• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.2
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• pp.220-229
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• 2008

Purpose: The present study was aimed to examine the effect of acellular dermal matrix ($AlloDerm^{(R)}$) grafted to the experimental tissue defect on tissue regeneration. Materials and Methods: Male albino rabbits were used. Soft tissue defects were prepared in the external abdominal oblique muscle. The animals were then divided into 3 groups by the graft material used: no graft, autogenous dermis graft, and $AlloDerm^{(R)}$ graft. The healing sites were histologically examined at weeks 4 and 8 after the graft. In another series, critical sized defects with 8-mm diameter were prepared in the right and left iliac bones. The animals were then divided into 5 groups: no graft, grafted with autogenous iliac bone, $AlloDerm^{(R)}$ graft, $AlloDerm^{(R)}$ graft impregnated with rhBMP-2, and $AlloDerm^{(R)}$ graft with rhTGF-${\beta}1$. The healing sites of bone defect were investigated with radiologic densitometry and histological evaluation at weeks 4 and 8 after the graft. Results: In the soft tissue defect, normal healing was seen in the group of no graft. Inflammatory cells and foreign body reactions were observed in the group of autogenous dermis graft, and the migration of fibroblasts and the formation of vessels into the collagen fibers were observed in the group of $AlloDerm^{(R)}$ graft. In the bone defect, the site of bone defect was healed by fibrous tissues in the group of no graft. The marked radiopacity and good regeneration were seen in the group of autogenous bone graft. There remained the traces of $AlloDerm^{(R)}$ with no satisfactory results in the group of $AlloDerm^{(R)}$ graft. In the groups of the $AlloDerm^{(R)}$ graft with rhBMP-2 or rhTGF-${\beta}1$, there were numerous osteoblasts in the boundary of the adjacent bone which was closely approximated to the $AlloDerm^{(R)}$ with regeneration features. However, the fibrous capsule also remained as in the group of $AlloDerm^{(R)}$ graft, which separated the $AlloDerm^{(R)}$ and the adjacent bone. Conclusions: These results suggest that $AlloDerm^{(R)}$ can be useful to substitute the autogenous dermis in the soft tissue defect. However, it may not be useful as a bone graft material or a carrier, since the bone defect was not completely healed by the bony tissue, regardless of the presence of osteogenic factors like rhBMP-2 or rhTGF-${\beta}1$.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.24-28
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• 2005

Skull or facial bone defect causes cosmetic and functional problems. On going efforts were taken to reconstruct the craniofacial bone defect with autogenous bone or alloplastic materials. Between 2001 and 2003, we reconstructed 15 cases with small to large craniofacial bone defect using Hydroxyapatite paste($BoneSource^{(R)}$, Leibinger Corp., Dallas, TX, U.S.A) and calvarial bone graft. All patients were followed up by clinical examination and periodic radiographic studies for an average of 1.6 years (range, 6 months to 2 years and 6 months). One complication case was noted with $BoneSource^{(R)}$ exposure. Otherwise, there was no evidence of adverse healing, wound infection, foreign body reaction and seroma collection in other patients. Adequate 3-dimensional aesthetic restoration of calvarial contour was noted in each case. In conclusion, $Bonesource^{(R)}$ is relatively safe and rigid material for craniofacial bone defect and reasonable method for the reconstruction of craniofacial bone defects.

• Journal of Acupuncture Research
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• v.18 no.5
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• pp.135-146
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• 2001

Objective : Bone homeostasis is maintained by balance of bone formation and resorption. Therefore, bone related diseases arose by disturbance of this balance between osteoblast and osteoclast activities. To develop a successful screening system of the therapeutic components based on oriental medicine is essential to set out systematic approach for that purpose. Methods : This study was perforated Sprague-Dawley rat femur for bony defects(${\phi}5mm$) by the fissure bur. And experimetal group were treated with Cervi Pantotricuhum Cornu injection at both $Sh{\grave{e}}nsh{\tilde{u}}$(BL23) & $D{\grave{a}}zh{\grave{u}}(BL11)(0.2m{\ell})$. This was evaluated by radiography and histological analysis with in situ hybridization. Results : Cervi Pantotricuhum Cornu Herbal Acupuncture has weak effect on bony defect healing and this was evaluated by X-ray taking and histological analysis with in situ hybridization. Osteocalcin gene expression was not changed by Cervi Pantotricuhum Cornu Herbal Acupuncture in bony defects animal model. Conclusion : Taken together this study show that the Cervi Pantotricuhum Cornu herbal-acupuncture has a weak effect healing of bony defects, this type of approach might give a good chance to explore the favorable effects of Cervi Pantotricuhum Cornu herbal-acupuncture on bone tissue.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.551-562
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• 2004

The purpose of this study was to evaluate the effects of negatively electric field on bone healing in rabbit segmental long bone defects using negatively charged PTFE membrane. Ten millimeter segmental defects in the rabbit radius were used as the experimental model. After membranes were then charge injected using a corona-charging apparatus, the left defects were covered with non charged PTFE membranes as control groups, whereas the right defect was covered with negatively charged PTFE membranes as test group. The animals were divided into 4 groups of 2 rabbits each, and sacrificed at 2, 4, 6, and 8 weeks. Histomorphometric analysis showed a more newly formed bone in negatively charged membrane at early healing period. At 2 weeks, the proportion of new bone formation to total defect area was 0.32% in control group, 1.10% in experimental group. At 4 weeks, the proportion of new bone formation to total defect area was 6.86% in control, and 13.75% in experimental. At 6 and 8 weeks, no obvious difference was found between the two groups but newly formed bone in test groups were slightly more than that in control groups. In conclusion, negatively charged membranes showed more newly bone tissue than noncharged membranes at an early healing period. Although the number of samples was small, this study showed that the combination of negatively electrical stimulation and P1FE membrane may be of value in long bone healing.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.110-119
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• 1999

The principle of guided tissue regeneration (GTR), as applied to bone healing, is based on the prevention of connective tissue from entering the bony defect during the healing phase. This allows the slower bone producing cells to migrate into and reproduce bone within the defect. The principle of guided tissue regeneration has demonstrated a level of success in regenerating bone defect. Several types of membrane barrier, each one with distinct properties, have been utilized to apply this principle in bone regeneration. The purpose of this study is to introduce and discuss the attributes of rubber dam as a barrier membrane and evaluate whether improved bone regeneration can be achieved by GTR using rubber dam. In the 15 New Zealand white rabbits, full-thickness bone defects on three sites of each rabbit calvaria were made. Non membrane group served as a control and experimental group 1 was covered with rubber dam and group 2 covered with Gore-Tex$^{TM}$ membrane. Macroscopic, radiographic, microscopic examinations were made serially on 1, 2, 3, 6, 12 weeks after operation. The results were as follows: 1. Macroscopically, the control site was collapsed and filled with connective tissue throughout the experimental period. But the defects of experimental groups 1 and 2 were filled with bone-like mass and showed the hard consistency on palpation. 2. Radiographically, the early new bone formation appeared similarly from the host bone in groups 1 and 2. 3. Microscopically, there were much connective tissue at the central part of control site but the defect of group 1 and 2 was filled with the mature bony trabeculae on the 12th week. This results suggest that rubber dam can be effectively used as a barrier membrane for guided bone regeneration.

• Journal of Periodontal and Implant Science
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• v.32 no.4
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• pp.753-767
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• 2002

The purpose of this study was to evaluate histologically the effect of LiF-maleic acid added calcium aluminate(LM-CA) bone cement & CA-PMMA composite bone cement on the healing of calvarial defect in Sprague-Dawley rats. The critical size defects were surgically produced in the calvarial bone using the 8mm trephine bur. The rats were divided in three groups : In the control group, nothing was applied into the defect of each rat. LM-CA bone cement was implanted in the experimental group 1 and CA-PMMA composite bone cement was implanted in the experimental group 2. Rats were sacrificed at 2, 8 weeks after surgical procedure. The specimens were examined by histologic analysis, especially about the bone-cement interface and the response of surrounding tissue. The results are as follows; 1. In the control group, inflammatory infiltration was observed at 2 weeks. At 8 weeks, periosteum and duramater were continuously joined together in the defect area. But the center of defect area was filled up with the loose connective tissue. 2. In the experimental group 1, the bonding between implanted bone cement and the existing bone was seen, which more increased in 8 weeks than 2 weeks. Inflammatory infiltration and the dispersion of implanted bone cement particles were seen in both 2 weeks and 8 weeks. 3. In the experimental group 2, implanted bone itself had a dimensional stability and no bonding between implanted bone cement and the existing bone was seen in both 2 weeks and 8 weeks. Implanted bone cement was encapsulated by fibrous connective tissue. In addition, inflammatory infiltration was seen around implanted bone cement. On the basis of these results, when LM-CA bone cement or CA-PMMA composite bone cement was implanted in rat calvarial defect, LM-CA bone cement can be used as a bioactive bone graft material due to ability of bonding to the existing bone and CA-PMMA can be used as a graft material for augmentation of bone-volume due to dimensional stability.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.6
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• pp.515-519
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• 2010

Introduction: Bone defects in the jaw are frequently observed after odontogenic cyst enucleation. The success of bone healing appears to be related to the size of the bone defect, the anatomical location, the patient's age and other parameters. The use of bone grafting material is dependent on the operator's preference. No evidence-based definite treatment protocol has been established. This study evaluated the effect of a bone graft into the defect after odontogenic cyst enucleation. Materials and Methods: A total of 55 patients, who had been treated for an odontogenic cyst with cyst enucleation from 2000 to 2009 at the department of Oral and Maxillofacial Surgery, Samsung Medical Center, were included in this study. Patients who were followed-up for more than 1 year were included. Two groups were defined according to the bone graft (with or without a bone graft) after cyst enucleation. The differences in the healing periods and patterns of bone healing were compared clinically and radiologically. The postoperative 1 year radiographs were analyzed for bone healing and density. Statistical analysis was performed using a Pearson chi square test and Wilcoxon rank-sum test. Results: More infection signs were observed in the bone graft group than in the other group, but there was no statistically significant difference. Radiographically, there was also no significant difference in the size of the radiolucent lesions between the two groups. Conclusion: There was no significant difference in healing between the groups with a bone graft and without bone graft after cyst enucleation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.2
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• pp.119-130
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• 2008

Absorbable atelo-collagen sponge $TERUPLUG^{(R)}$, Termo Co. Tokyo, Japan) is inserted in the extraction wound where alveolar bone is exposed. It protects wounds and promotes the formation of granulation. This is made of atelo-collagen, to minimize antigenicity, which is cross-linked by heat treatment for biocompatibility. $TERUPLUG^{(R)}$ consists of between 85 and 95 % of collagen type I and between 5 to 15 % of collagen type III. The raw material for the collagen is derived from bovine skin. It features a sponge block design and is shaped for easy insertion in the extraction wound. This study was designed to find out the bone healing capacity of $TERUPLUG^{(R)}$. We implanted $TERUPLUG^{(R)}$ (experimental group I) and $TERUPLUG^{(R)}$ with rhBMP-2 (experimental group II) in the rabbit cranium defect and then histologically analysed the specimen. The results were as follows. 1. In the 4 weeks, a lot of the newly formed collagen fibers around material of the experimental group I implanted $TERUPLUG^{(R)}$ were observed. But, in the experimental group II implanted $TERUPLUG^{(R)}$ with rhBMP-2, a little of newly formed collagen fibers around material were observed. The cell proliferating activity and apoptosis of the experimental group I, II was positive in and around the implanted material. 2. In the 8 weeks, the amount of newly formed and matured bone in the experimental group II was more observed than the experimental group I and control group. The results of this study indicate that absorbable atelo-collagen sponge ($TERUPLUG^{(R)}$) is relatively favorable bone void filler with biocompatibility and has the better bone healing capacity in case of application with rhBMP-2.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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• pp.179-185
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• 2000

The purpose of this study was to develop an osteogenic, biodegradable material using polymer and BMP. It was designed to have structural function and be moldable, for the reconstruction of load bearing areas and deformities of various configurations. Bone apatite was added to Poly(L-lactide)(PLLA) and made porous for osteoconductability and ease of BMP loading. The materials, with or without BMP purified from porcine bone matrix, were evaluated in cranial bone defect models in rats for biocompatibility and bone regeneration capability. The following results were obtained: The PLLA-BMP material with BMP added to the polymer showed 30% healing of cranial bone defects in rats during the 2 weeks to 3 months period of observation. The moldable PLLA agent without BMP also showed 25% bone healing capacity. Although new bone formation was incomplete in the critical size defect of rat cranium, it can be concluded that the unique moldability of those agents makes them useful for the reconstruction of various bone defects and maxillofacial deformities.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.1
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• pp.15-24
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• 1997

The principle of guided tissue regeneration (GTR), as applied to bone healing, is based on the prevention of connective tissue from entering the bony defect during the healing phase. This allows the slower bone producing cells to migrate into and reproduce bone within the defect. GTR has demonstrated a level of success in regenerating bone defect. Several types of membrane barrier have been utilized to apply this principle in bone regeneration. The purpose of this study was to evaluate whether improved bone regeneration can be achieved with different membrane barriers ($Gore-Tex^{TM}$membrane, $COLLACOTE^{(R)}$). In the 10 NewZealand white rabbits, full-thickness bone defects on three sites of each rabbit calvaria were made. Experimental group 1 was covered with $COLLACOTE^{(R)}$, and group 2 was covered with $Gore-Tex^{TM}$membrane. Macroscopic, microscopic examinations were made serially on 1, 2, 3, 6, 12 weeks after operation. The results were as follows : 1. Macroscopically, both of experimental group 1, 2 were filled with bone-like mass but the defects of experimental group 1 disclosed markedly thinner than the original bone. 2. Microscopically, the defect of experimental group 1, 2 was filled with bony trabeculae without infection and adverse reaction. But multinucleated giant cell infiltration around $COLLACOTE^{(R)}$ was seen till 6th week. 3. Resorption of $COLLACOTE^{(R)}$ started from 3rd week and it was completely resorped on the 12th week.