• 제목/요약/키워드: bone healing

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Immunomodulation for maxillofacial reconstructive surgery

  • Kim, Seong-Gon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.5.1-5.9
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    • 2020
  • Immunomodulation is a technique for the modulation of immune responses against graft material to improve surgical success rates. The main target cell for the immunomodulation is a macrophage because it is the reaction site of the graft and controls the healing process. Macrophages can be classified into M1 and M2 types. Most immunomodulation techniques focus on the rapid differentiation of M2-type macrophage. An M2 inducer, 4-hexylresorcinol, has been recently identified and is used for bone grafts and dental implant coatings.

아킬레스건 소매 견열 (Achilles Tendon Sleeve Avulsion)

  • 이우승;정진욱;민병권;여의동
    • 대한족부족관절학회지
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    • 제27권2호
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    • pp.39-42
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    • 2023
  • A ruptured Achilles tendon at the calcaneus attachment, which does not include a bone that can be fixed, is called 'sleeve avulsion'. A small amount of tendon in the calcaneal region can be sutured to the proximal portion of the ruptured Achilles tendon or insufficient bone to be fixed. Hence, tendon-bone healing is expected, but the results are not good compared to other parts of the tear. The incidence of Achilles tendon rupture is 7 to 40 per 100,000 patients, and 25% of patients undergo direct suture or reconstruction surgery, and 7.6% of patients with sleeve avulsion injuries undergo surgery. Surgical treatment may be a better choice for Achilles tendon sleeve avulsion because no successful case of conservative treatment has been reported. Distal wounds above the ruptured tendon adjacent to the bony eminence can have wound healing problems because of the thin, soft tissue and hypovascularity. An appropriate surgical method must be selected for each patient.

Morphometry of the patellar tendon using a simple tracing method: a gold standard for anterior cruciate ligament reconstruction

  • Sabiha Latiff;Oladiran Ibukunolu Olateju
    • Anatomy and Cell Biology
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    • 제56권2호
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    • pp.191-199
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    • 2023
  • The anterior cruciate ligament (ACL) is mostly damaged in sporting activities. To reconstruct the damaged ACL, a patellar tendon (PT) is often the most preferred graft due to its fast healing and bone integration i.e. bone-patellar tendon-bone graft. Suitability of the PT often depends on the morphometric profile of the tendon. This study reported on the harvestable surface area (SA) of the tendon using a simple tracing method. The PT of 79 adult formalin-fixed cadavers of South Africans of European Ancestry were dissected, and the margins of the PT were traced on a wax paper before the tracings were scanned. The SA, straight proximal width (SPW), curved proximal width (CPW), straight distal width (SDW), curved distal width (CDW) and length of tendon (LOT) from the digitized image of the PT was measured. In addition, the length of the lower limbs was measured to normalize the measurements. The results showed no significant side differences, and the measurements were not sexually dimorphic. A strong correlation was reported for SA vs. LOT, SPW vs. CPW and SDW vs. CDW for both sexes and sides. The presented morphological profile provides additional information on the usability of the graft and with respect to healing and recovery.

백서 대퇴골 결손부에 매식된 밀랍지혈제의 조직반응에 관한 실험적 연구 (AN EXPERIMENTAL STUDY OF THE EFFECTS OF BONE WAX ON THE MOUSE FEMORAL BONE DEFECTS)

  • 김장연;한경수;엄인웅;정호용
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제14권3호
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    • pp.228-236
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    • 1992
  • This study was to designed to evaluate the reactions of mouse femoral bone to bone wax. In sixteen mice with a strain of I. C. R. mouse weighed approximately 300 to 850g 2.0~2.0mm sized bone defects were created by drilling. Half of mice were inserted by bone wax and the remainder serving as control without bone wax application. The mice were sacrificed 1, 2, 6, 8 weeks after operation and block specimens were prepared for light microscopy examination. The results obtained were as follows. 1. Histologic features of tissue reaction to bone wax were the presence of inflammatory cell infiltration and multinucleated giant cell. 2. Bone ear healing from the created margin were markedly impaired by the application of bone wax 3. New bone formation was markedly decreased in bone wax application.

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Guided Bone Regeneration in Comminuted Long-Bone Fractures Using Recombinant Human Bone Morphogenetic Protein-2 and a Collagen Membrane

  • Jang, Kwangsik;Jo, Hyun Min;Shim, Kyung Mi;Kim, Se Eun;Kang, Seong Soo
    • 한국임상수의학회지
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    • 제39권2호
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    • pp.59-64
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    • 2022
  • A dog aged two years and seven months and a cat aged seven years were referred owing to fractures of long bones. Preoperative radiographs revealed comminuted bone fractures close to joints. Conventionally, long-bone fractures are treated using intramedullary pins, plate and screw systems, or an external fixator system. In cases of non-reducible fractures, various graft materials have been used in fracture treatments to stimulate bone repair. Here, recombinant human bone morphogenetic protein-2 (rhBMP-2) and a collagen membrane were applied. Four weeks after surgery, fractured bone fragments began to unite and the bone union was observed using radiography four months after surgery. No complications occurred related to grafted materials. We successfully applied rhBMP-2 and collagen membranes in two different species to support the healing process of comminuted fractures, according to the concept of guided bone regeneration.

하악골 결손부의 골형성에 미치는 Bioplant $HTR^{(R)}$의 영향 (THE EFFECT OF BIOPLANT $HTR^{(R)}$(HARD TISSUE REPLACEMENT) ON OSTEOGENESIS OF THE MANDIBULAR BONE DEFECTS IN RABBITS)

  • 최도현;유선열;김옥준;허원실
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권1호
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    • pp.87-94
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    • 2001
  • The present study was performed to investigate the effect of $HTR^{(R)}$ (Hard Tissue Replacement) on osteogenesis in the mandibular bone defects. Eight adult male white rabbits weighing 2.5 to 3.0kg were used. Four bone defects (8mm in diameter and 4mm in depth) were made at the both mandibular body. In the control group, the right mesial bone defect was filled with blood clot and spontaneously healed. In the DFDB group, the right distal bone defect was filled with xenogenic demineralized freeze-dried bone. In the $HTR^{(R)}$ group, the left mesial bone defect was filled with $HTR^{(R)}$. In the $HTR^{(R)}-membrane$ group, the left distal bone defect was filled with $HTR^{(R)}$ and covered with BioMesh membrane. The rabbits were sacrified at 2,4,6 and 9 weeks after the operation and microscopic examination was performed. Results obtained were as follows: In the control and DFDB groups, inflammatory cells and the fibrous connective tissue existed and the bone growth was slower than $HTR^{(R)}$ group by 6 week, and there was intervention of the soft tissue at 9 week. In the $HTR^{(R)}$ group, bone trabeculi extended between the $HTR^{(R)}$ particles without intervention of inflammatory cells and the connective tissue at 4 and 6 weeks. In addition, extensive osseous ingrowth into the $HTR^{(R)}$ particles was observed at 9 week. Bone formation was more active in the $HTR^{(R)}$ group than the control and DFDB groups. There was not obvious difference in the bone healing rate between the $HTR^{(R)}$ and the $HTR^{(R)}-membrane$ group. These results suggest that the $HTR^{(R)}$ promotes osteogenesis in the bone defects and the $HTR^{(R)}$ group has no difference in comparison with the $HTR^{(R)}-BioMesh^{(R)}$ membrane group in bone healing.

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방사선 조사 백서 경골에 티타늄 임플랜트 매식후 골 치유에 관한 연구 (THE EXPERIMENTAL STUDY ON BONE HEALING AROUND TITANIUM IMPLANTS PLACED IN IRRADIATED RAT'S TIBIAE)

  • 곽병학;김종렬;박봉수;신상훈;성일용
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권6호
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    • pp.379-391
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    • 2003
  • The present study was undertaken to evaluate bone regenerative capacity around titanium screw implants placed in irradiated rat's tibiae. At one week after single 15-Gy dose irradiation, miniaturized titanium screw implants were inserted into anterior aspect of the upper tibia of rats weighing 200-250g. Seventy rats were involved: 35 rats were control and 35 rats radiation group. The rats were killed at different intervals as 1, 2, 3, 4, 6, 8, 12 weeks after implantation for histologic observation, histomorphometric analysis and immunohistochemical study with fibronectin and CD34 antibody. 1. Histologically, various stages of bone maturation and ossification can be seen at 4 weeks and regenerated bone close to edges demonstrates more advanced calcification, and network of new bone are well formed at 12 weeks in non-irradiated group. In contrast, active bone formation with increased contact of newly formed bone to implant surface was noted at 4 weeks and a significant amount of new bone formation and bone-implant contact is oberved at 12 weeks in irradiated group. 2. Histomorphometrical analysis confirmed these histologic findings. A significant difference in implant-bone contact and bone density was measured between the control and radiation group. Mean MBD was 62.2% in control group and 27.5% in radiation group, mean MBIC was 86.6% in control group and 47.7% in radiation group, and mean TBIC was 87.3% in control group and 45.6% in radiation group at 12 weeks after implantation. 3. In immunohistochemical study with fibronectin and CD34, radiation reduced hematopoietic progenitor cells severely and disturbed differentiation of osteoblast in bone marrow. The results of this study revealed bone healing capacity around implant after radiation therapy was severely impaired and irradiation reduces the capacity for osseointegration of titanium implants. Many factors including radiation dose, period between radiation and implantation, bone quality, time elapse between first and second surgery, type of prosthetics and hyperbaric oxygen therapy must be considered carefully in postradiation implantation.

성견에 식립된 sandblasted and large-grit and acid-etched 임플란트에서 N-acetyl cysteine(NAC)의 탑재가 주위 골형성에 미치는 영향에 대한 선행연구 (The Effect of N-acetyl cysteine (NAC) loading on the bone formation surrounding sandblasted and large-grit and acid-etched implants in the dog: A pilot study)

  • 서재민;김인주;배민수;이정진;안승근
    • 대한치과보철학회지
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    • 제58권2호
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    • pp.77-85
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    • 2020
  • 목적: N-acetyl cysteine (NAC)를 탑재한 sandblasted and large-grit and acid-etched (SLA) 임플란트를 성견에 식립한 후, 조직형태학적 분석을 통하여 NAC가 SLA 임플란트 주위의 초기 골형성에 미치는 영향을 알아보고자 한다. 재료 및 방법: NAC 탑재 여부에 따라 2개의 실험군으로 구성하였으며, SI 군은 NAC를 탑재하지 않은 SLA 임플란트로, NSI 군은 NAC를 탑재한 SLA 임플란트로 설정하였다. 4마리의 성체 비글 견에 두 실험군의 임플란트를 식립하고(각 군당 n = 8) 술 후 3주와 6주에 각각 2마리의 비글 견을 희생하여 식립된 임플란트 매식체와 주위 골 조직을 채취하였다. 조직 표본을 제작하고 조직형태학적 검사를 통해 골-임플란트 접촉률 및 골면적비율을 계산하였다. NAC 탑재 여부에 따른 각 실험군간 골-임플란트 접촉률과 골면적비율의 유의성을 알아보기 위해 독립표본 t검정을 이용한 통계분석을 시행하였다(α = .05). 결과: 3주차의 경우 NAC를 탑재한 SLA 임플란트가 일반 SLA 임플란트보다 약 1.5배 높은 골-임플란트 접촉률을 보였으나 통계적 유의성은 없었다(51.79 vs 35.43%; P = .185). 골면적 비율에서는 NAC를 탑재한 SLA 임플란트가 일반 SLA 임플란트보다 통계적으로 유의성 있게 높은 결과 값을 보였다(45.09 vs 37.57 %; P = .044). 6주차의 경우 골-임플란트 접촉률과 골면적 비율 모두에서 NAC를 탑재한 SLA 임플란트와 일반 SLA 임플란트가 비슷한 결과 값을 보였다(P > .05). 결론: 본 실험의 한계 내에서 NAC는 SLA 임플란트 주위의 초기 골형성에 긍정적인 영향을 미침으로써 임플란트의 골유착기간을 단축시키고 하중 부담시기를 앞당기는 데에 기여할 것이라고 사료된다.

Resonance frequency analysis를 이용한 non-submerged type 임플란트의 초기 안정성 분석 (Non-submerged type implant stability analysis during initial healing period by resonance frequency analysis)

  • 김득한;방은경;김창성;최성호;조규성
    • Journal of Periodontal and Implant Science
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    • 제39권3호
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    • pp.339-348
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    • 2009
  • Purpose: The purpose of the present study was to analyze the implant stability quotient(ISQ) values for Korean non-submerged type implant and determine the factors that affect implant stability. Methods: A total of 49 Korean non-submerged type implants were installed in 24 patients, and their stability was measured by resonance frequency analysis(RFA) at the time of surgery, and 1, 2, 3, 4, 8, 12 weeks postoperatively. The data for implant site, age, sex, implant length and diameter, graft performing, bone type, and insertion torque were analyzed. Results: The lowest mean stability measurement was at 3 weeks. There was significant difference between implant placement and 12 weeks. There was significant difference between implant placement and 12 weeks in diameters of 4.1 mm and 4.8 mm. Also, there were significant differences between diameters of 4.1 mm and 4.8 mm at implant placement and 12 weeks after surgery. This result suggests that the factor related to implant diameter may affect the level of implant stability. No statistically significant relationship was found between the resonance frequency analysis and the variables of maxilla/mandible, sex, anterior/posterior, implant length, age of patient, graft performing, bone type, insertion torque during initial healing period. Conclusions: These findings suggest that the factor related to implant diameter may affect the variance of implant stability, and ISQ value of implant was stable enough for proved stability level during initial healing period.