• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.319-334
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• 2006

Mechanical and chemical methods are the two ways to treat the implant surfaces. By using mechanical method, it is difficult to eliminate bacteria and by-products from the rough implant surface and it can also cause the structural change to the implant surface. Therefore, chemical method is widely used in order to preserve and detoxicate the implant surface more effectively. The purpose of this study is to evaluate the effect of tetracylcline-hydrochloride(TC-HCI) on the change of implant surface microstructure according to application time. Implants with pure titanium machined surface, SLA surface and porous surface were used in this study. Implant surface was rubbed with sponge soaked in 50mg/ml TC-HCI solution for $\frac{1}{2}$ min., 1 min., $1\frac{1}{2}$ min., 2 min., and $2\frac{1}{2}$ min. respectively in the test group and with no treatment in the control group. Then, specimens were processed for scanning electron microscopic observation. 1. Both test and control group showed a few shallow grooves and ridges in pure titanium machined surface implants. There were not significant differences between two groups. 2. In the SLA surfaces, the control specimen showed that the macro roughness was achieved by large-grit sandblasting. Subsequently, the acid-etching process created the micro roughness, which thus was superimposed on the macro roughness. Irrespective of the application time of 50mg/ml TC-HCI solution, in general, test specimens were similar to control. 3. In the porous surfaces, the control specimen showed spherical particles of titanium alloy and its surface have a few shallow ridges. The roughness of surfaces conditioned with tetracycline-HCI was lessened and seen crater-like irregular surfaces relative to the application time. In conclusion, pure titanium machined surfaces and SLA surfaces weren't changed irrespective of the application time of tetracycline-HCI solution. But the porous surfaces conditioned with tetracycline-HCI solution began to be slightly changed from 2 min. This results are expected to be applied to the regenerative procedures for peri-implantitis treatment.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.85-90
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• 2010

Purpose: The goals of a blow-out fracture reconstruction are to restore the osseous continuity, provide support for the orbital contents and prevent functional and anatomic defects. Over the past several years, a range of autogenous and synthetic implants have been used extensively in orbital reconstructions. None of these implants have any absolute indications or contraindications in certain clinical settings. However, in extensive blow-out fractures, it is difficult to restore support of the orbital contents, which can cause more complications, such as enophthalmos. This study examined the clinical outcomes of extensive or comminuted blow-out fractures that were reconstructed by the simultaneous use of a titanium mesh plate and $Medpor^{(R)}$. Methods: Eighty six patients with extensive orbital fractures, who were admitted between March 1999 and February 2007, were reviewed retrospectively. The patients' chart and CT were inspected for review. Twenty three patients were operated on with both a titanium mesh plate (Matrix MIDFACE pre-formed orbital plate, Synthes, USA) and $Medpor^{(R)}$ (Porex, GA, USA). The patients underwent pre-operative CT scans to evaluate the fracture site and measure the area of the fracture. A transconjunctival approach was used, and titanium mesh plates were inserted subperiosteally with screw fixation. $Medpor^{(R)}$ was inserted above the titanium mesh plate. The patients were evaluated post-operatively for enophthalmos, diplopia, sensory disturbances and eyeball movement for a period of at least 6 months. Results: No implant-related complications were encountered during the follow-up period. Enophthalmos occurred in 1 patient, 1 patient had permanent sensory disturbance, and 3 patients complained of ocular pain and fatigue, which recovered without treatment. Although there were no significance differences between groups, the use of 2 implants had fewer complications. Therefore, it can be an alternative method for treating blow out fractures. Conclusion: The use of both a titanium mesh plate and $Medpor^{(R)}$ simultaneously may be a safe and acceptable technique in the reconstruction of extensive blow-out fractures.

• Journal of Periodontal and Implant Science
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• v.24 no.1
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• pp.120-130
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• 1994

The purpose of the present investigation was to compare the effectiveness of porous hydroxyapatite (PHA) and coralline based porous calcium carbonate(PCC) as implant materials in human periodontal osseous defects. 10 adult patients having periodontitis and 2 similar angular osseous defects ${\ge}$5mm as verified by radiographic analysis and clinical probing depth ${\ge}$4mm were selected. The measurements were recorded just before surgery and after 6 month. Clinical parameters used in this study included gingival recession, pocket depth, probing attachment level, Sulcus Bleeding Index, Plaque Index, tooth mobility and bone defect depth measurements. After initial therapy, patients were treated with mucoperiosteal flap surgery. The contralateral bony defects in each patient randomly assigned to either bone graft material, one with PHA(Interpore 200) and the other with coralline based calcium carbonate(Biocoral). After 6 month both groups showed statistically significant reduction of pocket depth, Sulcus Bleeding Index, Plaque Index and significant improvement in probing attachment level. No statistically significant differences were found between the groups. There were 3.0mm or 68% of bone repair with PHA and 3.1mm, 61% with PCC. These values were likewise not significantly different. The data and clinical impression strongly suggest that both PHA and PCC are alloplastic implants with clinically apparent acceptance by the soft and hard tissue and that they can be used as bone graft materials successfully.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.2
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• pp.127-132
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• 1998

$Medpor^{(R)}$(porous polyethylene) Surgical Implants are used for the augmentation or restoration of bony contour in craniofacial defects. The purpose of this study is to evaluate the ingrowth of soft tissue and bone after application in calvaria of rats. The experiment was carried out in 60 rats. The reflected periosteum was resutured after implantation of $Medpor^{(R)}$ as a experimental site, while in the calvarial bone the reflected periosteum resutured without implantation as a control site. The histologic examination was performed after 1-, 2-, 4-, 8-, 12-, 24-weeks implantation in calvaria of rats. I concluded that there was abundant ingrowth of soft tissue and bone without any adverse tissue response and that it shows good stability.

• Advances in biomechanics and applications
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• v.1 no.4
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• pp.227-237
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• 2014

The in vitro construction of osteo-articular large implants combining biomaterials and cells is of great interest since these tissues have limited regeneration capability. But the development of such organoids is particularly challenging, especially in the later time of the culture, when the extracellular matrix has almost filled the initial porous network. The fluid flow needed to efficiently perfuse the sample can then not be achieved using only the hydraulic driving force. In this paper, we investigate the interest of using an electric field to promote mass transport through the scaffold at the late stage of the culture. Based on the resolution of the electrokinetics equations, this study provides an estimation of the necessary electric driving force to reach a sufficient oxygen perfusion through the sample, thus analyzing the feasibility of this concept. The possible consequences of such electric fields on cellular activities are then discussed.

• Archives of Craniofacial Surgery
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• v.16 no.1
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• pp.35-38
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• 2015

Alloplastic implants have been used to repair orbital wall fractures in most cases. Orbital hemorrhage is a rare complication of these implants and has been reported rarely in Korea. The purpose of this article is to report a late complication case focusing on their etiology and management. A 20-year-old male patient underwent open reduction with Medpor (porous polyethylene) insertion for bilateral orbital floor fractures. The initial symptom occurred with proptosis in the right side as well as vertical dystopia, which had started 4 days earlier, 8 months after surgery. Any trauma history after the surgery was not present. We performed an exploration and removal of hematoma with Medpor titanium meshed alloplastic implant. A case of delayed orbital hematoma following alloplastic implant insertion was identified. It occurred within the pseudocapsule of the implant. One week after surgery, overall symptoms improved successfully, and no complications were reported during the 11-month follow-up period. Although rare, orbital hemorrhage is a potential complication of alloplastic orbital floor implants, which may present many years after surgery. As in the case presented, delayed hematoma should be included in the differential diagnosis of late proptosis or orbital dystopia.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.3
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• pp.307-319
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• 2008

STATEMENT OF PROBLEM: It is known that an anodic oxidation technique, one of the methods for the implant surface treatment, remarkably increased surface area, enhanced wettability and accelerated the initial bone healing. Purpose: This study was performed to evaluate the wettability of anodized titanium surface which has a nanotubular structure, to assess osseointegration after the placement of implant with nano-size tubes on tibia of rats and to analyze quantitatively transferable rhBMP-2 on each surface. MATERIAL AND METHOD: Four different kinds of surface-treated titanium discs (polished (machined surface) group, micro (blasting surface) group, nano (anodizedmachined surface) group, and nano-micro (anodized-blasting surface) group) were fabricated (n=10). Three different media were chosen to measure the surface contact angles; distilled water, plasma and rhBMP-2 solution. After a single drop (0.025 $m{\ell}$) of solution, the picture was taken with the image camera, and contact angle was measured by using image analysis system. For the test of osseointegration, 2 kinds of anodized surface (anodized-machined surface, anodized-blasting surface) implants having 2.0 mm in diameter and 5.0 mm in length inserted into the tibia of Wistar rats. After 3 weeks, tibia were harvested and the specimens were stained with hematoxylin and eosin for histological analysis. To test the possibility of drug delivery, after soaking sample groups in the concentration of 250 ng/$m{\ell}$l of rhBMP-2 for 48 hours, the excess solution of rhBMP-2 were removed. After that, they were lyophilized for 24 hours, and then the rhBMP-2 on the surface of titanium was resolved for 72 hours in PBS. All the extracted solution was analyzed by ELISA. One-way analysis of variance (ANOVA) was performed on the data. RESULTS: The wettability is improved by anodic oxidation. The best wettability was shown on the nano-micro group, and it was followed by nano group, micro group, and polished group. In the histological findings, all implants showed good healing and the new bone formation were observed along the implant surface. After 3 days, nano-micro group delivered the most amount of rhBMP-2, followed by nano group, micro group, and polished group. CONCLUSION: It indicated that anodic oxidation on blasting surface produce functionally graded nano-micro porous structure and enhance hydrophilicity of the surface and osseointegration. The findings suggest that the nano-micro porous structure could be a useful carrier of osteogenic molecules like rhBMP-2.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.1
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• pp.60-64
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• 1999

Recently, for the reconstruction of bony defect and cosmetic improvement, many graft materials and implants have been widely used in the various surgical situations. The alloplastic materials have many advantages such as simplicity of operation, no additional need of surgery, and easy manipulation. The $Medpor^{TM}$(porous high-density polyethylene, Porex Co., USA) was initially studied in 1972 for surgical implant and introduced as an implant material for oral and maxillofacial region by Sauer and King in 1988. This material permits full ingrowth of bone into the implants, substantially increasing the implant's incorporation into the recipient site. It can be shaved during the surgery, which results in an improvement and prefabricated various size and shapes to fit into the surgical defect. The $Medpor^{TM}$ was used in 32 patients from 1995 to 1997 at the maxillofacial region. It was used for paranasal augmentation in 24 cases, for malar augmentation in 2 cases, for infraorbital augmentation in 2 cases, for mandibular angle augmentation in 2 cases, for mandibular body augmentation in 2 cases, for chin vertical augmentation in 1 case. It was mainly fixed with miniplate or screw. There were few complications except one infection and one exposure of the implant.

• Archives of Craniofacial Surgery
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• v.10 no.1
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• pp.29-32
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• 2009

Purpose: Alloplastic implants, such as $Silastic^{(R)}$, $Supramid^{(R)}$, Porous polyethylene, $Teflon^{(R)}$ have been used to prevent reherniation of orbital tissue and are known to be inert for many years, though complications are infrequently reported many years after their insertion. Complications associated with implants are infrequent, but infection, orbital hemorrhage, implant extrusion, motility restriction, migration of implant causing dacryocystitis, cystic formation have been described. The latter was known as a rare late complication of blow-out fracture repair. Methods: We report the case of a discovery of a intraorbital hemorrhagic cyst which developed after silicon implant insertion. This patient developed diplopia, unilateral proptosis, exophthalmos, vertical dystopia, ectropion 10 years after repair of blow-out fracture. In this case, orbital CT scan revealed intraorbital cyst surrounding the orbital implant. At surgery, a fibrous capsule surrounded the silicon implant and was filled with mucin pools. Results: Proptosis, diplopia, exophthalmos, ectropion, vertical dystopia were resolved after surgical removal of the cyst and implant. Conclusion: This case illustrate that it is important for us to be aware of the complication of cyst formation around the silicon implants.

• Korean Journal of Materials Research
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• v.16 no.3
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• pp.178-182
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• 2006

A single electro-discharge-sintering (EDS) pulse (1.0 kJ/0.7 g), from a $300{\mu}F$ capacitor, was applied to atomized spherical Ti-6Al-4V powder in a low vacuum to produce porous-surfaced implant compacts. A solid core surrounded by a porous layer was formed by a discharge in the middle of the compact. XPS (X-ray photoelectron spectroscopy) was used to study the surface characteristics of the implant material. C, O, and Ti were the main constituents, with smaller amounts of Al, V, and N. The implant surface was lightly oxidized and was primarily in the form of $TiO_2$ with a small amount of metallic Ti. A lightly etched EDS implant sample showed the surface form of metallic Ti, indicating that EDS breaks down the oxide film of the as-received Ti-6Al-4V powder during the discharge process. The EDS Ti-6Al-4V implant surface also contained small amounts of aluminum oxide in addition to $TiO_2$. However, V detected in the EDS Ti-6Al-4V implant surface, did not contribute to the formation of the oxide film..