Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제30권6호
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pp.455-464
/
2004
The purpose of this study was to evaluate and compare the influence of Steroid topical irrigation and implant surface on bone healing in the irradiated rabbit tibia. Implant to bone contact surface ratio and the pattern of bone healing around hydroxyapatite(HA) coated implant and pure titanium (Ti) implant which were inserted into the irradiated rabbit tibia were compared. 16 Korean house mature male rabbits were used as experimental animal. Each rabbit received 15 Gy of irradiation. 4 weeks after the irradiation, two holes were prepared in the irradiated tibia of each rabbits, where two surface type of implants were inserted :1) HA coated type and 2) pure Ti type. Right before placing implants, one group of rabbit received steroid irrigation and the other group did saline. After the irrigation, two implants of HA coated type and pure Ti type were inserted into the tibia of each rabbits. Each rabbit were sacrificed at 2nd, 4th, and 8th week after the implantation and the specimens were observed by the light microscope. The pattern of bone healing and histomorphometric analysis of the implant-bone interface were done. The results were as follows. 1. All implants inserted into the irradiated tibia of rabbit did not show any sign of clinical mobility and the bone around implants inserted into the irradiated tibia of rabbit did not show any resorption. 2. The bone to implant contact surface ratio around HA coated implants that received steroid irrigation got more bone to implant contact surface ratio than that of the saline irrigation. This result showed statistically significant(p<0.05). There was no statistically significant difference in 8th week group. 3. Though there was no statistically significant difference HA coated implants had more bone to implant contact surface ratio than pure Ti implant in 2nd and 4th groups, and there was no difference in 8th week group. 4. All implants inserted into the irradiated tibia of rabbit had exhibited successful osseointegraion.
Yi Yang-Jin;Yang Jae-Ho;Lee Sun-Hyung;Kim Yung-Soo;Kwon Sang-Ho
대한치과보철학회지
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제39권6호
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pp.659-681
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2001
Platelet-rich plasma(PRP) has been known to increase the rate and degree of bone formation by virtue of growth factors in concentrated platelets. Although its great healing effect on bone defect or pre-implantation site preparation in conjunction with bone substitute has been reported, the effect associated with implant is unknown. The purpose of this study was to investigate the effect of PRP on rapid osseointegration of endosseous dental implants in the rabbit tibiae. Twenty two adult female New Zealand white rabbits, weighing approximately 2.7-3.3kg, were used for this study. Twelve of the 22 animals were used for histomorphometric analysis and ten of the 22 were for removal torque test. Each animal received two implants in each tibia (two treated with PRP and two as control) and was given fluorochrome intramuscularly. For histomorphometric analysis, rabbits were divided into four groups according to the healing period. At 1 week, 2 weeks, 4 weeks and 8 weeks postoperatively, each three animals were sacrificed serially and the amount and rate of bone formation around dental implant were examined on the undecalcified sections under fluorescent microscope, polarized microscope and light microscope connected to a personal computer equipped with image analysis system. For removal torque test, rabbits were divided into two groups and removal torque tests were performed at 4 weeks, 10 weeks after implant placement. In total, 88 screw shaped, commercially pure titanium implants (Neoplant, Neobiotech, Seoul, Korea) were used in this study. Labeling pattern reflected differences of two groups in bone formation rate at each period. Histomorphometrically, PRP group showed significantly higher bone volume within threads compared to control group at 2 weeks ($70.30{\pm}4.96%$ vs. $50.68{\pm}6.33%$; P < .01) and 4 weeks ($82.59{\pm}5.94%$ vs. $72.94{\pm}4.57%$; P < .05 ). PRP group at 1, 2 and 4 weeks revealed similar degree of bone volume formation comparable to control group at 2, 4 and 8 weeks, respectively. On the other hand, while PRP group showed higher bone-implant contact ($47.37{\pm}8.09%$) than control group ($33.16{\pm}13.47%$) at 2 weeks, there were no significant differences between PRP group and control group for any experimental period. Removal torque values also showed no significant differences between PRP group and control group at any experimental period (P > .05). These findings imply that PRP could induce rapid, more bone formation around implant during early healing period and get faster secondary stability for reducing healing period, though it has not induced bone maturation enough to resist functional loading.
Intraosseous phlebography was performed to determine the healing effect of the dosing treated with vitamin-D$_3$ and/or calcium phosphate on the fractured bone in male rabbits. Femoral shafts of 16 adult male rabbits were fractured and these animals were divided into 3 treated groups and 1 control group l. The 1st treated group of rabbits was dosed with vitamin-D$_3$(VD), the 2nd treated group of rabbits was given calcium phosphate(CP), and the 3.d treated group of rabbits received vitamin-D$_3$ and calcium phosphate. The control group of rabbits was dosed with saline alone. Radiographs were taken weekly in each rabbit over 6 weeks period and the results obtained were as follows. 1. Sinusoidal vein was visualized at 3rd week in eve animal received CP and VC, at 5 week in animals received VD and in control animals. 2. Main nutrient vein was observed more clearly in treated groups than in control group of animals. 3. These results indicate that venous reconstruction of the fractured bone in groups of rabbits received CP and VC was earlier and more complete than those of other groups of rabbits. 4. Therefore, intraosseous phlebography is suitable for determination of the bone healing effect of vitamin-D$_3$ and/or calcium phosphate in femoral fractured rabbits.
Many surgeons are on the point of bone excision and reconstruction of the bone defects by autograft. xenograft, and allograft in the treatment of begin and malignant tumors of bone. Of all type of bone grafts, we received the autograft as the best ideal bone graft. Of autogenic bone graft, replantation of excised autogenic bone for reconstructiong the bone defects has been the ideal method until now, but early bone healing reponses and tumor cell devitalization after replantation of excised autogenic bone have not been identified for clinical applications. So, to evaluate bone healing response after replantation in rabbit's calvarial bone, we divided the experimental group into three groups. Group 1 is a fresh autogenous bone group. Group 2 is a deep frozen group. Group 3 is freeze-dried demineralized group. Obtained result were as followed: 1. Inflammatory cell infiltration appeared at I week and disappeared at 4 weeks in all experimental group, Especially, severe inflammatory cell infiltration showed in fresh autogenous bone group at 2 weeks. Group 3 is the least showing group on the point of inflammatory cell infiltration. 2. Osteoblastic activity evenly increased upto 4 weeks and maintained to 6 weeks and decreased after this period, especially osteoblastic activity in group 2 is less than group 1 and group 3. We can't discriminate between osteoblastic activity of group 1 and that of group 3. 3. In new bone formation, group 3 was more active than any other groups at early stage, but there were little differences among three experimental groups at later state. 4. Bone resorption around the grafted bone slightly appeared at 1 week and disappeared at 4 weeks in all experimental groups. We can find the more bone resorption in group 2 at 2 weeks than any other groups. We could suggest, as appears from our results, that freeze-dried deminiralized bone graft is the useful bone graft in the clinical applications of excised autogenic bone.
Purpose: In the previous in vitro studies the bone marrow stromal cells(BSCs) have shown the superior effect for wound healing activity than fibroblasts, which includes cell proliferation, type I collagen synthesis, and the production of bFGF, VEGF and TGF-${\beta}$ in chronic wound healing. The aim of this study is to compare the effects of BSCs and fibroblasts on wound healing activity in vivo, especially on collagen synthesis. Methods: The fibroblasts and BSCs were harvested from patients and cultured. The cultured cells were infiltrated into the pores of polyethylene discs. These discs were divided into three groups according to the mixed cells. In groups I, II and III the discs were loaded with no cells, fibroblasts and BSCs, respectively. Twelve discs per group(total 36 discs) were made for this study. After creating 6 pockets in the back of each rats, each discs was implanted into each pockets. At three time intervals from 1 to 3 weeks, the implanted discs were harvested for the histological and quantitative analysis. The amount of collagen produced was evaluated using ELISA. Statistical comparisons were made using the Mann-Whitney U-test. Results: There was great difference in the collagen synthesis among the three groups by the 1st and 2nd weeks. The BSC group showed highest collagen level, followed by fibroblast group and no cell group(p<0.05). The 3rd week specimens also showed greater collagen amount in BSC and fibroblast groups compared to those of no cell group(p<0.05). However, there was little difference between BSC and fibroblast groups. Conclusion: This result demonstrates that BSC has superior effect on stimulating wound healing than fibroblast, which is currently used for wound healing.
Tibial defect, or fracture is very routine musculoskeletal case which brings fully uncomfortable and painful situations to patient. Moreover, it has long hospitalization period because of its risk of non-union. There are many studies using ultrasound, vibration, and laser for bone regeneration to figure out fast bone healing. Among them, Low Level Laser Therapy (LLLT) is already known that it is very easy to treat and may have positive effect for bone regeneration. However, LLLT has uncertain energy dose because of scattering and absorption of laser in tissue. In this study, we used interstitial LLLT to treat tibial defect in animal study. The Interstitial LLLT can overcome some limitations caused by laser scattering or absorption in tissue medium. The results were evaluated using u-CT which can calculate X-ray attenuation coefficient and bone volume of bone defect area. These results showed that interstitial LLLT may affect fast bone healing process in early phase.
The aim of this study was to describe the clinical availability of a variety of facial bone grafts in oral and maxillofacial surgery. Thirty patients with oral and maxillofacial bone defects were treated with mandible, maxilla, and zygoma bone grafts. The ages of the patients ranged from 8 to 64 years, with a mean age of 28.6 years. The follow-up period ranged from 2 to 30 months, with a mean follow-up of 11.7 months. Although postoperative follow-up was of short duration, the recilient sites were favorable to healing and bone consolidation. Healing progressed normally without severe morbidity. The donor site did not present a management problem in any of the patients.Some minor complications developed in 8 patients, of which three were infections and another three were wound dehiscence. There complications were easily managed with incision and drainage, antibiotics and local wound care. We consider that a variety of facial bone grafts can be used for reconsider that a variety of facial bone grafts can be used for reconstruction of small or moderate large bony defects.
Purpose: This study investigated the osteoconductivity of natural calcium carbonate-derived bone substitutes, hen eggshell (ES), and compared with those of commercial bone substitutes. Materials and Methods: Osseous defects created in the rat calvaria were filled with particulated ES(ES-1), ES with calcium-deficient hydroxyapatite surface layer (ES-2), Biocoral(Inoteb, France), and Bio-Oss(Geistlich Pharma, Wolhusen, Switzerland). After 4 and 8 weeks of healing, histomorphometic analysis was performed to evaluate the amount of newly formed mineralized bone area (NB%). Results: Histologic and histomorphometric analysis showed new bone formation and direct bony contact with the grafted materials in all groups. At 4 weeks, Biocoral group showed greater NB% compared to Bio-Oss and ES-1 groups (P<0.05). At 8 weeks, Biocoral and ES-2 groups showed significantly greater NB% compared to Bio-Oss group (P<0.05). Conclusion: These results indicate that natural calcium carbonate-derived bone substitutes with microporous calcium-deficient hydroxyapatite surface layer may be an effective materials treating osseous defects.
Purpose: The hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) are widely used in the treatment of dyslipidemia for the lowering of cholesterol. And studies about simvastatins have been shown to enhance bone formation in vitro and in vivo in rodents. But some other researchers have reported that there was no anabolic effect abouts simvastatins on bone. The peripheral distribution beyond the liver represents a small fraction of an orally administered dose. We hypothesize that this poor peripheral distribution is the likely reason that simvastatins, yield ambiguous results as anabolic agents. We therefore investigated whether the effects of simvastatins on bone may be enhanced by subcutaneous administration, providing better peripheral delivery of these drugs. Methods: 36 rat unilaterally mandible fractured models were prepared and divided into two groups. The simvastatin treated group where 1 mg/kg of simvastatin was daily injected subcutaneously. The same dose of normal saline was injected on the control group. And 3 rats in each group were sacrificed and taken bone samples in each week. Bone sample was evaluated with tensile strength and histological morphology after 1, 2, 3, 4, 5 and 6 weeks. Results: In simvastatin treated group, the fracture healing process, chondrocyte aggregation, collagen formation and trabecular bone formation was rapidly proceeded than the control group in histologically. The tensile strength of the simvastatin treated group was 1.02, 2.25, 3.95, 4.42, 5.49 and $6.00N/mm^2$ by weeks. The control group data was 0.60, 1.05, 2.17, 3.75, 4.15 and $5.17N/mm^2$ by weeks. The average tensile strength was higher by $1.04N/mm^2$ in simvastatin treated group. Conclusion: The currently available data on the effects of simvastatin on bone has done to confirm the finding that simvastatin helps fracture healing. And the potential for simvastatin to be used as anabolic agents for bone when delivered by the subcutaneous route.
Jae-Hong Lee;Hyun-wook An;Jae-Seung Im;Woo-Joo Kim;Dong-Won Lee ;Jeong-Ho Yun
Journal of Periodontal and Implant Science
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제53권4호
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pp.306-317
/
2023
Purpose: Biphasic calcium phosphate (BCP), a widely used biomaterial for bone regeneration, contains synthetic hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), the ratio of which can be adjusted to modulate the rate of degradation. The aim of this study was to evaluate the clinical and radiographic benefits of reconstructing peri-implant bone defects with a newly developed BCP consisting of 60% β-TCP and 40% HA compared to demineralized bovine bone mineral (DBBM). Methods: This prospective, multicenter, parallel, single-blind randomized controlled trial was conducted at the periodontology departments of 3 different dental hospitals. Changes in clinical (defect width and height) and radiographic (augmented horizontal bone thickness) parameters were measured between implant surgery with guided bone regeneration (GBR) and re-entry surgery. Postoperative discomfort (severity and duration of pain and swelling) and early soft-tissue wound healing (dehiscence and inflammation) were also assessed. Data were compared between the BCP (test) and DBBM (control) groups using the independent t-test and the χ2 test. Results: Of the 53 cases included, 27 were in the test group and 26 were in the control group. After a healing period of 18 weeks, the full and mean resolution of buccal dehiscence defects were 59.3% (n=16) and 71.3% in the test group and 42.3% (n=11) and 57.9% in the control group, respectively. There were no significant differences between the groups in terms of the change in mean horizontal bone augmentation (test group: -0.50±0.66 mm vs. control groups: -0.66±0.83 mm, P=0.133), postoperative discomfort, or early wound healing. No adverse or fatal complications occurred in either group. Conclusions: The GBR procedure with the newly developed BCP showed favorable clinical, radiographic, postoperative discomfort-related, and early wound healing outcomes for peri-implant dehiscence defects that were similar to those for DBBM.
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