• Journal of Korean Neurosurgical Society
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• 제38권2호
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• pp.96-101
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• 2005

Objective : This paper describes our experience and implant technique for cranioplasty of a large cranial defects using a porous polyethylene implant[Medpor] and compares the results with polymethylmethacrylate[PMMA]. Methods : Sixteen cranioplasties were performed using Medpor[n= 10] and PMMA[n=6] implants between June 2003 and January 2005. The criterion for patient enrollment was a defect larger than 10cm in diameter. This study compared the operation times and complications. Results : The operation times ranged from 105 to 250minutes[Mean $180^{\circ}{\pm}44minutes$) in Medpor and from 185 to 460minutes [mean 128minutes] in PMMA. The absolute operation times were shorter using the Medpor implant and the differences were statistically significant[P=0.030]. Satisfactory cosmetic results were obtained in all cases using the Medpor implant and with no implant-related complications. Bone ingrowth to the medpor implant was presumed to be the result on an increase in Houndsfield units of the implant, particularly at the marginal areas in the serial follow-up brain computed tomography images. Conclusion : It is believed that the properties of a Medpor implant make this implant an good alternative to the existing methods of a cranial contour correction. However, a further follow-up study will be needed.

• 한국진공학회지
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• 제7권s1호
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• pp.30-36
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• 1998

The plasma-spray technique is currently the most frequently used method to produce calcium phosphate coatings. Hydroxyapatite(HAp), one form of calcium phosphate, is preferred by its ability to form a direct bond with living bone, resulting in improvements of implant fixation and faster bone healing. Recently, concerns have been raised regarding the viable use and long-term stability of plasma-spray HAp coatings due to its nature of comparatively thick, porous, and poor bonding strength to metal implants. Thin layers (maximum of few microns) of calcium phosphate were formed by an e-beam evaporation with and without ion bombardments. The Ca/P ration of film was controlled by either using the evaporants having the different ration of Ca/P with addition of CaO, or adjusting the ion beam assist current. The Ca/P ration had great effects on the structure formation after heat treatment and the dissolution bahavior. The calcium phosphate films produced by IBAD exhibited high adhesion strength.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권2호
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• pp.177-183
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• 1996

With the increasing esthetic requirement in orthognathic surgeries, midfacial corrective surgeries were developed to improve the paranasal depression. Augmentation with autogenous bones has long been the standard in facial reconstruction, however limited graft availability, donor site morbidity, and difficulties in 3-dimensional shaping were led to limited use. Porous high density polyethylene$(Medpor{(R)})$ was introduced in the 1970s as an alloplastic implants. It can be used in various size and shapes, and shortend operation time. The purpose of this study is to determine, by means of cephalometrics, the degree of long term stability and gaining of the overlying soft tissue thickness. The results were as followings : 1. There was no evidence of foreign body reaction, infection, and tissue necrosis. 2. $(Medpor{(R)})$ implants had an advantage of clinical use ; easy to contour and adapt to obtain a precise 3-dimensional construction. 3. Cephalometric study of 16 cases of paranasal augmentation revealed an overall increase of soft tissue thickness of approximately 82.1% in 6-months following. 4. The successful results could be obtained under the aseptic handling.

• Archives of Plastic Surgery
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• 제47권4호
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• pp.310-316
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• 2020

Background To produce patient-specific nasal implants, it is necessary to harvest and grow autologous cartilage. It is crucial to the proliferation and growth of these cells for scaffolds similar to the extracellular matrix to be prepared. The pore size of the scaffold is critical to cell growth and interaction. Thus, the goal of this study was to determine the optimal pore size for the growth of chondrocytes and fibroblasts. Methods Porous disc-shaped scaffolds with 100-, 200-, 300-, and 400-㎛ pores were produced using polycaprolactone (PCL). Chondrocytes and fibroblasts were cultured after seeding the scaffolds with these cells, and morphologic evaluation was performed on days 2, 14, 28, and 56 after cell seeding. On each of those days, the number of viable cells was evaluated quantitatively using an MTT assay. Results The number of cells had moderately increased by day 28. This increase was noteworthy for the 300- and 400-㎛ pore sizes for fibroblasts; otherwise, no remarkable difference was observed at any size except the 100-㎛ pore size for chondrocytes. By day 56, the number of cells was observed to increase with pore size, and the number of chondrocytes had markedly increased at the 400-㎛ pore size. The findings of the morphologic evaluation were consistent with those of the quantitative evaluation. Conclusions Experiments using disc-type PCL scaffolds showed (via both morphologic and quantitative analysis) that chondrocytes and fibroblasts proliferated most extensively at the 400-㎛ pore size in 56 days of culture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권4호
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• pp.278-286
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• 2011

Introduction: This study examined the predictability of new bone formation in the pneumatized maxillary sinus using only fibrin-rich blocks with concentrated growth factors as an alternative to bone grafts. Materials and Methods: Maxillary sinus augmentation was performed in thirty-three patients with a deficient alveolar bone height (mean 3.9 mm). All patients were treated consecutively with sinus membrane elevation via the lateral window approach and panoramic radiograms and cone-beam computed tomograms were taken to evaluate the remaining bone height and the new bone formation in the maxillary sinus, before and after surgery. Four biopsy specimens were taken at the time of implant consolidation (after an average of five months healing) and were stained by H & E and Trichrome staining. Results: None of the patients had postoperative complications during implant consolidation. After an average of 5 months since sinus augmentation, newly formed bone was observed in all cases by a radiographic evaluation. In 4 biopsy samples, newly formed bone was observed along the floor of the replaced bony window. The osteoblast lining and well distinguished Osteocytes in the lacunas were observed in the newly formed bone. Of the 74 implants (4 different surfaced implants - resorbable blast media-surfaced (RBM), Hydroxyapatite (HA) coated, acid-etched, sintered porous-surfaced implant) placed, one RBM implant failed. The success rate was 98.6% after a mean of 15 months. Discussion: These results suggest that maxillary sinus augmentation using fibrin rich block with concentrated growth factors is a successful and predictable technique.

• 대한치과보철학회지
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• 제30권3호
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• pp.361-378
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• 1992

The purpose of this investigation was to evaluate the effect of the porous hydroxyapatite particles (Interpore $200^{(R)}$) and guided tissue regeneration membrane ($Gore-Tex^{TM}$ augmentation material) on amount and shape of generating new bone adjacent to implant. Implants were placed immediately after extraction in the bilateral 3rd, 4th premolars of the mandible of the adult dogs. In all experimental groups, artificial bony defects were formed at the buccal cortex area, 3.3mm in width and 3.0mm in depth. In the control group : sutured without HA particles & membranes after placing implants, the experimental group 1 : membrane was place over the artificial bony defect, the experimental group 2 : bony defect was filled with HA particles and covered with membrane. The examination of bone-implant interfaces using light microscope and fluorescent microscope concluded as follows. 1. In all three experimental groups, osseointegration was observed without epithelial migration. 2. In the healing degree of bony defect area, the experimental group 1, 2 showed more prominent healing than control group, and the experimental group 1 showed the most excellent bone formation. 3. In fluorescent microscopic finding, bone remodeling was observed in regenerated bone tissue at defect area of experimental group 1, but in experimental group 2, irregular, discontinuous linear fluorescence was observed at the lower portion of defect area and sign of bone remodeling was weak.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.27-46
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• 1996

The purpose of this study was designed to compare with the effects of 4 different surface active bioceramics on the healing process of alveolar bone defects in dogs. Artificial alveolar bone defects depth 4-6mm, width 3-4mm) were created with # 6 round bur at interproximal areas of maxillary canine, maxillary 2nd premolar, mandibular canine, and mandibular 3rd premolar. porous hydroxyapatite(Interpore $200^R$) , 45S5 bioglass, CJ4/lOC crystalline glass, and JJ crystalline glass were implanted in intrabony defects randomly. Experimental groups were divided into 4 categories according to its implant material. After implantation, all groups were examined postoperatively 4 weeks to 12 weeks. 3 dogs was selected randomly and sacrificed after vascular perfusion with 2.5% glutaraldehyde at every 4 weeks. Tissue blocks with surroundig alveolar bone and soft tissues were removed and immersed in formaldehyde/glutaraldehyde fixative. After 20 weeks decalcification with EDTA and formic acid, sections were made and observed under light microscope and transmission electron microscope. In all experimental groups, the encapsulation of inactive connective tissue was observed around graft particles in 4 weeks. As time elapsed, the thickness of surrounding connective tissue was decreased. Osteoconductive bone growth pattern was seen apparently in all groups. CJ4/lOC crystalline glass showed the most active bone formation until 8 weeks. 45S5 bioglass was, however, the most active in new bone formation at 12 weeks. Though there was difference in resorption rate among grafting materials, the size of graft particles was decreased gradually. 45S5 bioglass was resorbed faster than the others. On the other hand, porous hydroxyapatite was degraded most slowly. Phagocytosed particulate matters was observed in the cytoplasm of multinuclear multinuclear giant cell and macrophage under transmission electron microscope. The results suggested suggested that 45S5 bioglass and CJ4/lOC crystalline glass may have some enhanced reparative potential when compared to porous hydroxapatite in the treatment of periodontal defeds. JJ crystalline glass reguires a further investigation of the safety of its use.

• Journal of Periodontal and Implant Science
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• 제36권3호
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• pp.705-716
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• 2006

The present study was performed to evaluate the effect of tetracycline-HCl on the change of implant surface microstructure according to application time. Implant with pure titanium machined surface, GBA surface and RBM surface were utilized. Implant surface was rubbed with 50mg/ml tetracycline-HCl solution for ${\frac{1}{2}}$min. 1min. $1{\frac{1}{2}}$min. 2min. and $2{\frac{1}{2}}$min. respectively in the test group. Then, specimens were processed for scanning electron microscopic observation. The results of this study were as follow. 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 group. 2. In GBA surfaces, control group exhibit many porous depression, and each depression were divided by strict border. Experimental group applied with tetracycline-HCl for 2min. were similar with control group. But when applied for $2{\frac{1}{2}}$min. surface alteration and border breakdown started, resulting enlargement of the porous depression. 3. In REM surface, control group exhibit rough, uneven surface with crater-like depression can be found. The surface alteration started when tetracycline-HCl was applied for 30sec. resulting breakdown of the crater-like depression. Depression became larger as applying time increased.

• Journal of Korean Neurosurgical Society
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• 제61권6호
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• pp.737-746
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• 2018

Objective : The purpose of this study was to compare the cosmetic outcome and complications after cranioplasty (CP) due to three different implant materials, and analyze the mean implant survival and cumulative survival rate based on these results. Methods : We reviewed 108 patients retrospectively who underwent CP between January 2014 and November 2016. Autologous bone (AB; 45 patients) and synthetic materials with porous polyethylene (PP; 32 patients) and custom-made 3-dimensional printed titanium mesh (CT; 31 patients) were used as implants. Results : Regardless of implanted materials, more than 89.8% of the CP patients were satisfied with the cosmetic outcome. No statistically significant difference was observed among the three groups. The overall postoperative complication rates of each group were 31.1% in the AB group, 15.6% in the PP group and 3.2% in the CT group. The CT group showed lower complication rates compared with AB and PP groups (${\chi}^2$-test : AB vs. PP, p=0.34; AB vs. CT, p=0.00; PP vs. CT, p=0.03). The AB and PP groups demonstrated a higher post-CP infection rate (11.1% and 6.3%) than the CT group (3.2%). However, no significant difference in the incidence of post-CP infection was observed among the three groups. The PP and CT groups demonstrated a higher mean implant survival time and cumulative survival rate than the AB group at the last follow-up (p<0.05). Conclusion : In comparison with AB and PP, cranioplasty with CT shows benefits in terms of lower post-CP complication, less intraoperative bleeding loss, shorter operation time and in-hospital stay. The PP and CT groups showed higher implant survival time and cumulative survival rate compared with the AB group.

• Journal of Periodontal and Implant Science
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• 제43권6호
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• pp.251-261
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• 2013

A paradigm shift is taking place in medicine and dentistry from using synthetic implants and tissue grafts to a tissue engineering approach that uses degradable porous three-dimensional (3D) material hydrogels integrated with cells and bioactive factors to regenerate tissues such as dental bone and other oral tissues. Hydrogels have been established as a biomaterial of choice for many years, as they offer diverse properties that make them ideal in regenerative medicine, including dental applications. Being highly biocompatible and similar to native extracellular matrix, hydrogels have emerged as ideal candidates in the design of 3D scaffolds for tissue regeneration and drug delivery applications. However, precise control over hydrogel properties, such as porosity, pore size, and pore interconnectivity, remains a challenge. Traditional techniques for creating conventional crosslinked polymers have demonstrated limited success in the formation of hydrogels with large pore size, thus limiting cellular infiltration, tissue ingrowth, vascularization, and matrix mineralization (in the case of bone) of tissue-engineered constructs. Emerging technologies have demonstrated the ability to control microarchitectural features in hydrogels such as the creation of large pore size, porosity, and pore interconnectivity, thus allowing the creation of engineered hydrogel scaffolds with a structure and function closely mimicking native tissues. In this review, we explore the various technologies available for the preparation of macroporous scaffolds and their potential applications.