• Journal of Periodontal and Implant Science
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• v.30 no.1
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• pp.167-180
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• 2000

The present study evaluated the effects of guided tissue regeneration using biodegradable membrane, with and without calcium-phosphate thin film coated deproteinated bone powder in beagle dogs. Contralateral fenestration defects(6 × 4 mm) were created 4 mm apical to the buccal alveolar crest on maxillary canine teeth in 5 beagle dogs. Ca-P thin film coated deproteinated bone powder was implanted into one randomly selected fenestration defect(experimental group). Biodegradable membranes were used to provide bilateral GTR. Tissue blocks including defects with overlying membranes and soft tissues were harvested following a four- & eight-week healing interval and prepared for histologic analysis. The results of this study were as follows. 1.......The regeneration of new bone, new periodontal ligament, and new cementum was occurred in experimental group more than control group. 2.......The collapse of biodegradable membranes into defects were showed in control group and the space for regeneration was diminished. In experimental group, the space was maintained without collapse by graft materials. 3........In experimental group, the graft materials were resorbed at 4 weeks after surgery and regeneration of bone surrounding graft materials was occurred at 8 weeks after surgery. 4.......Biodegradable membranes were not resorbed at 4 weeks and partial resorption was occurred at 8 weeks but the framework and the shape of membranes were maintained. No inflammation was showed at resorption. In conclusion, the results of the present study suggest that Ca-P thin film coated deproteinated bone powder has adjunctive effect to GTR in periodontal fenestration defects. Because it has osteoconductive property and prohibit collapse of membrane into defect, can promote regeneration of much new attachment apparatus.

• Journal of Periodontal and Implant Science
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• v.47 no.2
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• pp.86-95
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• 2017

Purpose: The aim of this study was to determine the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded synthetic bone substitute on implants that were simultaneously placed with sinus augmentation in rabbits. Methods: In this study, a circular access window was prepared in the maxillary sinus of rabbits (n=5) for a bone graft around an implant (${\varnothing}3{\times}6mm$) that was simultaneously placed anterior to the window. Synthetic bone substitute loaded with rhBMP-2 was placed on one side of the sinus to form the experimental group, and saline-soaked synthetic bone substitute was placed on the other side of the sinus to form the control group. After 4 weeks, sections were obtained for analysis by micro-computed tomography and histology. Results: Volumetric analysis showed that the median amount of newly formed bone was significantly greater in the BMP group than in the control group ($51.6mm^3$ and $46.6mm^3$, respectively; P=0.019). In the histometric analysis, the osseointegration height was also significantly greater in the BMP group at the medial surface of the implant (5.2 mm and 4.3 mm, respectively; P=0.037). Conclusions: In conclusion, an implant simultaneously placed with sinus augmentation using rhBMP-2-loaded synthetic bone substitute can be successfully osseointegrated, even when only a limited bone height is available during the early stage of healing.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.19-25
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• 2011

Purpose: Addition of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) to grafting material has become widely accepted additively for bone regeneration because it can raise high expectations on it's clinical potential. The aim of this study was to evaluate the efficacy of PRP and PRF on early bone regeneration of rabbits when used in combination with beta tricalcium phosphate. Methods: In eight rabbits, the calvarium was exposed and the two marrows were penetrated. After then these artificial bone defects were augmented with ${\beta}$-TCP or ${\beta}$-TCP with PRP or ${\beta}$-TCP with PRF and covered. The animals were sacrificed after four and eight weeks. Histologic findings were observed under the light-microscope and histomorphometric analysis was performed by measuring calcified area of new bone formation within the CSD. Results: They demonstrated that new bone formation tended to be produced along the outline of graft materials. More amounts of newly bone was regenerated in ${\beta}$-TCP only and in combination of${\beta}$-TCP with PRF and it was statistically significant. In contrast, there was no significant difference between nothing apply and ${\beta}$-TCP with PRP groups in the relative amounts of newly mineralized bone. Conclusion: Within the limitation of this study, it can be concluded that PRF in combination with ${\beta}$-TCP showed a positive effect on bone regeneration and statistically it was significant.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.4
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• pp.181-187
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• 2014

Objectives: The purpose of this preliminary study is to evaluate the effectiveness of a customized, three-dimensional, preformed titanium mesh as a barrier membrane for peri-implant alveolar bone regeneration. Materials and Methods: Ten patients were recruited for this study. At the time of implant placement, all patients had fenestration or a dehiscence defect around the implant fixture. A mixture of particulate intraoral autologous bone and freeze-dried bone allograft was applied to the defect in a 1 : 1 volume ratio and covered by the preformed titanium mesh. A core biopsy specimen was taken from the regenerated bone four months postoperatively. Patients were followed for 12 months after the definitive prosthesis was placed. Results: Satisfactory bone regeneration with limited fibrous tissue was detected beneath the preformed titanium mesh. Histologic findings revealed that newly formed bones were well-incorporated into the allografts and connective tissue. New growth was composed of approximately 80% vital bone, 5% fibrous marrow tissue, and 15% remaining allograft. All implants were functional without any significant complications. Conclusion: The use of preformed titanium mesh may support bone regeneration by maintaining space for new bone growth through its macro-pores. This preliminary study presents the efficacy of a preformed titanium mesh as a ready-to-use barrier membrane around peri-implant alveolar bone defect. This preformed mesh is also convenient to apply and to remove.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.5
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• pp.285-293
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• 2019

Objectives: This study examined the effects of plasma-rich growth factors (PRGF) on accelerating bone regeneration/repair in fresh extraction sockets, and determined the quality and quantity of bone by assessing the bone density using cone-beam computed tomography (CBCT). Materials and Methods: Twenty patients, who had undergone bilateral extractions, were included in this study. In one extraction socket, PRGF was used and covered with an autologous fibrin plug. Nothing was used in the opposite side extraction socket. Thirteen weeks post extraction, the level of bone regeneration was evaluated on both sides with CBCT. Results: At the end of the study, the mean bone density according to the Hounsfield units (HU) in the control group and PRGF group was 500.05 HU (type III bone type) and 647.95 HU (type II bone type), respectively. Conclusion: This study recommends the use of PRGF in post extraction sites to accelerate the rate of bone regeneration and improve the quality of regenerated bone. The technique to process PRGF was simple compared to previously mentioned techniques used for platelet-rich plasma (PRP) preparation. PRP preparation requires a two-cycle centrifugation procedure, leading to a longer processing time.

• Journal of the Korean Society of Radiology
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• v.15 no.4
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• pp.539-545
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• 2021

Radiation therapy is accompanied by adverse radiation effective. In particular, it is accompanied by disorders of the vascular system. Therefore, oxygen and nutrient deficiency occurs in the regeneration area. Eventually, osteoradionecrosis is formed in this cellular environment. According to a precedent study, bone morphogenetic protein-2 is used to overcome osteoradionecrosis. The purpose of this study was to investigate the regeneration ability of osteoradionecrosis by treating bone-forming protein-2 on a fibrinogen scaffold which is a biomaterial that is frequently used for bone regeneration after irradiation of the rat head. In addition, the purpose of this study was to verify the bone regeneration effect from the eight weeks. According to the experimental results, in the calvarial defected model of the irradiated mouse, making bone-formation was obtained after 8 weeks rather than bone-formation period in the early 4 weeks. moreover, it was found that the regenerated bone formation of the fibrinogen scaffold is formed from the inside of the bone of the defect area.

• Journal of Periodontal and Implant Science
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• v.33 no.1
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• pp.91-102
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• 2003

Several effective treatment methods and materials have been developed for the treatment of furcation involvement. Currently, the combination of guided tissue regeneration (GTR) and bone grafts is the most commonly prescribed method of treating furcation involved defects. But because these cases often present with poor accessibility, placement of the membrane may be difficult and consequently, clinically impractical. In this study, the alveolar bone healing patterns of adult beagle dogs presenting with alveolar bone destruction treated by one of two methods - treatment using solely bone allografts (BBP(R)), or treatment using bone allografts (BBP(R)) stabilized by a fibrin adhesive - were comp ared. The effects of the fibrin adhesive on the initial stabilization of the newly formed bone, subsequent regeneration of bone, and the feasibility of the clinical application of the fibrin adhesive were analyzed. The results of the study were as follows: 1. Clinical signs of inflammation at the 4-8 week interval were not observed: but signs of mild inflammation were histologically observed at the 4-week interval. 2. Allografts stabilized by fibrin adhesive showed good bone formation, whereas defects treated with only the allograft material showed incomplete alveolar bone regeneration. 3. Allografts stabilized by fibrin adhesive showed a decrease in the amount old bone with a concurrent increase in the formation of new lamellar bone four weeks post-op, whereas defects treated with only the allograft material showed no new lamellar bone formation at the same interval. 4. In detects treated with only the allograft material, the defective area was filled with connective tissue 8-weeks post-op, whereas fibrin adhesive stabilized allografts showed viable connections between the original bone and the newly formed bone, in addition to neovascularization 8-weeks post-op. The results of this study show that concurrent use of fibrin adhesive materials can stabilize the allograft material and aid in new bone formation Although the stability of fibrin adhesives fall short of the results achievable by GTR membranes, in cases presenting with poor accessibility that contraindicate the use of membranes, fibrin adhesive materials provide a viable and effective alternative to graft stabilization and new bone formation.

• Journal of Periodontal and Implant Science
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• v.37 no.1
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• pp.77-89
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• 2007

This study was performed to evaluate the effect of deproteinized bovine bone mineral soaked in inorganic polyphosphate on bone regeneration in the calvaria of rabbit in the procedure of guided bone regeneration with titanium reinforced expanded polytetrafluoroethylene(TR-ePTFE) membrane. The rabbits were divided into four groups. Control group used TR-ePTFE membrane filled with de-proteinized bovine bone mineral, experimental group I used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in 4% inorganic polyphosphate, experimental group II and III used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in 8% or 16% inorganic poly-phosphate respectively. After decortication in the calvaria, GBR procedure was performed on 8 rabbits with only TR-ePTFE membrane or titanium reinforced ePTFE membrane filled with deproteinized bovine bone mineral soaked in inorganic polyphosphate. The animals were sacrificed at 4 weeks, and 8 weeks af-ter the surgery. Non-decalcified specimens were processed for histologic analysis, and new bone for-mation was assessed by histomorphometric as well as statical analysis. 1. Both control group and experirrental group dermnstrated increasing of new bone formation until 8weeks. 2. At 8 weeks, experimental group I and group II showed the significant difference compared to control group in new bone formation. Especially experimental group II showed the most in-creasing of new bone formation. 3. The higher concentration of inorganic polyphosphate filled, the more volume of bone formation pro-moted, but experimental group III did not reveal significant difference compared to contol group. 4. Deproteinized bovine bone mineral did not resorbed at all until 8 weeks. These results suggest that inorganic polyphosphate has a promoting effect on bone regeneration. possibly by enhancing osteoconductivity of the carrier and by increasing osteoinductivity of the defected alveolar bone tissue, but not as we respect.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.191-198
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• 2008

Purpose: Guided bone regeneration(GBR) has emerged as a treatment in the management of osseous defects associated with dental implants. But several studies have reported different degrees of success of guided bone regeneration, depending upon the type of barrier selected, presence or absence of an underlying graft material, types of graft material, feasibility of technique, and clinician's preference. The aim of the present study was to evaluate bone formation following dental implant placement with augmentation materials at dehiscence defects in dogs. Material and Methods: Standardized buccal dehiscence defects($3{\times}5\;mm$) were surgically 2 Mongrel dog's mandibles, each 8 SLA surface, 8 anodizing surface implants. Each buccal dehiscence defect received flap surgery only(no treatment, control), $Cytoflex^{(R)}$ membrane only, Resolut $XT^{(R)}$ membrane only, Resolut $XT^{(R)}+Osteon^{TM}$. Animals were sacrificed at 8 weeks postsurgery and block sections were harvested for histologic analysis. Resuts: All experimental group resulted in higher bone formation than control. Resolut $XT^{(R)}+Osteon^{TM}$ group resulted appeared highest defect resolution. There was no difference between SLA and anodizing surface, nonresorbable and resorbable membrane. Conclusion: GBR results in rapid and clinically relevant bone closure on dehiscence defects of the dental implants.

• Journal of Periodontal and Implant Science
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• v.38 no.sup2
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• pp.373-384
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• 2008

Purpose: The aim of this study is to compare the healing response of various Hydroxyapatite(HA) coated dental implants by Ion-Beam Assisted Deposition(IBAD) placed in the surgically created circumferential gap in dogs. Materials and methods: In four mongrel dogs, all mandibular premolars and the first molar were extracted. After an 8 weeks healing period, six submerged type implants were placed and the circumferential cylindrical 2mm coronal defects around the implants were made surgically with customized step drills. Groups were divided into six groups : anodized surface, anodized surface with 150nm HA and heat treatment, anodized surface with 300nm HA and heat treatment, anodized surface with 150nm HA and no heat treatment, and anodized surface with 150nm HA, heat treatment and bone graft, anodized surface with bone graft. The dogs were sacrificed following 12 weeks healing period. Specimens were analyzed histologically and histomorphometrically. Results: During the healing period, healing was uneventful and implants were well maintained. Anodized surface with HA coating and $430^{\circ}C$ heat treatment showed an improved regenerative characteristics. Most of the gaps were filled with newly regenerated bone. The implant surface was covered with bone layer as base for intensive bone formation and remodeling. In case that graft the alloplastic material to the gaps, most of the coronal gaps were filled with newly formed bone and remaining graft particles. The bone-implant contact and bone density parameters showed similar results with the histological findings. The bone graft group presented the best bone-implant contact value which had statistical significance. Conclusion: Within the scope of this study, nano-scale HA coated dental implants appeared to have significant effect on the development of new bone formation. And additional bone graft is an effective method in overcoming the gaps around the implants.