• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.2
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• pp.112-123
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• 2013

This study aims to investigate the clinical outcome following treatment of peri-implantitis lesions. Five subjects with 7 implants were treated with surgical approach. Four subjects with 6 implants were initially treated with non-surgical approach or hygiene control. However, inflammation was not resolved and more bone loss was found. Therefore, surgical treatment was performed. After surgical exposure of the defect, granulation tissue was removed and implant surface was treated using tetracycline and chlorhexidine. Then, the flaps were sutured. The wound healing was performed in a non-submerged mode. The present finding demonstrates stable results without progression of bone loss. In one subject, deep V shaped bone defect was filled with bone substitute (ICB, CanCellous Bone, Rockey Mountain Tissue Bank, USA), and resorbable membrane (Lyoplant$^{(R)}$, B.Braun Aesculap AG, Germany) was placed over the grafted defect and healing abutment was connected. However, the inflammation was not resolved and more bone loss was found. At one month after regenerative surgery, the implant was removed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.613-619
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• 2000

The purpose of the present study was to investigate the effect of Bioactive glass on bone regeneration in the experimental mandibular bone defects. Five rabbits, weighing about 2.0kg, were used. Three artificial bone defects, $5{\times}5{\times}5mm$ in size, were made at the inferior border of the mandible. In the experimental group 1, the bone defect was grafted with $Biogran^{(R)}$ and covered with $Bio-Gide^{(R)}$ resorbable membrane. In the experimental group 2, $Biogran^{(R)}$ was grafted only. In the control group, the bone defect was filled with blood clot and was spontaneously healed. The animals were sacrificed at 1, 2, 4, and 8 weeks after the graft. Microscopic examination was performed. Results obtained were as follows: In the control group, the osteoid tissue was observed at week 1 and the bone trabeculi were connected each other and matured at week 2. The lamellar bone formation appeared at week 4, and the amount of bone tissue was increased at week 8. In the experimental group 1, the fibrous tissue was filled between the granules of Bioactive glass and the cartilage formation was found adjacent to the normal bone at week 1. The bone tissue was formed between the granules at week 2, while the amount of bone tissue increased and the lamellar bone formation was observed at week 4. The lamellar bone was increased at week 8. Histologic findings were Similar between the experimental groups 1 and 2, although the amount of Bioactive glass granules lost was increased in the latter. These results suggest that new bone formation is found around the Bioactive glass granules grafted into the bone defects, and the membrane plays a role in keeping the granules and preventing the fibrous tissue invasion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.5
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• pp.481-489
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• 2000

This research was focused on overall examination of tissue alteration, wound healing promotion. After the hair on the dorsal surface was shaved, $5{\times}5mm$ oval skin defect was formed. Experimental wounds of right side were irradiated on every day for 90 second with Ga-Al-As semi-conductor laser. Left side wounds served as control group. The rats were sacrificed on the 1st, 3rd, 5th, 7th, 14th, 21th day. For light microscopically, parafin section were stained with H&E, MT. The outcomes were as follows : 1. On 1st day, experimental and control group were seen acute inflammatory cell infiltration, edema. 2. On the 3rd days, both groups were seen crust development, collagen, blood vessel proliferation. 3. On the 5th days, experimental group were reduced edema and inflammatory cell infiltration than control group. 4. On the 7th days, both groups were observed edema, inflammatory cell infiltration disappearance and keratinocytes motility from wound defect. 5. On the 14th days, experimental group appeared collagen, blood vessel proliferation and hair follicle than control group. 6. On the 21th days, both groups were seen normal status re-epithelization. According to the above results, The wound-healing stimulated by laser radiation involves an increased rate of epithelial growth. LLLT was confirmed that it has fibroblast, blood vessel proliferation, influence initial wound healing process.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.1
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• pp.85-92
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• 2005

Reconstruction of defect in the anterior part of the maxilla to enable implant placement or prothesis is a complicated treatment due to the anatomical position and lack of soft tissues. Two cases are presented in which autogenous iliac PMCB(particulate marrow and cancellous bone) with titanium mesh were used for premaxilla reconstruction and alveolar bone repair of the anterior maxillas prior to denture and implants fixation respectively. Cancellous bone from the anterior iliac crest was compressed and placed against a titanium mesh fixed to the bone of palate in a patient with severe defect of the anterior maxilla. There were no problem in the healing, and the anterior maxillas of two patients had increased height and width during the initial healing and remodeling. The clinical reports describe the use of titanium mesh for reconstruction of premaxilla. Autogenous bone grafts were harvested from the iliac crest and were loaded on a titanium mesh that were left in the patient's maxilla for 6 months before they were removed respectively. The radiographic analysis demonstrated that a 10mm vertical ridge augmentation had been achieved. In guided bone regeneration, the quantity of bone regenerated under the barrier has been demonstrated to be directly related to the amount of the space under the membrane. This space can diminish as a result of membrane collapse. To avoid this problem which involved the use of a titanium mesh barrier to protect the regenerating tissues and to achieve a rigid fixation of the bone segments, were used in association with autologous bone in 2 cases. The aim of this study was to evaluate the capability of a configured titanium mesh to serve as a mechanical and biologic device for restoring a vertically defected premaxilla.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.5
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• pp.299-310
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• 2012

Purpose: The purpose of this study was to evaluate the histological healing process of 3 different types of xenogenic tooth bone graft material and xenogenic bone graft material. Methods: Three types of human tooth bone graft material (chips, crowns, and roots) and BioOss (Geistlich Pharma AG, Wolhausen, Switzerland) was filled at the preformed 4 round-shaped calvarial bone defects of beagle dogs. The beagles were sacrificed at 2, 4, 8, and 12 weeks, respectively, for radiological and histological evaluation. Results: Increased strength and radiopacity were detected in all graft material groups in time-dependent manner. New bone was formed and matured surrounding the graft material histologically. Also, a new bone was directly integrated with graft material. Conclusion: It was expected that newly developed tooth bone graft material would show good bone healing capacity if it was used as a graft material for the restoration of bony defect.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.45.1-45.8
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• 2015

Background: Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unesthetic scar of the donor site and the need for a second donor site for skin graft are major disadvantages of the forearm flap. The purpose of this study was to report the clinical results of double-layered collagen graft to the donor site of the forearm free flap without skin graft. Methods: Twenty-two consecutive patients who underwent oral cancer ablation and forearm reconstruction between April 2010 and November 2013 were included in this study. Male to female ratio was 12:10, and average age was 61.0 years old (27-84). Double-layered collagen was grafted to the donor site of the forearm free flap and healed for secondary intention. Upper silicone had been trimmed at the periphery during secondary intention, and dry dressing was used. Postoperative scar healing and esthetic results and function were evaluated. Results: An average follow-up period was 34.9 months. The scar area was decreased to 63.9 % in average. The complete healing was obtained between 1.5 and 3 months according to the defect size. There was no functional defect or impairment 3 months after operation. All patients were satisfied with the esthetic results. Three patients died of recurred cancer. Conclusions: Double-layered collagen graft was successfully performed in this study. Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.2
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• pp.119-130
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• 2008

Absorbable atelo-collagen sponge $TERUPLUG^{(R)}$, Termo Co. Tokyo, Japan) is inserted in the extraction wound where alveolar bone is exposed. It protects wounds and promotes the formation of granulation. This is made of atelo-collagen, to minimize antigenicity, which is cross-linked by heat treatment for biocompatibility. $TERUPLUG^{(R)}$ consists of between 85 and 95 % of collagen type I and between 5 to 15 % of collagen type III. The raw material for the collagen is derived from bovine skin. It features a sponge block design and is shaped for easy insertion in the extraction wound. This study was designed to find out the bone healing capacity of $TERUPLUG^{(R)}$. We implanted $TERUPLUG^{(R)}$ (experimental group I) and $TERUPLUG^{(R)}$ with rhBMP-2 (experimental group II) in the rabbit cranium defect and then histologically analysed the specimen. The results were as follows. 1. In the 4 weeks, a lot of the newly formed collagen fibers around material of the experimental group I implanted $TERUPLUG^{(R)}$ were observed. But, in the experimental group II implanted $TERUPLUG^{(R)}$ with rhBMP-2, a little of newly formed collagen fibers around material were observed. The cell proliferating activity and apoptosis of the experimental group I, II was positive in and around the implanted material. 2. In the 8 weeks, the amount of newly formed and matured bone in the experimental group II was more observed than the experimental group I and control group. The results of this study indicate that absorbable atelo-collagen sponge ($TERUPLUG^{(R)}$) is relatively favorable bone void filler with biocompatibility and has the better bone healing capacity in case of application with rhBMP-2.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.1
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• pp.27-35
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• 2006

Purpose: This study was performed to investigate the expression of the transforming growth factor (TGF)-1, in a rat calvarium defect model using particulate dentin and/or plaster of Paris, and correlate the bone regeneration process with the histologic events. Materials and Methods: Thirty-two Sprague-Dawley rats were divided into 4 groups of 8 animals each. A 1.0 cm-sized calvarial defects were made and the defect was filled with different graft materials as follows : Group A, the defects were filled with a mixture of particulate dentin and plaster of Paris with a 2:1 ratio; Group B, the defects were filled with plaster of Paris only; Group C, defects were filled with particulate dentin only; Group D, untreated control group. The animals were sacrificed by 1, 2, 4, 8 weeks after implantation. Excised wound tissues were processed for histology, immunohistochemistry and RT-PCR for the analysis of TGF-1 expression. Results: Gene expression of TGF-1 was detected for all experimental groups. The highest gene expression was observed in the specimen taken at the first week after implantation in Group A. According to the histologic and immunohistochemical studies, TGF-1 positive osteoblast-like cells were found in the early stage of healing after the implantation of particulate dentin and plaster of Paris. Conclusion: These findings suggest that TGF-1 may be related to new bone formation at the early healing process after the implantation of particulate dentin and plaster of Paris.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.3
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• pp.94-102
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• 2014

Purpose: This study aims to validate the effect of autoclaved autogenous bone (AAB), incorporating Escherichia coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2), on critical-sized, segmental radius defects in rabbits. Delivery systems using absorbable collagen sponge (ACS) and fibrin glue (FG) were also evaluated. Methods: Radius defects were made in 12 New Zealand white rabbits. After autoclaving, the resected bone was reinserted and fixed. The animals were classified into three groups: only AAB reinserted (group 1, control), and AAB and ErhBMP-2 inserted using an ACS (group 2) or FG (group 3) as a carrier. Animals were sacrificed six or 12 weeks after surgery. Specimens were evaluated using radiology and histology. Results: Micro-computed tomography images showed the best bony union in group 2 at six and 12 weeks after operation. Quantitative analysis showed all indices except trabecular thickness were the highest in group 2 and the lowest in group 1 at twelve weeks. Histologic results showed the greatest bony union between AAB and radial bone at twelve weeks, indicating the highest degree of engraftment. Conclusion: ErhBMP-2 increases bony healing when applied on AAB graft sites. In addition, the ACS was reconfirmed as a useful delivery system for ErhBMP-2.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.3
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• pp.191-196
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• 2020

Objectives: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein-2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement properties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. Materials and Methods: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after sequestrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. Results: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann-Whitney U-test, P<0.05). Conclusion: Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.