• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.20 no.3
• /
• pp.256-262
• /
• 1998

The aim of this study was to evaluate treatment plan and treatment procedure such as bone graft material, timing of bone graft and orthodontic treatment in 31 alveolar cleft bone graft patients treated at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital from Jan. 1992 to Dec. 1996. Results obtained were as follows : In total 31 patients of alveolar bone grafts, males(64.5%) were more than females(35.5%). The patients' age ranged between 2 - 33 years of age. Secondary bone grafting was the highest incidence(58.1%) when procedures were undertaken in patients between 6 - 16 years of age. In distribution of cleft side, unilateral clefts(93.5%) were the major part with the left side was larger than the right side. The Missing teeth were found most in lateral incisor, the supernumary teeth were found most between lateral incisor and canine. The most common occlusion before operation was class III malocclusion and anterior cross-bite(65.1%), orthodontic treatment was performed similarly between before and after the bone graft. The most common combined operation with alveolar bone graft was secondary cheiloplasty. The complications were 6 cases of bone defect, a case of oronasal fistula, 3 cases of dehiscence. PMCB and DFDB were used bone graft materials. In marginal bone height after operation, PMCB grafts were higher than DFDB grafts and marginal bone level was increased in the PMCB group but not in the DFDB group.

• Journal of Periodontal and Implant Science
• /
• v.28 no.2
• /
• pp.249-264
• /
• 1998

The present study evaluates the effects of calcium sulfate and DFDB on alveolar bone regeneration and cementum formation and connective tissue adhesion in intrabony angulated 1 wall defects of dogs. Four millimeter-deep angulated one-wall intrabony defects were surgically created in the mesial & distal aspects of premolars and with flap operaion alone(control group), with calcium sulfate(experimental group 1), with composit graft of 50% calcium sulfate and 50% DFDB(experimental group 2), with DFDB alone(experimental group 3). Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of connective tissue adhesion was $1.05{\pm}0.48mm$ in the control, $1.30{\pm}0.67mm$ in the test group I, $0.97{\pm}0.22mm$ in the test group II and $0.93{\pm}0.15mm$ in the test group III. There was no statistical significance between control and all experimental groups. 2. Changes in alveolar bone level was $0.97{\pm}0.27mm$ in the control group, $1.45{\pm}0.42mm$ in the test group I, $2.00{\pm}0.33mm$ in the test group II, $1.88{\pm}0.34mm$ in the test group III. There was no statistically significant difference between control and experimental group I. There was a statistically significant difference between the control and experimental group II,III.(p<0.05). There was no statistically significant difference between all experimental group. 3. Cementum formation was $1.13{\pm}0.17mm$ in the control, $1.78{\pm}0.31mm$ in the test group I, $2.17{\pm}0.38mm$ in the test group II, $2.15{\pm}0.47mm$ in the test group III with statistically significant differences between control group and all experimental group(P<0.05). There was no statistically significant differences between all experimental group. These results suggest that the use of composit graft of 50% calcium sulfate and 50% DFDB and DFDB alone in angulated 1 wall intrabony defects has little effects on connective tissue adhesion, but has significant effects on new bone and new cementum formations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.28 no.4
• /
• pp.290-301
• /
• 2002

The purpose of this study was to evaluate new bone formation and healing process in rat calvarial bone defects using $BioMesh^{(R)}$. membrane and DFDB. Forty eight rats divided equally into 4 groups of 1 control group and 3 experimental groups. Standardized transosseous circular calvarial defects (8 mm in diameter) were made midparietally. In the control group, the defect was only covered with the soft tissue flap. In the experimental group 1, it was filled with DFDB only, in the experimental group 2, it was covered $BioMesh^{(R)}$. membrane only, and in the experimental group 3, it was filled DFDB and covered with membrane. At the postoperative 1, 2, 4, 8 weeks, rats were sacrificed and histologic and histomorphometric analysis were performed. These results were as follows. In histomorphometric analysis, It showed the greatest amount of new bone formation through experimental in the experimental group 3 (P<0.001). The amount of new bone formation at the central portion of the defect was greater in the experimental group 3 than experimental group 2. $BioMesh^{(R)}$. membrane began to resorb at 1 week and resorbed almost completely at 8 weeks after operation. The collapse of membrane into the defect was observed through the experimental periods in the experimental group 2. In the area of collapsed membrane, new bone formation was restricted. These results suggest that maintenance of some space for new bone to grow is required in the use of $BioMesh^{(R)}$. membrane alone in the defect. It is also thought that use of the membrane may promote new bone growth in DFDB graft.

• Journal of Periodontal and Implant Science
• /
• v.35 no.3
• /
• pp.687-702
• /
• 2005

The purpose of this study is to examine the effect of non-resorbable membrane such as e-PTFE which was used with DFDB in bone regeneration on dehiscence defect in peri-implant area. Amomg the patients, who have recieved an implant surgery at the department of Periodontics in Dan Kook University Dental Hospital, 12 patients showed implant exposure due to the dehiscence defect and 15 implants of these 22 patients were the target of the treatment. Periodontists randomly applied $Gore-Tex^{(R)}$ to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 15 cases, 1 membrane exposure was observed and in this case, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area $9.25{\pm}4.84$ preoperatively and significantly increased to $11.48{\pm}7.52$ postoperatively(0.05). 4. The increase of bone surface area in non-resorbable membrane was $2.23{\pm}3.38$. 5. As a result of histopathological finding, DFDB surrounded by new bone formation and lamellate bone, resorption of DFDB and bone mineralization was found. Also, fibrosis of connective tissue beneath the membrane was found. This study shows that the surgical method using DFDB and non-resorbable membrane on dehiscence defect in peri-implant area is effective in bone regeneration.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.27 no.2
• /
• pp.318-332
• /
• 2000

The purpose of this study was to investigate the effects of demineralized freeze-dried bone (DFDB) on mechanically exposed pulp of dog by evaluating the pulpal inflammation and healing process, formation of dental hard tissue, and structural changes of fibroblasts of the remaining pulp tissue. Teeth of 4 dogs, weighing 10kg, were used in this study. Class V cavities were prepared followed by exposed the pulp tissue mechanically by sterilized round bur. In control group, exposed pulps were capped with calcium hydroxide paste followed by sealed with IRM. In experimental groups, the exposed pulps of one group were capped with the collagen and those of the other group were capped with DFDB. All cavities were sealed with same manor as control group. The animals were sacrificed at the intervals of 3, 7, 14, and 28 days for histopathlogic evaluation. The specimens were observed by the light microscope and trans-electron microscope. The results were as follows: 1. Pulp necrosis was not observed in all groups. Inflammatory response was disappeared from 1 week in control group and group 2. But it was not disappeared until 2 weeks and also irregular arrangement of odontoblasts was showed at the lateral walls of root canal just beneath the amputated site of the pulp in group 1. 2. Dentinal bridge was formed incompletely at 2 weeks but it was formed completely at 4 weeks in control group. Odontoid tissue was also found in control group at 4 weeks from treatment. Amputated site of pulp was encapsulated with fibrous tissue and odontoblast and dentinal bridge was not found in group 1. Preodontoid tissue and reparative dentin which were formed by odontoblast differentiated around DFDB were found, but dentinal bridge was not found in group 2. 3. Cell with large basophillic-stained nuclei infiltrated to amputated site and DFDB at 1 week from treatment in control group and group 2. They were found more in group 2 than in control group. Odontoblasts arranged more regularly and reparative dentin was found more as time elapsed. 4. Dentin-formative odontoblasts which showed ultramicrostructure of cytoplasm with polarized nucleus, rEM, Golgi complex, secretory granules, secretion of organic matrix in control of group and group 2. In regards to above results, the demineralized freeze-dried bone(DFDB) induce odontoblastic differentiation and further come up to the dentin formation in amputated pulp.

• The Journal of Korean Academy of Prosthodontics
• /
• v.35 no.1
• /
• pp.43-66
• /
• 1997

Dental implant may be immediately placed in postextraction socket which has alveolar bone defect. The purpose of this study was to compare the bone regeneration and bone quality around defects adjacent to implants that were placed into extraction sockets according to EFEB, GTAM barrier and GTAM barrier with DFDB. Mandibular P2, P3 and P4 were extracted bilaterally in dogs, and buccal defects were created about 4mm in depth and 3.3mm in width. Screwed pure titanium implants, 3.8mm in diameter and 10mm in length, were placed into the extraction sockets. The experimental groups were divided into four groups : the G group was covered with a GTAM barrier on the defective area, the D+G group was filled with DFEB and covered with a GTAM barrier, the D group was filled with DFDB only and the control group was sutured without any special treatment on the defective area. The experimental animals were killed after 12 weeks and specimens were prepared for light microscopic evaluation and fluorescent dyes were administered daily for 2 weeks after implantation, and injected on the 4th and 11th week for fluorescent microscopic examination to observe new bone formation and bone remodeling. The new Bone height of the buccal defect was measured and compared with the another for bone gain and the removal torque for the implant was measured for the comparison of bone density and bone-implant osseointegration. Results obtained were as follows : 1. Experimental groups showed bone regeneration in oder from D+G, G, D group and control. D+G and G group was significantly from D group and control(P<0.01). 2. In the defective area of control the regenerated alveolar bone showed poorly developed lamellated structure and fibrous tissue intervention into the bone-implant interface but the others showed well developed lamellated structure and osseointegration. 3. All implant groups showed no significaant difference in the removal torque for implant(P>0.05) These results suggest that immediate implants placed in defective sockets were successfully osseointegrated and utilizing placed in defective sockets were successfully osseointegrated and utilizing not only the combination of GTAM and DFDB but also only the GTAM was favorable for the predictable regeneration of the defective area.

• Journal of Periodontal and Implant Science
• /
• v.24 no.3
• /
• pp.671-689
• /
• 1994

The purpose of this study was to compare effects of various bone grafts on periodontal regeneration of alveolar bone defects in dogs. Seven adult dogs aged 12 to 18 months were used in this study. Experimental alveolar bone defects were created surgically with a #1/2 round bur at the furcation area of the buccal surface of the mandibular 3rd, 4th premolars and 1st molar. Each experimental alveolar bone defects were grafted with dense hydroxyapatite, natural coral, and decalcified freeze-dried bone, and respectively divided into DHA, NC, DFDB group. An area without bone graft was divided into control group. At 1,2,4,6, and 12 weeks, dogs were serially sacrificed and specimens were prepared with Hematoxylin-Eosin stain and Mallory stain for light microscopic evaluation. The results of this study were as follows : 1. In control group, the matrix change of granulation tissue was observed at 1 week. And in experimental groups, the appearance of connective tissue around graft materials was loosely formed at 1 week, but densely formed at 2 weeks. 2. In every group, the slight formation of new trabecular bone was seen from remaining bone at 1 week. 3. The DHA and NC particles were gradually encapsulated by new trabecular bone from remaining bone, and the osteoid tissue was directly induced from DFDB particles. 4. The presence of osteoblasts was first observed at 1 week in control group and at 2 weeks in NC group, but at 6 weeks in DHA group. 5. In DHA group, the resorption of particles was not observed until 12 weeks. But in NC and DFDB group, the particles were resorbed at 6 weeks and replaced by new bone. And the amount and size of particles were reduced, and their border represented irregular form. In summary, in three experimental groups the inflammatory or foreign body reaction were slight, but the regeneration of new osteoid tissue and the matrix change of dense connective tissue fiber were observed. Especially, NC and DFDB materials were considered as the biocompatible graft materials which were effective in the regenertion of new bone.

• Journal of Periodontal and Implant Science
• /
• v.25 no.3
• /
• pp.557-567
• /
• 1995

The purpose of this study was to investigated the effect of root planing and decalcified freeze dried allografts on the resorption of transplanted roots and the healing of preveously diseased recipient extraction sockets. The experimental chronic periodontitis was induced by elastic ligatures on the 2nd and 3rd mandibular premolars of 4 adult dogs, and after 8 weeks, crowns were removed and the teeth extracted. The extracted roots were split in half along the long-axis, and the extednt of plaque exposure was morked on the root surfaces with burs. The roots were either root-planed(Test group), or left uninstrumented(Control group), and transplanted in the extraction sockets with decalcified freeze-dried allografts filling the void. The flaps were sutured to cover the sockets completely. The animals were sacrificed after 12 weeks of healing, and the specimens were examined histologically. The results were as follows : 1. No signs of inflammation or disease activity were observed in either groups. 2. Replacement root resorption was observed in both groups. 3. More connective tissue attachments and less ankylosis were observed in the test groups compared to the control. 4. The unresorbed remains of DFDB particles were observed in both groups. 5. DFDB particles in the apical portion of the alveolar sockets were encased in newly-formed bone, while those in the coronal areas were seen encapsulated with connective tissue. 6. No significant difference was found between root-planed and uninstrumented roots relative to the healing and the bone fromation in the recipient extraction sockdets. From the present study, there seemed to be no significant benefits in root planing the transplanted roots or grafting the sockets with DFDB in order to curve the replacement resorption, although the root-planed roots showed more connective tissue attachments. There was also no significant benefits in root transplantation and DFDB for and enhanced healing and bone formation in alveolar extraction sockets.

• Journal of Periodontal and Implant Science
• /
• v.36 no.2
• /
• pp.273-288
• /
• 2006

The purpose of this study was to evaluate exophytically vertical bone formation in rabbit calvaria by the concept of guided bone regeneration with a custom-made porous titanium membrane combined with bone graft materials. For this purpose, a total of 12 rabbits were used, and decorticated calvaria were created with round carbide bur to promote bleeding and blood clot formation in the wound area. Porous titanium membranes (0.5 mm in pore diameter, 10 mm in one side, 2 mm in inner height) were placed on the decorticated calvaria, fixed with metal pins and covered with full-thickness flap. Experimental group I was treated as titanium membrane only. Experimental group II, III, IV was treated as titanium membrane with BBM, titanium membrane with DFDB and titanium membrane with FDB. The animals were sacrificed at 8 and 12 weeks after surgery, and new bone formation was assessed by histomorphometric as well as statistical analysis. 1. Porous titanium membrane was biocompatable and capable of maintaining the regeneration space. 2. At 8 and 12 weeks, all groups demonstrated exophytic bone formation and there was a statistical significant difference among different groups only at 12 weeks. 3. The DFDB group revealed the most new bone formation compared to other groups (p<0.05). 4. At 12 weeks, DFDB and FDB groups showed the most significant resorption of graft materials (p<0.05). 5. The BBM was not resorbed at all until 12 weeks. 6. The fixation metal pin revealed excellent effect in peripheral sealing. On the basis of these findings, we conclude that a porous titanium membrane may be used as an augmentation membrane for guided bone regeneration, and DFDB as an effective bone forming graft material. The fixation of the membrane with pin will be helpful in GBR technique. However, further study is required to examine their efficacy in the intraoral experiments.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.23 no.1
• /
• pp.87-94
• /
• 2001

The present study was performed to investigate the effect of $HTR^{(R)}$ (Hard Tissue Replacement) on osteogenesis in the mandibular bone defects. Eight adult male white rabbits weighing 2.5 to 3.0kg were used. Four bone defects (8mm in diameter and 4mm in depth) were made at the both mandibular body. In the control group, the right mesial bone defect was filled with blood clot and spontaneously healed. In the DFDB group, the right distal bone defect was filled with xenogenic demineralized freeze-dried bone. In the $HTR^{(R)}$ group, the left mesial bone defect was filled with $HTR^{(R)}$. In the $HTR^{(R)}-membrane$ group, the left distal bone defect was filled with $HTR^{(R)}$ and covered with BioMesh membrane. The rabbits were sacrified at 2,4,6 and 9 weeks after the operation and microscopic examination was performed. Results obtained were as follows: In the control and DFDB groups, inflammatory cells and the fibrous connective tissue existed and the bone growth was slower than $HTR^{(R)}$ group by 6 week, and there was intervention of the soft tissue at 9 week. In the $HTR^{(R)}$ group, bone trabeculi extended between the $HTR^{(R)}$ particles without intervention of inflammatory cells and the connective tissue at 4 and 6 weeks. In addition, extensive osseous ingrowth into the $HTR^{(R)}$ particles was observed at 9 week. Bone formation was more active in the $HTR^{(R)}$ group than the control and DFDB groups. There was not obvious difference in the bone healing rate between the $HTR^{(R)}$ and the $HTR^{(R)}-membrane$ group. These results suggest that the $HTR^{(R)}$ promotes osteogenesis in the bone defects and the $HTR^{(R)}$ group has no difference in comparison with the $HTR^{(R)}-BioMesh^{(R)}$ membrane group in bone healing.