• Journal of Periodontal and Implant Science
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• 제41권2호
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• pp.98-104
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• 2011

Purpose: The aim of this study was to evaluate 3.5 years-cumulative survival rate of implants placed on augmentedsinus using Osteon, a bone graft material, and to assess the height of the grafted material through radiographic evaluation. Methods: Twenty patients were treated with maxillary sinus augmentation and 45 implant fixtures were installed simultaneously or after 6 months healing period. The height of the augmented sinus and the loss of marginal bone were measured by panoramic and intraoral radiographs immediately after augmentation and up to 42 months (mean, 19.4 months) subsequently. Changes in the height of the sinus graft material were calculated radiographically. Results: The cumulative survival rate was 95.56% in all 45 implants. Additionall, normal healing process without any complication was observed in all patients. The original sinus height was mean 4.3 mm and the augmented sinus height was mean 13.4 mm after the surgery. The mean marginal bone loss till 42 months was $0.52{\pm}0.56\;mm$. The reduced height of Osteon was $0.83{\pm}0.38\;mm$ and it did not show significant correlation with the follow up periods (P=0.102). There were no statistically significant differences in reduced height of Osteon according to the simultaneous/delayed implantation (P=0.299) and particle size of Osteon (P=0.644). Conclusions: It can be suggested that Osteon may have predictable result when it was used as a grafting material for sinus floor augmentation.

• Journal of Periodontal and Implant Science
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• 제45권2호
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• pp.46-55
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• 2015

Purpose: This study evaluated the mechanical and structural properties of biphasic calcium phosphate (BCP) blocks processed using a modified extrusion method, and assessed their in vivo effectiveness using a rabbit calvarial defect model. Methods: BCP blocks with three distinct ratios of hydroxyapatite (HA):tricalcium phosphate (TCP) were produced using a modified extrusion method:HA8 (8%:92%), HA48 (48%:52%), and HA80 (80%:20%). The blocks were examined using scanning electron microscopy, X-ray diffractometry, and a universal test machine. Four circular defects 8 mm in diameter were made in 12 rabbits. One defect in each animal served as a control, and the other three defects received the BCP blocks. The rabbits were sacrificed at either two weeks (n=6) or eight weeks (n=6) postoperatively. Results: The pore size, porosity, and compressive strength of the three types of bone block were $140-170{\mu}m$, >70%, and 4-9 MPa, respectively. Histologic and histomorphometric observations revealed that the augmented space was well maintained, but limited bone formation was observed around the defect base and defect margins. No significant differences were found in the amount of new bone formation, graft material resorption, or bone infiltration among the three types of BCP block at either of the postoperative healing points. Conclusions: Block bone substitutes with three distinct compositions (i.e., HA:TCP ratios) processed by a modified extrusion method exhibited limited osteoconductive potency, but excellent space-maintaining capability. Further investigations are required to improve the processing method.

• Journal of Periodontal and Implant Science
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• 제46권5호
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• pp.350-359
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• 2016

Purpose: The purpose of the present study was to evaluate the effectiveness of a minimal concentration of bone morphogenetic protein-2 (BMP-2) in terms of quantitative and qualitative analyses of newly formed bone in a rabbit maxillary sinus model. Methods: In 7 rabbits, sinus windows were prepared bilaterally. Biphasic calcium phosphate (BCP) loaded with 0.05 mg/mL BMP-2 was grafted into one sinus (the BMP group) and saline-soaked BCP was placed into the other (the control group) in each animal. The animals were allowed an 8-week healing period before being sacrificed. Specimens including the augmented area and surrounding tissues were then removed and evaluated both radiographically and histologically. Results: There was a difference in the mineralization of new bone between the groups. In the BMP group, the greater part of the new bone consisted of mature lamellar bone with an evident trabecular pattern, whereas the control group showed mostly woven bone, consisting only partially of lamellar bone. Histometrically, the area of new bone was significantly greater ($4.55{\pm}1.35mm^2$ vs. $2.99{\pm}0.86mm^2$) in the BMP group than in the control group (P<0.05); however, the total augmentation volumes were not significantly different between the groups. Conclusions: Within the limitations of this study, it can be suggested that a minimal concentration of BMP-2 (0.05 mg/mL) had an osteoinductive effect with accelerated mineralization in a rabbit sinus model using a BCP carrier.

• Journal of Periodontal and Implant Science
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• 제53권5호
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• pp.321-335
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• 2023

Purpose: The aim of this study was to investigate the efficacy of photo-crosslinked gelatin methacryloyl (GelMa) hydrogel containing calcium phosphate nanoparticles (CNp) when applying different fabrication methods for bone regeneration. Methods: Four circular defects were created in the calvaria of 10 rabbits. Each defect was randomly allocated to the following study groups: 1) the sham control group, 2) the GelMa group (defect filled with crosslinked GelMa hydrogel), 3) the CNp-GelMa group (GelMa hydrogel crosslinked with nanoparticles), and 4) the CNp+GelMa group (crosslinked GelMa loaded with nanoparticles). At 2, 4, and 8 weeks, samples were harvested, and histological and micro-computed tomography analyses were performed. Results: Histomorphometric analysis showed that the CNp-GelMa and CNp+GelMa groups at 2 weeks had significantly greater total augmented areas than the control group (P<0.05). The greatest new bone area was observed in the CNp-GelMa group, but without statistical significance (P>0.05). Crosslinked GelMa hydrogel with nanoparticles exhibited good biocompatibility with a minimal inflammatory reaction. Conclusions: There was no difference in the efficacy of bone regeneration according to the synthesized method of photo-crosslinked GelMa hydrogel with nanoparticles. However, these materials could remain within a bone defect up to 2 weeks and showed good biocompatibility with little inflammatory response. Further improvement in mechanical properties and resistance to enzymatic degradation would be needed for the clinical application.

• Journal of Periodontal and Implant Science
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• 제45권6호
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• pp.238-246
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• 2015

Purpose: The purpose of this study was to evaluate bone formation around recombinant human bone morphogenetic protein (rhBMP-2)-coated implants placed with or without absorbable collagen sponge (ACS) in rabbit maxillary sinuses. Methods: The Schneiderian membrane was elevated and an implant was placed in 24 sinuses in 12 rabbits. The space created beneath the elevated membrane was filled with either blood (n=6) or ACS (n=6). In the rabbits in which this space was filled with blood, rhBMP-2-coated and non-coated implants were alternately placed on different sides. The resulting groups were referred to as the BC and BN groups, respectively. The AC and AN groups were produced in ACS-grafted rabbits in the same manner. Radiographic and histomorphometric analyses were performed after eight weeks of healing. Results: In micro-computed tomography analysis, the total augmented volume and new bone volume were significantly greater in the ACS-grafted sinuses than in the blood-filled sinuses (P<0.05). The histometric analysis showed that the areas of new bone and bone-to-implant contact were significantly larger in the AC group than in the AN group (P<0.05). In contrast, none of the parameters differed significantly between the BC and BN groups. Conclusions: The results of this pilot study indicate that the insertion of ACS after elevating the Schneiderian membrane, simultaneously with implant placement, can significantly increase the volume of the augmentation. However, in the present study, the rhBMP-2 coating exhibited limited effectiveness in enhancing the quantity and quality of regenerated bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권1호
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• pp.19-25
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• 2011

Purpose: Addition of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) to grafting material has become widely accepted additively for bone regeneration because it can raise high expectations on it's clinical potential. The aim of this study was to evaluate the efficacy of PRP and PRF on early bone regeneration of rabbits when used in combination with beta tricalcium phosphate. Methods: In eight rabbits, the calvarium was exposed and the two marrows were penetrated. After then these artificial bone defects were augmented with ${\beta}$-TCP or ${\beta}$-TCP with PRP or ${\beta}$-TCP with PRF and covered. The animals were sacrificed after four and eight weeks. Histologic findings were observed under the light-microscope and histomorphometric analysis was performed by measuring calcified area of new bone formation within the CSD. Results: They demonstrated that new bone formation tended to be produced along the outline of graft materials. More amounts of newly bone was regenerated in ${\beta}$-TCP only and in combination of${\beta}$-TCP with PRF and it was statistically significant. In contrast, there was no significant difference between nothing apply and ${\beta}$-TCP with PRP groups in the relative amounts of newly mineralized bone. Conclusion: Within the limitation of this study, it can be concluded that PRF in combination with ${\beta}$-TCP showed a positive effect on bone regeneration and statistically it was significant.

• Journal of Periodontal and Implant Science
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• 제51권6호
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• pp.433-443
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• 2021

Purpose: This study aimed to evaluate the effectiveness of the partial split-flap technique with a K-incision on vertical guided bone regeneration (vGBR) and to retrospectively analyze the clinical and radiographic outcomes of dental implantation using this approach. Methods: In total, 78 patients who received 104 dental implants with vGBR, categorized as (1) pre-GBR and post-implantation and (2) simultaneous GBR and implantation, were enrolled. Data analysis was based on periapical radiographs, clinical photos, and dental records. The 2-sample t-test was used to compare the 2 surgical procedures. Results: The baseline vertical bone level, augmented bone height (ABH), and treatment duration were significantly higher in the pre-GBR procedure group. The survival rates of the implants were 96.1% and 94.8% in implant- and patient-based analyses, respectively. In Cox regression analysis, high rates of implant failure were found in the presence of ABH of ≥4 mm, smoking, and diabetes. Conclusions: Within the limitations of this retrospective study, the partial split-flap technique using a K-incision for vGBR showed stable clinical outcomes and favorable dental implant survival.

• Journal of Periodontal and Implant Science
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• 제39권sup2호
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• pp.223-230
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• 2009

Purpose: Synthetic bone products such as biphasic calcium phosphate (BCP) are mixtures of hydroxyapatite (HA) and ${\beta}$-tricalcium phosphate (${\beta}$- TCP). In periodontal therapies and implant treatments, BCP provides to be a good bone reconstructive material since it has a similar chemical composition to biological bone apatites. The purpose of this study was to compare bone regeneration capacity of two commercially available BCP. Methods: Calvarial defects were prepared in sixteen 9-20 months old New Zealand White male rabbits. BCP with HA and ${\beta}$- TCP (70:30) and BCP with Silicon-substituted hydroxyapatite (Si-HA) and ${\beta}$-TCP (60:40) particles were filled in each defect. Control defects were filled with only blood clots. Animals were sacrificed at 4 and 8 week postoperatively. Histomorphometric analysis was performed. Results: BCP with HAand ${\beta}$- TCP 8 weeks group and BCP with Si-HA and ${\beta}$- TCP 4 and 8 weeks groups showed statistically significant in crease (P <0.05) in augmented area than control group. Newly formed bone area after 4 and 8 weeks was similar among all the groups. Residual materials were slightly more evident in BCP with HA and ${\beta}$- TCP 8 weeks group. Conclusions: Based on histological results, BCP with HA and ${\beta}$- TCP and BCP with Si-HA and ${\beta}$- TCP appears to demonstrate acceptable space maintaining capacity and elicit significant new bone formation when compared to natural bone healing in 4 and 8 week periods.

• Journal of Periodontal and Implant Science
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• 제40권2호
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• pp.76-85
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• 2010

Purpose: This study aimed to evaluate the effectiveness of the modified sinus floor elevation technique described hereafter as a "hybrid technique," in 11 patients with severely resorbed posterior maxillae. Methods: Eleven patients who received 22 implants in the maxillary premolar and molar areas by the hybrid technique were enrolled in this study. A slot-shaped osteotomy for access was prepared on the lateral wall along the lower border of the sinus floor. The Schneiderian membrane was fully reflected through the lateral slot. Following drilling with the membrane protected by a periosteal elevator, the bone was grafted. All implants were placed simultaneously with sinus augmentation. The cumulative success rate was calculated and clinical parameters were recorded. Radiographic measurements were performed. Results: All implants were well maintained at last follow up (cumulative success rate=100%). The mean residual bone height, augmented bone height, crown-to-implant ratio, and marginal bone loss were $4.1{\pm}1.64mm$, $8.76{\pm}1.77mm$, $1.21{\pm}0.34mm$, and $0.34{\pm}0.72mm$, respectively. Conclusions: Simultaneous implant placement with sinus augmentation by hybrid technique showed successful clinical results over a 2-year observation period and may be a reliable modality for reconstruction of a severely resorbed posterior maxilla.

• Journal of Periodontal and Implant Science
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• 제37권sup2호
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• pp.397-407
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• 2007

골형성 유도 단백질(bone morphogenetic protein, BMP)은 성장이나, 골형성과정에서 중용한 역할을 한다고 입증되었고 그것의 운반체에 대한 연구가 이뤄져 왔다. 하지만 수직압이 존재하는 곳에서 골증대술에 적용할 수 있을 만큼 강한 공간유지능력이 있는 운반체에 대한 연구는 그리 많지 않았다. Macroporous biphasic calcium phosphate block (MBCP block)은 공간유지능력이 뛰어나며 강한 수직압을 견딜수 있는 골대체물질이다. 이 연구의 목적은 MBCP block을 골형성유도 단백질(rhBMP-2)의 운반체로 사용하여 백서 두개골 결손부에 적용하였을 때, 골 형성 효과를 평가하는 것이다. 36마리의 웅성백서에서 8mm 지름을 갖는 임계크기의 두 개부 결손을 형성하였다. 20마리씩 2개의 군으로 나누어 MBCP block만 이식한 군, MBCP block을 운반체로 사용하여 농도 0.025mg/ml rhBMP-2를 이식한 군으로 나누어 술 후 2주와 8주에 치유결과를 조직학적, 조직계측학적으로 비교 관찰 하였다. 조직계측학적 관찰 결과, rhBMP-2/MBCP block 군에서 MBCP block군에서 보다 2, 8주 모두 골밀도(bone density)가 유의성있게 증가하였다 (P<0.01). 각 군에서도 8주째가 2주째보다 골밀도가 유의성있게 증가하였다(P<0.01). 총조직 형성량 (augmented area)에서는 변화가 없었다. 이 연구 결과, 백서 두개골 결손부에서 MBCP block은 rhBMP의 운반체로 사용하였을 때 신생골 형성에 유의한 효과가 있을뿐 아니라 공간유지능력이 우수해서 수직압이 존재하는 골증대술(bone augmentation)시 rhBMP의 운반체로 가능성이 있다고 사료된다.