It has been established that a graft of fibroblasts is able to improve wound healing. However, there has been no research on the effect of a graft of bone marrow stromal cells on wound healing. The wound healing process requires cell proliferation and production of extracellular matrix and various growth factors. The purpose of this study was to compare the abilities of human fibroblasts and bone marrow stromal cells, which contains mesenchymal stem cells, to proliferate and to produce collagen. Human bone marrow stromal cells and fibroblasts were isolated from bone marrow and dermis of the same patients and grown in culture respectively. Cell proliferation and production of type I collagen by human bone marrow stromal cells and dermal fibroblasts were examined by MTT method and by ELISA of cell culture media on day 1, 3, and 5 days post-incubating. The human bone marrow stromal cells showed 11-17% higher cell proliferation than fibroblasts at each time interval. The levels of type I collagen in the human bone marrow stromal cell group was also significantly higher than those in the fibroblast group. The results indicate that the grafts of human bone marrow stromal cells can show more promising effect than that of fibroblasts for healing of chronic wounds.
Since the early study about the osseointegration, lots of researches have been performed to increase the success rate and the stress around the implant in the jaw bone has been considered as one of the causes of failure. The purpose of this study was to examine the relationship between the implant failure and the stress by analysing the influence of different bone quality and bite force of some foods on the stress distribution around the implant, and to estimate the treatment result according to the bone quality and dietary pattern of patients. Bone quality was divided in 4 groups and models were drawn with the assumption that thread type implant(Nobel Biocare AB, Goteborg, Sweden) of 3.75mm diameter, 13mm length was installed to the bones. Various bite forces were applied to the occlusal surface of superstructure and the stress distributed around the implant were analysed with finite element analysis program. The results were as follows ; 1. The stress was changed proportionally to the bite forces of foods at all measuring points in all load cases. 2. The stress at the marginal bone was higher than that of the other measuring points in all load cases, and it was decreased at the first thread area. 3. The stress at the marginal bone was highest in type IV bone in all load cases. Especially it was twice those of other bone types at the bucco-lingual marginal bone and 50% higher at the mesio-distal marginal bone. 4. The stress at the bucco-lingual sides of the bone around the apical portions of implant showed little differences among the bone types, while type IV bone showed lower stress concentration than the other bone types in the mesio-distal sides. 5. Under the buccal oblique load ($15^{\circ}$ ), the stress at the lingual marginal bone was higher than that of buccal marginal bone, and the difference between the two points was almost same regardless of bone types.
Kim, Tae-Yi;Kim, Ye-Mi;Kim, Ji-Youn;Kim, Myung-Rae;Kim, Sun-Jong
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.37
no.6
/
pp.483-489
/
2011
Introduction: This study examined the cumulative resorption of implants placed in a severely atrophic mandible and analyzed the radiologic bone resorption in the marginal bone, after an autogenous bone graft including both block and particulates that had been harvested from the ramus and iliac crest. Materials and Methods: A retrospective study was performed on patients who had bone grafts for augmentation followed by implant installation in the mandible area from 2003 to 2008. Twelve patients (6 men and 6 women) who received 34 implants in the augmented sites were evaluated. Cumulative radiologic resorption around the implants was measured immediately, 3 months, 6 months and 12 months after implant installation surgery. Results: The installed implant in grafted bone showed 0.84 mm marginal bone resorption after 3 months and 50% total cumulative resorption after 1 year. The mean marginal bone resorption around the implant installed in the grafted bone was 0.44 mm after 3 months, 0.52 mm after 1 year, after which it stabilized. The implant survival rate was 97% (failed implant was 1/34). Marginal bone resorption of the installed implant in the autogenous onlay block bone grafts was 0.98 mm after 3 months, which was significantly higher than that of a particulated bone graft (0.74 mm) (P <0.05). Conclusion: An autogenous graft including block type and particulate type is a predictable procedure for the use of dental implants in a severely atrophic mandible. Implant placement in augmented areas show a relatively high survival and minimal bone loss, as revealed by a radiologic evaluation.
The purpose of this study was to analyze the magnitude and mode of the stress distribution induced in the supporting alveolar bone and periodontal ligament and, to determine the displacement of abutment teeth and telescope denture base by applying chewing force to the telescope denture quantitatively and qualitatively. Two finite element models of telescope denture that were restored the missing mandibular second molar with two abutment teeth which were constructed. In two different models, parallel and tapering type telescope crowns were constructed. These finite element models of two cases used for these experiment were a two-dimensional mesiodistal section of the mandibular second bicuspid and first molar. Chewing force of 25Kg that was devided in the ratio of 45/155 (29%) in bicuspid and 55/155 (35.5%) in molars was applied to telescope denture and abutment teeth respectively. The displacement of the telescope denture base and abutment teeth and the stress distribution in the periodontal ligament and alveolar bone were analized to investigate the influence of chewing force acting on the telescope denture and abutment teeth. The results were as follows: 1. Abutment teeth displaced mesially and the magnitude of displacement of abutment teeth in vertical direction were more than that of horizontal direction in two cases. The displacement of abutment teeth on the telescope denture treated with tapering type telescope crown were less than that of the parallel type crown. 2. The displacement of the telescope denture base that were treated with parallel type telescope crown were less than that of treated with tapering type telescope crown. 3. The stress induced in the alveolar bone and periodontal ligament on abutment teeth that treated with parallel type telescope crown were more than that of treated with tapering type telescope crown and more stress induced in the alveolar bone than in the periodontal ligament. 4. In the telescope denture, the magnitude of displacement of abutment teeth and stress induced in the periodontal ligament and alveolar bone were within physiologic limit.
Choi, Min Hyub;Cheon, Ji Seon;Son, Kyung Min;Cho, Woo Young
Archives of Craniofacial Surgery
/
v.21
no.1
/
pp.7-14
/
2020
Background: It is difficult to completely fix nasal bone fractures with closed reduction, as it is often accompanied by septal cartilage damage, and this often results in postoperative secondary deformities. Thus, patients are often reluctant to undergo closed reduction surgery. The present study aimed to evaluate aesthetic and functional satisfaction, as well as satisfaction with and complications of closed reduction, according to nasal bone fracture type. Methods: The subjects were patients who underwent closed reduction under general anesthesia from January 2017 to December 2018. Based on the modified Murray classification, patients were classified into five groups according to the fracture site, septal fracture, and deviation. A total of 211 patients were sent a web-based survey on postoperative satisfaction and complications, as well as intention for revision and cosmetic surgery. Sixty-one patients (28.9%) responded. Results: There were no significant differences in aesthetic and functional satisfaction or satisfaction with closed reduction according to the fracture type, site, or severity. Postoperative functional complications developed in 14 of 61 patients (22.95%). With 10 out of 24 (41.67%) patients (p = 0.044), the bilateral fracture with septal fracture or prominent septal deviation type had a higher incidence of complications than the other types. Conclusion: The incidence of complications is higher for bilateral fracture with septal fracture or prominent septal deviation compared to the other nasal bone fracture types. Therefore, long-term follow-up after closed reduction surgery for this fracture type can aid in establishing additional postoperative treatment plans and improving patient satisfaction.
In order to find the degree of osseointegration at bone-implant interface of clinically successful implants, models including the 3.75mm wide, 10mm long screw type $Br{\aa}nemark$ implant as a standard and cylinder, 15mm long, 5.0mm wide, two splinted implants, and implants installed in various cancellous bone density were designed. Also, the amount of load and material of prostheses were changed. The stress and minimum contact fraction were analyzed on each model using three-dimensional finite element method(I-DEAS and ABAQUS version 5.5). The results of this study were as follows. 1. 10mm long, 3.75mm diameter-screw type implant had $36.5{\sim}43.7%$ of minimum contact fraction. 2. Cylinder type implant showed inferior stress distribution and higher minimum contact fraction than screw type. 3. As implant length was increased, minimum contact fraction was increased a little, however, maximum principal stress was decreased. 4. Implants with a large diameter had lower stress value with slightly higher minimum contact fraction than standard screw type. 5. Two splinted implants showed no change of minimum contact fraction. 6. The higher bone density, the lower stress value. 7. The material of occlusal surface had no effect on the stress of the bone-implant interface.
Yong Jig Lee;Dong Gil Han;Se Hun Kim;Jeong Su Shim;Sung-Eun Kim
Archives of Craniofacial Surgery
/
v.24
no.1
/
pp.18-23
/
2023
Background: When performing reduction of zygomatic arch fractures, locating the inward portion of the fracture can be difficult. Therefore, this study investigated the discrepancy between the locations of the depression on the soft tissue and bone and sought to identify how to determine the inward portion of the fracture on the patient's face. Methods: We conducted a retrospective review of chart with isolated zygomatic arch fractures of type V in the Nam and Jung classification from March 2013 to February 2022. For consistent measurements, a reference point (RP), at the intersection between a vertical line passing through the end point of the root of the ear helix in the patient's side-view photograph and a transverse line passing through the longest horizontal axis of the external meatus opening, was established. We then measured the distance between the RP and the soft tissue depression in a portrait and the bone depression on a computed tomography (CT) scan. The discrepancy between these distances was quantified. Results: Among the patients with isolated zygomatic arch fractures, only those with a fully visible ear on a side-view photograph were included. Twenty-four patients met the inclusion criteria. There were four types of discrepancies in the location of the soft tissue depression compared to the bone depression: type I, forward and upward discrepancy (7.45 and 3.28 mm), type II, backward and upward (4.29 and 4.21 mm), type III, forward and downward (10.06 and 5.15 mm), and type IV, backward and downward (2.61 and 3.27 mm). Conclusion: This study showed that discrepancy between the locations of the depressions on the soft tissue and bone exists in various directions. Therefore, applying the transverse and vertical distances measured from a bone image of the CT scan onto the patient's face at the indicated RP will be helpful for predicting the reduction location.
This study investigates the biomechanical efficacies of various cement augmentation techniques with or without pressurization for varying degrees of osteoporotic femur. For this study, a biomechanical analysis using a finite element method (FEM) was undertaken to evaluate surgical procedures, Simulated models include the non-cemented(i.e., hip screw only, Type I), the cement-augmented(Type II), and the cemented augmented with pressurization(Type III) models. To simulate the fracture plane and other interfacial regions, 3-D contact elements were used with appropriate friction coefficients. Material properties of the cancellous bone were varied to accommodate varying degrees of osteoporosis(Singh indices, II∼V). For each model. the following items were analyzed to investigate the effect surgical procedures in relation to osteoporosis of varying degrees : (a) von Mises stress distribution within the femoral head in terms of volumetric percentages. (b) Peak von Mises stress(PVMS) within the femoral head and the surgical constructs. (c) Maximum von Mises strain(MVMS) within the femoral head, (d) micromotions at the fracture plane and at the interfacial region between surgical construct and surrounding bone. Type III showed the lowest PVMS and MVMS at the cancellous bone near the bone-construct interface regardless of bone densities. an indication of its least likelihood of construct loosening due to failure of the host bone. Particularly, its efficacy was more prominent when the bone density level was low. Micromotions at the interfacial surgical construct was lowest in Type III. followed by Type I and Type II. They were about 15-20% of other types. which suggested that pressurization was most effective in limiting the interfacial motion. Our results demonstrated the cement augmentation with hip screw could be more effective when used with pressurization technique for the treatment of intertrochanteric fractures. For patients with low bone density. its effectiveness can be more pronounced in limiting construct loosening and promoting bone union.
Purpose: The present study was aimed to evaluate the level of cortical bone strain during the placement of an implant. The primary concern was to investigate if the extent of overloading area near the marginal bone could be affected by microthread fabricated at the cervical 1/3 of an implant. Materials and methods: Three dimensional finite element analysis was used to simulate the insertion of 3 implants. Control model was $4.1{\times}10$ mm implant (Submerged model, Dentis Co,, Daegu, Korea) equipped with a main thread only. Type I was with main thread and microthread, and Type II had similar thread pattern but was of tapered body. A PC-based finite element software (DEFORM 3D ver 5, SFTC, Columbus, OH, USA) was used to calculate a total of 3,600 steps of analysis, which simulated the whole insertion. Results: Results showed that the strain field in the marginal bone within 1 mm of the implant wall was higher than 4,000 micro-strain in the control model. The size of bone overloading was 1-1.5 mm in Type I, and greater than 2 mm in Type II implants. Conclusion: These results indicate that the marginal bone may be at the risk of resorption on receiving the implant for all 3 implant models studied. Yet, the risk was greater for Type I and Type II implants, which had microthread at the cervical 1/3.
Objective: The purpose of this study was to quantitatively evaluate the cortical bone densities of the maxillary and mandibular alveolar processes in adults with different vertical facial types using cone-beam computed tomography (CBCT) images. Methods: CBCT images (n = 142) of adult patients (20-45 years) were classified into hypodivergent, normodivergent, and hyperdivergent groups on the basis of linear and angular S-N/Go-Me measurements. The cortical bone densities (in Hounsfield units) at maxillary and mandibular interdental sites from the distal aspect of the canine to the mesial aspect of the second molar were measured on the images. Results: On the maxillary buccal side, female subjects in the hyperdivergent group showed significantly decreased bone density, while in the posterior region, male subjects in the hyperdivergent group displayed significantly decreased bone density when compared with corresponding subjects in the other groups (p<0.001). Furthermore, the subjects in the hyperdivergent group had significantly lower bone densities on the mandibular buccal side than hypodivergent subjects. The maxillary palatal bone density did not differ significantly among groups, but female subjects showed significantly denser palatal cortical bone. No significant difference in bone density was found between the palatal and buccal sides in the maxillary premolar region. Overall, the palatal cortical bone was denser anteriorly and buccal cortical bone was denser posteriorly. Conclusion: Adults with the hyperdivergent facial type tend to have less-dense buccal cortical bone in the maxillary and mandibular alveolar processes. Clinicians should be aware of the variability of cortical bone densities at mini-implant placement sites.
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