Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.30
no.4
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pp.316-322
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2004
A low molecular weight component named bone morphogenetic protein(BMP) chemically isolated from the organic matrix of bone, induce postfetal connective tissue cells surrounding small blood vessels to differentiate into cartilage and bone. The end product of BMP is a spherical ossicle of lamella bone filled with red bone marrow for the functional loading. This is a important point that the graft material is embedded the defect site during the implant surgery. Because present knowledge of the relationship between BMP and bone regeneration arises mainly from studies of induced bone formation in heterotopic sites, it would be helpful to determine whether BMP plays any part in the process of bone healing. The BMPs have been shown to play crucial roles in normal skeletal development as well as bone healing and are able to activate transcription of genes involved in cellular migration, proliferation, and differentiation. The delivery of BMP on matrices has been efficacious in the treatment of defect bone in implant surgery. The purpose of the histologic study was to evaluate the effect of DLB(demineralized lyophilized bone) coated with purified human BMP(hBMP-I) in immediate implant surgery with bony defect to obtain the functional structure of implant asap. The ability of a graft of hBMP-I to accelerate bony defect repair provides a rationale for its use in immediate implant surgery that have large bone defect in edentulous area.
Kim, Mi-Suk;Yeo, Hwan-Ho;Kim, Su-Gwan;Lim, Sung-Chul
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.28
no.4
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pp.274-279
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2002
The purpose of this study is to evaluate the critical maintenance period of absorbable membrane for guided bone regeneration. Fortynine Sprague-Dawley rats weighing about 300g were divided into seven groups. An 8 mm circular full-thickness defect in calvarial bone was made and then cellular acetate porous filter (Millipore $filter^{(R)}$.) was placed on the calvarial bone defect. The filter was removed at 2, 3, 4, 5, 6, 8 and 11 weeks after placement. Rats were sacrificed at 12 weeks the placement of cellular acetate porous filter. The specimens were stained with Hematoxylin-Eosin and observed under light microscope. The amount of regenerated bone was measured from both margin of calvarial bone defect (unit : mm). The results were as follows. Bone regeneration of each experimental group was increased gradually and the bond defect was almost completely filled with new bone in 5-, 6-, 8-, and 11-week experimental group. Histologic findings showed mild inflammatory response and granulation tissue formation without apparent adverse effects on the healing process. In 11-week experimental group, the bone defect was completely filled with new bone containing abundant osteoid which was oriented to the dural side and contribute to bony thickening. We suggest that non-absorbable membrane and bioabsorbable membrane presumably should remain intact for longer than 5 weeks to be effective.
The purpose of this study was to present the clinical significance of rectus abdominis free muscle flap for large sized diabetic ulcer and necrosis of the foot to salvage limb. From June 2000 to February 2006, eleven patients were included in our study. There were seven males and four females with a mean age of 58.3 years (48~65) at the surgery. All had a history of diabetics and subsequent huge soft tissue defect caused by necrotizing abscess formation around the foot and the ankle. After complete debridement of large sized, infected necrotic tissue, susceptible intravenous antibiotics and wound care were done. After control of infection, confirmed by clinical and laboratory findings, the rectus abdominis free muscle flap was applied to cover remained large soft tissue defect and to prevent the recurrence of infection. All flaps survived and it provided satisfactory coverage for the soft tissue defect on the foot and the ankle area for a mean of 41.1 months (24~85) follow up period. All except of one patients did not have any recurrence of infection on the operation site and could salvage their limbs. The rectus abdominis free muscle flap could be recommended for large sized soft tissue defect after necrotizing abscess in diabetic foot to salvage major limb.
Purpose: This study evaluated histologically the tissue responses to and the effects of a customized nano-hydroxyapatite (n-HA) block bone graft on periodontal regeneration in a one-wall periodontal-defect model. Methods: A customized block bone for filling in the standardized periodontal defect was fabricated from prefabricated n-HA powders and a polymeric sponge. Bilateral $4{\times}{\times}4{\times}5$ mm (buccolingual width${\times}$mesiodistal width${\times}$depth), one-wall, critical-size intrabony periodontal defects were surgically created at the mandibular second and fourth premolars of five Beagle dogs. In each dog, one defect was filled with block-type HA and the other served as a sham-surgery control. The animals were sacrificed following an 8-week healing interval for clinical and histological evaluations. Results: Although the sites that received an n-HA block showed minimal bone formation, the n-HA block was maintained within the defect with its original hexahedral shape. In addition, only a limited inflammatory reaction was observed at sites that received an n-HA block, which might have been due to the high stability of the customized block bone. Conclusions: In the limitation of this study, customized n-HA block could provide a space for periodontal tissue engineering, with minimal inflammation.
The purpose of this investigation was to evaluate the effect of the porous hydroxyapatite particles (Interpore $200^{(R)}$) and guided tissue regeneration membrane ($Gore-Tex^{TM}$ augmentation material) on amount and shape of generating new bone adjacent to implant. Implants were placed immediately after extraction in the bilateral 3rd, 4th premolars of the mandible of the adult dogs. In all experimental groups, artificial bony defects were formed at the buccal cortex area, 3.3mm in width and 3.0mm in depth. In the control group : sutured without HA particles & membranes after placing implants, the experimental group 1 : membrane was place over the artificial bony defect, the experimental group 2 : bony defect was filled with HA particles and covered with membrane. The examination of bone-implant interfaces using light microscope and fluorescent microscope concluded as follows. 1. In all three experimental groups, osseointegration was observed without epithelial migration. 2. In the healing degree of bony defect area, the experimental group 1, 2 showed more prominent healing than control group, and the experimental group 1 showed the most excellent bone formation. 3. In fluorescent microscopic finding, bone remodeling was observed in regenerated bone tissue at defect area of experimental group 1, but in experimental group 2, irregular, discontinuous linear fluorescence was observed at the lower portion of defect area and sign of bone remodeling was weak.
Kim, Ho-Chul;Song, Jae-Min;Kim, Chang-Joo;Yoon, Sang-Yong;Kim, In-Ryoung;Park, Bong-Soo;Shin, Sang-Hun
Maxillofacial Plastic and Reconstructive Surgery
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v.37
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pp.16.1-16.7
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2015
Background: This study aimed to investigate new bone formation using recombinant human bone morphogenetic protein 2 (rhBMP-2) and locally applied bisphosphonate in rat calvarial defects. Methods: Thirty-six rats were studied. Two circular 5 mm diameter bony defect were formed in the calvaria using a trephine bur. The bony defect were grafted with $Bio-Oss^{(R)}$ only (group 1, n = 9), $Bio-Oss^{(R)}$ wetted with rhBMP-2 (group 2, n = 9), $Bio-Oss^{(R)}$ wetted with rhBMP-2 and 1 mM alendronate (group 3, n = 9) and $Bio-Oss^{(R)}$ wetted with rhBMP-2 and 10 mM alendronate (group 4, n = 9). In each group, three animals were euthanized at 2, 4 and 8 weeks after surgery, respectively. The specimens were then analyzed by histology, histomorphometry and immunohistochemistry analysis. Results: There were significant decrease of bone formation area (p < 0.05) between group 4 and group 2, 3. Group 3 showed increase of new bone formation compared to group 2. In immunohistochemistry, collagen type I and osteoprotegerin (OPG) didn't show any difference. However, receptor activator of nuclear factor ${\kappa}B$ ligand (RANKL) decreased with time dependent except group 4. Conclusion: Low concentration bisphosphonate and rhBMP-2 have synergic effect on bone regeneration and this is result from the decreased activity of RANKL of osteoblast.
The goal of periodontal therapy is the regeneration of the periodontium lost by periodontal disease. The purpose of this study was to evaluate the regenerative potential of the autogenous bone graft and guided tissue regeneration in the treatment of periodontal bony defect in dogs. Experimental periodontitis were induced in the mandibular left 3rd premolar and right 3rd and 4th premolars of 5 dogs using orthodontic ligature wire. After 6 weeks, the ligature wire removed, surgical procedure were performed as follows. 1) control group : Flap operation(Mn.Lt 3rd premolar) 2) experimental group I : Flap operation + autogenous bone graft (Mn.Rt. 3rd premolar) 3) experimental group II : Flap operation + Gore-Tex membrane (Mn.Rt. 4th premoalr) Thereafter, dogs were sacrificed on the 1,2,4,8,16th week and the specimens were prepared and stained with hematoxyline-eosin stain for the light microscopic examination. The results of this study were as follows. 1. The apical migration of junctional epithelium was most remarkable in the flap operation and the experimental group II was less than the experimental group I. 2. In the formation of new alveolar bone, it was found in experimental group I,II and experimental group I is more than II. In the control group, few bone formation was found. 3. In the formation of new cementum, it was found in experimental group I,II and experimental group II is more than I. So, the periodontal therapy combined with autogenous and guided tissue regeneration will be produce the periodontal regeneration.
The purpose of this investigation was to evaluate the acceptability of the collagen-based xenograft ($Laddec^{(R)}$). Full thickness bone defects were prepared in the calvaria of the rats. In the experimental groups the bone defects were filled with a kind of collagen based xenograft. And bone defects, which left without filling, were used as control groups. Sequential sacrifice was performed at the 1st, 2nd, 4th, 8th, and 16th weeks of experiment. 1. At the 1st week of experiment, infiltration of chronic inflammatory cell was observed in all groups. In the experimental group, resorption of the xenograft was initiated. 2. At the 2nd week of experiment, infiltration of chronic inflammatory cells was decreased in all groups. In the experimental group, active resorption of xenograft and new bone formation from the periphery of the xenograft was observed. 3. At the 4th and 8th weeks of experiment, more resorption of the xenograft and new bone formation with calcification was observed in the experimental group. 4. At the 16th week of experiment, small bone trabecula was formed partially in the control group but that couldn't fill the whole bone defect. In the experimental group, more advanced resorption of xenograft and more new bone formation was observed. However mid portion of the xenograft was still remained without resorption. 5. From this experiment, we concluded that the collagen-based xenograft had some osteoconductive but no osteoinductive property. So the xenograft would be used for the bone defect filling material where rapid bone remodeling is not required.
Purpose: Hyaluronic acid (HA) affects angiogenesis and promotes the migration and differentiation of mesenchymal cells, thereby activating the osteogenic ability of osteoblasts. Although studies on the action of HA during bone regeneration are being actively conducted, the optimal dose of HA required for bone regeneration remains unclear. Therefore, the purpose of this study was to elucidate the most effective HA dose for bone formation using a rat critical-size defect model. Methods: Thirty rats were randomly divided into 5 groups, with 6 rats in each group. An absorbable collagen sponge soaked with HA or saline was used to fill an 8-mm defect, which was then covered with a collagen membrane. Different treatments were performed for each group as follows: (1) saline control, (2) 1 mg/mL HA, (3) 25 mg/mL HA, (4) 50 mg/mL HA, or (5) 75 mg/mL HA. After a healing period of 4 weeks, micro-computed tomography and histological analysis were performed. The obtained values were analyzed using analysis of variance and the Tukey test (P<0.05). Results: At week 4, the 75 mg/mL HA group had the highest bone volume/total volume ratio, new bone, and bone fill among the 5 groups, and these values were significantly different from those observed in the control group (P<0.01) and 1 mg/mL HA group (P<0.001). More active bone formation was observed in the higher-dose HA groups (25 mg/mL, 50 mg/mL, and 75 mg/mL HA), which included a large amount of woven bone. Conclusions: The 75 mg/mL HA group showed better bone formation than the other groups (1, 25, and 50 mg/mL HA and control).
In order to study the development of partial discharge (PD) under typical protrusion defects in gas-insulated switchgear, we applied step voltages on the defect and obtained the ${\varphi}-u$ and ${\varphi}-n$ spectrograms of ultra-high frequency (UHF) PD signals in various PD stages. Furthermore, we extracted seven kinds of features to characterize the degree of deterioration of insulation and analyzed their values, variation trends, and change rates. These characteristics were inconsistent with the development of PD. Hence, the differences of these features could describe the severity of PD. In addition, these characteristics could provide integrated characteristics regarding PD development and improve the reliability of PD severity assessment because these characteristics were extracted from different angles. To explain the variation laws of these seven kinds of parameters, we analyzed the relevant physical mechanism by considering the microphysical process of PD formation and development as well as the distortion effect generated by the space charges on the initial field. The relevant physical mechanism effectively allocated PD severity among these features for assessment, and the effectiveness and reliability of using these features to assess PD severity were proved by testing a large number of PD samples.
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