• Journal of Periodontal and Implant Science
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• v.34 no.4
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• pp.711-722
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• 2004

The purpose of this study is to evaluate the regenerated bone histollogically using titanium reinforced ePTFE(TR-ePTFE) membrane and to investigate cell occlusiveness, wound stabilization and tissue integration of TR-ePTFE membrane. Adult male rabbits (mean BW 2kg) and TR9W (W.L.Gore&Associate.INC,USA) were used in this study. Intramarrow penetration defects were surgically created with round carbide bur(HP long #6) on calvaria of rabbits. TR-ePTFE membrane was applied to defect. Then guided bone regeneration was carried out using TR-ePTFE membrane and resorbable suture. At 2,4,8,12 weeks after the surgery, animals were sacrificed. Nondecalcified specimens were processed for histologic analysis. The result and conclusion of this study were as follows: 1. TR-ePTFE membrane had good ability of biocompatibility and cell occlusiveness. 2. space making for guided bone regenerayion was good at TR-ePTFE membrane. 3. Tissue integration was not good at TR-ePTFE membrane. So, wound stabilization was not good. 4. At 8 weeks, 12 weeks after GBR procedure, bone formation was seen. From the above results, TR-ePTFE membrane fixed tightiy on alveolar bone might be recommended for the early bone formation.

• Journal of Periodontal and Implant Science
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• v.35 no.2
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• pp.491-510
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• 2005

This study was performed to evaluate the effect of inorganic polyphosphate on bone formation in the calvaria of rabbit in the procedure of guided bone regeneration with bovine cancellous bone graft and titanium reinforced expanded polytetrafluoroethylene(TR-ePTFE) membrane. The rabbits were divided into four groups. Control group I used only TR-ePTFE membrane, control group II used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in saline, experimental group III and IV used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in 1% or 2% inorganic polyphosphate respectively. After decortication in the calvaria, GBR procedure was performed on 12 rabbits with titanium reinforced ePTFE membrane filled with deproteinized bovine bone mineral soaked in saline or inorganic polyphosphate. The animals were sacrificed at 2 weeks, 4 weeks, and 8 weeks after the surgery. Decalcified and non-decalcified specimens were processed for histologic and immunohistochemistric analysis. 1. Titanium reinforced ePTFE(TR-ePTFE) membrane showed good spacemaking and cell occlusiveness capability, but it showed poor wound stabilization. 2. The deproteinized bovine bone mineral did not promote bone regeneration, but it acted as a space filler. 3. There was no complete resorption of the deproteinized bovine bone mineral within 8 weeks. 4. 1% inorganic polyphosphate did not promote bone formation, but 2% inorganic polyphosphate promoted bone formation. Within the above results, 2% inorganic polyphosphate could be used effectively for bone regeneration.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.289-303
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• 2006

This study was performed to evaluate the effect of bone graft materials including demineralized freeze-dried bone, freeze-dried bone, deproteinized bovine bone on space-making capacity and bone formation in guided bone regeneration with titanium reinforced ePTFE membrane(TR-ePTFE). Adult male rabbits(mean BW 2kg) were used in this study. Intramarrow penetration defects were surgically created with round bur on calvaria of rabbits. TR-ePTFE membrane was adapted to calvarial defect and bone graft materials were placed. Animals were sacrificed at 2, 8, 12 weeks after surgery. Non-decalcified specimens were processed for histologic analysis and prepared with Villaneuva bone stain. The results of this study were as follows: 1. TR-ePTFE membrane was biocompatible and capable of maintaining the space-making. 2. Tissue integration was not good at TR-ePTFE membrane. Fixation was not enough. so, wound stabilization was not good. 3. In animals using deproteinized bovine bone, demineralized freeze-dried bone, bone formation was little. 4. In animals using freeze-dried bone, bone formation was better. Within the above results, bone formation may be inhibited when wound stabilizafion was not good.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.179-190
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• 2008

Purpose: In this study, the effect of micro-macroporous biphasic calcium phosphate(MBCP) incorporated with inorganic polyphosphate for bone regeneration in the calvaria of rabbit was evaluated. Materials and Methods: The procedure of guided bone regeneration was performed with titanium reinforced expanded polytetrafluoroethylene(TR-ePTFE) membrane. Four animal groups were compared : 1) TR-ePTFE membrane for negative control group, 2) TR-ePTFE membrane filled with MBCP for positive control group, 3) TR-ePTFE membrane filled with MBCP soaked in 4% inorganic polyphosphate for experimental group I, and 4) TR-ePTFE membrane filled with MBCP soaked in 8% inorganic polyphosphate for experimental group II. Results: 1. Negative control group showed the highest new bone formation at 16 weeks. 2. Positive control group showed the smallest new bone formation compared to other groups. 3. 8% inorganic polyphosphate induced more volume of bone formation, otherwise experimental group II did not show significant difference compared to negative control group. Conclusion: These results suggest that inorganic polyphosphate has a promoting effect on bone regeneration, possibly by enhancing osteoconductivity of the carrier and by increasing osteoinductivity of the defected alveolar bone tissue.

• Journal of Periodontal and Implant Science
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• v.37 no.1
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• pp.77-89
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• 2007

This study was performed to evaluate the effect of deproteinized bovine bone mineral soaked in inorganic polyphosphate on bone regeneration in the calvaria of rabbit in the procedure of guided bone regeneration with titanium reinforced expanded polytetrafluoroethylene(TR-ePTFE) membrane. The rabbits were divided into four groups. Control group used TR-ePTFE membrane filled with de-proteinized bovine bone mineral, experimental group I used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in 4% inorganic polyphosphate, experimental group II and III used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in 8% or 16% inorganic poly-phosphate respectively. After decortication in the calvaria, GBR procedure was performed on 8 rabbits with only TR-ePTFE membrane or titanium reinforced ePTFE membrane filled with deproteinized bovine bone mineral soaked in inorganic polyphosphate. The animals were sacrificed at 4 weeks, and 8 weeks af-ter the surgery. Non-decalcified specimens were processed for histologic analysis, and new bone for-mation was assessed by histomorphometric as well as statical analysis. 1. Both control group and experirrental group dermnstrated increasing of new bone formation until 8weeks. 2. At 8 weeks, experimental group I and group II showed the significant difference compared to control group in new bone formation. Especially experimental group II showed the most in-creasing of new bone formation. 3. The higher concentration of inorganic polyphosphate filled, the more volume of bone formation pro-moted, but experimental group III did not reveal significant difference compared to contol group. 4. Deproteinized bovine bone mineral did not resorbed at all until 8 weeks. These results suggest that inorganic polyphosphate has a promoting effect on bone regeneration. possibly by enhancing osteoconductivity of the carrier and by increasing osteoinductivity of the defected alveolar bone tissue, but not as we respect.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.149-162
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• 2004

This study was performed to evaluate the effect of freeze-dried bone graft on space-making capacity and bone formation in the procedure of guided bone regeneration with titanium reinforced ePTFE membrane. After decortication in the calvaria, GBR procedure was performed on 8 rabbits with titanium reinforced ePTFE membrane filled with human FDBA(Rocky Mountain Tissue Bank,Aurora Co., USA). Decortication was performed to induce the effect of bone forming factor from bone marrow. The animals were sacrificed at 2 weeks, 4 weeks, 8 weeks and 12 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis. πle results of this study were as follows: 1. Titanium reinforced-ePTFE membrane was biocompatable and capable of maintaining the space-making. 2. FDBA particle was surrounded with connective tissues but there was no evidence on new bone formation. 3. FDBA particle resorbed continuously but it remained until 12weeks after the surgery. Within the above results, TR-ePTFE membrane could be used effectively for Guided bone regeneration but It was assumed that FDBA does not appear to contribute to bone formation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.4
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• pp.275-279
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• 2010

Introduction: Guided bone regeneration (GBR) is a common procedure for the treatment of bone defects and bone augmentation. The nonresorbable barriers are well-documented barriers for GBR because of their stability and malleability. However, few GBR studies have focused on the different types of non-resorbable barriers. Therefore, this study examined the clinical results of different non-resorbable barriers for GBR; expanded polytetrafluoroethylene (e-PTFE) (TR-Gore Tex, Flagstaff, AZ, USA), and high-density polytetrafluoroethylene (d-PTFE) (Cytoplast membrane, Oraltronics, Bremen, Germany). Materials and Methods: The analysis was performed on patients treated with GBR and implant placement from January 2007 to October 2007 in the department of the Seoul National University Bundang Hospital. The patients were divided into two groups based on the type of non-resorbable barrier used, and the amount of bone regeneration, marginal bone resorption after prosthetics, implant survival rate and surgical complication in both groups were evaluated. Results: The implants in both groups showed high survival rates, and the implant-supported prostheses functioned stably during the follow-up period. During the second surgery of the implant, all horizontal defects were filled with new bone, and there was no significant difference in the amount of vertical bone defect. Conclusion: In bone defect areas, GBR with non-resorbable barriers can produce favorable results with adequate postoperative management. There was no significant difference in bone regeneration between e-PTFE and d-PTFE.

• Journal of Periodontal and Implant Science
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• v.38 no.1
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• pp.75-82
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• 2008

Purpose: The purpose of this study was to evaluate exophytically vertical bone formation in the mandibular premolar area of beagle dogs by the concept of guided bone regeneration with a titanium reinforced e-PTFE membrane combined with human demineralized freeze-dried bone. Materials and Methods: Four one-year old beagle dogs were divided into control and experimental group. All mandibular premolars were extracted and surgical vertical defects of 5 mm in height were created in the extracted sockets. At 8 weeks after the extraction, TR e-PTFE membrane sized with 8 mm in length, 5 mm in width, and 4 mm in height was placed on the decorticated mandible, fixed with metal pins and covered with full-thickness flap and assigned as control group. In experimental group, decorticated mandibule was treated with TR e-PTFE membrane and human demineralized freeze-dried bone. The animals were sacrificed at 16 weeks after the regenerative surgery, and new bone formation was assessed by histomorphometric as well as statistical analysis. Results: Average of new bone formation was 38% in the control group, whereas was 25% in the experimental group (p<0.05). Average of connective tissue formation was 42% in the experimental group, whereas was 30% in the control group (p<0.05). The lamellar bone formation with haversian canals was observed in the both groups. In the experimental group, the particles of human demineralized freeze-dried bone were observed after 16 weeks and complete resorption of graft was not observed. Conclusion: On the basis of these findings, we conclude that titanium reinforced e-PTFE membrane may be used alone for vertical guided bone regeneration, but demineralized freeze-dried bone has no additional effect on vertical guided bone regeneration.

• Journal of Periodontal and Implant Science
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• v.37 no.4
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• pp.791-803
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• 2007

The purpose of this study was to evaluate exophytically vertical bone formation in residual ridge of the beagle dog by the concept of guided bone regeneration with a titanium reinforced e-PTFE membrane combined with irradiated cancellous human bone. Twelve male beagle dogs(mean age 1.5 years and mean weight 12kg) were used for this study. The alveolar ridges after extraction of all mandibular premolars were surgically and horizontally removed. At 8 weeks after extractions, full-thickness flap was reflected and cortical bone was removed with round bur and copious irrigation. Rectangular parallelepiped(10mm in length, 5mm in width, and 4mm in height) bended with titanium-reinforced e-PTFE(TR e-PTFE) membrane was placed on the decorticated alveolar ridge, fixed with metal pins and covered with full-thickness flap and assigned as a control group. Test groups ere treated with TR e-PTFE membrane filled with irradiated cancellous human bone. Of twelve beagle dogs, four control dogs and four test dogs without membrane exposure to oral cavity were sacrificed at 8 and 16 weeks respectively. The surgical sites were dissected out, fixed in 4% buffered formaldehyde, dyed using a Villanueva staining technique, and processed for embedding in plastic resin. The cutting and grinding methods were routinely processed for histologic and histomophometric analyis of exophytic bone formation as well as statistical analysis. The results of this study were as follows: 1. Exophytic bone formation in the both of experimental groups was increased respectively after surgery from 23.40% at 8 weeks to 46.26% at 16 weeks in the control groups, from 40.23% at 8 weeks to 47.11% at 16 weeks in the test groups(p<0.05). 2. At 8 weeks after surgery, exophytic bone formation was made 40.23% in the test groups and 33.40% in the control groups. Exophytic bone formation was significantly made in the test group more than in the control group. At 16 weeks after surgery, exophytic bone formation was made 44.11% in the test groups and 46.26% in the control groups. Exophytic bone formation was made in the test groups more than in the control groups, but there was no statistically significant differences. 3. The membrane was fixed with metal pins to closely contact it to the bone surface. So, collapse and deviation of the membrane could be prevented and in growth of connective tissue also could be blocked from the periphery of the membrane. On the basis of these findings, wee suggest that intraoral experimental model for exophytic bone formation may be effective to evaluate the effect of bone graft material. And it indicates that combined use of membrane and ICB graft material is more effective than use of membrane only for exophytic bone formation.

• Journal of Periodontal and Implant Science
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• v.38 no.1
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• pp.59-66
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• 2008

Purpose: It has been shown that the inorganic polyphosphate is effective for the regeneration of bones through the preliminary animal test of rabbits. The most effective concentration of the polyphosphate, however, is not known yet. Moreover, the effectiveness of carriers inside human body is not confirmed.. Materials and Methods: In this study, we examined the effect of the concentration of the inorganic polyphosphate on the process of the bone regeneration using the 6 weeks old rabbits with the weight of 2.0 kg in average. We performed the experiment using TR-ePTFE membrane(membrane) filled with collagen immersed in 4%, 8% of inorganic polyphosphate, respectively, following removal of the proper sized cortical bones from the rabbit calvaria. The experimental results were compared with the one of the following four groups: The negative control group for membrane only, the positive control group for membrane filled with collagen, the first experimental group for membrane filled with collagen immersed in 4% of inorganic polyphosphate, and the second experimental group for membrane filled with collagen immerse in 8% of inorganic polyphosphate. The fragments of the tissue with membrane obtained from each group of the sacrificed rabbits for 8 or 16 weeks sustained after surgery were then prestained by the Hematoxylin-Eosin stain and coated by resin to form non-decalcified specimens for the histologic examination and analysis. New bone formation was assessed by histomorphometric and statistical analysis. Results: 1. All groups have shown better bone regeneration at 16weeks than 8weeks. 2. Negative control group has shown more bone regeneration relative to the other groups at 8 and 16 weeks. 3. All experimental groups have shown better bone regeneration relative to positive control group. 4. At 16 weeks, the first experimental group has shown more bone regeneration compared to the second experimental group. Exophytic bone formation is not good at the first and the second experimental groups compared with negative control group. But, the use of 4% inorganic polyphosphate was more effective to bone formation than the use of 8% inorganic polyphosphate. Conclusion: With above results, it is suggested the use of inorganic polyphosphate with vehicle under TR-ePTFE membrane.