• The Journal of Korea Assosiation for Disability and Oral Health
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• v.6 no.2
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• pp.105-111
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• 2010

Objective : To report eruption of maxillary canine through Bio-$Oss^{(R)}$ graft in patients with secondary bone-grafted alveolar clefts. Methods : Secondary alveolar bone grafts placed in the cleft alveolar defect have been shown to support dental eruption through the graft and may further affect the prevalence of impacted teeth. As the case may be, it could be difficult to do secondary alveolar bone graft with autologous bone. In particular, few reports have been shown the secondary bone graft with heterogenous bone(Bio-$Oss^{(R)}$). In this report, the eruption of canine into bone-grafted alveolar clefts was recorded as panoramic, occlusal radiographs, in 3 patients grafted with Bio-$Oss^{(R)}$ Results : Like autologous bone graft, the canine was erupted and developed into the cleft alveolar defect through Bio-$Oss^{(R)}$ graft. Conclusion : In some cases that autologous bone graft is not available, we can consider heterogenous bone graft into the cleft alveolar defect for dental development and eruption of impacted teeth.

• Journal of Periodontal and Implant Science
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• v.47 no.2
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• pp.86-95
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• 2017

Purpose: The aim of this study was to determine the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded synthetic bone substitute on implants that were simultaneously placed with sinus augmentation in rabbits. Methods: In this study, a circular access window was prepared in the maxillary sinus of rabbits (n=5) for a bone graft around an implant (${\varnothing}3{\times}6mm$) that was simultaneously placed anterior to the window. Synthetic bone substitute loaded with rhBMP-2 was placed on one side of the sinus to form the experimental group, and saline-soaked synthetic bone substitute was placed on the other side of the sinus to form the control group. After 4 weeks, sections were obtained for analysis by micro-computed tomography and histology. Results: Volumetric analysis showed that the median amount of newly formed bone was significantly greater in the BMP group than in the control group ($51.6mm^3$ and $46.6mm^3$, respectively; P=0.019). In the histometric analysis, the osseointegration height was also significantly greater in the BMP group at the medial surface of the implant (5.2 mm and 4.3 mm, respectively; P=0.037). Conclusions: In conclusion, an implant simultaneously placed with sinus augmentation using rhBMP-2-loaded synthetic bone substitute can be successfully osseointegrated, even when only a limited bone height is available during the early stage of healing.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.331-338
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• 2004

Stress transfer to the surrounding tissues is one of the factors involved in the design of dental implants. Unfortunately, insufficient data are available for stress transfer within the regenerated bone surrounding dental implants. The purpose of this study was to investigate the concentration of stresses within the regenerated bone surrounding the implant using three-dimensional finite element stress analysis method. Stress magnitude and contours within the regenerated bone were calculated. The $3.75{\times}10-mm$ implant (3i, USA) was used for this study and was assumed to be 100% osseointegrated, and was placed in mandibular bone and restored with a cast gold crown. Using ANSYS software revision 6.0, a program was written to generate a model simulating a cylindrical block section of the mandible 20 mm in height and 10 mm in diameter. The present study used a fine grid model incorporating elements between 165,148 and 253,604 and nodal points between 31,616 and 48,877. This study was simulated loads of 200N at the central fossa (A), at the outside point of the central fossa with resin filling into screw hole (B), and at the buccal cusp (C), in a vertical and $30^{\circ}$ lateral loading, respectively. The results were as follows; 1. In case the regenerated bone (bone quality type IV) was surrounded by bone quality type I and II, stresses were increased from loading point A to C in vertical loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, concentrated on the top of the cylindrical collar loading point B and C in vertical loading. And, In case the regenerated bone (bone quality type IV) was surrounded by bone quality type III, stresses were increase from loading point A to C in vertical loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, B and C in vertical loading. 2. In case the regenerated bone (bone quality type IV) was surrounded by bone quality type I and II, stresses were decreased from loading point A to C in lateral loading. Stresses according to the depth of regenerated bone were concentrated on the top of the cylindrical collar in loading point A and B, distributed along the implant evenly in loading point C in lateral loading. And, In case the regenerated bone (bone quality type IV) was surrounded by bone quality type III, stresses were decreased from loading point A to C in lateral loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, B and C in lateral loading. In summary, these data indicate that both bone quality surrounding the regenerated bone adjacent to implant fixture and load direction applied on the prosthesis could influence concentration of stress within the regenerated bone surrounding the cylindrical type implant fixture.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.223-237
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• 2006

The purpose of the present study was to evaluate the effect of bone graft materials including deproteinized bovine bone(DBB), demineralized freeze-dried bone(DFDB), freeze-dried bone(FDB) on bone formation in guided bone regeneration using perforated titanium membrane(TM). 16 adult male rabbits(mean BW 2kg) were used in this study and 4 rabbits allotted to each test group. Intramarrow penetration(diameter 6.5mm) was done with round carbide bur on calvaria to promote blood supply and clot formation in the wound area. The test groups were devided into 4 groups as follows: TM only(test 1), TM +DBB(test 2), TM +DFDB(test 3), TM +FDB(test 4). Perforated titanium membrane was contoured in rectangular parallelepiped shape(0.5mm pore diameter, 10mm in one side, 2mm in inner height), filled the each graft material and placed on the decorticated carvaria. Perforated titanium membrane was fixed with resorbable suture materials. The animals were sacrificed at 2, 8 weeks after the surgery. Non-decalcified preparations were routinely processed for histologic analysis. The results of this study were as follows: 1. Perforated titanium membrane was biocompatible. 2. Perforated titanium membrane had capability of maintaining the space during the healing period but invasion of soft tissue through the perforations of titanium membrane decreased the space available for bone formation. 3. In test 1 group without bone graft material, the amount of bone formation and bone maturation was better than other test groups. 4. Among the graft materials, the effect of freeze-dried bone on bone formation was best. 5. In the test groups using deproteinized bovine bone, demineralized freeze-dried bone, bone formation was a little. The spacemaking capability of the membrane may be crucial for bone formation. The combined treatment with the perforated titanium membrane and deproteinized bovine bone or demineralized freeze-dried bone failed to demonstrate any added effect in the bone formation. Minimization of size and numbers of perforations of titanium membrane or use of occlusive titanium membrane might be effective to acquire predictable results in the vertical bone formation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.570-578
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• 2006

A severely atrophic maxilla may disturb the proper implant placement. The various bone graft techniques are required for simultaneous or delayed implantation in the cases of atrophic alveolar ridges. We present 11 consecutive patients treated with simultaneous implantation using the autogenous inlay and/or onlay bone grafts from iliac crest to the floor of the maxillary sinus and the alveolar crest. In the cases of atrophic maxilla, a total 69 implants were simultaneously placed with autogenous iliac bone graft. 40 fixtures were inserted in the sinus floor simultaneously with subantral block bone graft, the other 29 fixtures were placed in the anterior or premolar areas with block or particulate bone graft. The vertical alveolar bone height was measured with Dental CT at the preoperation and 6 months postoperation. Moreover, the implant stability quotients (ISQ) were measured by $Osstell^{TM}$ during second implant surgery at 6 months later of first implantation. All implants were obtained successful osseointegration with the grafted bone. The mean vertical increases were 3.9mm in the anterior ridges and 12.8mm in the posterior ridges. During the second implant surgery, mean ISQ were 62.95 in the anterior ridge and 61.32 in the posterior ridge. We concluded that the simultaneous implantation with autogenous iliac bone graft were stable and available methods for severely atrophic maxilla.

• 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 Medicine and Life Science
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• v.20 no.2
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• pp.60-66
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• 2023

Gentamicin-loaded bone cement used in total joint arthroplasty is indispensable, as it provides stability by directly binding the surfaces of implants and bones. Depending on multiple factors, including the material of the bone cement used, common complications, such as aseptic loosening, osteolysis, and infection can occur postoperatively. In clinical practice, Doujet bone cement is easy to handle (pre-packed all-in-one system), and has shown low failure rates and non-inferior results compared with similar available products. We conducted a retrospective comparative study to analyze the clinical and radiological results of each bone cement group to establish the safety and usefulness of Doujet bone cement. From July 2020 to July 2022, we enrolled 198 patients in this study after an average follow-up period of 37 months (range, 6-48 months). In 99 patents, Doujet^® bone cement (Injecta, Gunpo, Korea) was used for total knee arthroplasty (TKA), while Refobacin^® bone cement (Biomet, Warsaw, IN, USA) was used in 99 patients. The average range of motion (ROM) of the knee increased by 2.4° (from 127.0° preoperatively to 129.4° postoperatively) in the Doujet group, and by 0.1° (from 128.7° to 128.8°) in the Refobacin group (P=0.701). The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores decreased from 44.1 to 7.8 in the Doujet group, and from 44.2 to 6.3 in the Refobacin group (P=0.162). Complications, such as osteolysis or post-operative wound infection, did not occur in more than two cases in both groups. The WOMAC and ROM of the knee in both groups had no clinical differences. Both Doujet and Refobacin similarly showed low complication rates after TKA.

• Journal of Periodontal and Implant Science
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• v.50 no.1
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• pp.38-47
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• 2020

Purpose: The aim of this study was to investigate the available alveolar bone height between the maxillary molars and the sinus floor according to their anatomical relationship using cone-beam computed tomographic (CBCT) images. Methods: A total of 752 maxillary first (M1) and second molars (M2) on CBCT scans of 188 patients were selected. First, each maxillary molar was categorized as type 1, 2, 3, or 4 according to the relationship of the molar root with the maxillary sinus floor. The frequency distribution of each type was analyzed. Second, the shortest vertical distance (VD) of each molar was measured from the furcation midpoints of the roots to the lowest point of the sinus floor by 2 observers. Intraclass correlation coefficients and the t-test were calculated for the VD measurements. Results: For M1, type 3 was the most frequent, followed by type 2. For M2, type 3 was the most common, followed by type 1. The VD measurements of type 1 were 9.51±3.68 mm and 8.07±2.73 mm for M1 and M2, and those of type 3 were 3.70±1.52 mm and 4.03±1.53 mm for M1 and M2, respectively. The VD measurements of M2 were significantly higher in female patients than in male patients. Conclusions: Type 3 was the most frequent anatomical relationship in the maxillary molars, and showed the lowest alveolar bone height. This information will help clinicians to prevent complications related to the maxillary sinus during maxillary molar treatment and to predict the available bone height for immediate implant planning.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.647-653
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• 2007

Rapid crestal bone resorption following maxillary tooth loss is further accentuated in the posterior regions because of pneumatization and enlargement of the maxillary sinuses. A treatment rationale that allows preservation and augmentation of vertical available bone at the time of posterior maxil-lary tooth extraction may offer numerous therapeutic benefits which are more short courses of ther-apy and no needs of additional surgical augmentation. The present study comprised 3 patients who had 4 posterior maxillary teeth with no evident bone between the tooth apex and sinus floor, as estimated through preoperative radiographic analysis. Sinus floor augmentation at the time of tooth extraction was chosen for the ltreatment of these patients. After the tooth was carefully extracted, the empty alveolus was thoroughly debrided and a trephine approach was performed. Particulated autogenous bone was gently pushed beyond the empty alveolus to elevate the sinus membrane using an osteotome. The distance between bone crest and si-nus floor was radiographically estimated 4 months after the first procedure. Another procedure was then carried out to place the implants of 11 mm length without another augmentation procedure. All implant were clinically stable, with no sign of infection. The presented surgical procedure performed at the time of extraction of posterior maxillary teeth in close proximity to the sinus floor allowed placement of implants of proper length.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.5
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• pp.631-639
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• 2000

Root-form endosseous implants which are in use today have a variety of materials, designs and surface characteristics. Among them, pure titanium surface implants and titanium matrix coated with HA are popular as well as are available in many studies. Rate of clinical success is obviously lower in jaw with cancellous bone than dense bone. In order to increase the rate of success in poor bone quality. More advanced techniques of implant surgery and surface treatment of implant fixture body have been developed. As a successful result, the installation of HA coated implant in bone quality type III or IV became highly successful. Since most clinical studies were performed without knowing the characteristics of HA coated implants, it has been impossible to come up with proper clinical data. Therefore the characterization of HA coated implants is essential to understand long term clinical performance and the predictability of HA coated implant system Our results showed that HA coated implants had the success rate at 93.7% in bone quality type III, IV for 3.8 years, and the fixture of Steri-Oss showed more stability with time.