• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.6
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• pp.465-470
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• 2021

Few cases of spontaneous bone regeneration after extensive resection of the jaw bone have been reported, but it is more common in young adults or children. In this case, we report spontaneous bone healing in a 73-year-old female patient. On radiological examination, necrotic regions were seen in the right mandible. She was diagnosed with medication-related osteonecrosis of the jaw due to previous bisphosphonate use. After segmental resection, stabilization achieved using a reconstruction plate. The periosteum was preserved during the procedure. Twelve months later, panoramic radiography was taken and bone formation was seen both horizontally and vertically around the plate. If the periosteum is preserved and stabilization is achieved after resection in benign lesions, the bone may regenerate spontaneously regardless of age. Therefore, instead of simultaneous autogenous bone application, such patients may be followed to determine whether spontaneous bone healing will occur. This should improve patient comfort and reduce surgical cost.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.3
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• pp.229-236
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• 2009

Purpose: Some recent literatures report that it is possible to recover defected areas caused by enucleation of relatively large jaw cysts without using bone grafts. The aim was to find out whether spontaneous recovery of defected area with time occurred and what the contributing factors were. Materials and methods: In total, 194 patients were considered as patients. Out of these 194 patients, 74 patients who had no wound dehiscence and who were available for follow-up studies were selected. They were classified into two groups according to the size of radiolucent area in the preoperative panoramic radiographs: in one group, it was larger than $3{\times}4cm$, while in the other group, it was smaller than $3{\times}4cm$. Follow-up panoramic radiographs were taken immediately after the surgery, then after 3, 6, 9 and 12 months. On those radiographs, changes in size and density of the defected areas were observed using the Gray-level histogram of Adobe photoshop v7.0. Correlation between bone regeneration and factors such as the type and size of the cysts, age, sex, site of the cysts and systemic disease was evaluated using the General repeated measure and Mann-Whitney Test. Results: Analyses of panoramic radiographs showed that the recovery of radiopacity after 12 months was more than 97% on average in defected areas that were smaller than $3{\times}4cm$. in the defected areas that were larger than $3{\times}4cm$, considerable portion showed recovery of radiopacity. No statistically significant change was observed in bone density according to the type of cysts. Young patients under 20 years of age with highly active metabolism presented more significant bone regeneration than patients over 20 years of age. Bone regeneration was more hampered in patients who had medical disease, compared with patients who didn’t have any medical problem. No statistically significant change was seen in bone density according to sex. Changes in bone density according to the site of cysts such as maxilla, mandible, anterior or posterior region were not considered to be significant. Conclusion: Analyses of panoramic radiographs suggest that in approximately 12 months after the enucleation of cysts, clinically acceptable spontaneous bone regeneration can be observed even though normal bone graft procedures have not been applied.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.100-107
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• 2010

Introduction: A cyst is a closed pathologic sac containing fluid or semi-solid material in central region. The most common conventional treatment for a cyst is enucleation. It was reported that spontaneous bone healing could be accomplished without bone grafting. We are trying to evaluate bone reconstruction ability by analyzing panorama radiograph and computed tomography (CT) scan with retrograde studying after cyst enucleation. In this way we are estimating critical size defect for spontaneous healing without bone graft. Materials and Methods: The study comprised of 45 patients who were diagnosed as cysts and implemented enucleation treatment without bone graft. After radiograph photo taking ante and post surgery for 6, 12, 18, 24 months, the healing surface and volumetric changes were calculated. Results: 1. Spontaneous bone healing was accomplished clinically satisfying 12 months later after surgery. But analyzing CT scan, defect volume changes indicate 79.24% which imply incomplete bone healing of defect area. 2. Comparing volume changes of defect area of CT scan, there are statistical significance between under $5,000mm^{3}$ and over $5,000mm^{3}$. The defect volume of $5,000mm^{3}$ shows $2.79{\times}1.91$cm in panoramic view. Conclusion: Bone defects, which are determined by a healed section using a panoramic view, compared to CT scans which do not show up. Also we can estimate the critical size of defects for complete healing.

• Korean Journal of Veterinary Pathology
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• v.1 no.1
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• pp.7-12
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• 1997

Lethally irradited C3H/HeN mice were transplanted with syngeneic bone marrow. The B cell regeneration levels of spontaneous serum Ig, fecal igA and specific ig to diphtheria toxoid were determined at various time points. The number of B220+ cells reached normal range at 4 weeks after bone marrow transplantation(BMT) in spleen and lymph node. The B cell number of spleen returned to normal relatively soon than in the lymph node. Within 5 to 7 weeks after BMT, the transplanted mice contained nearly normal levels of spontaneous serum IgA, IgG2b and fecal IgA, but 2 fold lower levels of serum IgG2a, IgM and IgG3. Especially IgG3 levels were within low-normal range throughout the study. One to two weeks after immunization the predominant anti-diphtheria toxoid subtype was IgM. The levels of specific serum Ig were very low and after booster immunization at week 6, the short-lasting increase of Ig production was notd.

• Journal of Periodontal and Implant Science
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• v.50 no.1
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• pp.14-27
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• 2020

Purpose: To overcome several drawbacks of chemically-crosslinked collagen membranes, modification processes such as ultraviolet (UV) crosslinking and the addition of biphasic calcium phosphate (BCP) to collagen membranes have been introduced. This study evaluated the efficacy and biocompatibility of BCP-supplemented UV-crosslinked collagen membrane for guided bone regeneration (GBR) in a rabbit calvarial model. Methods: Four circular bone defects (diameter, 8 mm) were created in the calvarium of 10 rabbits. Each defect was randomly allocated to one of the following groups: 1) the sham control group (spontaneous healing); 2) the M group (defect coverage with a BCP-supplemented UV-crosslinked collagen membrane and no graft material); 3) the BG (defects filled with BCP particles without membrane coverage); and 4) the BG+M group (defects filled with BCP particles and covered with a BCP-supplemented UV-crosslinked collagen membrane in a conventional GBR procedure). At 2 and 8 weeks, rabbits were sacrificed, and experimental defects were investigated histologically and by micro-computed tomography (micro-CT). Results: In both micro-CT and histometric analyses, the BG and BG+M groups at both 2 and 8 weeks showed significantly higher new bone formation than the control group. On micro-CT, the new bone volume of the BG+M group (48.39±5.47 ㎣) was larger than that of the BG group (38.71±2.24 ㎣, P=0.032) at 8 weeks. Histologically, greater new bone area was observed in the BG+M group than in the BG or M groups. BCP-supplemented UV-crosslinked collagen membrane did not cause an abnormal cellular reaction and was stable until 8 weeks. Conclusions: Enhanced new bone formation in GBR can be achieved by simultaneously using bone graft material and a BCP-supplemented UV-crosslinked collagen membrane, which showed high biocompatibility and resistance to degradation, making it a biocompatible alternative to chemically-crosslinked collagen membranes.

• Journal of Periodontal and Implant Science
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• v.40 no.4
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• pp.180-187
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• 2010

Purpose: This study evaluated the spontaneous healing capacity of surgically produced cranial defects in rabbits with different healing periods in order to determine the critical size defect (CSD) of the rabbit cranium. Methods: Thirty-two New Zealand white rabbits were used in this study. Defects of three sizes (6, 8, and 11 mm) were created in each of 16 randomly selected rabbits, and 15-mm defects were created individually in another 16 rabbits. The defects were analyzed using radiography, histologic analysis, and histometric analysis after the animal was sacrificed at 2, 4, 8, or 12 weeks postoperatively. Four samples were analyzed for each size of defect and each healing period. Results: The radiographic findings indicated that defect filling gradually increased over time and that smaller defects were covered with a greater amount of radiopaque substance. Bony islands were observed at 8 weeks at the center of the defect in both histologic sections and radiographs. Histometrical values show that it was impossible to determine the precise CSD of the rabbit cranium. However, the innate healing capacity that originates from the defect margin was found to be constant regardless of the defect size. Conclusions: The results obtained for the spontaneous healing capacity of rabbit cranial defects over time and the underlying factors may provide useful guidelines for the development of a rabbit cranial model for in vivo investigations of new bone materials.

• Journal of Periodontal and Implant Science
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• v.52 no.4
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• pp.312-324
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• 2022

Purpose: The role of hard-type crosslinked hyaluronic acid (HA) with particulate bone substitutes in bone regeneration for combined inlay-onlay grafts has not been fully investigated. We aimed to evaluate the effect of hard-type crosslinked HA used with bone substitute in terms of new bone formation and space maintenance. Methods: A 15-mm-diameter round defect was formed in the calvaria of 30 New Zealand White rabbits. All animals were randomly assigned to 1 of 3 groups: the control group (spontaneous healing without material, n=10), the biphasic calcium phosphate (BCP) graft group (BCP, n=10), and the BCP graft with HA group (BCP/HA, n=10). The animals were evaluated 4 and 12 weeks after surgery. Half of the animals from each group were sacrificed at 4 and 12 weeks after surgery. Samples were evaluated using micro-computed tomography, histology, and histomorphometry. Results: The BCP group showed higher bone volume/tissue volume (BV/TV) values than the control and BCP/HA groups at both 4 and 12 weeks. The BCP and BCP/HA groups showed higher bone surface/tissue volume (BS/TV) values than the control group at both 4 and 12 weeks. The BCP group showed higher BS/TV values than the control and BCP/HA groups at both 4 and 12 weeks. No statistically significant difference in newly formed bone was found among the 3 groups at 4 weeks. The BCP group showed significantly higher new bone formation than the BCP/HA group at 12 weeks. Conclusions: Hard-type crosslinked HA did not show a positive effect on new bone formation and space maintenance. The negative effect of hard-type crosslinked HA may be due to the physical properties of HA that impede osteogenic potential.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.4.1-4.10
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• 2019

Background: The mandibular third molar (M3) is typically the last permanent tooth to erupt because of insufficient space and thick soft tissues covering its surface. Problems such as alveolar bone loss, development of a periodontal pocket, exposure of cementum, gingival recession, and dental caries can be found in the adjacent second molars (M2) following M3 extraction. The specific aims of the study were to assess the amount and rate of bone regeneration on the distal surface of M2 and to evaluate the aspects of bone regeneration in terms of varying degree of impaction. Methods: Four series of panoramic radiographic images were obtained from the selected cases, including images from the first visit, immediately after extraction, 6 weeks, and 6 months after extraction. ImageJ software^® (NIH, USA) was used to measure linear distance from the region of interest to the distal root of the adjacent M2. Radiographic infrabony defect (RID) values were calculated from the measured radiographic bone height and cementoenamel junction with distortion compensation. Repeated measures of analysis of variance and one-way analysis of variance were conducted to analyze the statistical significant difference between RID and time, and a Spearman correlation test was conducted to assess the relationship between Pederson's difficulty index (DI) and RID. Results: A large RID (> 6 mm) can be reduced gradually and consistently over time. More than half of the samples recovered nearly to their normal healthy condition (RID ≤ 3 mm) by the 6-month follow-up. DI affected the first 6 weeks of post-extraction period and only showed a significant positive correlation with respect to the difference between baseline and final RID. Conclusions: Additional treatments on M2 for a minimum of 6 months after an M3 extraction could be recommended. Although DI may affect bone regeneration during the early healing period, further study is required to elucidate any possible factors associated with the healing process. The DI does not cause any long-term adverse effects on bone regeneration after surgical extraction.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.429-436
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• 2008

Purpose: The goal of periodontal regenerative therapy is to replace bone, cementum, and periodontal ligament on a previously diseased root surface, which has suffered the loss of these supporting structures. To accomplish the regeneration, a number of surgical procedures have been advocated throughout the years. There seems to be a potential for some spontaneous periodontal tissue regeneration in the bottom of periodontal defect following open flap debridement alone. The aim of this study was to analyse the radiographic bone changes over 2-year after flap operation. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of infrabony defect(s). forty two sites of 33 patients aged 26 to 65 (mean age 45.5) were treated by flap operation with or without osseous surgery. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, gender, defect depth, defect angle) using the paired t-test were examined. Result: We observed 0.74 mm of bone fill, 0.66 mm of crestal resorption, 1.40 mm of defect resolution, and 27% of percentage of defect resolution. Mandible, women, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. Conclusion: The results of this study suggest that the use of flap operation did enhance the outcome in terms of radiographically detectable bone fill. Both treatment resulted in some loss of crestal bone height.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.3
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• pp.613-618
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• 1998

A dentigerous cyst is an epithelium-lined sac that surrounds the crown of an impacted, embedded, or unerupted tooth. Many surgical procedures have been described for the elimination of dentigerous cyst, but they can be devided into two basic group: enucleation and marsupialization. Marsupialization is a conservative technique which allows the reduction or elimination of a cystic lesion by making it an accessory compartment to the oral cavity and it is the best way to conserve a tooth affected by dentigerous cyst and to permit its eruption, especially in young patient. After using marsupialization to treat dentigerous cyst associated with the crown of unerupted premolar in young patient, the results were as follows: 1. Reduction of bony expansion and rapid bone regeneration without infection and recurrence were observed. 2. Normally spontaneous eruption of involved teeth were permitted, as well as loss of affected tooth was avoided. 3. Follow-up examinations revealed no complication and recurrence.