Purpose: The aim of the present study was to evaluate the healing of post-extraction sockets following alveolar ridge preservation clinically, radiologically, and histologically. Methods: Overall, 7 extraction sockets in 7 patients were grafted with demineralised bovine bone mineral and covered with a porcine-derived non-crosslinked collagen matrix (CM). Soft tissue healing was clinically evaluated on the basis of a specific healing index. Horizontal and vertical ridge dimensional changes were assessed clinically and radiographically at baseline and 6 months after implant placement. For histological and histomorphometric analysis, bone biopsies were harvested from the augmented sites during implant surgery 6 months after the socket preservation procedure. Results: Clinically, healing proceeded uneventfully in all the sockets. A trend towards reduced horizontal and vertical socket dimensions was observed from baseline to the final examination. The mean width and height of resorption were 1.21 mm (P=0.005) and 0.46 mm (P=0.004), respectively. Histologically, residual xenograft particles ($31.97%{\pm}3.52%$) were surrounded by either newly formed bone ($16.02%{\pm}7.06%$) or connective tissue ($50.67%{\pm}8.42%$) without fibrous encapsulation. The CM underwent a physiological substitution process in favour of well-vascularised collagen-rich connective tissue. Conclusions: Socket preservation using demineralised bovine bone mineral in combination with CM provided stable dimensional changes of the alveolar ridge associated with good reepithelialisation of the soft tissues during a 6-month healing period.
Kim, Young-Kyun;Jun, Sang-Ho;Um, In-Woong;Kim, Sooyeon
Maxillofacial Plastic and Reconstructive Surgery
/
v.35
no.5
/
pp.310-315
/
2013
Micromorphometric and histological examinations were conducted with a collected tissue specimen nine months after sinus bone graft using autogenous tooth bone graft material (AutoBT). As a result of micro-computed tomographic analysis, the total bone volume (graft material+new bone) was 76.45%, and the proportion of new bone was 45.4%. The bone mineral density and the average Hounsfield Unit of new bone were 0.26 and 1,164.69, respectively. The histological examination showed that AutoBT particles were united well with new bone. AutoBT was considered to have excellent bone healing ability after sinus graft and bone density that can resist repneumatization.
The purpose of this study was to evaluate the effects of negatively electric field on bone healing in rabbit segmental long bone defects using negatively charged PTFE membrane. Ten millimeter segmental defects in the rabbit radius were used as the experimental model. After membranes were then charge injected using a corona-charging apparatus, the left defects were covered with non charged PTFE membranes as control groups, whereas the right defect was covered with negatively charged PTFE membranes as test group. The animals were divided into 4 groups of 2 rabbits each, and sacrificed at 2, 4, 6, and 8 weeks. Histomorphometric analysis showed a more newly formed bone in negatively charged membrane at early healing period. At 2 weeks, the proportion of new bone formation to total defect area was 0.32% in control group, 1.10% in experimental group. At 4 weeks, the proportion of new bone formation to total defect area was 6.86% in control, and 13.75% in experimental. At 6 and 8 weeks, no obvious difference was found between the two groups but newly formed bone in test groups were slightly more than that in control groups. In conclusion, negatively charged membranes showed more newly bone tissue than noncharged membranes at an early healing period. Although the number of samples was small, this study showed that the combination of negatively electrical stimulation and P1FE membrane may be of value in long bone healing.
The aim of this study was to achieve healing of Peri-implantitis defects and hard tissue augmentation using a bovine-derived bone mineral on the defect site. Two patients were treated with the surgical approach. With a full muco-periosteal flap elevation, the implant surfaces were exposed and granulation tissue removed around the implant and between the threads. Each surface of the contaminated implant was prepared with the air-abrasive device(PerioFlow$^{(R)}$) for decontamination. Bovine-derived bone mineral(Bio-Oss collagen$^{(R)}$) was then used to fill the defects and muco-periosteal flaps sutured to achieve transmucosal healing. Radiographs and clinical photographs were taken before and after 6 months of healing and an estimate of bone fill was assessed. Within the limits of the present case report, a surgical approach in treatment of peri-implantitis defects using a collagen form of bovine bone mineral was visited. Although limited, the two cases showed the stability and biocompatibility of a bovine-derived bone mineral and effectiveness of air-abrasive device(PerioFlow$^{(R)}$) as a decontamination method.
Purpose: Alveolar bone develops with tooth eruption and is absorbed following tooth extraction. Various ridge preservation techniques have sought to prevent ridge atrophy, with no superior technique evident. Collagen has a long history as a biocompatible material. Its usefulness and safety have been amply verified. The related compound, atelocollagen, is also safe and displays reduced antigenicity since telopeptides are not present. Materials and Methods: The current study evaluated whether the $Rapiderm^{(R)}$ atelocollagen plug (Dalim Tissen, Seoul, Korea) improves tissue healing of extraction sockets and assessed the sequential pattern of bone regeneration using histology and microcomputed tomography in six beagle dogs. To assess the change of extraction socket, hard tissues were examined 2, 4, 6, and 8 weeks after tooth extraction. Result: The experimental groups showed better bone fill with slow remodeling process compared to the control groups although there was no statistical difference between groups. Conclusion: The atelocollagen seems to have a tendency to slow bone remodeling in the early phase of healing period and maintain remodeling capacity until late phase of remodeling. Also, use of atelocollagen increased the bone-to-tissue ratio compared to healing of untreated extraction socket.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.38
no.4
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pp.221-230
/
2012
Objectives: This study sought to evaluate the efficacy of collagen graft materials, as compared to other graft materials, for use in healing calvarial defects in rabbits. Materials and Methods: Ten mm diameter calvarial defects were made in ten rabbits. The rabbits were then divided into 4 groups: control, autogenous bone graft, SureOss graft, and Teruplug graft. Bone regeneration was evaluated using histological and radiographic methods. Results: Based on visual examination, no distinct healing profile was observed. At 4 weeks after treatment, histological analysis showed there was no bone regeneration in the control group; however, at 8 weeks after treatment, new bone formation was observed around the margin of the defective sites. In the autogenous bone graft group, new bone formation was observed at 4 weeks after treatment and mature bone was detected around the grafted bone after 8 weeks. In the SureOss graft group, at 4 weeks after treatment, acute inflammatory and multinuclear cells were noted around the grafted materials; at 8 weeks after treatment, a decrease in graft materials coupled with new bone formation were observed at the defective sites. In the Teruplug graft group, new bone formation was detected surrounding the bone margin and without signs of inflammation. There were statistically significant differences observed between the graft and control group in terms of bone density as evidenced by radiographic analysis using computed tomography (P<0.05), particularly for the autogenous bone graft group (P<0.001). Conclusion: These results suggested that autogenous bone, SureOss and Teruplug have the ability to induce bone regeneration as compared to an untreated control group. The osteogenic potential of Teruplug was observed to be lower than that of autogenous bone, but similar to that of SureOss.
Peri-acetabular bone ingrowth plays a crucial role in long-term stability of press-fit acetabular cups. A poor bone ingrowth often results in increased cup migration, leading to aseptic loosening of the implant. The rate of peri-prosthetic bone formation is also affected by the polar gap that may be introduced during implantation. Applying a mechano-regulatory tissue differentiation algorithm on a two-dimensional plane strain microscale model, representing implant-bone interface, the objectives of the study are to gain an insight into the process of peri-prosthetic tissue differentiation and to investigate its relationship with implant-bone relative displacement and size of the polar gap. Implant-bone relative displacement was found to have a considerable influence on bone healing and peri-acetabular bone ingrowth. An increase in implant-bone relative displacement from $20{\mu}m$ to $100{\mu}m$ resulted in an increase in fibrous tissue formation from 22% to 60% and reduction in bone formation from 70% to 38% within the polar gap. The increase in fibrous tissue formation and subsequent decrease in bone formation leads to weakening of the implant-bone interface strength. In comparison, the effect of polar gap on bone healing and peri-acetabular bone ingrowth was less pronounced. Polar gap up to 5 mm was found to be progressively filled with bone under favourable implant-bone relative displacements of $20{\mu}m$ along tangential and $20{\mu}m$ along normal directions. However, the average Young's modulus of the newly formed tissue layer reduced from 2200 MPa to 1200 MPa with an increase in polar gap from 0.5 mm to 5 mm, suggesting the formation of a low strength tissue for increased polar gap. Based on this study, it may be concluded that a polar gap less than 0.5 mm seems favourable for an increase in strength of the implant-bone interface.
The purpose of this study is to compare the healing aspects of the use of ePTFE membrane alone versus combination treatment of ePTFE membrane and bone grafts on class II furcation defects. Seventeen defects were applied ePTFE membrane alone on mxillary molar buccal class II furcation defects as Group I, seventeen defects were applied ePTFE membrane and bone grafts on maxillary molar buccal class II furcation defects as Group II, twenty-three defects were applied ePTFE membrane alone on mandibular molar buccal class II furcation defects as Group III, twenty defects were applied ePTFE membrane and bone grafts on mandibular molar buccal class II furcation defects as Group IV . Measurements were made to determine clinical attachment level, probing depth, gingival depth, SBI, mobility at baseline, 3, 6, 12 months postoperatively. Additional measurements were made to determine membrane exposure level at surgery, 1, 2, 6 weeks postoperatively. And then healing patterns and postoperative complications were evaluated. The result as follows : There were statistically significant differences in probing depth reduction, clinical attachment gain, mobility reduction at values of 3, 6, 12 months postoperatively compared to values of baseline(p<0.05), whereas no significant differences in SBI and gingival recession. In group II, membrane exposure level was increased at 1, 2, 6 weeks postoperatively compared to value of baseline(p<0.05). There were statistically significant differences in changes of probing depth at 3, 6, 12 months postoperatively in combination groups of ePTFE membrane and bone graft compared to groups of ePTFE membrane alone(p<0.05). The vast majority of cases fall into typical healing and delayed healing response when membranes were removed in all groups. Pain and swelling were common postoperative complications. In conclusion, this study was showed more effective healing aspects in combination treatment of ePTFE membrane and bone graft than ePTFE membrane alone and on mandibular molar class II furcation defects than maxillary molar.
Purpose: We evaluated the usefulness of 24 hour/3 hour radio-uptake ratio, lesion to non-lesion ratio, in differentiating bony metastases from acute (<2 months) and healing (${\geq}2$ months) fractures. Materials and Methods: Sixty-three patients (age range: 26-81, 32 males, 31 females) having 90 lesions (30 bone metastases, 30 acute fractures, 30 healing fractures) were included. Bone scans were obtained 3 and 24 hours after administration of 740 MBq of $^{99m}Tc$-MDP. The ratio of radio-uptake in the lesion to normal area was measured as 24/3 hour radio-uptake ratio ([lesion/non-lesion RUR at 24 hour]/[lesion/non-lesion RUR at 3 hour], 24/3 RUR) and analyzed clinical significance in differentiating bone metastases from acute or healing fractures. Results: Mean 24/3 RUR were $1.22{\pm}0.18$ for bone metastases, $1.25{\pm}0.14$ for acute fractures, and $0.99{\pm}0.15$ for healing fractures. 24/3 RUR values of bone metastases and acute fractures were not significantly different. But 24/3 RUR values of bone metastases and healing fractures, and those of acute and healing fractures were found to be significantly different (p<0.001). When 24/3 RUR of 1.0 was considered as the cut off point separating metastases from fracture, a sensitivity of 100% (30/30) was obtained. The specificity was 0% (0/30) in separating metastases from acute fractures, and 47% (14/30) in separating metastases from healing fractures. When 24/3 RUR of 1.2 was considered as the cut off point, sensitivity of 53% (16/30) in the diagnosis of bone metastasis, and specificity of 37% (11/30) in separating metastases from acute fractures, and 100% (30/30) in separating metastases from healing fractures were obtained. Conclusion: 24/3 RUR is useful in differentiating bone metastases from healing fractures, but not in differentiating bone metastases from acute fractures. A 24/3 RUR of less than 1.0 suggests healing fractures. A 24/3 RUR of more than 1.2 suggests bone metastases or acute fractures.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.34
no.2
/
pp.119-130
/
2008
Absorbable atelo-collagen sponge $TERUPLUG^{(R)}$, Termo Co. Tokyo, Japan) is inserted in the extraction wound where alveolar bone is exposed. It protects wounds and promotes the formation of granulation. This is made of atelo-collagen, to minimize antigenicity, which is cross-linked by heat treatment for biocompatibility. $TERUPLUG^{(R)}$ consists of between 85 and 95 % of collagen type I and between 5 to 15 % of collagen type III. The raw material for the collagen is derived from bovine skin. It features a sponge block design and is shaped for easy insertion in the extraction wound. This study was designed to find out the bone healing capacity of $TERUPLUG^{(R)}$. We implanted $TERUPLUG^{(R)}$ (experimental group I) and $TERUPLUG^{(R)}$ with rhBMP-2 (experimental group II) in the rabbit cranium defect and then histologically analysed the specimen. The results were as follows. 1. In the 4 weeks, a lot of the newly formed collagen fibers around material of the experimental group I implanted $TERUPLUG^{(R)}$ were observed. But, in the experimental group II implanted $TERUPLUG^{(R)}$ with rhBMP-2, a little of newly formed collagen fibers around material were observed. The cell proliferating activity and apoptosis of the experimental group I, II was positive in and around the implanted material. 2. In the 8 weeks, the amount of newly formed and matured bone in the experimental group II was more observed than the experimental group I and control group. The results of this study indicate that absorbable atelo-collagen sponge ($TERUPLUG^{(R)}$) is relatively favorable bone void filler with biocompatibility and has the better bone healing capacity in case of application with rhBMP-2.
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