• The Journal of Advanced Prosthodontics
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• v.6 no.6
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• pp.521-527
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• 2014

This case series evaluated the clinical efficacy of autogenous tooth bone graft material (AutoBT) in alveolar ridge preservation of an extraction socket. Thirteen patients who received extraction socket graft using AutoBT followed by delayed implant placements from Nov. 2008 to Aug. 2010 were evaluated. A total of fifteen implants were placed. The primary and secondary stability of the placed implants were an average of 58 ISQ and 77.9 ISQ, respectively. The average amount of crestal bone loss around the implant was 0.05 mm during an average of 22.5 months (from 12 to 34 months) of functional loading. Newly formed tissues were evident from the 3-month specimen. Within the limitations of this case, autogenous tooth bone graft material can be a favorable bone substitute for extraction socket graft due to its good bone remodeling and osteoconductivity.

• Journal of Periodontal and Implant Science
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• v.44 no.5
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• pp.259-264
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• 2014

Purpose: The aim of this case report is to present the longitudinal results of sinus grafting using a new demineralized bovine bone material (DBBM) in human cases. Methods: A patient with a resorbed maxilla was treated by maxillary sinus grafting using a new deproteinized bovine bone material. After a healing period of 6.5 months, three implants were placed and restored. The patient was periodically recalled and followed up for 5 years after restoration. Results: Twelve partially edentulous patients (average age, 55.7 years) were followed up. All patients had insufficient residual height in their maxillary posterior area and underwent maxillary sinus graft surgery to increase the height of their maxilla. In all, 27 fixtures were placed in the augmented bone area. On average, 8.6 months later, implants were loaded using provisional or final restorations. The observation period ranged from 27 to 75 months (average, 43.3 months), and the patients did not show any severe resorption of the graft material or any infection during this time. Conclusions: Our results show that the new DBBM is useful for a maxillary sinus graft procedure. Good healing responses as well as reliable results were obtained for an average follow-up period of 43.3 months.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.221-226
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• 2013

Purpose: This study is to evaluate the efficacy of the autogenous tooth bone graft material, clinically and radiologically, as related to implant installation. Methods: In oral and maxillofacial surgery department of Ajou University Hospital, guided bone regeneration (GBR), implant placement combined with GBR, sinus graft, implant placement combined with sinus graft, and defect filling were performed in 46 patients, using autogenous tooth bone. Among these, 66 implants were inserted with autogenous tooth bone. Implant stability quotient (ISQ) was measured by Osstell Mentor (Integration Diagnostics, Goteborg, Sweden) on 39 implants on the operation date and 4 months later, and on 21 implants 9months on the average at the final setting of restoration. Twenty-eight implants with GBR and sinus graft (GBR group: n=14, sinus graft group: n=14) were evaluated radiologically to measure the resorption of grafted autogenous tooth bone after loading. Results: The average initial stabilization of the installed implants was 67 ISQ, and the average secondary stabilization at 4 months later was 76. The average bone loss of GBR group as measured 8.0 months after application of prosthesis loading was 0.29 mm and the average bone loss of the sinus graft group as measured 7.6 months after application of prosthesis loading was 0.66 mm, respectively. In the histological assessment, formation of the new bone and continuous trabecular bone pattern was identified around autogenous tooth bone. Conclusion: Based on these results, we concluded that autogenous tooth bone is an excellent bone graft material that can substitute the autogenous bone.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.3
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• pp.325-341
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• 2003

Statement of problem: In cases where bony defects were present, guided bone regenerations have been performed to aid the placement of implants. Nowadays, the accepted concept is to isolate bone from soft tissue by using barrier membranes to allow room for generation of new bone. Nonresorbable membranes have been used extensively since the 1980's. However, this material has exhibited major shortcomings. To overcome these faults, efforts were made to develop resorbable membranes. Guided bone regenerations utilizing resorbable membranes were tried by a number of clinicians. $Bio-Gide^{(R)}$ is such a bioresorbable collagen that is easy to use and has shown fine clinical results. Purpose: The aim of this study was to evaluate the histological results of guided bone regenerations performed using resorbable collagen membrane($Bio-Gide^{(R)}$) with autogenous bone, bovine drived xenograft and combination of the two. Surface morphology and chemical composition was analyzed to understand the physical and chemical characteristics of bioresorbable collagen membrane and their effects on guided bone regeneration. Material and methods: Bioresorbable collagen membrane ($Bio-Gide^{(R)}$), Xenograft Bone(Bio-Oss), Two healthy, adult mongrel dogs were used. Results : 1. Bioresorbable collagen membrane is pure collagen containing large amounts of Glysine, Alanine, Proline and Hydroxyproline. 2. Bioresorbable collagen membrane is a membrane with collagen fibers arranged more loosely and porously compared to the inner surface of canine mucosa: This allows for easier attachment by bone-forming cells. Blood can seep into these spaces between fibers and form clots that help stabilize the membrane. The result is improved healing. 3. Bioresorbable collagen membrane has a bilayered structure: The side to come in contact with soft tissue is smooth and compact. This prevents soft tissue penetration into bony defects. As the side in contact with bone is rough and porous, it serves as a stabilizing structure for bone regeneration by allowing attachment of bone-forming cells. 4. Regardless of whether a membrane had been used or not, the group with autogenous bone and $Bio-Oss^{(R)}$ filling showed the greatest amount of bone fill inside a hole, followed by the group with autogenous bone filling, the group with blood and the group with $Bio-Oss^{(R)}$ Filling in order. 5. When a membrane was inserted, regardless of the type of bone substitute used, a lesser amount of resorption occurred compared to when a membrane was not inserted. 6. The border between bone substitute and surrounding bone was the most indistinct with the group with autogenous bone filling, followed by the group with autogenous bone and $Bio-Oss^{(R)}$ filling, the group with blood, and the group with $Bio-Oss^{(R)}$ filling. 7. Three months after surgery, $Bio-Gide^{(R)}$ and $Bio-Oss^{(R)}$ were distinguishable. Conclusion: The best results were obtained with the group with autogenous bone and $Bio-Oss^{(R)}$ filling used in conjunction with a membrane.

• Proceedings of the Materials Research Society of Korea Conference
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• 2011.05a
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• pp.52.1-52.1
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• 2011

In this work, the effect of the addition of bioactive glass in the biocompatibility and mechanical behavior of conventional TTCP/DCPA based bone cement were investigated. The cement was initially modified with chitosan and HPMC which cross-linked with citric acid to improved mechanical properties.The injectable bone substitutes were further modified by adding varying amounts of bioactive glass (0%, 10%, 20% and 30%) and its effects on the biocompatibility of the material were studied. Afterbio-glass powders were mixed with the optimized composition for HPMC and citric acid content,the IBS was incubated at $37^{\circ}C$ at different time intervals and showed progressive formation of HAp with increasing time. Mechanical properties like Vickers hardness and compressive strength were found to increase with the increasing amount of bioactive glass addition and that setting time was shortened. The fabricated IBS morphologies were further characterized using SEM. MTT assay was performed to check the cell cytotoxicity and cell proliferation for 1, 3 and 5 days. Cell morphology, adhesion and proliferation behavior of cell in the IBS by culturing MG-63 cells on the IBS for 20, 60 and 90 mins and 1, 3 and 5 days was also investigated. All the results showed increasing biocompatibility as the bioglass content increased. MTT results found the materials to be cytocompatible and SEM images showed that cells attached and proliferated successfully.

• Journal of Periodontal and Implant Science
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• v.49 no.3
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• pp.171-184
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• 2019

Purpose: To evaluate the effects of intra-alveolar socket grafting, subepithelial connective tissue grafts, and individualized abutments on peri-implant hard and soft tissue outcomes following immediate implant placement. Methods: This randomized experimental study employed 5 mongrel dogs, with 4 sites per dog (total of 20 sites). The mesial roots of P3 and P4 were extracted in each hemimandible and immediate dental implants were placed. Each site was randomly assigned to 1 of 4 different treatment groups: standardized healing abutment (control group), alloplastic bone substitute material (BSS) + standardized healing abutment (SA group), BSS + individualized healing abutment (IA group), and BSS + individualized healing abutment + a subepithelial connective tissue graft (IAG group). Clinical, histological, and profilometric analyses were performed. The intergroup differences were calculated using the Bonferroni test, setting statistical significance at P<0.05. Results: Clinically, the control and SA groups demonstrated a coronal shift in the buccal height of the mucosa ($0.88{\pm}0.48mm$ and $0.37{\pm}1.1mm$, respectively). The IA and IAG groups exhibited an apical shift of the mucosa ($-0.7{\pm}1.15mm$ and $-1.1{\pm}0.96mm$, respectively). Histologically, the SA and control groups demonstrated marginal mucosa heights of $4.1{\pm}0.28mm$ and $4.0{\pm}0.53mm$ relative to the implant shoulder, respectively. The IA and IAG groups, in contrast, only showed a height of 2.6mm. In addition, the height of the mucosa in relation to the most coronal buccal bone crest or bone substitute particles was not significantly different among the groups. Volumetrically, the IA group ($-0.73{\pm}0.46mm$) lost less volume on the buccal side than the control ($-0.93{\pm}0.44mm$), SA ($-0.97{\pm}0.73mm$), and IAG ($-0.88{\pm}0.45mm$) groups. Conclusions: The control group demonstrated the most favorable change of height of the margo mucosae and the largest dimensions of the peri-implant soft tissues. However, the addition of a bone substitute material and an individualized healing abutment resulted in slightly better preservation of the peri-implant soft tissue contour.

• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.559-568
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• 1998

direct bone apposition during bone remodelling. To address these problem, we developed a new ceramic, calcium metaphosphate(CMP), and report herein the biologic response to CMP in subcutaneous tissue, muscle and bone. Porous CMP blocks were prepared by condensation of anhydrous $Ca(H_2PO_4)_2$ to form non-crystalline $Ca(PO_3)_2$. Macroporous scaffolds were made using a polyurethane sponge method. CMP block possesses a macroporous structure with approximate pore size range of 0.3-1mm. CMP blocks were implanted in 8mm sized calvarial defect, subcutaneous tissue and muscle of 6 Newzealand White rabbits and histologic observation were performed at 4 and 6 weeks later. CMP blocks in subcutaneous tissue and muscle were well adapted without any adverse tissue reaction and resorbed slowly and spontaneously. Histologic observation of calvarial defect at 4 and 6 weeks revealed that CMP matrix were mingled with and directly apposed to new bone without any intervention of fibrous connective tissue. CMP blocks didn't show any adverse tissue reaction and resorbed spontaneously also in calvarial defect. This result revealed that CMP had a high affinity for bone and was very biocompatible. From this preliminary result, it was suggested that CMP was a promising ceramic as a bone substitute and tissue engineering scaffold for bone formation.

• Journal of Korean Neurosurgical Society
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• v.50 no.5
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• pp.409-414
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• 2011

Objective : The aim of this study was to evaluate the impact of sodium hyaluronate-sodium carboxymethyl cellulose (HA-CMC), an anti-adhesive material for spinal surgery, on bone fusion by applying it to rat spinal models after lumbar posterolateral fusion. Methods : Lumbar posterolateral fusion was performed at L4-5 using bone graft substitutes in 30 rats. HA-CMC was injected in 15 rats at a dose of 0.2 cc (HA-CMC group) and a saline solution of 0.2 cc in the other 15 rats (control group). Simple radiographs were taken until postoperative 9 weeks with an interval of one week. At postoperative 4 and 9 weeks, three dimensional computed tomography (3D CT) scanning was performed to observe the process of bone fusion. At 9 weeks, bone fusion was confirmed by gross examination and manual palpation. Results : There were no statistically significant differences in bone fusion between the two groups. 3D CT scanning did not reveal significant differences between the groups. The gross examination and manual palpation after autopsy performed at 9 weeks confirmed bone union in 93.3% of both groups. Conclusion : The anti-adhesive material used for spinal surgery did not have adverse effects on spinal fusion in rats.

• Journal of Periodontal and Implant Science
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• v.47 no.1
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• pp.2-12
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• 2017

The aim of this narrative review is to describe treatment options for the posterior regions of the mandible and the maxilla, comparing short implants vs. longer implants in an augmented bone. The dental literature was screened for treatment options enabling the placement of dental implants in posterior sites with a reduced vertical bone height in the maxilla and the mandible. Short dental implants have been increasingly used recently, providing a number of advantages including reduced patient morbidity, shorter treatment time, and lower costs. In the posterior maxilla, sinus elevation procedures were for long considered to be the gold standard using various bone substitute materials and rendering high implant survival rates. More recently, implants were even placed without any further use of bone substitute materials, but the long-term outcomes have yet to be documented. Vertical bone augmentation procedures in the mandible require a relatively high level of surgical skill and allow the placement of standard-length dental implants by the use of autogenous bone blocks. Both treatment options, short dental implants, and standard-length implants in combination with vertical bone augmentation procedures, appear to result in predictable outcomes in terms of implant survival rates. According to recent clinical studies comparing the therapeutic options of short implants vs. long implants in augmented bone, the use of short dental implants leads to a number of advantages for the patients and the clinician.

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