• Archives of Craniofacial Surgery
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• v.16 no.1
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• pp.11-16
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• 2015

Background: Source material used to fill calvarial defects includes autologous bones and synthetic alternatives. While autologous bone is preferable to synthetic material, autologous reconstruction is not always feasible due to defect size, unacceptable donor-site morbidity, and other issues. Today, advanced three-dimensional (3D) printing techniques allow for fabrication of titanium implants customized to the exact need of individual patients with calvarial defects. In this report, we present three cases of calvarial reconstructions using 3D-printed porous titanium implants. Methods: From 2013 through 2014, three calvarial defects were repaired using custom-made 3D porous titanium implants. The defects were due either to traumatic subdural hematoma or to meningioma and were located in parieto-occipital, fronto-temporo-parietal, and parieto-temporal areas. The implants were prepared using individual 3D computed tomography (CT) data, Mimics software, and an electron beam melting machine. For each patient, several designs of the implant were evaluated against 3D-printed skull models. All three cases had a custom-made 3D porous titanium implant laid on the defect and rigid fixation was done with 8 mm screws. Results: The custom-made 3D implants fit each patient's skull defect precisely without any dead space. The operative site healed without any specific complications. Postoperative CTs revealed the implants to be in correct position. Conclusion: An autologous graft is not a feasible option in the reconstruction of large calvarial defects. Ideally, synthetic materials for calvarial reconstruction should be easily applicable, durable, and strong. In these aspects, a 3D titanium implant can be an optimal source material in calvarial reconstruction.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.375-390
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• 2000

The purpose of this study is to evaluate the expression ofIGF-I, considered as the mediator of action of estrogen, and IGF-IA and IGF-IB, alternative slicing form of IGF-I, using $17{\beta}-estradiol$ in MC3T3-E1 cells. We observed the effect on type I collagen and osteopontin gene expression and DNA synthetic activity of MC3T3-E1 cells, added by estrogen, IGF-I and combination and the interactionon proliferation and differentiation of MC3T3-E1 cells. The results were as follows :RT-PCR experiment for observing timedependantIGF-I gene expression patternshowed IGF-IA and IB gene expression in both of control and test group. In these IGF-IA gene expression was appeared predominantly. In control, IGF-I geneexpression level was maintained until 24hr and then decreased gradually. In testgroup, IGF-I gene expression level increased as time goes by. Experiment measuring DNA synthetic activity, as it is added by $17{\beta}-estradiol$, IGF-I and combination, showed that first day , there was the tendency of more increase of synthetic activity in all test group than control but no statical significance(P>0.05), and third day, there was more increase of DNA synthetic activity in $17{\beta}-estradiol$ group and combination group and it was statically significant. (P<0.005) Experiment for observing type I collagen gene expression pattern showed more increase of expression in $17{\beta}-estradiol$ group than control and no significant difference in IGF-I group and combination group. Experiment for observing osteopontin gene expression pattern showed no significant difference in control and test group. In conclusion, $17{\beta}-estradiol$ in MC3T3- E1 cells increased IGF-I gene and DNA synthetic activity simultaneously, therefore it appeared that IGF-I is related to the action of estrogen. Combination treatment of IGF-I and $17{\beta}-estradiol$ has effect on cell proliferation but this effect is lower than IGF-I or $17{\beta}-estradiol$ alone. However, combination treatment has not great effect on type I collagen or osteopontin gene expression thus little effect of cell differentiation.

• Asian-Australasian Journal of Animal Sciences
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• v.20 no.2
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• pp.237-244
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• 2007

An experiment was conducted to study the growth performance, bone mineralization and mineral excretion in broiler starter chicks fed high levels of cholecalciferol (CC) at sub-optimal levels of calcium (Ca) and non-phytate phosphorus (NPP). Five hundred and sixty day-old Vencobb female broiler chicks were housed in raised wire floor stainless steel battery brooder pens ($24"{\times}30"{\times}18"$) at the rate of five chicks per pen. A maize-soyabean meal basal diet was supplemented with dicalcium phosphate, oyster shell powder and synthetic CC to arrive at two levels each of Ca (0.50 and 0.60%), and NPP (0.25 and 0.30%) and four levels of CC (200, 1,200, 2,400 and 3,600 ICU/kg) in a $2{\times}3{\times}4$ factorial design. Each diet was fed ad libitum to chicks in 7 pens from 2 to 21days of age. Body weight gain, feed intake and bone weight increased (p<0.05) with increase in level of CC at both the Ca and NPP levels tested. The CC levels required to obtain significant improvement in body weight gain and feed intake reduced (2,400 ICU/kg vs. 1,200 ICU/kg) with increase in levels of P in diet (0.25% vs. 0.3%, respectively). The feed conversion ratio was significantly improved (p<0.05) with increase in level of CC from 200 to 1,200 ICU/kg diet at 0.5% Ca, while at 0.6% Ca, the level of CC in diet did not influence the feed efficiency. Tibia mineralization (density, breaking strength and ash content) and Ca and P contents in serum increased significantly (p<0.05) with increase in levels of CC in diet. The CC effect on these parameters was more pronounced at lower levels of Ca and NPP (0.5 and 0.25%, respectively). The data on body weight gain and feed intake indicated that NPP level in diet can be reduced from 0.30 to 0.25% by increasing CC from 200 to 2,400 ICU/kg. Similarly, the bone mineralization (tibia weight, density and ash content) increased non-linearly (p<0.01) with increase in CC levels in diet. Concentrations of P and Mn in excreta decreased (p<0.01), by increasing CC level from 200 to 2,400 ICU/kg diet. It can be concluded that dietary levels of Ca and NPP could be reduced to 0.50 and 0.25%, respectively by enhancing the levels of cholecalciferol from 200 to 2,400 ICU/kg with out affecting body weight gain, feed efficiency and bone mineralization. Additionally, phosphorus and manganese excretion decreased with increase in levels of CC in broiler diet.

• The Journal of the Korean dental association
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• v.48 no.1
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• pp.45-55
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• 2010

Purpose: The aim of this study was to evaluate 1 year cumulative survival rate of implants placed on augmented sinus using Osteon$^{(R)}$, bone graft material and to assess height of the grafted material radiographically. Material and Methods: 10 maxillary sinuses were augmented in 10 patients and 25 implant fixtures were installed simultaneously or after 6 months healing period. The height of the sinus graft material was measured using panoramic images immediately after augmentation and up to 19 months subsequently. Changes in the height of the sinus graft material were calculated with respect to implant length and original sinus wall height. Results: The cumulative survival rate was 100% in all 25 implants. Additionally, normal healing process without any complication was observed in all patients. The mean crown/Implant ratio was 1.25. The mean marginal bone loss was 0.95mm and the mean resorption rate of Osteon$^{(R)}$ was 0.05mm/month. The fastest resorption site of Osteon$^{(R)}$ is the first molar area. The grafted material was well maintained in sinus and decreased slightly over 1 year. Conclusion: In conclusion, It can be suggested that Osteon$^{(R)}$ may have predictable result when it was used as a grafting material for sinus floor augmentation.

• Archives of Plastic Surgery
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• v.41 no.4
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• pp.350-354
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• 2014

Background The authors sought to compare the use of the nonabsorbable polyvinyl alcohol sponge (PVA, Merocel) and absorbable synthetic polyurethane foam (SPF, Nasopore Forte plus) as intranasal splints after closed reduction of fractured nasal bones during the hospitalization period. Methods The medical records of 111 patients who underwent closed reduction for nasal bone fracture at Sanggye Paik Hospital, Inje University College of Medicine, from 2012 to 2013 were reviewed retrospectively. PVA (group A) or SPF (group B) was packed as an internal splint after closed reduction. The efficacy of the materials was compared and statistically analyzed. Results PVA was used in 82 patients, and SPF was used in 29 patients. The patients in group B complained significantly more of nasal pain on the first day after operation than the patients in group A. Headaches on the operation day were significantly more painful in group B than in group A. Bleeding on the fourth postoperative day was significantly reduced in group B as compared to group A. The patients in group B exhibited significantly more intensive nasal obstruction on the operation day and the following day than the patients in group A. However, on the third and fourth postoperative days, the nasal obstruction in group B was less than that in group A. The pain and bleeding related to the packing material was significantly reduced in group B as compared to group A. Conclusions The use of SPF as an absorbable packing material is a reasonable substitute for the traditional nonabsorbable material.

• International Journal of Oral Biology
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• v.30 no.3
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• pp.99-103
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• 2005

Bone morphogenetic proteins (BMPs), members of a large group of TGF-beta family, are important molecular regulators of morphogenesis of numerous tissues and organs, including bones and teeth. Most BMPs are capable of inducing bone formation in vivo and therefore are of considerable clinical interest for regenerating mineralized tissues. Recently, we have developed a method to culture cells from human cementum (human cementum-derived cells, HCDCs). HCDCs, when attached to synthetic hydroxyapatite/tricalcium phosphate (HA/TCP) ceramic and transplanted into immunodeficient mice, formed histologically identifiable cementum-like tissue. Since it is unclear to what extent BMPs are involved in cementogenesis, the aim of this study was to establish which BMPs are expressed by cementogenic HCDCs and whether the expression of BMPs is related to the degree of cellular differentiation in vitro. HCDCs were maintained in growth medium (DMEM/F12 supplemented with 10% FBS) until confluent (proliferation stage). Upon reaching confluence, cells were incubated in the differentiation medium (DMEM/F12 medium containing 10% FBS and 50 mg/ml ascorbic acid) for 14 days (differentiation stage). Next, HCDCs were incubated in mineralization medium (DMEM/F12, 50 mg/ml ascorbic acid, 2.5 mg/ml of ITS (insulin-transferrinselenium), 5 mM beta-glycerophosphate and $10^{-8}M$ dexamethasone) for another 14 days (mineralization stage). At the end of each differentiation stage, total RNA was isolated and evaluated for BMPs (2 through 8) expression by employing real time RT-PCR. HCDCs expressed most of BMPs examined except BMP-7 and BMP-8. Furthermore, on average, the highest levels of BMPs were expressed at the earlier differentiation stage, prior to the initiation of mineralization in vitro. These results indicate that several BMPs are expressed during cementoblastic differentiation and suggest that BMPs may be involved in the homeostasis of human cementum.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.465-475
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• 2001

The purpose of this study was to evaluate effect of platelet rich plasma on the treatment of Grade II furcation involvement, with and without porous resorbable calcium carbonate($Biocoral^{(R)}$)in humans by digital subtraction radiography. 15 teeth(control group) were treated with porous resorbable calcium carbonate($Biocoral^{\(R)}$), and 15 teeth(test group) were treated with porous resorbable calcium carbonate($Biocoral^{(R)}$) and Platelet Rich Plasma. The change of bone density was assessed by digital subtraction radiography in this study. The change of mineral content by as much as 5%(vol) could be perceived in the subtracted images. The change of mineral content was assessed in the method that two radiographs are put into computer program to be overlapped and the previous image is subtracted by the later one. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-whitney Test using SPSS program(5% significance level). The results were as follows: 1. In test group, the radiolucency in 3 months after surgry were significantly increased than 1 month after surgery(p<0.05). 2. In test group, there were no significant difference between 1 month after surgery and 6 months after surgery(p>0.05). 3. In test group, the radiopacity in 6 months after surgery were significantly increased than 3 months after surgery(p<0.05). 4. In control group, the radiolucency in 3 months and 6 months after surgery were significantly increased than 1 month after surgery(p<0.05). 5. In control group, the radiopacity in 6 months after surgery were significantly increased than 3 months after surgery(p<0.05). 6. There were no significant difference between test group and control group at 1 month, 3 months after surgery, but radiopacity in test group were significantly increased than control group at 6 months after surgery(p<0.05). In conclusion, Platelet Rich Plasma can enhance bone density.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.788-794
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• 2010

Purpose: The fingertip is the most commonly injured part of the hand and its injury frequently results in avulsion or crushing of a segment of the nail bed and fracture of the distal phalangeal bone. Restoration of a flat and smooth nail bed is essential for regrowth of a normal nail, which is important not only for cosmetic reasons but also for tactile capability of the fingertip. It is also anatomical reduction of the distal phalanx to promote patient's cosmetics and prevent nail bed deformity. Absence or no replacement of the nail plate results in obliterated proximal skin fold. When the avulsed nail plate cannot be returned to its anatomic position or when it is absent, we use a synthetic material for splinting the nail bed and alternative reductional method for distal phalangeal bone fracture, especially, instead of hardwares. Methods: From January of 2006 to June of 2009, a total of ten patients and fourteen fingers with crushing or avulsion injuries of the fingertip underwent using the artificial nails for finger splint. We shaped artificial nails into the appropriate sizes for use as fingernail plates. We placed them under the proximal skin fold and sutured to the fold proximally and to the lateral and medial edges of the nail bed or to the distal fingertip. Our splints were as hard as K-wire and other fixation methods and more similar to anatomic nail plates. Artificial nails were kept in place for at least 3 weeks. Results: No artificial nail related complication was noted in any of the ten cases. No other nail fold or nail bed complications were observed, except for minor distal nail deformity because of trauma. Conclusion: In conclusion, in order to secure the nail bed after injury and reduce the distal phalangeal bone fracture, preparing a nail bed splint from a artificial commercial nail is a cheap and effective method, especially, for crushed or avulsion injuries of the fingertip.

• Journal of Korean Neurosurgical Society
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• v.61 no.6
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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 Biomedical Engineering Research
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• v.43 no.1
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• pp.61-70
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• 2022

Natural and synthetic forms of calcium phosphate cement (CPC) have been widely used in bone repair and augmentation. The major challenge of injectable CPC is to deliver the cells without cell death in order to regenerate new bone. The study objective was to investigate for the potential of stem cell-laden gelatin fibers containing injectable, nanocrystalline CPC to function as a delivery system. Gelatin noddle fiber method was developed to delivered cells into nCPC. Experimental groups were prepared by mixing cells with nCPC, mixing cell-laden gelatin fibers with nCPC and mixing cell-laden gelatin fibers containing BMP-2 with nCPC. Media diffusion test was conducted after dissolving the gelatin fibers. SEM examined the generated channels and delivered cell morphology. Fibers mixed with nCPC showed physical setting and hardening within 20 min after injection and showed good shape maintenances. The gelatin fibers mixed nCPC group had several vacant channels generated from the dissolved gelatin. Particularly, proliferation and attachment of the cells were observed inside of the channels. While live cells were not observed in the cell mixed nCPC group, cells delivered with the gelatin fibers into the nCPC showed good viability and increased DNA content with culture. Cell-laden gelatin fiber was a novel method for cell delivery into nCPC without cell damages. Results also indicated the osteogenic differentiation of gelatin fiber delivered cells. We suggest that the cell-laden gelatin fibers mixed with nCPC can be used as an injectable cell delivery vehicle and the addition of BMP-2 to enhances osteogenesis.