• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.26-32
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• 1996

This study was performed to determine the ideal mixing ratio of toothash and plaster of Paris. The histopathologic and histomorphometric study of bone response of five implant materials, toothash(Group A), tooth and plaster mixture, mixing ratio due to weight 2 : 1(Group B), 3 : 1(Group C), 4 : 1(Group D), and plaster Paris(Group E), were performed in rat calvarial defect. No sign of extensive inflammatory reaction was defected. Newly-formed bony ingrowth occurred in all experimental groups except for group E at 12 weeks after operation. Bone was deposited directly on the surface of implant materials. The highest rate of direct bony union between implant material and newly-formed bone occurred with the group B, followed group C, D, and A.

• Journal of Industrial and Engineering Chemistry
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• 제68권
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• pp.220-228
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• 2018

In this study, we found a simple surface biofunctionalization of biphasic calcium phosphate (BCP) based on the high affinity between alendronate and the calcium ions of BCP, and the strong interaction between heparin and bone morphogenic protein-2 (BMP-2). The biofunctionalized BCP did not be precipitated well and display a remarkable enhancement of osteogenic activity of human adipose-derived stem cells by showing increased alkaline phosphatase (ALP), calcium deposition and osteogenic-related genes (i.e., Runx-2, ALP, osteocalcin, and osteopontin), and bone regeneration in the calvarial defect model. Therefore, this simple surface technique can be used to easily functionalize various calcium phosphates.

• International Journal of Industrial Entomology and Biomaterials
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• 제45권2호
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• pp.78-83
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• 2022

There are several subspecies of Bombyx mori, whose silk sericin variants differ. Silk sericin can induce bone morphogenic protein-2 (BMP-2) in macrophages, and silk sericin from different species may have different levels of BMP-2 induction ability. In this study, silk sericin from three B. mori subspecies (Baegokjam, Yeonnokjam, and Goldensilk) was prepared. They were administered to RAW264.7 cells and BMP-2 expression level was studied. Bone regeneration was evaluated using a rat calvarial defect model. BMP-2 expression level was the highest in the Baegokjam group. The bone volume in the Baegokjam group was significantly higher than that in the Yeonnokjam group (P = 0.003). In conclusion, sericin from Baegokjam showed higher levels of BMP-2 expression and bone regeneration than those from Yeonnokjam and Goldensilk.

• Archives of Plastic Surgery
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• 제43권2호
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• pp.204-209
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• 2016

Temporal hollowing occurs to varying degrees after pterional craniotomy. The most common cause of temporal hollowing is a bony defect of the pterional and temporal regions due to the resection of the sphenoid ridge and temporal squama for adequate exposure without overhang. The augmentation of such bony defects is important in preventing craniofacial deformities and postoperative hollowness. Temporal cranioplasty has been performed using a range of materials, such as acrylics, porous polyethylene, bone cement, titanium, muscle flaps, and prosthetic dermis. These methods are limited by the risk of damage to adjacent tissue and infection, a prolonged preparation phase, the possibility of reabsorption, and cost inefficiency. We have developed a method of temporal augmentation using a calvarial onlay graft as a single-stage neurosurgical reconstructive operation in patients requiring craniotomy. In this report, we describe the surgical details and review our institutional outcomes. The patients were divided into pterional craniotomy and onlay graft groups. Clinical temporal hollowing was assessed using a visual analog scale (VAS). Temporal soft tissue thickness was measured on preoperative and postoperative computed tomography (CT) studies. Both the VAS and CT-based assessments were compared between the groups. Our review indicated that the use of an onlay graft was associated with a lower VAS score and left-right discrepancy in the temporal contour than were observed in patients undergoing pterional craniotomy without an onlay graft.

• Archives of Plastic Surgery
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• 제49권6호
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• pp.729-739
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• 2022

Cranioplasties are common procedures in plastic surgery. The use of tissue expansion (TE) in staged cranioplasties is less common. We present two cases of cranioplasties with TE and systematically review literature describing the use of TE in staged cranioplasties and postoperative outcomes. A systematic review was performed by querying multiple databases. Eligible articles include published case series, retrospective reviews, and systematic reviews that described use of TE for staged bony cranioplasty. Data regarding study size, patient demographics, preoperative characteristics, staged procedure characteristics, and postoperative outcomes were collected. Of 755 identified publications, 26 met inclusion criteria. 85 patients underwent a staged cranioplasty with TE. Average defect size was 122 cm², and 30.9% of patients received a previous reconstruction. Average expansion period was 14.2 weeks. The most common soft tissue closures were performed with skin expansion only (75.3%), free/pedicled flap (20.1%), and skin graft (4.7%). The mean postoperative follow-up time was 23.9 months. Overall infection and local complication rates were 3.53 and 9.41%, respectively. The most common complications were cerebrospinal fluid leak (7.1%), hematoma (7.1%), implant exposure (3.5%), and infection (3.5%). Factors associated with higher complication rates include the following: use of alloplastic calvarial implants and defects of congenital etiology (p = 0.023 and 0.035, respectively). This is the first comprehensive review to describe current practices and outcomes in staged cranioplasty with TE. Adequate soft tissue coverage contributes to successful cranioplasties and TE can play a safe and effective role in selected cases.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.14.1-14.6
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• 2016

Background: In guided bone regeneration (GBR) technique, many materials have been used for improving biological effectiveness by adding on membranes. The new membrane which was constructed with chitin-fibroin-hydroxyapatite (CNF/HAP) was compared with a collagen membrane (Bio-$Gide^{(R)}$) by means of micro-computed tomography. Methods: Fifty-four rats were used in this study. A critical-sized (8 mm) bony defect was created in the calvaria with a trephine bur. The CNF/HAP membrane was prepared by thermally induced phase separation. In the experimental group (n = 18), the CNF/HAP membrane was used to cover the bony defect, and in the control group (n = 18), a resorbable collagen membrane (Bio-$Gide^{(R)}$) was used. In the negative control group (n = 18), no membrane was used. In each group, six animals were euthanized at 2, 4, and 8 weeks after surgery. The specimens were analyzed using micro-CT. Results: Bone volume (BV) and bone mineral density (BMD) of the new bone showed significant difference between the negative control group and membrane groups (P < 0.05). However, between two membranes, the difference was not significant. Conclusions: The CNF/HAP membrane has significant effect on the new bone formation and has the potential to be applied for guided bone regeneration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권4호
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• pp.250-254
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• 2010

Introduction: This study evaluated the bone regenerative effect of silk fibroin mixed with platelet-rich fibrin (PRF) of a bone defect in rabbits. Materials and Methods: Ten New Zealand white rabbits were used for this study and bilateral round shaped defects were formed in the parietal bone (diameter: 8.0 mm). The silk fibroin mixed with PRF was grafted into the right parietal bone (experimental group). The left side (control group) was grafted only PRF. The animals were sacrificed at 4 weeks and 8 weeks. A micro-computerized tomography (${\mu}$CT) of each specimen was taken. Subsequently, the specimens were decalcified and stained for histological analysis. Results: The average value of plane film analysis was higher in the experimental group than in the control group at 4 weeks and 8weeks after surgery. However, the difference was not statistically significant.(P>0.05) The tissue mineral density (TMD) in the experimental group at 4 weeks after surgery was significantly higher than the control group.(P<0.05) Conclusion: Silk fibroin can be used as a scaffold of PRF for rabbit calvarial defect repair.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권4호
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• pp.325-331
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• 1999

We tested the bone regenerating capacity and histologic response of bioresorbable matrix-type implant, which was made with Poly(lactide-co-glycolide)(PLGA) and bone apatite for the carrier of bone morphogenetic protein(BMP). The critical size defect of 8mm in diameter was created at the calvaria of SD rats(n=18), and repaired with polymer implant with $15{\mu}g$ of rhBMP-2(n=9) or without it(n=9). At 2 weeks, 1 months after implantation, the animals were sacrificed(3 animals at every interval and group) and histologically evaluated. The calvarial defect which was repaired with polymer with BMP healed with newly formed bone about 70% of total defect. But that without BMP showed only 0 to under 30% bony healing. Inflammatory response was absent in both group through the experimental period, but there's marked foreign body giant response though it was a little less significant in polymer with BMP group. As the polymer was resorbed, the space was infiltrated and replaced by fibrovascular tissue, not by bone. In conclusion, our formulation of bioresorbable matrix implant loaded with bone morphogenetic protein works good as a bone regenerating material. However, it is mandatory to devise our system to have better osteoinductive and osteoconductive property, and less multinucleated giant cell response.

• Journal of Periodontal and Implant Science
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• 제51권1호
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• pp.40-52
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• 2021

Purpose: Various crosslinking methods have been introduced to increase the longevity of collagen membranes. The aim of this study was to compare and evaluate the degradation and bone regeneration patterns of 3 collagen membranes. Methods: Four 8-mm-diameter circular bone defects were created in the calvaria of 10 rabbits. In each rabbit, each defect was randomly allocated to 1) the sham control group, 2) the non-crosslinked collagen sponge (NS) group, 3) the chemically crosslinked collagen membrane (CCM) group, or 4) the biphasic calcium phosphate (BCP)-supplemented ultraviolet (UV)-crosslinked collagen membrane (UVM) group. Each defect was covered with the allocated membrane without any graft material. Rabbits were sacrificed at either 2 or 8 weeks post-surgery, and radiographic and histologic analyses were done. Results: New bone formed underneath the membrane in defects in the CCM and UVM groups, with a distinctive new bone formation pattern, while new bone formed from the base of the defect in the NS and control groups. The CCM maintained its shape until 8 weeks, while the UVM and NS were fully degraded at 8 weeks; simultaneously, sustained inflammatory infiltration was found in the margin of the CCM, while it was absent in the UVM. In conclusion, the CCM showed longer longevity than the UVM, but was accompanied by higher levels of inflammation. Conclusions: Both the CCM and UVM showed distinctive patterns of enhancement in new bone formation in the early phase. UV crosslinking can be a biocompatible alternative to chemical crosslinking.

• Journal of Periodontal and Implant Science
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• 제53권5호
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• pp.321-335
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• 2023

Purpose: The aim of this study was to investigate the efficacy of photo-crosslinked gelatin methacryloyl (GelMa) hydrogel containing calcium phosphate nanoparticles (CNp) when applying different fabrication methods for bone regeneration. Methods: Four circular defects were created in the calvaria of 10 rabbits. Each defect was randomly allocated to the following study groups: 1) the sham control group, 2) the GelMa group (defect filled with crosslinked GelMa hydrogel), 3) the CNp-GelMa group (GelMa hydrogel crosslinked with nanoparticles), and 4) the CNp+GelMa group (crosslinked GelMa loaded with nanoparticles). At 2, 4, and 8 weeks, samples were harvested, and histological and micro-computed tomography analyses were performed. Results: Histomorphometric analysis showed that the CNp-GelMa and CNp+GelMa groups at 2 weeks had significantly greater total augmented areas than the control group (P<0.05). The greatest new bone area was observed in the CNp-GelMa group, but without statistical significance (P>0.05). Crosslinked GelMa hydrogel with nanoparticles exhibited good biocompatibility with a minimal inflammatory reaction. Conclusions: There was no difference in the efficacy of bone regeneration according to the synthesized method of photo-crosslinked GelMa hydrogel with nanoparticles. However, these materials could remain within a bone defect up to 2 weeks and showed good biocompatibility with little inflammatory response. Further improvement in mechanical properties and resistance to enzymatic degradation would be needed for the clinical application.