• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.35 no.2
• /
• pp.120-124
• /
• 2009

The concept of biostimulation of wounds by low-level laser therapy(LLLT) is attracting considerable attention. Although its effect on whole tissues has been studied quite extensively, the biological and cellular mechanisms underlying LLLT have not been clarified. In an experimental radius fracture in rabbits, Tang and Chai reported that LLLT enhanced the activity of red blood cells, macrophages, fibroblasts, chondrocytes, and osteoclasts within the fracture area. The purpose of the present study was to evaluate the effect of LLLT with a GaAlAs diode laser device on bone healing in rabbit mandibular fractures. We use 12 rabbits for this study. All rabbits were fractured mandible angle area using saw in anesthetic condition. In control group(n=6), none treatment was performed at fracture site. In experimental group(n=6), LLLT with a GaAlAs diode laser was radiated at fracture site daily for 7 days. All rabbits were sacrificed at 6 weeks later from performed fracture day. We studied the immunohistochemical staining of CD34 and Vimentin and the histochemical analysis for calcium and phosphorus content. The results were as follows. 1. In the histological and immunohistological staining, after 6week, fibroblasts, osteogenic cells and collgen fibers were observed more in experimental group than in control group. 2. In the histochemical analysis, the amount of calcium and phosphorus contents of the experimental group were more than the control group. From the results obtained, we suggest that the bone healing is stimulated by low-level laser irradiation in bone fractures.

• Composites Research
• /
• v.23 no.1
• /
• pp.1-7
• /
• 2010

In this paper, finite element analyses for estimating the behavior of fractured femur just after the operation were carried out by using ABAQUS 6.71. A stainless steel bone plate and composite bone plates with various stacking angles were considered to find out the effect of bone plate properties on bone fracture healing. In order to simulate the actual state, contact conditions between the plate and bone and fractured bones were imposed on the finite element models and the whole analysis was divided by two steps; screw fastening step and load bearing step. The stress and strain distributions at the fracture site for the cases of the stainless steel and composite bone plates were analyzed and compared with. From the analyses it was found that the composite bone plate had potential advantages for effective bone fractures healing relieving stress shielding effect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.5
• /
• pp.380-385
• /
• 2011

Introduction: Hydroxyapatite ($Ca_{10}(PO_4)_6(OH)_2$, HA) is the main inorganic phase of human hard tissue that is used widely as the repair material for bones. When HA is applied to a bony defect, however, it can be encapsulated with fibrous tissue and float in the implanted area due to a lack of consolidation. Bioceramics as allogenic graft materials are added to HA to improve the rate and bone healing capacity. Fluoridated hydroxyapatite ($Ca_{10}(PO_4)_6(OH,F)_2$, FHA), where F- partially replaces the OH- in hydroxyapatite, is considered a good alternative material for bone repair owing to its solubility and biocompatibility. Materials and Methods: This study was designed to determine the bone healing capacity of FHA newly produced as a nanoscale fiber in the laboratory. HA and FHA with bioglass was implanted in a rabbit cranium defect and the specimen was analysed histologically. Results: 1. At 4 weeks, fibrous connective tissue and little bone formation was observed around the materials of the experimental group I implanted HA and bioglass. Newly formed bone was observed around the materials in the experimental group II implanted FHA and bioglass. 2. At 8 weeks, the amount of newly formed and matured bone was higher in experimental group II than in experimental group I and the control group. Conclusion: These results suggest that FHA and bioglass is a relatively favorable bone substitute with biocompatibility and better bone healing capacity than pure HA and bioglass.

• Journal of Periodontal and Implant Science
• /
• v.49 no.4
• /
• pp.228-236
• /
• 2019

Purpose: The purpose of this study was to evaluate the synergistic effect of adjunctive hyperbaric oxygen (HBO) therapy on new bone formation and angiogenesis after 8 weeks of healing. Methods: Sprague-Dawley rats (n=28) were split into 2 groups according to the application of adjunctive HBO therapy: a group that received HBO therapy (HBO group [n=14]) and another group that did not receive HBO therapy (NHBO group [n=14]). Each group was divided into 2 subgroups according to the type of bone graft material: a biphasic calcium phosphate (BCP) subgroup and an Escherichia coli-derived recombinant human bone morphogenetic protein-2-/epigallocatechin-3-gallate-coated BCP (mBCP) subgroup. Two identical circular defects with a 6-mm diameter were made in the right and left parietal bones of each rat. One defect was grafted with bone graft material (BCP or mBCP). The other defect was not grafted. The HBO group received 2 weeks of adjunctive HBO therapy (1 hour, 5 times a week). The rats were euthanized 8 weeks after surgery. The specimens were prepared for histologic analysis. Results: New bone (%) was higher in the NHBO-mBCP group than in the NHBO-BCP and control groups (P<0.05). Blood vessel count (%) and vascular endothelial growth factor staining (%) were higher in the HBO-mBCP group than in the NHBO-mBCP group (P<0.05). Conclusions: HBO therapy did not have a positive influence on bone formation irrespective of the type of bone graft material applied after 8 weeks of healing. HBO therapy had a positive effect on angiogenic activity.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.2
• /
• pp.179-185
• /
• 2000

The purpose of this study was to develop an osteogenic, biodegradable material using polymer and BMP. It was designed to have structural function and be moldable, for the reconstruction of load bearing areas and deformities of various configurations. Bone apatite was added to Poly(L-lactide)(PLLA) and made porous for osteoconductability and ease of BMP loading. The materials, with or without BMP purified from porcine bone matrix, were evaluated in cranial bone defect models in rats for biocompatibility and bone regeneration capability. The following results were obtained: The PLLA-BMP material with BMP added to the polymer showed 30% healing of cranial bone defects in rats during the 2 weeks to 3 months period of observation. The moldable PLLA agent without BMP also showed 25% bone healing capacity. Although new bone formation was incomplete in the critical size defect of rat cranium, it can be concluded that the unique moldability of those agents makes them useful for the reconstruction of various bone defects and maxillofacial deformities.

• Composites Research
• /
• v.20 no.5
• /
• pp.7-12
• /
• 2007

This paper aims to enhance the efficiency of bone fracture healing with bone plate made of fiber reinforced composite materials. The composite bone plate was designed as the same dimension and shape as the existing stainless steel bone plate. To find out the appropriate stacking sequence of the composite bone plate the variations of strain distributions were calculated using FE analysis when the bone plates were applied to the fracture site. From the analysis result it was found that the composite bone plate whose Young's modulus is lower than that of metal bone plate gave more uniform strain distribution and provided appropriate condition for callus formation and its development.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.4
• /
• pp.746-757
• /
• 1996

Bony defects may be found as a result of congenital anomalies, traumatic injury, automobile collisions and industrial accidents in the maxillofacial area. Such conditions are often associated with severs functional and esthetic problem. Various surgical procedure has been utilized in attempts to repair and reconstruct bony defects. Bone is a complex, living, constantly changing tissue. The architecture and composition of cancellous and cortical bone allow the skeleton to perform its essential mechanical functions. Periosteum covers the external surface of bone and consists of two layers : an outer fibrous layer and an inner more cellular and vascular layer. The inner osteogenic layer or cambium layer can form new bone while the outer layer firms part of the insertions of tendons, ligaments and muscles. This study was under taken to evaluate bone healing process on partial defect of calvarial bone with or without periosteum in rat. We made calvarial defects of different size(4mm, 6mm, 8mm) with periosteum or without periosteum in rat to study the effect of defect size on healing process. Control and experimental groups sacrified at 1, 2, 4, 6, 8 weeks, postoperatively. We examed the specimens by gloss findings, light microscophy, and fluorescent microscophy. The results were as follows. 1. Gloss findings: Control groups are larger bony defects than experimental groups after 2 weeks, and than control groups advanced healing of defected bone but experimental groups are lesser after 4, 6 weeks. After 8 weeks, bone defect has not been identified in control and experimental groups. 2. Light microscope: All defects of control groups are larger bony defects than experimental groups after 2 weeks. And than control groups show smaller defect after 4 weeks. After 8 weeks, the control group reveal pin-point sized, hardly identifiable defect space and the experimental group reveal small, but definite defect space. 3. Fluorescent microscope : Each week, new bone formation of control group is very similar to the experimental group. In this study, Osteogenesis of calvarial bone defects with periosteum or without periosteum was examined for 8 weeks in rats. The replaced periosteum had batter new bone formation than the removed periosteum.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.31 no.5
• /
• pp.417-421
• /
• 2005

This study was to analyze the changes of levels of alkaline phosphatase before and after enucleation of jaw cysts combined with bone grafting, and to evaluate biochemically the effectiveness of the early detection of bone healing and infection as a prognostic marker. Eighteen patients (13 males, 5 females) with cystic lesions of the jaws were divided into two groups. The bone graft group underwent enucleation and bone graft. The control group underwent only enucleation. Both groups were measured levels of ALP before surgery, and plus-minus 4 weeks postoperatively. The more discriminating results were obtained in the bone graft group. The results were as follows : 1. Levels of ALP after enucleation of jaw cysts were decreased in all patients with and without bone graft. 2. The bone graft group showed more marked decrease in variation of levels of ALP than the control group.(p=0.008) This should be considered as a result of increased osteoblastic activity and new bone formation. 3. Such variation could be used as a prognostic marker for bone healing after cyst operation. In the cost/benefit ratio, measurement of ALP activity could be useful as a convenient procedure in routine clinical practice.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.1
• /
• pp.30-35
• /
• 2011

Introduction: Dental implants are used routinely with high success rates in generally healthy individuals. By contrast, their use in patients with diabetes mellitus is controversial because altered bone healing around implants has been reported. This study examined the bone healing response around titanium implants placed immediately in rats with controlled and uncontrolled diabetes. Materials and Methods: Twenty rats were divided into the control, insulin-treated and diabetic groups. The rats received streptozotocin (60 mg/kg) to induce diabetes; animals in the insulin-treated group also received three units of subcutaneous slow-release insulin. A titanium implant ($1.2{\times}3\;mm$) was placed in the extraction socket of the maxillary first molar and bone block was harvested at 1, 2 and 4 weeks. Results: Bone formation around the implants was consistently (from 1 to 4 week post-implantation) slower for the diabetic group than the control and insulin-treated group. Bone morphogenesis in the diabetic rats was characterized by fragmented bone tissues and extensive soft tissue intervention. Conclusion: The immediate placement of titanium implants in the maxilla of diabetic rats led to an unwanted bone healing response. These results suggest that immediate implant insertion in patients with poorly controlled diabetes might be contraindicated.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.45 no.1
• /
• pp.34-42
• /
• 2019

Objectives: Various bone graft substitute materials are used to enhance bone regeneration in the maxillofacial skeleton. In the recent past, synthetic graft materials have been produced using various synthetic and natural calcium precursors. Very recently, eggshell-derived hydroxyapatite (EHA) has been evaluated as a synthetic bone graft substitute. To assess bone regeneration using EHA in cystic and/or apicectomy defects of the jaws through clinical and radiographic evaluations. Materials and Methods: A total of 20 patients were enrolled in the study protocol (CTRI/2014/12/005340) and were followed up at 4, 8, 12, and 24 weeks to assess the amount of osseous fill through digital radiographs/cone-beam computed tomography along with clinical parameters and complications. Wilcoxon matched pairs test, means, percentages and standard deviations were used for the statistical analysis. Results: The sizes of the lesions in the study ranged from 1 to 4 cm and involved one to four teeth. The study showed significant changes in the formation of bone, the merging of material and the surgical site margins from the first week to the first month in all patients (age range, 15-50 years) irrespective of the size of the lesions and the number of teeth involved. Bone formation was statistically significant from the fourth to the eighth week, and the trabecular pattern was observed by the end of 12 weeks with uneventful wound healing. Conclusion: EHA showed enhancement of bone regeneration, and healing was complete by the end of 12 weeks with a trabecular pattern in all patients irrespective of the size of the lesion involved. The study showed enhancement of bone regeneration in the early bone formative stage within 12 weeks after grafting. EHA is cost effective and production is environment friendly with no disease transfer risks. Thus, natural bioceramics will play an important role in the reduction of costs involved in grafting and reconstruction.