are as follows; 1. In the control group, inflammatory cells were observed at 2 weeks. At 8 weeks, periosteum and dura mater were continuously joined together in the defect areas. But in the center of defect area were filled up with the loose connective tissues. 2. In the experimental group l($212{\mu}m{\sim}250{\mu}m$ particle), immature bone was formed and outermost layer was surrounded by osteoid layer at 2 weeks. Osteoblasts were arranged between immature bone and osteoid layer. And, osteoid layer was remained until 8 weeks after surgery. 3. In the experimental group 2, periosteum and dura mater lost its continuity at 2 weeks. Scattering of CAC particles and infiltration of inflammatory cells were observed, which this findings deepened at 8 weeks. The result of this study shows that when calvarial defects in white rats are filled with calcium aluminate cement of 212${\sim}$250${\mu}m$, the materials are to be bio-compatible in growth and healing on surrounding tissues. When further researches are fulfilled, such as direct bone adhesion and bone regeneration ability, it's possible that CAC could be applied to various periodontology fields in the future.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2006.05a
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• pp.208-208
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• 2006