• The Journal of Korean Obstetrics and Gynecology
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• v.27 no.2
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• pp.23-33
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• 2014

Objectives: In this study, the author aimed to evaluate the effect of EtOH extract of Ganoderma lucidum (GLE) on osteoblast proliferation in rat fetus calvarial cells. Methods: The osteoblast separated from rat fetus calvariae was cultivated for 6~21 days and evaluated the cell function. After the addition of GLE on the culture medium, we determined the effect of GLE on the cell viability, cell proliferation, bone matrix protein synthesis, alkaline phosphatase (ALP) activity, collagen synthesis and calcified nodule formation of the cultivated osteoblast. Results: GLE did not change the survival rate of rat calvarial osteoblast. GLE increased the proliferation of rat calvarial osteoblast. GLE increased ALP activity of rat calvarial osteoblast. GLE increased bone matrix protein synthesis of rat calvarial osteoblast. GLE increased collagen synthesis of rat calvarial osteoblast. GLE slightly affected calcified nodule formation of rat calvarial osteoblast. Conclusions: This study suggests that Ganoderma lucidum might improve the osteoporosis resulted from augmentation of osteoblast proliferation.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.345-351
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• 2012

Background Cranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction. Methods Between April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability. Results The mean follow-up period was 11.8 months and the mean operation time for reconstruction was $8.4{\pm}3.36$ hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures. Conclusions The reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.33-36
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• 2011

Background: In a frontal sinus reconstruction, the literature primarily recommends a surgical approach for definite treatment with the exception of for anterior wall fractures with no dislocation. Many studies have assessed a range of methods for the reduction of frontal sinus fractures. This paper presents a case, in whom the anterior wall of the frontal sinus was reconstructed using an outer table calvarial bone graft in an en bloc manner. Patient and methods: A 36-year-old male visited the emergency room with a heavy injury to the forehead. He was diagnosed with fractures of the anterior and posterior wall of the frontal sinus. The neurosurgeon removed the fractured area and repaired the meninges. Afterwards, cranialization was performed and the opening of the nasofrontal duct was obstructed. After fixing the removed bone to its original location, all fragments of fractured anterior wall were purged out and the anterior wall reconstructed using an en bloc calvarial bone graft. Results: In the post-operative 8 months period, there were no complications, the round contour of the forehead was expressed well and the patient was satisfied with the result. Conclusion: There are many methods for reconstructing the anterior wall of the frontal sinus. On the other hand, in cases of large fracture sites with many fractured bone fragments, en bloc harvesting of the outer table calvarial bone could be a better choice than making use of only plates and screws because this method shows a good results in terms of aesthetics with a low complication rate.

• The korean journal of orthodontics
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• v.25 no.6 s.53
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• pp.697-704
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• 1995

Chicken calvarial bone is known to contain various cell types, but their exact composition is unknown. By characterizing the chicken calvarial bone biochemically, it can be used to study biochemical, histochemical actions of bone cells in general. Calvaria of 18-day-old white leg horn embryo was aseptically dissected and bone cell populations were isolated by sequential enzymatic digestion. Histochemical study for osteoclast-like bone cell. population was performed with tartrate resistant acid phosphatase(TRAP) stain and for osteoblast-like bone cell population, alkaline phosphatase(ALP) stain was performed. Biochemical study for osteoblast-like bone cell population was performed using alkaline phosphatase(ALP) assay. Following conclusions were obtained from this study. 1. TRAP positive multi and mononuclear cells were mostly observed in group I and II, indicating that osteoclast-like bone cell population is mostly found in these groups. 2. All the cultured groups showed almost equal ALP activities and were positive for ALP stain, indicating that osteoblast-like bone cell population is evenly dispersed in all culture groups. 3. Experimental group treated with $1,25(OH)_{2}D_3$ showed increase in ALP activity in contrast to the control group, confirming previous studies that $1,25(OH)_{2}D_3$ increases ALP activities in in vitro bone cultures. 4. Results from von Kossa's stain indicated that in vitro bone formation had occured after 3 weeks of culture with beta-glycero phosphate.

• Journal of Periodontal and Implant Science
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• v.39 no.3
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• pp.349-358
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• 2009

Purpose: This study was aimed to evaluate the effect of the Freeze Dried Bone Allograft and Demineralized Bone Matrix on osseous regeneration in the rat calvarial defects. Methods: Eight mm critical-sized calvarial defects were created in the 80 male Sprague-Dawley rats. The animals were divided into 4 groups of 20 animals each. The defects were treated with Freeze Dried Bone Allograft($SureOss^{TM}$), Demineralized Bone Matrix($ExFuse^{TM}$ Gel, $ExFuse^{TM}$ Putty), or were left untreated for sham-surgery control and were evaluated by histologic and histomorphometric parameters following a 2 and 8 week healing intervals. Statistical analysis was done between each groups and time intervals with ANOVA and paired t-test. Results: Defect closure, New bone area, Augmented area in the $SureOss^{TM}$, $ExFuse^{TM}$ Gel, $ExFuse^{TM}$ Putty groups were significantly greater than in the sham-surgery control group at each healing interval(P < 0.05). In the New bone area and Defect closure, there were no significant difference between experimental groups. Augmented area in the $ExFuse^{TM}$ Gel, $ExFuse^{TM}$ Putty groups were significantly greater than $SureOss^{TM}$ group at 2weeks(P < 0.05), however there was no significant difference at 8 weeks. Conclusions: All of $SureOss^{TM}$, $ExFuse^{TM}$ Gel, $ExFuse^{TM}$ Putty groups showed significant new bone formation and augmentation in the calvarial defect model.

• Journal of Periodontal and Implant Science
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• v.32 no.4
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• pp.753-767
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• 2002

The purpose of this study was to evaluate histologically the effect of LiF-maleic acid added calcium aluminate(LM-CA) bone cement & CA-PMMA composite bone cement on the healing of calvarial defect in Sprague-Dawley rats. The critical size defects were surgically produced in the calvarial bone using the 8mm trephine bur. The rats were divided in three groups : In the control group, nothing was applied into the defect of each rat. LM-CA bone cement was implanted in the experimental group 1 and CA-PMMA composite bone cement was implanted in the experimental group 2. Rats were sacrificed at 2, 8 weeks after surgical procedure. The specimens were examined by histologic analysis, especially about the bone-cement interface and the response of surrounding tissue. The results are as follows; 1. In the control group, inflammatory infiltration was observed at 2 weeks. At 8 weeks, periosteum and duramater were continuously joined together in the defect area. But the center of defect area was filled up with the loose connective tissue. 2. In the experimental group 1, the bonding between implanted bone cement and the existing bone was seen, which more increased in 8 weeks than 2 weeks. Inflammatory infiltration and the dispersion of implanted bone cement particles were seen in both 2 weeks and 8 weeks. 3. In the experimental group 2, implanted bone itself had a dimensional stability and no bonding between implanted bone cement and the existing bone was seen in both 2 weeks and 8 weeks. Implanted bone cement was encapsulated by fibrous connective tissue. In addition, inflammatory infiltration was seen around implanted bone cement. On the basis of these results, when LM-CA bone cement or CA-PMMA composite bone cement was implanted in rat calvarial defect, LM-CA bone cement can be used as a bioactive bone graft material due to ability of bonding to the existing bone and CA-PMMA can be used as a graft material for augmentation of bone-volume due to dimensional stability.

• The Journal of Advanced Prosthodontics
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• v.6 no.6
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• pp.539-546
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• 2014

PURPOSE. Silk fibroin (SF) is a new degradable barrier membrane for guided bone regeneration (GBR) that can reduce the risk of pathogen transmission and the high costs associated with the use of collagen membranes. This study compared the efficacy of SF membranes on GBR with collagen membranes (Bio-$Gide^{(R)}$) using a rat calvarial defect model. MATERIALS AND METHODS. Thirty-six male Sprague Dawley rats with two 5 mm-sized circular defects in the calvarial bone were prepared (n=72). The study groups were divided into a control group (no membrane) and two experimental groups (SF membrane and Bio-$Gide^{(R)}$). Each group of 24 samples was subdivided at 2, 4, and 8 weeks after implantation. New bone formation was evaluated using microcomputerized tomography and histological examination. RESULTS. Bone regeneration was observed in the SF and Bio-$Gide^{(R)}$-treated groups to a greater extent than in the control group (mean volume of new bone was $5.49{\pm}1.48mm^3$ at 8 weeks). There were different patterns of bone regeneration between the SF membrane and the Bio-$Gide^{(R)}$ samples. However, the absolute volume of new bone in the SF membrane-treated group was not significantly different from that in the collagen membrane-treated group at 8 weeks ($8.75{\pm}0.80$ vs. $8.47{\pm}0.75mm^3$, respectively, P=.592). CONCLUSION. SF membranes successfully enhanced comparable volumes of bone regeneration in calvarial bone defects compared with collagen membranes. Considering the lower cost and lesser risk of infectious transmission from animal tissue, SF membranes are a viable alternative to collagen membranes for GBR.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.557-564
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• 2000

The bone graft materials can be grossly divided into autogenous bone, allogenic bone, xenogenic bone, and alloplastic material. Much care was given to other bone graft materials away from autogenous bone due to its additional operation for harvesting, delayed resorption and limitation of quantity. Demineralized freeze-dried bone(DFDB) and hydroxyapatite are the representatives of bone graft materials. As resorbable hydroxyapatite is developed in these days, the disadvantage of nonresorbability can be overcome. So we planned to study on the strength and the bone formation at the rats calvarial defects of DFDB graft and those of the composite graft with DFDB and resorbable hydroxyapatite. We used the 16 male rats weighting range from 250 to 300 gram bred under the same environment during same period. After we made the 6mm diameter calvarial defect, we filled the DFDB in 8 rats and DFDB and resorbable hydroxyapatite in another 8 rats. We sacrificed them at the postoperative 1 month and 2 months with the periostium observed. As soon as the specimens were delivered, we measured the compressive forces to break the normal calvarial area and the newly formed bone in calvarial defect area using Instron(Model Autograph $S-2000^{(R)}$, Shimadzu, Japan). The rest of the specimens were stained with H&E(Hematoxylin & Eosin) and evaluated with the light microscope. So we got the following results. 1. In every rats, there was no significant difference between the measured forces of normal bone area and those of the bone graft area. 2. In 1 month, the measured forces at DFDB graft group were higher than those of the DFDB and resorbable hydroxyapatite composite graft group(P<0.05). 3. In 2 months, there was no significant differences between the measured forces of DFDB graft group and those of the DFDB and resorbable hydroxyapatite composite graft group. 4. In lightmicroscopic examination, most of the grafted DFDB were transformed into bone in 1 month and a large numbers of hydroxyapatite crystal were observed in DFDB and resorbable hydroxyapatite composite graft group in 1 month. 5. Both group showed no inflammatory reaction in 1 month. And hydroxyapatite crystals had a tight junction without soft tissue invagination when consolidated with newly formed bone. 6. In both groups, newly formed bone showed the partial bone remodeling and the lamellar bone structures and some of reversal lines were observed in 2 months. From the above results, it is suggested that DFDB and resorbable hydroxyapatite composite graft group had a better resistance to compressive force in early stage than DFDB graft group, but there would be no significant difference between two groups after some period. And it is suggested that the early stage of bone formation procedure of DFDB and resorbable hydroxyapatite composite graft group was slight slower than that of DFDB graft group, but there would be no significant difference between two groups after some period.

• Archives of Craniofacial Surgery
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• v.19 no.3
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• pp.200-204
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• 2018

Fibrous dysplasia (FD) is a rare, benign bone disease with abnormal bone maturation and fibroblastic proliferation. Optimal treatment of zone 1 craniofacial FD is radical resection and reconstruction. To achieve of structural, aesthetic, and functional goals, we use three-dimensionally designed calvarial bone graft for reconstruction of zygomatic defect after radical resection of FD. The authors used a rapid-prototyping model for simulation surgery for radical resection and immediate reconstruction. Donor site was selected from parietal bone reflect shape, contour, and size of defect. Then radical resection of lesion and immediate reconstruction was performed as planned. Outcomes were assessed using clinical photographs and computed tomography scans. Successful reconstruction after radical resection was achieved by three-dimensional calvarial bone graft without complications. After a 12-month follow-up, sufficient bone thickness and symmetric soft tissue contour was well-maintained. By considering three-dimensional configuration of zygomaticomaxillary complex, the authors achieved satisfactory structural, aesthetic and functional outcomes without complications.

• Journal of Yeungnam Medical Science
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• v.4 no.2
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• pp.75-81
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• 1987

Bone grafts are an integral and important aspect of craniofacial reconstruction. Ribs, tibia, and iliac bone have traditionally used as donor site but each of these has various problems, however using to the calvarial bone as a donor site has several advantage. These are as follows ; there are abundance of material, easy to reach the donor site through coronal incision, minimal pain of donor area, less functional inability, shorter hospitalization, no need of immobilization, hidden scar at donor site, no secondary deformity and appropriate curvature obtained properly selected. From march to December 1987, we experienced three cases of autogenous calvarial bone graft such as congenital saddle nose deformity, fibrous dysplasia on the right side frontal bone, and deviated nose. The results were very excellent without any significant complication. The detail technique of autogenous calvarial bone graft and its advantages compared with the traditional methods of bone grafts are discussed.