• Journal of Periodontal and Implant Science
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• 제32권2호
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• pp.325-338
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• 2002

Bone graft using growth factors and guided tissue regeneration have been used for the regeneration of infrabony defects which caused by periodontal disease. Calcium sulfate which is one of the resorbable barrier materials used for guided tissue regeneration. Platelet rich plasma which is a easy method to obtain the growth factors had many common points but, platelet rich plasma was still studying. This study was the comparative study between bone graft using platelet rich plasma and guided tissue regeneration using calcium sulfate barrier material in clinical view. For the study, 28 sites(2 or 3 wall infrabony defects) were treated. 14 infrabony defects were received surgical implantation of BBP-calcium sulfate composite with a calcium sulfate barrier and the others received BBP mixed with platelet rich plasma. Clinical outcome was accessed 3 and 6 months of postsurgery. 1. There was no statistical difference between CS group and PRP group in pocket depth, gingival recession, clinical attachment level, and probing bone level at baseline. 2. There was statistically significant reduction in probing depth, clinical attachment level, and probing bone level at 3 and 6 months postsurgery(p<0.05). 3. In the probing depth and clincial attachment level PPR group had less improvement than CS group, but there was no statistically difference at 3 and 6 months postsurgery. 4. In the recession PPR group had less recession than CS group, but there was no statistically difference at 3 and 6 months postsurgery. 5. In the probing bone level PPR group had less improvement than CS group, but there was no statistically difference at 6 months postsurgery. In conclusion bone graft using platelet rich plasma and guided tissue regeneration using calcium sulfate barrier showed similar clinical improvement for the treatment of 2 or 3 wall infrabony defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권3호
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• pp.116-123
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• 2014

Purpose: The purpose of this study was to evaluate risks for wound dehiscence after guided bone regeneration (GBR) in dental implant surgery. Methods: Patients who received dental implant therapy with GBR procedure at Seoul National University Bundang Hospital (Seongnam, Korea) from June 2004 to May 2007 were included. The clinical outcome of interest was complications related to dental implant surgery. The factors influencing wound dehiscence, classified into patient-related factors, surgery-related factors and material-related factors, were evaluated. Results: One hundred and fifteen cases (202 implants) were included in this study. Wound dehiscence (19.1%) was considered a major complication. The risk of wound dehiscence was higher in males than in females (odds ratio=4.279, P =0.014). In the main graft, the allogenic group had the lowest risk of wound dehiscence (odds ratio=0.106, P =0.006). Though the external connection group had a higher risk of wound dehiscence than the internal connection group (odds ratio=2.381), the difference was not significant (P =0.100). Conclusion: In this study, male gender and main graft have the highest risk of wound dehiscence. To reduce wound dehiscence after GBR, instructions on postoperative care with supplementary procedure for the protection of the wound dehiscence is recommended, especially to male patients. A main graft with a gel base can reduce the risk of wound dehiscence.

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.187-198
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• 2002

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Recently, bioactive glass that has been utilized in plastic surgery is being investigated for application in dental practice. But, there has not been any long-term assessment of bioactive glass when used in periodontal intrabony defects. The present study evaluates the long-term effects of bioactive glass on the periodontal regeneration in intrabony defects of human and the effect of plaqu control on long term treatment results after dividing patients into those who underwent 3-month regular check-up and those who didn't under go regular check-up The clinical effect on 74sites from 17 infrabony pockets of 11 patients were analyzed 36months after treatment. 51 sites which underwent regular check up were classified as the Follow-up group(F/U group), and 23 sites which did not undergo regular check up were classified as Non Follow-up group(Non F/U group). After comparing the probing depth, attachment loss, bone probing depth before and 36months after treatment, the following results could be concluded. 1. The changes of probing pocket depth showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.79${\pm}$0.68mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(0.61${\pm}$0.54mm) (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.44${\pm}$0.74mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(1.18${\pm}$1.54) (P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after baseline and 36 months after treatment in both F/U(1.35${\pm}$0.28) and Non F/U group(0.78${\pm}$0.55mm) (P<0.05). The results suggest that treatment of infrabony defects with bioactive glass resulted in significan reduction of attachment loss and bone probing depth 36months after the treatment. The use of bioactive glass in infrabony defects, combined with regular check-up and proper plaque control generally shows favorable clinical results. This measn that bioactive glass could be a useful bone substitute.

• 대한치과교정학회지
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• 제31권6호
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• pp.601-610
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• 2001

치조골 파열을 동반한 순구개열 환자의 대부분은 영구견치 상방의 치조골 결손으로 인하여 맹출장애를 일으키게 되는데 이차적인 치조골이식을 통하여 영구견치의 맹출을 유도하게 된다. 본 연구의 목적은 순구개열 환자에서 재건된 치조골을 통하여 맹출된 영구견치의 치조골 지지도(alveolar bone support)를 정상 치조골을 통하여 맹출한 영구견치의 치조골 지지도(alveolar bone support)와 비교 평가하고 치조골 파열에 인접한 측절치의 유무 또는 치조골 이식수술시의 견치의 치근발육 정도가 수술후 견치의 치조골 지지도에 미치는 영향에 대하여 알아보는 것이다. 본 연구는 편측성 구개열 환자중 장골을 이용하여 이차적인 치조골 이식 수술을 받은 21명의 아동을 대상으로 하였고 치조골 이식수술 당시의 평균 연령은 9.8세 였으며 치조골 지지도 평가시의 최소 연령은 12.4세 였다. 치조골 지지도의 평가를 위하여 치근단 방사선 사진을 이용하였으며 해부학적 치근 길이에 대한 치조골로 지지된 치근단 길이를 백분율로 환산하여 치조골 지지도로 계산하였다. 동일한 환자에 있어서 치조골 파열부위의 견치를 실험군으로 정상부위의 견치를 대조군으로 사용하여 실험군의 대조군에 대한 치조골 지지도 획득 비율을 계산하였다. 실험군 견치의 치조골 지지도($88.7\%$)와 대조군 견치의 치조골 지지도($92.9\%$)사이에는 통계학적으로 유의한 차이가 있었으며 실험군 견치에서는 대조군 견치의 평균 $95\%$에 해당하는 치조골 지지도를 보였다. 치조골 파열 부위의 측절치의 존재여부와 치조골 이식당시의 환자의 나이 또는 영구견치의 치근 발육정토는 영구견치의 치조골 지지도에 유의할 만한 차이를 만들지는 않았다.음과 같다. 1 Alkaline phosphatase활성은 10, 100ng/m1의 IGF-I으로 처리한 군과 치주인대 섬유모세포의 조절배양액을 이용한 군, IGF-I으로 처리한 치주인대 섬유모세포의 조절배양액을 이용한 군에서 대조군보다 더 높게 나타났다. 10, 100ng/ml의 IGF-I으로 처리한 치주인대 섬유모세포의 조절배양액을 이용한 실험군에서 유의성 있게 높게 나타났다. 2. 100ng/m1농도의 IGF-I으로 직접 처리한 군에서 골모세포증식이 유의성 있게 증가하였다. 3. 총단백질량은 IGF-I투여와 상관없이 대조군, 실험군 모두 유사하였다. 4. 모든 실험군에서 BMP2,4가 발현되었고, 대조군과 유의한 차이는 없었다. 이상의 결과에서 IGF-I의 투여여부와는 상관없이 치주인대 섬유모세포가 유리하는 물질이 골모세포의 활성을 증가시키는 것으로 나타났으며, IGF-I은 고농도일때만 유의성있게 골모세포 활성을 촉진함을 알 수 있었다. 따라서 이 연구를 통하여 치주인대 섬유모세포가 골모세포활성을 촉진 시키는 작용을 가지고 있음이 확인되었다.8회의 회전후 파절한다. 그 다음으로 Jinsung Stainless Steel, Unitek Hi-T, Ormco Stainless Steel, Unitek Standard(50.6회) 순이었다. 0.019x0.025의 경우 Jinsung Stainless Steel이 가장 커서 83.2회의 회전에 저항하고, Unitek Resilient, Unitek Standard의 순이고 Ormco와 Unitek Hi-T가 가장 저항력이 작았다. 6. 주사전자현미경으로 본 표면은 모든 제품에서 생산과정 중에 보이는 압흔과 pitting이 관찰되는데, 진성기업의 Stainless Steel은 가늘고 긴 압흔이 있으며 비교적

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권2호
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• pp.109-115
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• 2015

Odontoma is the most common odontogenic benign tumor, and the treatment of choice is generally surgical removal. After excision, bone grafts may be necessary depending on the need for further treatment, or the size and location of the odontoma. Although the osteogenic capacity of a demineralized tooth was verified as early as 1967 by Urist and many other investigators, the cumbersome procedure, including a long demineralization time, may be less than comfortable for clinicians. A modified ultrasonic technology, with periodic negative pressure and temperature control, facilitated rapid and aseptic preparation of demineralized teeth for bone grafts. This approach reduces the demineralization time dramatically (${\leq}80$ minutes), so that the graft material can be prepared chairside on the same day as the extraction. The purpose of this article is to describe two cases of large compound odonotomas used as graft material prepared chairside for enucleation-induced bony defects. These two clinical cases showed favorable wound healing without complications, and good bony support for future dental implants or orthodontic treatment. Finally, this report will suggest the possibility of recycling the benign pathologic hard tissue as an alternative treatment option for conventional bone grafts in clinics.

• 대한치과보철학회지
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• 제46권4호
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• pp.335-342
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• 2008

연구목적: 난소 절제술을 시행하여 골다공증을 재연한 쥐의 두개 결함부에 골 이식시 정상 쥐와 어떠한 골 재생 능력 차이를 보이는지 비교하고자 한다. 연구재료 및 방법: 20마리의 쥐를 2 그룹으로 각 10마리씩 나눈다. 그 중 10마리만 난소 절제술을 시행하고 7주 후 20마리 모두 두개골에 8 mm 직경의 임계 크기의 결함을 형성한 후 $OSTEON^{TM}$을 이식한다. 그 후 4주 후 모두 희생하여 조직학적 조각을 형성하여 방사선학적 및 조직형태학적 분석을 시행한다. 결과: Ovariectomy & $OSTEON^{TM}$군과 Non-Ovariectomy & $OSTEON^{TM}$군과의 신생골 형성 넓이의 효과 검증 결과, Ovariectomy & $OSTEON^{TM}$군은 평균 넓이는 19660.93 ${\pm}$ 17207.68 ${\mu}m$으로 Non-Ovariectomy & $OSTEON^{TM}$군의 69793.57 ${\pm}$ 33227.17 ${\mu}m$에 비해 적어진 것으로 나타났으며, 이러한 차이는 통계적으로도 유의한 것으로 나타났다 (t = -4.237, P < .01). 따라서 Ovariectomy & $OSTEON^{TM}$군의 new bone formation 넓이가 Non-Ovariectomy & $OSTEON^{TM}$군에 비해 작아진 것을 알 수 있다. Ovariectomy & $OSTEON^{TM}$ 군과 Non-Ovariectomy & $OSTEON^{TM}$ 군과의 알칼리 포스파타아제의 효과 검증 결과, Ovariectomy & $OSTEON^{TM}$군은 ALP는 평균 163.90 ${\pm}$ 61.44 IU/L으로 Non-Ovariectomy & $OSTEON^{TM}$군의 58.40 ${\pm}$ 18.30 IU/L에 비해 크게 높아진 것으로 나타났으며, 이러한 차이는 통계적으로도 유의한 것으로 나타났다 (t = 5.204, P < .001). 따라서 Ovariectomy & $OSTEON^{TM}$군의 ALP 수치가 Non-Ovariectomy & $OSTEON^{TM}$군 ALP 수치보다 높아진 것을 알 수 있다. 결론: 본 실험을 통해 골다공증이 유발되면 골 재생능력이 감소한다는 것을 결론지을 수 있다.

• Journal of Periodontal and Implant Science
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• 제53권6호
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• pp.467-477
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• 2023

Purpose: The purpose of this study was to evaluate the regenerative capacity of stem cells combined with bone graft material and a collagen matrix in rabbit calvarial defect models according to the type and form of the scaffolds, which included type I collagen matrix and synthetic bone. Methods: Mesenchymal stem cells (MSCs) were obtained from the periosteum of participants. Four symmetrical 6-mm-diameter circular defects were made in New Zealand white rabbits using a trephine drill. The defects were grafted with (1) group 1: synthetic bone (β-tricalcium phosphate/hydroxyapatite [β-TCP/HA]) and 1×10⁵ MSCs; (2) group 2: collagen matrix and 1×10⁵ MSCs; (3) group 3: β-TCP/HA, collagen matrix covering β-TCP/HA, and 1×10⁵ MSCs; or (4) group 4: β-TCP/HA, chipped collagen matrix mixed with β-TCP/HA, and 1×10⁵ MSCs. Cellular viability and cell migration rates were analyzed. Results: Uneventful healing was achieved in all areas where the defects were made at 4 weeks, and no signs of infection were identified during the healing period or at the time of retrieval. New bone formation was more evident in groups 3 and 4 than in the other groups. A densitometric analysis of the calvarium at 8 weeks post-surgery showed the highest values in group 3. Conclusions: This study showed that the highest regeneration was found when the stem cells were applied to synthetic bone along with a collagen matrix.

• Clinics in Shoulder and Elbow
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• 제15권1호
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• pp.32-36
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• 2012

목적: 쇄골 간부 불유합에서 개재 삼면피질 장골 이식술 및 금속판 고정술을 시행하고 그 방사선학적 및 임상적 결과를 알아보고자 하였다. 대상 및 방법: 2007년 9월부터 2011년 5월까지 쇄골 간부 불유합으로 개재 삼면피질 장골 이식술 및 금속판 고정술을 시행한 10예를 대상으로 하였으며, 평균 추시 기간은 30.7 (12~57)개월이었다. 불유합 부위의 경화된 골을 충분히 절제한 후 구조적 지지 및 쇄골 길이를 회복할 수 있도록 삼면피질 장골을 골 결손 부위에 개재한 후 금속판 고정술을 시행하였다. 술 후 방사선적 평가는 단순 방사선 사진을 이용하여 골 유합을 판단하였고, 임상적 평가는 UCLA, ASES, Quick DASH 평가 점수를 이용하였다. 결과: 전 예에서 골 유합을 얻을 수 있었으며, 평균 골 유합 기간은 18.4 (14~24)주였다. UCLA 점수는 술 전 평균 16.7점에서 최종 추시 시 평균 27.4점으로, ASES 점수는 술 전 평균 52.1점에서 최종 추시 시 평균 83.6점으로 호전되었다 (p<0.05). 최종 추시 시 Quick DASH 점수는 평균 40.5점이었다. 합병증으로 2예에서 견관절 강직이 있었으며, 그 중 1예는 술 후 11개월째 금속물 제거술과 함께 견관절 관절경 수술을 시행하였다. 그 외 고정물의 파손 및 감염 등의 합병증은 없었다. 결론: 쇄골 간부 불유합에서 개재 삼면피질 장골 이식술은 구조적 지지대 역할 뿐만 아니라 쇄골의 길이를 회복할 수 있는 좋은 술식으로 사료된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권4호
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• pp.218-222
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• 2023

Re-ankylosis is a common postoperative complication of temporomandibular joint (TMJ) ankylosis surgery. Various surgical options to prevent re-ankylosis, both with and without interpositional material, have been discussed in the literature. However, no standardized protocol has been suggested for management or prevention of TMJ ankylosis. This paper discusses the probable causes behind TMJ re-ankylosis and presents a case of unilateral TMJ re-ankylosis, which was managed by gap arthroplasty using an autologous abdominal dermal fat graft as an interpositional material and closely monitored for signs of relapse. Autologous fat graft acted as an effective barrier between the glenoid fossa and mandibular condyle, thus preventing dead space, hematoma and heterotrophic bone formation. A brief review of the literature and update on TMJ re-ankylosis are also presented.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권3호
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• pp.57-62
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• 1990

Many alloplastic materials have been used as the bony substitute in large bony defects caused by fracture, periodontitis, & cyst, etc. Nowadays Hydroxyapatite(HAP) is the most usable material as the bony substitute. The reasonable properties of HAP are nontoxic, biocompatible to host tissues & have osteoconductivity. Other bioceramic materials are recommended as the bony substitute with high success rate. We have studied the clinical use of HAP as the bony substitute in the defected area caused by cyst. The reasonalbe & successful results are obtained. The results were as followed. 1. Better prognosis was obtained in the case of HAP & bone mixed graft than HAP graft only. And the best prognosis was obtained in the case of iliac bone graft. 2. Better prognosis was obtained in Mx. than in Mn. 3. It seems that the soft tissue ingrowth into the HAP granule play an important role in the success of the HAP graft. 4. Though the flap covering the HAP granules was perforated, the relative good prognosis was obtained by re-suturing the perforeated site.