• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.4
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• pp.146-153
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• 2014

Purpose: This study compares and evaluates the efficacy of graft materials after maxillary sinus bone grafts with autogenous tooth bone graft material (AutoBT), demineralized freeze-dried bone allograft (DFDBA) and deproteinized bovine bone mineral (DBBM). Methods: The study involved 30 sinuses in 26 patients who visited the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital and received either AutoBT, DFDBA or DBBM with sinus elevation using the lateral window technique. Sinus graft height was measured before, immediately after, and six months after bone graft with panoramic radiography and the height changes of the sinus floor was compared according to the graft materials. Results: After six months, the decrease ratio of graft heights were 13.57% for AutoBT group, 14.30% for DFDBA group, and 11.92% for DBBM group. There was no statistically significant difference. Conclusion: The new maxillary sinus floor formed by the upper border of bone graft material, can repneumatize after the maxillary sinus elevation. Thus, long-term stability of sinus graft height represents an important factor for implant success. We found that the three graft materials for sinus elevation do not differ significantly and all three graft materials showed excellent resistance to maxillary sinus repneumatization. However, due to the special circumstances of the maxillary sinus and small sample, the actual difference between the three graft materials may not have been detectable. Therefore further study needs to be conducted for more reliable study results.

• Journal of Periodontal and Implant Science
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• v.31 no.1
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• pp.73-91
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• 2001

The present study was performed to compare effects of demineralized freeze-dried bone allograft(DFDBA) with deproteinized bovine bone mineral(DBBM) on periodontal fenestration defect in rats. Twelve adult male rats weighing 500 to 540 grams were used in this study. Periodontal fenestration defects were surgically created with tapered fissure bur(${\Phi}1mm$) at the left side of buccal surface of the mandible. The defect size was from anterior border of the first molar to anterior of the ascending ramus mesiodistally and from just below the alveolar crest to apically 1.5-2mm area apicocoronally with 2mm in depth. Rats were divided into control group, test group I and II. Four defects were assigned to the test group I grafted with DBBM and other 4 defects were assigned to the test group II grafted with DFDBA. The rest of defects were the negative control group. At 10 days and 35 days after surgery, 12 rats were sacrificed through intracardiac perfusion and specimens were obtained prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows : 1. In the control group, new bone, osteoid, dense connective tissue were observed in the defects at 10 days. new bone formation was not found but loose connective tissue was formed in the defect and fibrous encapsulation of graft materials was shown in two test groups at 10 days. 2. In all groups, new bone formation was shown in the defect at 35 days. And in the control group, bone formation increased at 35 days than at 10 days. 3. In the test group I and II at 35 days, graft materials were combined with new bone and joined host bone. There was very close contact between new bone, graft materials, and host bone with no gaps. 4. In the test group I and II, new bone formation was similar to that in the control group but not exeeded. In conclusion, in the test group I new bone formation was similar to that in the test group II at 35 days, but there was infiltration of inflammatory cells at 10 days. DFDBA and DBBM were considered as the biocompatible graft materials and effective in the regeneration of new bone.

• Journal of Periodontal and Implant Science
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• v.42 no.6
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• pp.224-230
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• 2012

Purpose: Various bone graft materials have been used for periodontal tissue regeneration. Demineralized freeze-dried bone allograft (DFDBA) is a widely used bone substitute. The current widespread use of DFDBA is based on its potential osteoinductive ability. Due to the lack of verifiable data, the purpose of this study was to assess the osteoinductive activity of different DFDBAs in vitro. Methods: Sarcoma osteogenic (SaOS-2) cells (human osteoblast-like cells) were exposed to 8 mg/mL and 16 mg/mL concentrations of three commercial types of DFDBA: Osseo+, AlloOss, and Cenobone. The effect of these materials on cell proliferation was determined using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay. The osteoinductive ability was evaluated using alizarin red staining, and the results were confirmed by evaluating osteogenic gene expression using reverse transcription polymerase chain reaction (RT-PCR). Results: In the SaOS-2 cells, an 8 mg/mL concentration of Osseo+ and Cenobone significantly increased cell proliferation in 48 hours after exposure (P<0.001); however, in these two bone materials, the proliferation of cells was significantly decreased after 48 hours of exposure with a 16 mg/mL concentration (P<0.001). The alizarin red staining results demonstrated that the 16 mg/mL concentration of all three tested DFDBA induced complete morphologic differentiation and mineralized nodule production of the SaOS-2 cells. The RT-PCR results revealed osteopontin gene expression at a 16 mg/mL concentration of all three test groups, but not at an 8 mg/mL concentration. Conclusions: These commercial types of DFDBA are capable of decreasing proliferation and increasing osteogenic differentiation of the SaOS-2 cell line and have osteoinductive activity in vitro.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1043-1049
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• 2000

Objective : This study was undertaken to evaluate the availability of allogenic fibular bone graft filled with autogenous bone dust in anterior cervical fusion after cervical discectomy. Methods : During a 4-year period(1995-1998), twenty four cases of anterior cervical fusion after discectomy were performed with fibular allograft filled with autogenous bone dust in degenerative cervical disease. We used freeze-dried fibular allograft and autogenous bone dust. Autogenous bone dust obtained from spondylotic spurs, osteophytes, and during foraminotomy. Cervical plating system was done at 8 patients. 5 patients were 1 level and 3 patients were 2 levels. All patients were routinely evaluated after surgery at 2 weeks, 1 month, 3 months, 5 months and 12 months. Mean follow-up period was 21months. Results : Eighty eight percent of the patients were found to have excellent or good clinical results. Radiographic follow-up revealed that 92% of the patients obtained complete or partial union by 5 months after surgery. One patient had graft extrusion immediately after surgery and had the graft reinserted. Two patients had longitudinal graft fractures. There were no graft related complications. Conclusion : Fibular allograft filled with autogenous bone dust for cervical interbody fusion after discectomy is an ideal graft material by showing obvious benefits of good fusion rate and elimination of donor site complications. And also we were able to obtain satisfactory clinical outcome.

• Journal of Veterinary Clinics
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• v.22 no.4
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• pp.377-381
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• 2005

We tried to extract bone morphogenetic protein (BMP) from the freeze-dried bovine cortical bone (FBCB) for bone graft, which were defatted with chloroform-methanol for 20 days, freeze-dried at $-80^{\circ}C$ for 7 days and sterilized by ethylene oxide gas. Two kg of FBCB were pulverized in a wheel mill to $0.5-2.0mm^3$ cubic in size. The bone particles were demineralized in 0.6N HCI for 10 days at chloroform-methanol$4^{\circ}C$ and defatted with chloroform-methanol for 6 hours at room temperature, which was going to be defatting and demineralized cortical bone (DDM). For extracting BMP, DDM was agitated continuously through 72 hours with magnetic stirrer at $4^{\circ}C$ into 12 times of volume of 6 M guanidine hydrochloride (Gdn-HCl) solution containing proteinase inhibitors to protect BMP such as 2mM N-ethylaleimide, 1mM iodoacetic acid, 1mM phenylmethylsulfonyl fluoride and a sterilizer, 1mM sodium azide. The extraction procedure was repeated for three times. All extracted solution was centrifuged at 10,000 rpm for 30 min and then, the supernatant was dialyzed with 12 times of volume of deionized water at $4^{\circ}C$ for 24-72 hours, which cut off below 6,000-8,000 molecular weight. The dialyzed specimen contained crude-BMP was centrifuged, freeze-dried, and weighted. Through these processing, we could obtained $84.9\%$ as FBCB, $17.8\%$ as DDM and $0.71\%$ as crude-BMP from the wet cortical bone without cancellous bone, marrow and muscles. The crude-BMP were obtained $68.3\%$ from the first extraction, $29.6\%$ from secondary and $2.1\%$ from tertiary, respectively. It was suggested that high yield of crude-BMP migth be explained by three-time repetition of the extraction processing for crude-BMP with Gdn-Hcl sol.

• 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.

• Journal of Periodontal and Implant Science
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• v.42 no.6
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• pp.237-242
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• 2012

Purpose: The aim of this study was to clinically and radiographically evaluate and compare treatment of intrabony defects with the use of decalcified freeze-dried bone allograft in combination with a calcium sulphate barrier to collagen membrane. Methods: Twelve patients having chronic periodontal disease aged 20 to 50 years and with a probing depth >6 mm were selected. Classification of patient defects into experimental and control groups was made randomly. In the test group, a calcium sulphate barrier membrane, and in control group, a collagen membrane, was used in conjunction with decalcified freeze-dried bone graft in both sides. Ancillary parameters as well as soft tissue parameters along with radiographs were taken at baseline and after 6 months of surgery. Parameters assessed were plaque index, modified gingival index, probing depth, relative attachment level, and location of the gingival margin. A Student's t-test was done for intragroup and a paired t-test for intergroup analysis. Results: Intragroup analysis revealed statistically significant improvement in all the ancillary parameters and soft tissue parameters with no statistically significant difference in intergroup analysis. Conclusions: The study concluded that a calcium sulphate barrier was comparable to collagen membrane in achieving clinical benefits and hence it can be used as an economical alternative to collagen membrane.

• Journal of Periodontal and Implant Science
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• v.24 no.3
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• pp.671-689
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• 1994

The purpose of this study was to compare effects of various bone grafts on periodontal regeneration of alveolar bone defects in dogs. Seven adult dogs aged 12 to 18 months were used in this study. Experimental alveolar bone defects were created surgically with a #1/2 round bur at the furcation area of the buccal surface of the mandibular 3rd, 4th premolars and 1st molar. Each experimental alveolar bone defects were grafted with dense hydroxyapatite, natural coral, and decalcified freeze-dried bone, and respectively divided into DHA, NC, DFDB group. An area without bone graft was divided into control group. At 1,2,4,6, and 12 weeks, dogs were serially sacrificed and specimens were prepared with Hematoxylin-Eosin stain and Mallory stain for light microscopic evaluation. The results of this study were as follows : 1. In control group, the matrix change of granulation tissue was observed at 1 week. And in experimental groups, the appearance of connective tissue around graft materials was loosely formed at 1 week, but densely formed at 2 weeks. 2. In every group, the slight formation of new trabecular bone was seen from remaining bone at 1 week. 3. The DHA and NC particles were gradually encapsulated by new trabecular bone from remaining bone, and the osteoid tissue was directly induced from DFDB particles. 4. The presence of osteoblasts was first observed at 1 week in control group and at 2 weeks in NC group, but at 6 weeks in DHA group. 5. In DHA group, the resorption of particles was not observed until 12 weeks. But in NC and DFDB group, the particles were resorbed at 6 weeks and replaced by new bone. And the amount and size of particles were reduced, and their border represented irregular form. In summary, in three experimental groups the inflammatory or foreign body reaction were slight, but the regeneration of new osteoid tissue and the matrix change of dense connective tissue fiber were observed. Especially, NC and DFDB materials were considered as the biocompatible graft materials which were effective in the regenertion of new bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.4
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• pp.365-378
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• 1995

Allogeneic bone grafting has recently been used in oral and maxillofacial regions to restore the cosmetic and functional problem. There are several types of allogeneic bone grafts ; bone powder, bone chips, bone blocks. Empirically, it is thought to be better to combine the allogeneic bone chips to any type of tissue adhesive not to displace during packing and condensing. But, there are no reports about using tissue adhesive in allogeneic bone grafting. This experimental study is designed to investigate the effect of the fibrin adhesive on bone healing process after demineralized allogeneic bone grafting in 60 rats. In control groups (30 rats), routine demineralized allogeneic bone grafting were done in 7 ${\times}$ 7mm calvarial bone defects which were drilled intentioally. And we used the fibrin adhesive for holding the bone particle in experimental groups (30 rats). Each experimental specimen was sacrified at 1, 2, 4, 6, 8 weeks postoperatively The results were as follows : 1. The degree of inflammatory cell infiltrations were more prominent in experimental than in control groups till 2 weeks. 2. Early fibroblast proliferation and new capillary proliferation were uncorporated around graft sites in the experimental groups later than in control groups at early stages. 3. Osteoblastic activity in control group was more prominent at 2 weeks. 4. Osteoblastic activity in experimental groups was more prominent than in control group till 4 weeks. 5. New bone formation was more in control group than experimental group till 3 weeks, but similar appearance after that time. As above results, initial bone healing within 2 weeks were more processed in without adhesive group than with adhesive group. But above 4 weeks; similar bone healing were observed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.4
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• pp.290-301
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• 2002

The purpose of this study was to evaluate new bone formation and healing process in rat calvarial bone defects using $BioMesh^{(R)}$. membrane and DFDB. Forty eight rats divided equally into 4 groups of 1 control group and 3 experimental groups. Standardized transosseous circular calvarial defects (8 mm in diameter) were made midparietally. In the control group, the defect was only covered with the soft tissue flap. In the experimental group 1, it was filled with DFDB only, in the experimental group 2, it was covered $BioMesh^{(R)}$. membrane only, and in the experimental group 3, it was filled DFDB and covered with membrane. At the postoperative 1, 2, 4, 8 weeks, rats were sacrificed and histologic and histomorphometric analysis were performed. These results were as follows. In histomorphometric analysis, It showed the greatest amount of new bone formation through experimental in the experimental group 3 (P<0.001). The amount of new bone formation at the central portion of the defect was greater in the experimental group 3 than experimental group 2. $BioMesh^{(R)}$. membrane began to resorb at 1 week and resorbed almost completely at 8 weeks after operation. The collapse of membrane into the defect was observed through the experimental periods in the experimental group 2. In the area of collapsed membrane, new bone formation was restricted. These results suggest that maintenance of some space for new bone to grow is required in the use of $BioMesh^{(R)}$. membrane alone in the defect. It is also thought that use of the membrane may promote new bone growth in DFDB graft.