• Journal of Periodontal and Implant Science
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• 제38권3호
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• pp.437-444
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• 2008

Purpose: A number of techniques and materials have been used for periodontal regeneration and bone graft procedures with guided tissue regeneration(GTR) have been suggested as alternatives to osseous surgery in the management of local infra-bony defects. However, the long-term stability and treatment outcome following bone graft procedure of infra-bony defects is poorly documented. The purpose of this study was to assess radiographic change in infra-bony defects over 2 years after bone graft procedures with various graft materials. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients showed clinical and radiographic evidence of infra-bony defect(s). 44 sites of 34 patients aged 31 to 69 (mean age 48.3) were treated by bone graft procedure with a bone graft material. Baseline and 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, defect depth, defect angle, bone graft materials) using the paired t-test were examined. Result: We observed $1.15{\pm}1.95\;mm$ of bone fill, $0.40{\pm}1.19\;mm$ of crestal resorption, $1.55{\pm}1.77\;mm$ of defect resolution, and $40{\pm}44%$ of percentage of defect resolution. Deeper initial defect depth, narrower initial defect angle showed significantly greater bone fill, defect resolution, and % of defect resolution. But no significant difference was observed in graft sites and graft materials. Conclusion: If good oral hygiene maintenance and periodic recall check of patients is assured, bone graft procedure using various graft materials is one of the appropriate treatment modality for regenerative therapy of infra-bony defects.

• International Journal of Oral Biology
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• 제39권3호
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• pp.153-157
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• 2014

Natural biopolymers such as collagen and fibrin have been widely used in bone regenerative applications. Despite the frequent use, their comparative biological propertiesis are largely unknown. In a previous study, we found the superiority of fibrin to collagen in the adsorption of serum proteins and the proliferation and differentiation of cultured osteoblasts. In this study, we used an in vivo model to evaluate how effectively fibrin supports bone regeneration, as compared with collagen. Collagen and fibrin were placed in critical size defects made on rat calvarial bones. Compared with collagen, fibrin supported substantially more new bone tissue formation, which was confirmed by micro-CT measurement and histological analyses. The cells in the regenerative tissues of the fibrin-filled defects were immunostained strongly for Runx2, while collagen-placed defects were stained weakly. These in vivo results demonstrate that fibrin is superior to collagen in supporting bone regeneration.

• Journal of Periodontal and Implant Science
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• 제31권1호
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• pp.57-74
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• 2001

The purpose of this study was to evaluate the adjunctive combined effect of demineralized freeze-dried bone allograft(DFDB) in guided bone regeneration on supra-alveo-lar peri-implant defect. Supra-alveolar perio-implant defects, 3mm in height, each including 4 IMZ titanium plasma-sprayed implants were surgically created in two mongrel dogs. Subsequently, the defects were treated with 1 of the following 3 modalities: Control) no membrane or graft application, Group1) DFDB application, Group2) guided bone regeneration using an expanded polytetra-fluoroethylene membrane, Group3) guided bone regeneration using membrane and DFDB. After a healing period of 12-week, the animals were sacrificed, tissue blocks were harvested and prepared for histological analysis. Histologic examination were as follows; 1. New bon formation was minimal in control and Group 1, but considerable new bone formation was observed in Group 2 and Group 3. 2. There was no osteointegration at the implant-bone interface in the high-polished area of group2 and Group 3. 3. In fluorescent microscopic examination, remodeling of new bone was most active during week 4 and week 8. There was no significant difference in remodeling rate between group 2 and group 3. 4. DFDB particles were observed, invested in a connective tissue matrix. Osteoblast activity in the area was minimal. The results suggest that guided bone regeneration shows promising results in supra-alveolar peri-implant defects during the 12 week healing period although it has a limited potential in promoting alveolar bone regeneration in the high-polished area. There seems to be no significant adjunctive effect when DFDB is combined with GBR.

• Journal of Periodontal and Implant Science
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• 제52권5호
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• pp.370-382
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• 2022

Purpose: The aim of this study was to evaluate the preclinical results of 2 types of commercially available deproteinized bovine bone mineral (DBBM) when applied to alveolar bone defects in dogs. Methods: This study was conducted using 6 beagles. Alveolar defects in the mandible were formed and filled with 2 DBBMs produced by a similar procedure. Defects were randomly assigned to be filled using DBBM 1 or 2. All defects were covered with a collagen membrane and had a healing period of 12 weeks. After the dogs were sacrificed, histological, histomorphometric, and linear/volumetric analyses were performed. Results: Both DBBM groups showed similar histological findings, demonstrating that bone remodeling had occurred and new bone had formed. The residual bone particles were surrounded by newly formed vital bone. In the histomorphometric analysis, the ratio of the area of vital bone and residual bone substitute in DBBM 2 (38.18% and 3.47%, respectively) was higher than that of DBBM 1 (33.74% and 3.41%, respectively), although the difference was not statistically significant. There were also no statistically significant differences between both groups in linear and volumetric analyses using micro-computed tomography scans and digitized images of dental casts. Conclusions: In the present study, DBBM 1and 2, which were produced by similar processes, showed similar results in histological, histomorphometric, and volumetric analyses. Further studies are needed to identify more specific differences between the 2 DBBMs.

• Biomaterials and Biomechanics in Bioengineering
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• 제5권1호
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• pp.25-35
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• 2020

We carry the knowledge that the skeleton bones of the human body are not always without defects and some various defects could occur in them. In the present paper, as the first endeavor, free vibration and buckling analysis of femur bones with femoral defects are investigated. A major strength of this study is the modeling of defects in femur bones. Materialise Mimics software is adopted to model the bone geometry and the SOLIDWORKS software is used to generate the defects in bones. Next, the ABAQUS software is employed to study the behaviors of bones with defects.

• 한국임상수의학회지
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• 제27권6호
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• pp.652-662
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• 2010

개에서 넙다리뼈 뼈겉질에 결손을 유발하여 뼈 이식재로 사용하는 calcium sulfate (CS), demineralized bone matrix (DBM), calcium metaphosphate (CMP)를 이식하여 뼈 재생 효과를 비교 분석하였다. 비글견 9두, 총 18개의 넙다리뼈에 각각 4개의 결손부를 외과적으로 유발하고, 이 중 3 곳에는 CS, DBM, CMP를 각각 이식하고 나머지 하나는 대조군으로서 총 4개의 군으로 나누어 관찰하였다. 방사선 검사는 수술 전, 수술 후 4, 8, 24주에 실시하였으며, 조직 검사는 4, 8, 24주에 안락사 후에 실시하였다. 방사선 검사에서는 시간 경과에 따른 이식재의 분해성을 관찰할 수 있었으며 뼈겉질의 치유가 이루어짐을 확인하였다. CS군은 빠르게 흡수되어 뼈겉질을 형성하였으며, DBM군은 이식재 주위에 뼈가 형성되면서 점차적으로 겉질뼈를 채우는 양상을 보였다. CMP군은 빠르게 흡수되지 않고 24주가 지난 후에도 이식재 잔여물이 남아 뼈 겉질의 구조적 역할을 수행하면서 뼈를 형성하였다. 방사선 intensity는 대조군이 모든 실험군에 비해서 유의성 있게 낮았다 (p < 0.05). 조직학적 검사에서 CS,DBM,CMP 모두 대조군과 비교할 때 뼈 재생을 촉진시켰으며 (p < 0.05), 뼈 겉질 결손 시 입자 공간이 다소 넓은 DBM보다 CMP가, CMP보다 CS가 뼈 접합체로 적합하였다. CS, DBM, CMP 모두 상당 양의 뼈를 형성하여, 뼈 재생 촉진에 효과적인 것으로 판단되었다.

• Journal of Periodontal and Implant Science
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• 제28권1호
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• pp.87-102
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• 1998

The purpose of this stuffy was to assess and compare the osseous responses to implanted particles of porous synthetic HA (Interpore $200^{(R)}$, Interpore International, U.S.A.), resorbable natural bovine derived HA (Bio-$oss^{(R)}$, Gestlich Pharma, Switzerland) and calcium carbonate(Biocoral $450^{(R)}$, Inoteb, France) in bone defects. Four calvarial defects of 2.5mm diameter were created in earth of 16 Sprague-Dawley rats. The experimental materials were subsequently implanted hi three defects, leaving the fourth defect for control purpose. Four animals were earth sacrificed at 3 days, 1week, 2weeks and 4 weeks after surgery. The tissue response was evaluated under light microscope. Overall, histologic responses showed that all the particles were well tolerated and caused no aberrent tissue responses. There were difference in the amount of newly formed bone at the experimental sites and control site. There was more new bone formation associated with calcium carbonate site. In addition, the calcium carbonate site displayed multinucleated giant cells surrounding calcium carbonate particles after the 1st week, and osteoid tissue within the particle after the 2nd week. After 4 weeks, calcium carbonate particles were resorbed and replaced with new bone. The healing of the natural bovine derived HA site was similar to that of porous synthetic HA, except that new bone growth between the two particles have progressed more in the former site after the 2nd week. In the natural bovine derived HA site, the particle was surrounded by newly formed bone after the 4th week. After 4 weeks, the control site showed more mature bone than other sites. In conclusion, the grafted site were better in new bone formation than non-grafted sites. In particular the calcium Carbonate site showed the ability of osteoinduction and natural bovine denver HA showed osteoconduction in rat calvarial defects. This suggest that calcium carbonate and natural bovine derived HA could enhance the regenerative potential in periodontal defects.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.519-540
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• 1999

The purpose of this study is to compare the healing aspects of the use of ePTFE membrane alone versus combination treatment of ePTFE membrane and bone grafts on class II furcation defects. Seventeen defects were applied ePTFE membrane alone on mxillary molar buccal class II furcation defects as Group I, seventeen defects were applied ePTFE membrane and bone grafts on maxillary molar buccal class II furcation defects as Group II, twenty-three defects were applied ePTFE membrane alone on mandibular molar buccal class II furcation defects as Group III, twenty defects were applied ePTFE membrane and bone grafts on mandibular molar buccal class II furcation defects as Group IV . Measurements were made to determine clinical attachment level, probing depth, gingival depth, SBI, mobility at baseline, 3, 6, 12 months postoperatively. Additional measurements were made to determine membrane exposure level at surgery, 1, 2, 6 weeks postoperatively. And then healing patterns and postoperative complications were evaluated. The result as follows : There were statistically significant differences in probing depth reduction, clinical attachment gain, mobility reduction at values of 3, 6, 12 months postoperatively compared to values of baseline(p<0.05), whereas no significant differences in SBI and gingival recession. In group II, membrane exposure level was increased at 1, 2, 6 weeks postoperatively compared to value of baseline(p<0.05). There were statistically significant differences in changes of probing depth at 3, 6, 12 months postoperatively in combination groups of ePTFE membrane and bone graft compared to groups of ePTFE membrane alone(p<0.05). The vast majority of cases fall into typical healing and delayed healing response when membranes were removed in all groups. Pain and swelling were common postoperative complications. In conclusion, this study was showed more effective healing aspects in combination treatment of ePTFE membrane and bone graft than ePTFE membrane alone and on mandibular molar class II furcation defects than maxillary molar.

• 한국임상수의학회지
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• 제34권6호
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• pp.410-413
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• 2017

Composites of hydroxyapatite (HAp) and chitosan (CS) have been successfully used in bone healing in humans and animals. However, the characteristics of HAp and CS are different. Therefore, the effects of HAp/CS composites on canine bone formation could differ according to their ratio. This study investigated the therapeutic effects of different contents ratios (100, 80:20, 60:40 wt%) on bone defects in a canine model. Thirty intrabony cylindrical defects were created in the humeruses and femurs of 5 beagle dogs, and then the defects were implanted with different composites. The evaluations were performed using radiographs obtained at 10 weeks post-surgery and by histological findings. In radiographic evaluation including the grades of bone filling, periosteal and endosteal reactions, pure hydroxyapatite composite had a significant effect on bone filling, and chitosan containing the composites showed vigorous responses at the periosteum and endosteum. In histological findings, the defect implanted with pure hydroxyapatite had healed completely into mature bony tissue with an obvious osteon structure, and the defect implanted with chitosan containing the composites had the amount of fibrous connective tissue increased significantly within the cortical bone tissue. The results indicate that hydroxyapatite/chitosan composites are therapeutically useful, promoting effective bone healing in defects when the ratio of hydroxyapatite is high and enhanced fibrous connective tissue formation at the periosteum as more chitosan is added.

• Hip & pelvis
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• 제36권2호
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• pp.101-107
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• 2024

Treatment of femoral bone defects continues to be a challenge in revision total hip arthroplasty (THA); therefore, meticulous preoperative evaluation of patients and surgical planning are required. This review provides a concise synopsis of the etiology, classification, treatment strategy, and prosthesis selection in relation to femoral bone loss in revision THA. A search of literature was conducted for identification of research articles related to classification of bone loss, management of femoral revision, and comparison of different types of stems. Findings of a thorough review of the included articles were as follows: (1) the Paprosky classification system is used most often when defining femoral bone loss, (2) a primary-length fully coated monoblock femoral component is recommended for treatment of types I or II bone defects, (3) use of an extensively porous-coated stem and a modular fluted tapered stem is recommended for management of types III or IV bone defects, and (4) use of an impaction grafting technique is another option for improvement of bone stock, and allograft prosthesis composite and proximal femoral replacement can be applied by experienced surgeons, in selected cases, as a final salvage solution. Stems with a tapered design are gradually replacing components with a cylindrical design as the first choice for femoral revision; however, further confirmation regarding the advantages and disadvantages of modular and nonmodular stems will be required through conduct of higher-level comparative studies.