• Journal of Periodontal and Implant Science
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• 제51권5호
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• pp.352-363
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• 2021

Purpose: Some systemic conditions, especially diabetes mellitus (DM), adversely affect dental implant success. This study aimed to investigate the effects of ibuprofen-loaded TiO₂ nanotube (ILTN) dental implants in alloxan-induced diabetic rabbits. Methods: Twenty-six New Zealand white rabbits were treated with alloxan monohydrate to induce DM. At 2 weeks following DM induction, 3 types of implants (sandblasted, large-grit, and acid-etched [SLA], ILTN, and machined) were placed into the proximal tibia in the 10 rabbits that survived following DM induction. Each type of implant was fitted randomly in 1 of the holes (round-robin method). The animals were administered alizarin (at 3 weeks) and calcein (at 6 weeks) as fluorescent bone markers, and were sacrificed at 8 weeks for radiographic and histomorphometric analyses. Results: TiO₂ nanotube arrays of ~70 nm in diameter and ~17 ㎛ in thickness were obtained, and ibuprofen was loaded into the TiO₂ nanotube arrays. A total of 26 rabbits were treated with alloxan monohydrate and only 10 rabbits survived. The 10 surviving rabbits showed a blood glucose level of 300 mg/dL or higher, and the implants were placed in these diabetic rabbits. The implant stability quotient (ISQ) and bone-to-implant contact (BIC) values were significantly higher in the ILTN group (ISQ: 61.8, BIC: 41.3%) and SLA group (ISQ: 62.6, BIC: 46.3%) than in the machined group (ISQ: 53.4, BIC: 20.2%), but the difference in the BIC percentage between the SLA and ILTN groups was not statistically significant (P=0.628). However, the bone area percentage was significantly higher in the ILTN group (78.0%) than in the SLA group (52.1%; P=0.000). Conclusions: The: ILTN dental implants showed better stability (ISQ) and BIC than the machined implants; however, these values were similar to the commercially used SLA implants in the 2-week diabetic rabbit model.

• Journal of Periodontal and Implant Science
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• 제49권4호
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• pp.215-227
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• 2019

Purpose: To histologically characterize periodontal healing at 8 weeks in surgically created dehiscence defects in beagle dogs that received a collagen matrix with periodontal ligament (PDL) progenitor cells. Methods: The bilateral maxillary premolars and first molars in 6 animals were used. Standardized experimental dehiscence defects were made on the buccal side of 3 premolars, and primary culturing of PDL progenitor cells was performed on the molars. Collagen matrix was used as a scaffold and a delivery system for PDL progenitor cells. The experimental sites were grafted with collagen matrix (COL), PDL progenitor cells with collagen matrix (COL/CELL), or left without any material (CTL). Histologic and histomorphometric analyses were performed after 8 weeks. Results: The defect height from the cementoenamel junction to the most apical point of cementum removal did not significantly differ across the CTL, COL, and COL/CELL groups, at $4.57{\pm}0.28$, $4.56{\pm}0.41$, and $4.64{\pm}0.27mm$ (mean ${\pm}$ standard deviation), respectively; the corresponding values for epithelial adhesion were $1.41{\pm}0.51$, $0.85{\pm}0.29$, and $0.30{\pm}0.41mm$ (P<0.05), the heights of new bone regeneration were $1.32{\pm}0.44$, $1.65{\pm}0.52$, and $1.93{\pm}0.61mm$ (P<0.05), and the cementum regeneration values were $1.15{\pm}0.42$, $1.81{\pm}0.46$, and $2.57{\pm}0.56mm$ (P<0.05). There was significantly more new bone formation in the COL/CELL group than in the CTL group, and new cementum length was also significantly higher in the COL/CELL group. However, there were no significant differences in the width of new cementum among the groups. Conclusions: PDL progenitor cells carried by a synthetic collagen matrix may enhance periodontal regeneration, including cementum and new bone formation.

• Journal of Periodontal and Implant Science
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• 제53권2호
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• pp.157-169
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• 2023

Purpose: The aim of this study was to evaluate the impact of polydeoxyribonucleotide (PDRN) on histologic outcomes when implant placement and lateral sinus floor elevation are performed simultaneously. Methods: Three bimaxillary premolars (P2, P3, and P4) were extracted from 4 beagle dogs 2 months before lateral sinus floor elevation. After lateral elevation of the sinus membrane, each sinus was allocated to either the test or control group. Sinuses underwent either 1) collagenated synthetic bone graft with PDRN following lateral sinus floor elevation (test group) or 2) collagenated synthetic bone graft without PDRN after lateral sinus floor elevation (control group). Eight weeks after the surgical procedure, all animals were euthanised for a histologic and histomorphometric assessment. Augmented height (AH), protruding height (PH), and bone-to-implant contact in pristine (BIC_p) and augmented (BIC_a) bone were measured. The composition of the augmented area, which was divided into 3 areas of interest located in coronal, middle and apical areas (AOI_C, AOI_M, and AOI_A), was calculated with 3 parameters: the area percentage of new bone (pNB), residual bone graft particle (pRBP), and fibrovascular connective tissue (pFVT). Results: AH, PH, BIC_p, BIC_a total, BIC_a coronal, and BIC_a middle values were not significantly different between sinuses in the control and test groups (all P>0.05). The BIC_a apical of sinuses in the test group (76.7%±9.3%) showed statistically higher values than those of sinuses in the control group (55.6%±22.1%) (P=0.038). pNB, pRBP, and pFVT showed statistically significant differences between the 2 groups in AOI_A (P=0.038, P=0.028, and P=0.007, respectively). pNB, pRBP, and pFVT in AOI_C and AOI_M were not significantly different between samples in the control and test groups (all P>0.05). Conclusions: The histologic findings revealed that lateral sinus floor elevation with PDRN might improve early new bone formation and enable higher bone-to-implant contact.

• 대한치과보철학회지
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• 제52권4호
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• pp.298-304
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• 2014

목적: 본 선행 연구는 recombinant human transforming growth factor-${\beta}2$ (rhTGF-${\beta}2$)/ poly lactic-co-glycolic acid (PLGA) 복합체를 타이타늄 임플란트에 처리하였을 때 골 유착에 미치는 영향을 알아보기 위해 시행된 것으로 토끼 모델을 사용하였다. 재료 및 방법: 8개의 임플란트를 300V에서 3분 동안 양극 산화하였다. 그 중 4개는 electrospray법으로 rhTGF-${\beta}2$/PLGA를 코팅하여 실험군으로 설정하였다. 4마리의 New Zealand rabbit의 tibiae에 1개씩의 실험군과 대조군 임플란트를 식립하였으며, 3주와 6주에 2마리씩 희생하여 micro-computed tomography(microCT) 촬영 후 분석하였다. 결과: Scanning electron microscope (SEM) 사진에서 rhTGF-${\beta}2$/PLGA 입자가 임플란트 표면에 균일하게 분산되어 있음을 확인하였다. MicroCT 분석 결과 통계적으로 유의하지는 않지만 rhTGF-${\beta}2$/PLGA를 처리한 임플란트가 bone volume/total volume (BV/TV)와 trabecular thickness (Tb.Th) 값이 더 높은 경향성을 보였으며, cross sectional view에서 더 많은 골이 형성되었음을 확인하였다. 결론: rhTGF-${\beta}2$/PLGA 표면처리된 임플란트가 주변 골의 양적 성장을 촉진시킬 수 있으며 임플란트 초기 골 유착을 증진시킬 수 있는 가능성을 보였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.16.1-16.9
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• 2016

Background: The association of biomaterial combined with repair factor-like platelet-rich plasma (PRP) has prospective values. Bovine-derived xenograft has been identified as an osteoconductive and biocompatible grafting material that provides osseointegration ability. PRP has become a valuable adjunctive agent to promote healing in a lot of dental and oral surgery procedures. However, there are controversies with respect to the regenerative capacity of PRP and the real benefits of its use in bone grafts. The purpose of this study was to assess the influence of PRP combined with xenograft for the repair of peri-implant bone defects. Methods: Twelve rabbits were used in this study, and the experimental surgery with implant installation was performed simultaneously. Autologous PRP was prepared before the surgical procedure. An intrabony defect (7.0 mm in diameter and 3.0 mm deep) was created in the tibia of each rabbit; then, 24 titanium dental implants (3.0 mm in diameter and 8.5 mm long) were inserted into these osteotomy sites. Thus, a standardized gap (4.0 mm) was established between the surrounding bony walls and the implant surface. The gaps were treated with either xenograft alone (control group) or xenograft combined with PRP (experimental group). After healing for 1, 2, 3, 4, 5, and 6 weeks, the rabbits were sacrificed with an overdose of KCl solution. Two rabbits were killed at each time, and the samples including dental implants and surrounding bone were collected and processed for histological analysis. Results: More newly formed bone and a better bone healing process were observed in control group. The histomorphometric analysis revealed that the mean percentage of bone-to-implant contact in the control group was significantly higher than that of the experimental group (25.23 vs. 8.16 %; P < 0.05, independent-simple t test, analysis of variance [ANOVA]). Conclusions: The results indicate that in the addition of PRP to bovine-derived xenograft in the repair of bone defects around the implant, PRP may delay peri-implant bone healing.

• Journal of Periodontal and Implant Science
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• 제52권4호
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• pp.338-350
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• 2022

Purpose: Various studies have investigated 3-dimensional (3D)-printed implants using Ti6Al-4V powder; however, multi-root 3D-printed implants have not been fully investigated. The purpose of this study was to explore the stability of multirooted 3D-printed implants with lattice and solid structures. The secondary outcomes were comparisons between the 2 types of 3D-printed implants in micro-computed tomographic and histological analyses. Methods: Lattice- and solid-type 3D-printed implants for the left and right mandibular third premolars in beagle dogs were fabricated. Four implants in each group were placed immediately following tooth extraction. Implant stability measurement and periapical X-rays were performed every 2 weeks for 12 weeks. Peri-implant bone volume/tissue volume (BV/TV) and bone mineral density (BMD) were measured by micro-computed tomography. Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were measured in histomorphometric analyses. Results: All 4 lattice-type 3D-printed implants survived. Three solid-type 3D-printed implants were removed before the planned sacrifice date due to implant mobility. A slight, gradual increase in implant stability values from implant surgery to 4 weeks after surgery was observed in the lattice-type 3D-printed implants. The marginal bone change of the surviving solid-type 3D-printed implant was approximately 5 mm, whereas the value was approximately 2 mm in the lattice-type 3D-printed implants. BV/TV and BMD in the lattice type 3D-printed implants were similar to those in the surviving solid-type implant. However, BIC and BAFO were lower in the surviving solid-type 3D-printed implant than in the lattice-type 3D-printed implants. Conclusions: Within the limits of this preclinical study, 3D-printed implants of double-rooted teeth showed high primary stability. However, 3D-printed implants with interlocking structures such as lattices might provide high secondary stability and successful osseointegration.

• 대한치과보철학회지
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• 제51권3호
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• pp.190-198
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• 2013

연구 목적: 최근 지르코니아 임플란트가 크게 향상된 물리적 성질, 자연치와 유사한 색조, 뛰어난 생체 적합성으로 주목 받고 있다. 이에 본 연구에서는 국내에서 시판되고 있는 상용 타이타늄 임플란트와 개발 단계인 지르코니아 임플란트의 골유착을 비교 연구하였다. 연구 재료 및 방법: 상용 타이타늄 임플란트(T 군)와 기계 절삭된 나사형 지르코니아 임플란트(Z 군), 기계 절삭 후 알루미나 샌드 블라스팅으로 표면 처리된 나사형 지르코니아 임플란트(ZS 군)의 표면 거칠기를 측정한 후 6마리 돼지의 좌, 우측 하지 경골에 식립하여 1주, 4주, 12주에 각각 희생하여 Periotest values (PTVs) 측정, 조직학적 측정 및 조직 계측학적 측정, 주사 전자 현미경 관찰을 시행하였다. 평균 표면 거칠기와 PTVs, 조직계측학적 측정 결과는 일원분산분석을 통해 통계 처리되었다(${\alpha}=.05$). 결과:각 군 임플란트의 표면 거칠기를 측정한 결과 T 군이 Z 군, ZS 군에 비해 더 유의하게 높은 평균 표면 거칠기 값을 보였다. PTVs는 측정 시기 모두에서 T 군이 상대적으로 낮은 값을 보였으나 각 군에 따라, 시기에 따라 모두 통계적으로 유의하지는 않았다. 식립 1주차 골접촉율 측정 결과 Z 군이 T 군, ZS 군에 비해 유의성 있게 높았고, 골면적율은 T 군, Z 군이 ZS 군에 비해 유의성 있게 높았다. 식립 4주차 골접촉율 측정에서 T 군이 Z 군, ZS 군에 비해 유의성 있게 높았고, 골면적율은 군간 유의한 차가 없었다. 식립 12주차 골접촉율은 T 군, ZS 군, Z 군 순으로 낮아졌고 모든 군간 통계적으로 유의한 차이가 존재하였다. 골면적율은 T 군, ZS 군이 Z 군에 비해 유의성 있게 높았다. 결론: 이상의 결과는 지르코니아 임플란트의 골유착이 타이타늄 임플란트에 비해 부족하며, 상용화를 위해서는 지르코니아 임플란트의 표면 변형에 관한 연구가 더 필요함을 시사한다.

• 대한치과교정학회지
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• 제38권6호
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• pp.416-426
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• 2008

본 연구는 비글견에 식립된 sandblasted, large grit and acid-etched (SLA) 표면처리된 교정용 마이크로임플랜트와 평활면 마이크로임플랜트에 교정력을 가한 후 시간 경과에 따른 동요도와 골접촉률의 차이를 규명하기 위해 시행되었다. 비글 성견 네 마리를 이용하여 상, 하악 협측과 구개측 골에 대해 SLA 표면처리된 표면처리군 48개, 평활면의 비처리군 48개의 마이크로임 플랜트 96개를 식립하고 2주의 치유기간 후 교정력(150 - 200 g)을 지속적 으로 가했으며 식립 4주 후에 두 마리를 희생시키고, 12주 후에 나머지 2마리를 희생시켰다. 표면처리군과 비처리군 간의 마이크로 임플랜트의 동요도와 골과 임플랜트 간 접촉률을 조직학적인 측면에서 측정 비교하여 다음과 같은 결과를 얻었다. 상악 협측과 구개측에서는 표면처리군과 미처리군의 동요도에서 유의성 있는 차이가 없었으나 하악협측에서는 표면 처리군이 유의하게 안정적인 동요도를 보였다. 마이크로임플랜트와 인접골 간 접촉률은 상악 협측에서는 4주와 12주 모두 표면처리군과 미처리군 간에 유의 한 차이가 없었으나 하악 협측과 구개측의 경우 4주와 12주 모두 표면처리군이 비처리군에 비해 유의하게 높은 접촉률을 보였다. 표면처리군은 비처리군에 비해 임플랜트 주변에서 활발한 골개조가 관찰되었으며 모든 군에서 이물반응은 관찰되지 않았다. 본 연구를 통해 SLA 표면처리된 마이크로임플랜트는 평활면 마이크로임플랜트에 비하여 식립 초기에는 식립 부위에 따라 유의하게 높은 인접골 간 접촉률과 동요도의 안정성을 보임으로써 다양한 크기와 방향의 교정력의 적용이 가능할 것이라 생각한다.

• 대한치과보철학회지
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• 제41권6호
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• pp.720-731
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• 2003

Statement of problem. The importance of fixture design and surface treatment. Purpose. The clinical success of dental in plants is affected by many factors such like as degree of osseointegration, the effective load dispersion for the prostheses, and a lot of attempts have been made to overcome the difficulties. In this study, efforts were made to find the possibility of clinical acceptance of the dental implants of newly designed surface and resorbable blast media surcace. Materials and methods. In this study, two groups of custom-made, screw-shaped implants were prepared. The first with the consisting of Branemark clone design and the other with the new design. These implants were divided into four groups according to the kinds of surface treatment. Four implants($AVANA^{(R)}$, Osstem, Busan, Korea)of each group were installed in twenty rabbits. Group A was consisted of Branemark done implant left as machined, Group B with Branemark clone implants with RBM(Resorbable blast media) surface, Group C with newly designed implants left as machined and Group D with newly designed implants with RBM surface. One of the twenty rabbits died from inflammation and the observation was made for six weeks. Specimens from four groups were observed using scanning electron microscopy with 40, 100, 1000 magnification power and microsurface structures were measured by white-light scanning interferometry for three dimensional surface roughness measurements(Accura $2000^{(R)}$, Intek-Plus, Korea.). Removal torque was measured in 17 rabbits using digital torque gauge(MGT 12R, Mark-10 corp., NY, U.S.A.) immediately after the sacrifice and two rabbits were used for the histologic preparation(EXAKT $310^{(R)}$, Heraeus Kulzer, wehrheim, Germany) of specimens and observed under light microscope. Resonance frequency measurement($Osstell^{(R)}$) was taken with the 19 rabbits at the beginning of the implant fixation and immediately after the sacrifice. Results. Following results were taken from the experiment. 1. The surface of the RBM implants as seen with SEM had rough and irregular pattern with reticular formation compared to that of fumed specimens showing different surface topographies. 2. The newly designed implant with RBM surface had high removal torque value among four groups with no statistical significance. The average removal torque was $49.95{\pm}6.70Ncm$ in Group A, $51.15{\pm}4.40Ncm$ in Group B, $50.78{\pm}9.37Ncm$ in Group C, $51.09{\pm}4.69Ncm$ in Group D. 3. The RFA values were $70.8{\pm}4.3Hz$ in Group A, $71.8{\pm}3.1Hz$ in Group B, $70.9{\pm}2.5Hz$, $72.7{\pm}2.5Hz$ in Group D. Higher values were noted in the groups which had surface treatment compared to the untreated groups with no statistical significance. 4. The results from the histomorphometric evaluation showed a mean percentage of bone-to-implant contact of $45{\pm}0.5%$ in Group A, $55{\pm}3%$ in Group B, $49.5{\pm}0.5%$ in Group C, and $55{\pm}3%$ in Group D. Quite amount of newly formed bone were observed at the surface RBM-treated implants in bone marrow space.

• 대한치과보철학회지
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• 제52권1호
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• pp.9-17
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• 2014

연구 목적: 본 연구에서는 외과적으로 형성한 골 결손부에 이종골 이식과 함께 식립한 지르코니아 임플란트의 골유착에 대한 기계적 안정성과 조직학적 반응을 타이타늄 임플란트와 비교하고자 하였다. 연구 재료 및 방법: 6마리 돼지의 경골에 인위적으로 형성한 골 결손 부위에 대조군인 18개의 상용 타이타늄 나사형 임플란트와 실험군인 18개의 샌드블라스팅한 지르코니아(Y-TZP) 나사형 임플란트를 각각 식립하고 차폐막을 이용하여 이종골을 이식하였으며 1주, 4주, 12주후에 각각 2마리씩 희생시켜 조직 시편을 제작하였다. 식립 직후와 식립 1주, 4주, 12주 후에 각각 페리오테스트를 이용하여 임플란트의 안정성을 측정하였고, 광학현미경으로 조직학적 관찰과 조직계측학적 분석을 하였으며 주사전자현미경으로 임플란트의 표면 특성과 골-임플란트 계면을 관찰하였다. 결과: 페리오테스트를 이용한 임플란트 안정성 분석 결과, 대조군과 실험군 사이에 유의한 차이가 없었고, 조직학적 분석 결과, 각 군 모두 4주에 이식골의 재흡수와 조골세포의 활발한 활동에 의해 신생골이 형성되기 시작하였다. 골-임플란트 접촉률 분석 결과, 대조군과 실험군 사이에 유의한 차이가 있었으며(P<.05), 특히 4주와 12주에서 실험군과 대조군 사이에 2시점에서 유의한 차이를 보였다(P<.05). 골 면적률 분석 결과, 대조군과 실험군 사이에 유의한 차이가 없었다. 주사전자현미경 관찰 결과, 대조군은 균일한 다공성의 거친 표면을 나타냈고 실험군은 무정형 입자들이 불규칙하게 산재된 표면을 보여 주었다. 각 군 모두 4주에 임플란트 표면과 골 조직 사이에 빈 공간이 관찰되었고 12주에는 일부 공간에서 골 조직으로 채워진 양상을 보였다. 결론: 차폐막을 이용한 이종골 이식을 동반하는 경우 본 실험에 사용된 지르코니아 임플란트의 골-임플란트 접촉률은 양극산화 표면처리를 한 타이타늄 임플란트에 크게 미치지 못하므로 지르코니아 임플란트의 실용화를 위해서는 표면 처리 방법 등에 대한 지속적인 연구를 통한 개선이 필요하다고 사료된다.