• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.3
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• pp.243-248
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• 2009

Purpose: Rehabilitation of the edentulous posterior maxilla with dental implants often poses difficulty because of insufficient bone volume caused by pneumatization of the maxillary sinus and by crestal bone resorption. Sinus grafting technique was developed to increase the vertical height to overcome this problem. The present study was designed to evaluate the sinus floor augmentation with anorganic bovine bone (Bio-$cera^{TM}$) using histomorphometric and clinical measures. Patients and methods: Thirteen patients were involved in this study and underwent total 14 sinus lift procedures. Residual bone height was ${\geq}2mm$ and ${\leq}6mm$. Lateral window approach was used, with grafting using Bio-$cera^{TM}$ only(n=1) or mixed with autogenous bone from ramus and/or maxillary tuberosity(n=13). After 6 months of healing, implant sites were created with 3mm diameter trephine and biopsies taken for histomorphometric analysis. The parameters assessed were area fraction of new bone, graft material and connective tissue. Immediate and 6 months after grafting surgery, and 6 months after implantation, computed tomography (CT) was taken and the sinus graft was evaluated morphometric analysis. After implant installation at the grafted area, the clinical outcome was checked. Results: Histomorphometry was done in ten patients.Bio-$cera^{TM}$ particles were surrounded by newly formed bone. The graft particles and newly formed bone were surrounded by connective tissue including small capillaries in some fields. Imaging processing revealed $24.86{\pm}7.59%$ of new bone, $38.20{\pm}13.19%$ connective tissue, and $36.92{\pm}14.51%$ of remaining Bio-$cera^{TM}$ particles. All grafted sites received an implant, and in all cases sufficient bone height was achieved to install implants. The increase in ridge height was about $15.9{\pm}1.8mm$ immediately after operation (from 13mm to 19mm). After 6 months operation, ridge height was reduced about $11.5{\pm}13.5%$. After implant installation, average marginal bone loss after 6 months was $0.3{\pm}0.15mm$. Conclusion: Bio-$cera^{TM}$ showed new bone formation similar with Bio-$Oss^{(R)}$ histomorphometrically and appeared to be an effective bone substitute in maxillary sinus augmentation procedure with the residual bone height from 2 to 6mm.

• Journal of Periodontal and Implant Science
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• v.36 no.4
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• pp.797-808
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• 2006

Objective : The purpose of this study was to evaluate the physicochemical properties and cytocompatibility of microporous, spherical biphasic calcium phosphate(BCP) ceramics with a 60/40 $hydroxyapatite/{\beta}$ -tricalcium phosphate weight ratio for application as a bone graft substitute. Materials and Methods : Microporous, spherical BCP granules(MGSB) were prepared and their basic characteristics were compared with commercially available BCP(MBCP; Biomatlante, France) and deproteinized bovine bone mineral(Bio-Oss; GBistlich-Pharma, Switzerland, BBP; Oscotec. Korea), Their physicochemical properties were evaluated by scanning electron microscopy, X-ray diffractometry, Fourier-transform infrared spectroscopy, inductively coupled plasma atomic emission spectrometer, and Brunauer-Emmett-Teller method. Cell viability and proliferation of MC3T3-El cells on different graft materials were evaluated. Results : MGSB granules showed a chemical composition and crystallinity similar with those in MBCP, they showed surface structure characteristic of three dimensionally, well-interconnected micropores. The results of MTT assay showed increases in cell viablity with increasing incubation times. At 4d of incubation, MGSB, MBCP and BBP showed similar values in optical density, but Bio-Oss exhibited significantly lower optical density compared to other bone substitutes(p <0,05). MGSB showed significantly greater cell number compared to other bone substitutes at 3, 5, and 7d of incubation(p <0,05), which were similar with those in polystyrene culture plates. Conclusion: These results indicated the suitable physicochemical properties of MGSB granules for application as an effective bone graft substitute. which provided compatible environment for osteoblast cell growth. However, further detailed studies are needed to confirm its biological effects on bone formation in vivo.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.578-582
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• 2009

Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.1
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• pp.58-66
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• 2007

The purpose of this study is to understand the structure and biomechanics of the skeletal muscle. The skeletal muscle takes 40 to 45% of the whole body. Stable posture requires a balance of muscle. However, when the muscle strength is unbalanced, movement initiates. The power generated by the muscle is a primary means to adjust the equilibrium of posture and movement. The structural unit of the skeletal muscle is a long cylindrical type muscle fiber which contains hundreds of nucleus. The thickness of muscle fiber is about $10-100{\mu}m$, and its length is about 1-50cm. Muscle fiber is composed of myofibril that is covered with plasma membrane which is called sarcolemma. In understanding the movement of human body, it is important to comprehend the movement of bone and joint and the tension of muscle. Understanding the structure and biomechanics of muscle also provides basic information on clinical treatment of patients.

• Korean Journal of Computational Design and Engineering
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• v.16 no.6
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• pp.458-466
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• 2011

The morphology of a bone is closely associated with its biomechanical response. Thus, much research has been focused on analyzing the effects of variation of bone morphology with subject-specific models. Subject-specific models, which are generally achieved from 3D imaging devices like CT and MRI, incorporate more of the detailed information that makes a model unique. Hence, it may predict individual responses more accurately. Despite these powerful characteristics, specific models are not easily parameterized to the extent possible with statistical models because of their morphologic complexities. Thus, it is still proven challenging to analyze morphologic variations of subject-specific models across changes due to aging or disease. The aim of this article is to propose a generic and robust parametric morphing method for a subject-specific bone structure. We demonstrate this by using the proposed method on a model of a human proximal femur. Automatic segmentation algorithms are also presented to parameterize the specific model efficiently. A total of 48 femur models were evaluated for defining morphing vector fields. Also, several anatomical and mechanical functions of femur were considered as morphing constraints, and the NURBS interpolating technique was applied in the method to guarantee the generality of our morphed results.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2002.05a
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• pp.128-131
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• 2002

Several FE models were developed based on micro-CT images of a mandibular specimen. A new dental implant model was suggested from parameter study for the relation between shape and interfacial stress of dental implants. It is found that the proposed model is highly beneficial.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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• pp.197-203
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• 2000

Maxillary defect may be induced by trauma, inflammation, cyst, tumor and surgical procedure. In case of limited wall defect, free bone graft has been preferred. But it has some problems such as postoperative bone resorption and soft tissue inclusion to recipient site. And we can not use free bone in the case who has inflammation in the donor site. So we used the micro-titanium mesh as reconstructive material for the maxillary wall defect. We had operated 8 patients who were diagnosed as maxillary partial defects from June 1997 to September 1998 in the Chin-Hae military hospital. They were 1 case of antral wall defect, 1 case of palatal wall defect, 5 cases of infra-orbital wall defects and 1 case of oroantral fistula case. As a result, the micro-titanium mesh has shown the morphological stability and biocompatibility and it could be used in case who has infection. And mesh structure could prevent soft tissue ingrowth to bony defect area. Thus it can be used to the case of maxillary partial defect successfully.

• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.263-290
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• 1997

Homogenization technique is employed to investigate the series of stress analyses of mandible for three different types of dental implants. This technique helps to make proper material model of bone and analyze such a non homogeneous structure at the level of individual microstructural unit. The stress analyses with homogenization technique show much higher stress level in the sponge bone, compared to those of conventional FEM. It also manifested that even a minor lateral force results in crucial stresses in the dental implant system and that the macroscale model should take the shape and size after real mandible to produce reasonable solution in the analyses of dental implant systems. The shapes of dental implants simulated in this study are rectangular-cross-sectioned type, hemi-sphere rooted type, and wedge type implant. The stress states of mandible with hemisphere rooted type implant and wedge type implant show similar levels, while those with sectioned rectangular implant results in higher stresses. It is suggested that the distance between the implant tip and cortical bone be kept far enough to prevent stress concentrations in the mandible.

• Molecules and Cells
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• v.25 no.3
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• pp.352-357
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• 2008

Osteoprotegerin (OPG) is a soluble decoy receptor that inhibits osteoclastogenesis and is closely associated with bone resorption processes. We have designed and determined the solution structures of potent OPG analogue peptides, derived from sequences of the cysteine-rich domain of OPG. The inhibitory effects of the peptides on osteoclastogenesis are dose-dependent ($10^{-6}M-10^{-4}M$), and the activity of the linear peptide at $10^{-4}M$ is ten-fold higher than that of the cyclic OPG peptide. Both linear and cyclic peptides have a ${\beta}$-turn-like conformation and the cyclic peptide has a rigid conformation, suggesting that structural flexibility is an important factor for receptor binding. Based on structural and biochemical information about RANKL and the OPG peptides, we suggest that complex formation between the peptide and RANKL is mediated by both hydrophobic and hydrogen bonding interactions. These results provide structural insights that should aid in the design of peptidyl-mimetic inhibitors for treating metabolic bone diseases caused by abnormal osteoclast recruitment.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.2
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• pp.243-249
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• 2006

Statement of problem: It is important to have a correct presurgical treatment plan before any implant surgery. It must contain substantial information about the patient concerned. However, the standard classification only notifies the dentist about various structural, pathological and physiological dimensions Due to diverse structure of the jaw bone, current standard classification does not tell spatial dimensions of the available bone for implant insertion sites. Purpose of study: The purpose of this study is to report the establishment of the systematic implant treatment plan and its clinical treatment using $Implan^(R)$ program which is based on ASCIi-classification that is available for future diagnosis and scale of treatment and for systematic implant insertion. Results: By assisting the systemic measurement of the available alveolus dimension during implant surgery, it was easy to set initial implant treatment plan. Conclusion: Using $Implan^(R)$ program which is based on ASCIi-classification system that allows the establishment of systemic implant treatment plan and successful clinical performance, it was possible to establish the founding or initial implant treatment plan , the acquisition of information, and the systematization of documentation.