• Journal of Periodontal and Implant Science
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• v.39 no.2
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• pp.149-156
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• 2009

Purpose: Deproteinized bovine bone substitutes are commonly used in dental regenerative surgery for treatment of alveolar defects. In this study, three different bovine bone minerals - OCS-B (NIBEC, Seoul, Korea), Bio-Oss (Geistlich - Pharma, Switzerland), Osteograft/N - 300 (OGN, Dentsply Friadent Ceramed. TN, USA) - were investigated to analyze the basic characteristics of commercially available bone substitutes. Methods: Their physicochemical properties were evaluated by scanning electron microscopy, energy dispersive X-ray spectrometer (EDS), surface area analysis, and Kjeldahl protein analysis. Cell proliferation and alkaline phosphatase (ALP) activity of human osteosarcoma cells on different bovine bone minerals were evaluated. Results: Three kinds of bone substitutes displayed different surface properties. Ca/P ratio of OCS - B shown to be lower than other two bovine bone minerals in EDS analysis. Bio-Oss had wider surface area and lower amount of residual protein than OCS - B and OGN. In addition Bio - Oss was proved to have lower cell proliferation and ALP activity due to lots of residual micro particles, compared with OCS - B and OGN. Conclusions: Based on the results of this study, three bovine bone minerals that produced by similar methods appear to have different property and characteristics. It is suggested that detailed studies and quality management is needed in operations for dental use and its biological effects on new bone formation.

• Journal of Periodontal and Implant Science
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• v.39 no.2
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• pp.129-138
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• 2009

Purpose: This study was designed to compare the bond regeneratiom effects of treatment using silk fibroin membrane ( Nanogide-S$^{(R)}$ ) resorbable barrier with control group treated by polyactic acid / polylacticglycolic acid membrane(Biomesh$^{(R)}$ ) Methods: 44 severe bone loss on extraction socket from 44 patients were used in this study. In experimental group 22 sites of them were treated by silk fibrin membrane as and the other 22 sites were treated by polyactic acid/ polylacticglycolic acid membrane as a control group. Clinical parameters including recovered bone width, length and radiographic parameter of vertical length were evlauated at base line and 3 months after surgery. Results: 1) Severe bone width, length was significantlly decreased in two group. 2) Bone width, length was significantlly decreased in two group. 3) Decreased bone width, length and radiographic examination differences between group. Conclusions: On the basis of these results, silk fibrin resorbable membrane has similar bone regeneration ability to polyactic acid / polylacticglycolic acid membrane in guided bone regeneration for severe bone loss defect on extraction socket.

• Journal of Periodontal and Implant Science
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• v.38 no.sup2
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• pp.395-404
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• 2008

Purpose: Osteoprotegerin (OPG) is a secreted glycoprotein and a member of the tumor necrosis factor (TNF) receptor family that inhibits bone resorption by suppressing osteoclastogenesis. Gingival fibroblasts (GF) play a role in periodontal disease progression, and the purpose of this experiment was to evaluate influence of osteotropic factors on the expression of osteoprotegerin mRNA in these cells. Materials and Methods: In this experiment, the influence of osteoclastogenic factors, interleukin-1 beta (IL-$1{\beta}$), TNF-$\alpha$, prostanglandin E2 ($PEG_2$). parathyroid hormone (PTH) and 1$\alpha$, 25-dihydroxyvitamin $D_3$ on the expression of osteoprotegerin mRNA in GF was studied by Northern blot hybridization. Results: As expected, $PEG_2$ tended to inhibit OPG levels and this was most prominent at 24 hours of culture with $10^{-7}M$ of $PEG_2$. TNF-$\alpha$ at 10ng/ml and also at 25ng/ml decreased OPG levels to almost 30% of the control at 24 hours. This contrasts with reports of increased OPG levels from osteoblast/stromal cells and gingival fibroblasts stimulated by TNF-$\alpha$. Decrease of OPG levels with $PEG_2$ and TNF-$\alpha$ suggests a pathway whereby these mediators exert their resorptive effects. However, OPG levels were increased almost 3-fold at 24 hours with IL-1$\beta$(1 to 15ng/ml) and increased 1.4 fold with 24-hour treatment of $10^{-7}M$ PTH. Conclusion: Increase of OPG levels suggests that these 'osteoclastogenic' factors act in more complex ways and may act to inhibit bone resorption in inflammatory periodontitis. This result supports the role of OPG as a negative feedback mechanism in osteoclastic activity.

• Journal of the Korean Ceramic Society
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• v.41 no.7
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• pp.508-512
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• 2004

For abutment of dental implants, (Y, Nb)-TZP/Alumina composites were prepared by addition of 10-90 vol% alumina at an interval of 10 vol％ into tetragonal zirconia solid solution which consists of 90.24 mol% Zr $O_2$, 5.31 mol% Y$_2$ $O_3$, and 4.45 mol% Nb$_2$O$\_$5/. Biaxial flexure strength and fracture toughness of composite were optimized by adding 10 vol% alumina, which resulted in 900 MPa and 8.9 MPam$\^$1/2/, respectively. The composite did not undergo low temperature degradation even after autoclave treatment at 200$^{\circ}C$ for 10 h. 65 of (Y, Nb)-TZP/Alumina composite abutments were employed into 40 patients and any adverse reaction, screw loosing, or fracture of abutments was not observed for the span of 2 years, indicating that the ceramic abutments can be safely used for restorations.

• Proceedings of the Korean Institute of Surface Engineering Conference
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• 2016.11a
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• pp.117-117
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• 2016

Total ankle replacement (TAR) is a visible option in the surgical treatment of degenerative or inflammatory diseases of ankle joint. it is attributed to the current TAR which has improvements in surgical technique, uncemented implant fixation and minimally constrained articulation. In the clinical result, they can show promised surgical result when compared to earlier attempts in TAR. However, TAR is still not as successful as total knee replacement (TKR) or total hip replacement (THR), it needs to be note that there are limitations in concerning of long term performance of TAR, the high failure rate still associated with wear of the PE (polyethylene) component that has related with their material property and surface roughness. The aim of this study was to introduce the tribology characteristics of total ankle joint prosthesis with one of TDR model which was fabricated to try multi-axis wear test as a region of motion in ankle joint. The wear specimen of TDR was prepared with Ti-6Al-4V alloy and UHMWPE (ultra-high molecular weight polyethylene) for tibia-talus and bearing component, respectively. A wear test was carried out using a Force 5 (AMTI, Massachusetts, US) wear simulator which can be allowed to move in three axis to flexion-extension ($+3^{\circ}{\sim}-6^{\circ}$), internal-external axial rotation (${\pm}5^{\circ}$), as well as sinusoidal compressive load (1.6 kN, R=10). All tests were performed following standard ISO 14243, wear rate was calculated with weight loss of UHMWPE bearing while the specimen has tested at certain cycles. As based on the preliminary results, wear rate of UHMWPE bearing was $7.9{\times}10^{-6}mg/cycles$ ($R^2=0.86$), calculated loss weight until $10^7cycles$ was 79 mg, respectively.

• Journal of International Society for Simulation Surgery
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• v.2 no.1
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• pp.1-6
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• 2015

Purpose Bisphophonate-related osteonecrosis of the jaw (BRONJ) is an emerging problem. Extensive osteonecrosis of the jaw needs free flap reconstruction. Free fibular flap is the most useful flap for maxilla-mandibular hard and soft tissue reconstruction. The advantages of fibular free flap are simultaneous soft and hard tissue reconstruction and placing implant in reconstructed mandible and maxilla. In this study, four consecutive BRONJ patients who underwent fibula free flap reconstruction using simulation surgery were reviewed. Materials and Methods Four BRONJ patients who underwent free fibula reconstruction between May 2006 and September 2014 were included in this study. Male to female ratio was 1:3 and average age was 67.3 years old (62-70). All patients need mandibular bone reconstruction. Three patients suffered from osteoporosis and one male patient had multiple myeloma. Postoperative flap survival, functional reconstruction, esthetic results, food taking were evaluated. Results Three osseous flaps and one osteocutaneous flap were used. All the fibular flaps were survived and patients were recovered without complications. Oro-cutaneous fistula was resolved after operation. All patients were satisfied with the esthetic results. Patients reported improved solid food intake after operation with partial denture. One fully edentulous patient had semi-fluid diet after operation. Conclusion Treatment of the BRONJ is difficult due to lack of standard protocol. Fibular free flap using simulation surgery is the workhorse flap for mandibular hard and soft tissue reconstruction, especially in stage III BRONJ patient. In this study, functional and esthetic results were successful in all patients. Normal diet was possible with partial dentures.

• Imaging Science in Dentistry
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• v.46 no.2
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• pp.127-131
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• 2016

Purpose: This study was performed to compare the condylar position in patients with temporomandibular joint disorders (TMDs) and a normal group by using cone-beam computed tomography (CBCT). Materials and Methods: In the TMD group, 25 patients (5 men and 20 women) were randomly selected among the ones suffering from TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The control group consisted of 25 patients (8 men and 17 women) with normal temporomandibular joints (TMJs) who were referred to the radiology department in order to undergo CBCT scanning for implant treatment in the posterior maxilla. Linear measurements from the superior, anterior, and posterior joint spaces between the condyle and glenoid fossa were made through defined landmarks in the sagittal view. The inclination of articular eminence was also determined. Results: The mean anterior joint space was 2.3 mm in the normal group and 2.8 mm in the TMD group, respectively. The results showed that there was a significant correlation between the superior and posterior joint spaces in both the normal and TMD groups, but it was only in the TMD group that the correlation coefficient among the dimensions of anterior and superior spaces was significant. There was a significant correlation between the inclination of articular eminence and the size of the superior and posterior spaces in the normal group. Conclusion: The average dimension of the anterior joint space was different between the two groups. CBCT could be considered a useful diagnostic imaging modality for TMD patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.1
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• pp.20-30
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• 2016

Objectives: To validate a critical-size mandibular bone defect model in miniature pigs. Materials and Methods: Bilateral notch defects were produced in the mandible of dentally mature miniature pigs. The right mandibular defect remained untreated while the left defect received an autograft. Bone healing was evaluated by computed tomography (CT) at 4 and 16 weeks, and by micro-CT and non-decalcified histology at 16 weeks. Results: In both the untreated and autograft treated groups, mineralized tissue volume was reduced significantly at 4 weeks post-surgery, but was comparable to the pre-surgery levels after 16 weeks. After 16 weeks, CT analysis indicated that significantly greater bone was regenerated in the autograft treated defect than in the untreated defect (P=0.013). Regardless of the treatment, the cortical bone was superior to the defect remodeled over 16 weeks to compensate for the notch defect. Conclusion: The presence of considerable bone healing in both treated and untreated groups suggests that this model is inadequate as a critical-size defect. Despite healing and adaptation, the original bone geometry and quality of the pre-injured mandible was not obtained. On the other hand, this model is justified for evaluating accelerated healing and mitigating the bone remodeling response, which are both important considerations for dental implant restorations.

• Imaging Science in Dentistry
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• v.39 no.2
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• pp.81-87
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• 2009

Purpose: To evaluate the anteroposterior length and buccal angle of the anterior loop, and the size and location of the mental foramen using cone beam computed tomography (CBCT). Materials and Methods: 100 CBCT images from 87 adults (43 males and 44 females) ranging in age from 20 to 73 years (average 50 years) with edentulous ridge of the mandibular premolar region were obtained. Axial, sagittal, coronal images were reconstructed from Dental and Block Images of CBCT. The anteroposterior length, shape and buccal angle of the anterior loop, and the size and location of the mental foramen were calculated from reconstructed images of axial, sagittal and coronal CBCT. Results: The anteroposterior length and buccal angle of the mental canal was 4.0${\pm}$1.2mm, 37.8${\pm}$11.60$^{\circ}$respectively. The loop type with straight course was the most common shape of the mental canal. The location of the mental foramen below the apex of the lower second premolar (78%) was the most common. The maximum size of the mental foramen was 4.6${\pm}$1.0 mm in width and 3.0${\pm}$0.6 mm in height. The inner size of the mental canal was 2.6${\pm}$0.6 mm in width and 2.1 mm${\pm}$0.4 mm in height. Conclusion: CBCT is useful to evaluate the anterior loop and mental foramen of the mandibular canal. Safe guideline of 4 mm from the most anterior point of the mental foramen is recommended for implant and surgical treatment. (Korean J Oral Maxillofac Radiol 2009; 39: 81-7)

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.61-68
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• 2002

The objective of this study was to determine the incidence and distribution of root fusion as well as its sexlinkage in maxillary and mandibular molars. One hundred fifty patients who had eight maxillary and mandibular molars (third molars excluded) were consecutively selected for the study subjects. The subjects provided a total of 1200 molars, i.e., 600 maxillary and 600 mandibular molars. A decision about root fusion was made on the radiographic examination. If a molar had one root and/or roots fused at any part in the root surface, it was considered as having root fusion. The results showed that : (1) 14.1 % of the maxillary molars and 5.8 % of the mandibular molars had a fused root, (2) the prevalence of root fusion in the male was 33 % and 56.4 % in the female, (3) 60 % in the male and 48.8 % in the female had bilaterally paired root fusion, (4) the root fusion was most frequently observed in the maxillary second molar position, but none in the mandibular first position in this study. Within limitations of this study, it can be concluded that, in management of molars with a furcation problem, treatment options such as hemisection and root amputation should be chosen after careful evaluation of root fusion. Further studies are needed to investigate a possible relationship between root fusion and periodontal disease progression.