Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제34권4호
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pp.428-434
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2008
Introduction: Piezosurgery device is one of the most commonly used instrument on the intraoral surgery such as maxillary sinus lift and autogeneous bone graft. Piezosurgery instrument also contains the tips that are manufactured especially for the convenient bone graft, which now many surgeons apply them for collecting bone graft materials in the curettage method for the restoration of skull defects. However, objective data has not been shown concerning the effects about bone graft with using Piezosurgery. Therefore we investigated the effects of Piezosurgery on the rabbit-skull defect healing. Materials & Methods: To investigate the regeneration of the bony defect with various bone graft, 10 adult New Zealand white rabbits (average weight : $2.8{\pm}0.3kg$, about 12weeks) were used. The four circular bony defects measuring 6mm in diameter were made with Piezosurgery device on each rabbit cranial bone. The harvested bone tissues during defect formation were also used for autogeneous bone graft. They were grafted into the defects in a various type; block type (Group 1), particulated type by the bone mill (Group 2), chopped type by curette shaped Piezosurgery tip (Group 3), the defect without any graft was served as control (control group). The animals were sacrificed after 6 weeks and bone regeneration capacity was evaluated histomorphometrically. Result & Conclusion: Autogeneous bone graft harvested using a Piezosurgery instrument showed satisfactory bone regeneration. There was no conspicuous difference bone prepared among by bone mill or Piezosurgery and block bone graft. Therefore, the bone harvested from the intraoral site near the operation field using the piezosurgery device can be a feasible and reliable graft for intraoral bony defects.
The purpose of this study is to investigate the effect of constant direct current electrical stimulation in healing the bone defects and surrounding tissues of the endo-oseous(TPS-IMZ) implants. Implants were inserted in the femur of adult dogs. Then a constrant direct current of approximately $10{\mu}A$ was applied. Artificial bone defects were prepared on one side of the implant site. Experimental groups were divided into 4 : control group : bone defect without treatment group I : bone defect filled with hydroxyapatite powders group II : bone defect, in which a negative and positive electrodes were inserted 5mm apart from both sides of the implant group III : bone defect, in which negative current was directly connected to the IMZ implant and a positive electrode was placed 10mm apart from the implant The animals were sacrificed in the 1st, 2nd, 4th and 8th week after implantation for the light microscopic examination. The results obtained were as follows : 1. In electrically stimulated experimental groups, new bone formation and osseointegration around implants were accelerated. 2. Group III showed the greatest activity in new bone formation. Osteoconductivity around HA particles was observed in group 1. 3. The defect area of the control group was healed by forming new bone, which grew from the underlying cancellous bone. The defect areas of the electrically stimulated experimental groups were healed by newly formed bone, which grew upward from the cancellous bone and downward from the periosteum. 4. 8 weeks after implantation, all the groups showed good osseointegration between the surrounding bone and implants.
본 연구는 외과적으로 형성된 흰쥐 하악골 결손부에 S.mutan에서 분리 정제된 mutan을 주사하고, ${\mu}CT$로 촬영하여 골결손부의 치유에 미치는 영향을 3차원 골 미세구조 지표로 평가하기 위하여 실시하였다. 흰쥐 치조골에 임계 크기 결손부인 1.5 mm 지름의 원형 결손부를 형성하여 대조군에는 동일량의 saline을 투여하고, 실험군으로 LPS와, mutan을 주사하여 골치유에 미치는 영향을 관찰하였다. 수술 후 4주에 희생하고 치유 결과를 3차원 미세구조의 형태 계측학적 지표값을 비교 분석하여 다음과 같은 결론을 얻었다. 실험동물의 체중변화는 총 12회 투여 기간 동안 일정한 증가를 나타냈다. 8회차부터 mutan 처리군은 대조군과 비교하여 유의한 차이를 보였으며(p<0.05), 9회차에는 mutan 처리군이 대조군과 LPS 처리군과 비교하여(p<0.05), 10~12회차에는 LPS 처리군과 비교하여 유의한 체중증가를 나타냈다(p<0.01). Mutan이 생체 내에서 하악의 골치유 효과를 알아보기 위해 ${\mu}CT$를 통해 형태계측학적 지표 분석 결과, 대조군에 비해 LPS 처리군에서 뚜렷한 골결손부 치유 지연 및 골흡수 양상을 보였으며, mutan 처리군 은 LPS의 작용보다 미약하지만 골치유를 지연시키는 것으로 확인되었다. ${\mu}CT$를 통해 골밀도 분석 결과, 대조군과 비교하여 LPS와 muatn 처리군에서 낮은 골밀도치를 나타냈고, mutan은 LPS 처리군보다 유의하게 높은 골밀도치를 보였다(p<0.01).
Purpose: Biphasic calcium phosphates have been of great interest recently. Mixing adequate ratios of hydroxyapatite(HA) and beta-tricalcium phosphate($\beta$-TCP) allowed to control the resorption rate without distorting its osteoconductive property. This study evaluated the bone formation effect of newly developed biphasic calcium phosphate(BCP) in calvarial defect of rabbits. Materials and Methods: 6 male New Zealand rabbits were used. Four defects with 8mm in diameter were created on each animal. BCP with HA/$\beta$-TCP ratio of 7:3 and particle size of $0.5{\sim}1.0\;mm$ was used as the test group and bovine bone with $0.25{\sim}1.0\;mm$ particle size, as the control group. Both test and control group materials were randomly implanted in the calvarial defects and were covered witha polymer membrane. The animals were sacrificed after 12, 24, and 48 weeks of implantation under general euthanasia. Resin blocks were obtained and were stained by masson's trichrome for histological observation. Results: Overall results were uneventful without any defect exposure or inflammation. The amount of new bone formation and bone maturity increased with increase in healing period at both groups. New bone in test group was mostly formed along the material particle surrounded by osteoblasts, and observation of osteoblastic stream was also present. Bone maturity increased as it was closer to thedefect margins. Under the same healing period, the test group showed more bone formation than the control group with more stable bovine bone particles remaining even after 48 weeks, whereas considerable resorption took place in BCP. Almost total defect closure was observed in test group with new bone formation in the central part of the defect. However, limited new bone formation was observed in the control group. Conclusion: Within the limits of the study, the present study reveals the newly developed BCP to be a good osteoconductive material. However, further studies are needed to be conducted in a different study model with a larger sample size.
Purpose: The aim of the present study is to evaluate the long term bone healing after horizontal ridge augmentation using auto block bone graft for implant installation timing. Materials and Methods: Five Beagle dogs(which were 14 months old and weighted approximately 10kg). In surgery 1(extraction & bone defect), premolars(P2, P3,P4) were extracted and the buccal bone plate was removed to create a horizontally defected ridge. After three months healing, in surgery 2(ridge augmentation). Auto block bone grafts from the mandibular ramus were used in filling the bone defects were fixed with stabilizing screws. The following fluorochrome labels were given intravenously to the beagle dogs: oxytetracycline 1week after the surgery, alizarin red 4 weeks after the surgery, calcein blue 8 weeks after the surgery. The tissue samples were obtained from the sacrificed dogs of 1, 4, 8, 12, 16 weeks after the surgery. Non-decalcified sections were prepared by resin embedding and microsection to find thickness of $10{\mu}m$ for the histologic examination and analysis. Results: 1. We could achieve the successful reconstruction of the horizontal bone defect by auto block bone graft. The grafted bone block remained stable morohologically after 16 weeks of the surgery. 2. In the histologic view. We observed osteoid tissue from the sample $4^{th}$ week sample and active capillary reconstruction in the grafted bone from the $12^{th}$ week sample. Healing procedures of auto bone grafts were compared to that of the host bone. 3. Bone mineralization could be detected from the $8^{th}$ week sample. 4. Fluorochrome labeling showed active bony changes and formation at the interface of the host bone and the block graft mainly. Bony activation in the grafted bone could be seen from the $4^{th}$ week samples. Conclusions: Active bone formation and remodeling between the grafted bone and host bone can be seen through the revascularization. After the perfect adhesion to host bone, Timing of successful implant installation can be detected through the ideal ridge formation by horizontal ridge augmentation.
The commercial availability of processed heterogenous bone has provided the surgeons with almost unlimited supply, avoidance of additional operation and prevention of the postoperative complications. In addition to these merits, unnecessary bone bank, easy availibility and storage have been achieved. The purpose of this study was to compare and examine the healing capacity of Kiel bone, Pyrost and Osteovit which used as the processed heterografts for the reconstruction of bony defect. Twenty rabbits weighing about 1.7-2.0 Kg were selected and divided into two groups. In experimental group A, the left mandibular defect was allowed to fill with blood, and the right defect was filled with Kiel bone. In experimental group B, the left defect was grafted with Pyrost, and the right with Osteovit. The experimental animals were sacrified after 1, 2, 4 and 8 weeks and the grafted site was studied histologically. To evaluate the strength of healed bone, 2 rabbits from each experimental group and a nonoperated control were sacrified at the 6th week after implantation and used for biometric testing on universal testing machine. The results obtained were as follows : 1. It was considered that these heterogenous bone grafts has feeble or absent immunogenicity since all of them appeared to evoke little inflammatory or forign body reaction. 2. In all experimental groups, new bone formation began from the adjacent region of host bone and extended progressively into the defect sites. New bone was partly formed within the intertrabecular space of the implant and gradually united with the bone that formed at the margin of the host bone. 3. With Pyrost bone formation was rapid and prominent comparing with other graft materials. 4. Osteovit was begun to be absorbed from 2 weeks, and Kiel bone from 4 weeks, however Pyrost was remained to be intact until the end of 8 weeks. 5. As the results of tensile test, the mean values of maximum tensile stress were 1.11${\uparrow}$$Kgf/mm^{2}$ in Pyrost implanted specimens, 0.85 $Kgf/mm^{2}$ in Osteovit, 0.42 $Kgf/mm^{2}$ in Kiel bone, 0.66 $Kgf/mm^{2}$ in blood filled specimens and 1..13 $Kgf/mm^{2}$ in control. These results indicate that heterogenous bones grafted have little antigenicity to the host tissue, and that they mediate effectively osteoconduction by providing the scaffold for the bone formation. Pyrost and Osteovit appeared to be suitable for the clinical use.
Purpose: Adipose tissue-derived stem cells(ADSC) has an osteoconductive potential and demineralized bone matrix(DBM) is an osteoinductive material. A combination of DBM and ADSC wound probably create osteoinductive properties. The purpose of this study is to determine the effect of the combination of DBM and ADSC mixture on healing of rat calvarial defect. Methods: Thirty adult male Sprague-Dawley rats were randomized into 3 groups(n=10) as 1) Control, 2) DBM alone, 3) DBM with ADSC mixture. DBM with ADSC mixture group has had a 3-day preculture of ADSC from groin fat pad. An 6 mm critical size circular calvarial defect was made in each rat. Defect was implanted with DBM alone or DBM with ADSC mixture. Control defect was left unfilled. 6 and 12 weeks after the implantation, the rats were sacrificed and the defects were evaluated by histomorphometric and radiographical studies. Results: Histomorphometric analysis revealed that DBM with ADSC mixture group showed significantly higher bone formation than DBM alone group(p<0.05). Although radiographs from DBM alone group and DBM with ADSC group revealed similar diffuse radiopaque spots dispersed throughout the defect. Densitometric analysis of calvarial defect revealed DBM with ADSC mixture group significantly higher bone formation than DBM alone(p<0.05). There was correlation of densitometry with new bone formation(Spearman's correlation of coefficient=0.804, 6 weeks, 0.802, 12 weeks). Conclusion: The DBM with ADSC mixture group showed the best healing response and the osteoinductive properties of DBM were accelerated with ADSC mixture. It will be clinically applicable that DBM and ADSC mixture in plastic and reconstructive surgery, such as alveolar cleft and congenital facial deformities that bone graft should be required.
Background: Radiation therapy is widely employed in the treatment of head and neck cancer. Adverse effects of therapeutic irradiation include delayed bone healing after dental extraction or impaired bone regeneration at the irradiated bony defect. Development of a reliable experimental model may be beneficial to study tissue regeneration in the irradiated field. The current study aimed to develop a relevant animal model of post-radiation cranial bone defect. Methods: A lead shielding block was designed for selective external irradiation of the mouse calvaria. Critical-size calvarial defect was created 2 weeks after the irradiation. The defect was filled with a collagen scaffold, with or without incorporation of bone morphogenetic protein 2 (BMP-2) (1 ㎍/ml). The non-irradiated mice treated with or without BMP-2-included scaffold served as control. Four weeks after the surgery, the specimens were harvested and the degree of bone formation was evaluated by histological and radiographical examinations. Results: BMP-2-treated scaffold yielded significant bone regeneration in the mice calvarial defects. However, a single fraction of external irradiation was observed to eliminate the bone regeneration capacity of the BMP-2-incorporated scaffold without influencing the survival of the animals. Conclusion: The current study established an efficient model for post-radiation cranial bone regeneration and can be applied for evaluating the robust bone formation system using various chemokines or agents in unfavorable, demanding radiation-related bone defect models.
The main goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal diseases. Although conventional forms of periodontal therapy show sound clinical results, the healing results in long junctional epithelium. There have been numerous materials and surgical techniques developed for new attachment and bone regeneration. Bone grafts can be catagorized into: autografts, allografts, xenografts and bone substitutes. Synthetic bone substitute materials include hydroxyapatite, tricalcium phosphate, calcium carbonate, and Plaster of Paris. Calcium sulfate has found its use in dental practice for the last 30 years. Recent animal studies suggest that periodontal regeneration in 3 wall intrabony defect may be enhanced by the presence of calcium sulfate. And it is well known that 2 wall & 1 wall defect have less osteogenic potential, So we need to study the effect of calcium sulfate in 1 wall intrabony defect in dogs. The present study evaluates the effects of calcium sulfate on the epithelial migration, alveolar bone regeneration and cementum formation in intrabony defects of dogs. Four millimeter-deep one-wall intrabony defects were surgically created in the mesial aspect of anterior teeth and mesial & distal aspects of premolars. The test group received calcium sulfate grafts with a flap procedure. The control underwent flap procedure only. Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of junctional epithelium were: 2.52mm in the control, and 1.89mm in the test group. There was no statistical significance between the two groups. 2. Alveolar bone formation were: 0.61mm in the control, and 1.88mm in the test group. There was a statistically significant difference between the two groups (p<0.05). 3. Cementum formations were: l.lmm in the control, and 2.46mm in the test group. There was a statistically significant difference between the two groups (p<0.05). 4. The length of CT adhesion were: O.97mm in the control, and 0.17mm in the test group. There was no statistically significant differences between the two groups These results suggest that the use of calcium sulfate in intrabony defects has little effect on junctional epithelium migration, but has significant effects on new bone and new cementum formations.
The aim of this study was to achieve healing of Peri-implantitis defects and hard tissue augmentation using a bovine-derived bone mineral on the defect site. Two patients were treated with the surgical approach. With a full muco-periosteal flap elevation, the implant surfaces were exposed and granulation tissue removed around the implant and between the threads. Each surface of the contaminated implant was prepared with the air-abrasive device(PerioFlow$^{(R)}$) for decontamination. Bovine-derived bone mineral(Bio-Oss collagen$^{(R)}$) was then used to fill the defects and muco-periosteal flaps sutured to achieve transmucosal healing. Radiographs and clinical photographs were taken before and after 6 months of healing and an estimate of bone fill was assessed. Within the limits of the present case report, a surgical approach in treatment of peri-implantitis defects using a collagen form of bovine bone mineral was visited. Although limited, the two cases showed the stability and biocompatibility of a bovine-derived bone mineral and effectiveness of air-abrasive device(PerioFlow$^{(R)}$) as a decontamination method.
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