• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.2
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• pp.77-84
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• 2013

Objectives: This study evaluated implant success rate, survival rate, marginal bone resorption of implants, and material resorption of sinus bone graft in cases wherein tapered body implants were installed. Materials and Methods: From September 2003 to January 2006, 20 patients from Seoul National University Bundong Hospital, with a mean age of 54.7 years, were considered. The mean follow-up period was 19 months. This study covered 50 implants; 14 implants were placed in the maxillary premolar area, and 36 in the maxillary molar area; 24 sinuses were included. Results: The success rate was 92%, and the survival rate was 96.0%. The mean amount of sinus augmentation was $12.35{\pm}3.27$ mm. The bone graft resorption rate one year after surgery was $0.97{\pm}0.84$ mm; that for the immediate implantation group was $0.91{\pm}0.86$ mm, and that for the delayed implantation group was $1.16{\pm}0.77$ mm. However, the difference was not statistically significant. The mean marginal bone resorption one year after restoration was $0.17{\pm}0.27$ mm (immediate group: $0.12{\pm}0.23$ mm; delayed group $0.40{\pm}0.33$ mm); statistically significant difference was observed between the two groups. Conclusion: Tapered body implant can be available in the maxillary posterior edentulous ridge which sinus bone graft is necessary.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.422-441
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• 1993

The purpose of this study was to compare effects of the bioceramics on healing processes of the alveolar bone defects in dogs. Five adult dogs aged 1 to 2 years were used in this study. Experimental alveolar bone defects were created surgically with a #1/2 round bur at the furcation area of the buccal surface of the mandibular 3rd, 4th premolars and 1st molar. Fifteen experimental alveolar bone defects were devided into three groups according to the type of graft materials. The groups were as follows : 1) flap operation with dense hydroxyapatite( DHA group ) 2) flap operation with porous hydroxyapatite( PHA group ) 3) flap operation with natural coral ( NC group ) At 1, 2, 4, 6, and 12 weeks, dogs were serially sacrificed and specimens were prepared with Hematoxylin-Eosin stain and Mallory stain for light microscopic evaluation. The results of this study were as follows : 1. In every group, inflammatory cell infiltrations were seen at 1st weeks due to surgical trauma, however inflammatory response owing to graft materials were not seen. 2. In every group, the appearance of connective tissue around graft materials was loosely formed at the initial stages, however the connective tissue was densely formed at 2 weeks. 3. The presence of osteocytes were observed at 2 weeks in the natural coral group, however the osteocytes were appeared at 6weeks in the dense hydroxyapatite group. 4. A new bone was formed from the base and walls of the defect and gradually expanded toward the graft materials. 5. A resorption of the natural coral occurred irregularly at the periphery of the material, therefore the size and shape of the natural coral were reduced at 6 weeks. 6. At 12 weeks, the porous hydroxyapatite and natural coral were surrounded by newly formed bone most completely, however dense hydroxyapatite was surrounded by newly formed bone in part.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.478-487
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• 2023

Background The outcome of alveolar grafting with synthetic bone substitute (Osteon III) in various bone defect volumes is highlighted. Methods A prospective study was accomplished on 55 patients (6-13 years of age) with unilateral alveolar bone cleft. Osteon III, consisting of hydroxyapatite and tricalcium phosphate, is used to reconstruct the defect. Alveolus defect diameter was calculated before surgery (V1), after 3 months (V2), and finally after 6 months (V3) postsurgery. In the t-test, a significant difference and correlation between V1, V2, and V3 are stated. A p-value of 0.01 is considered a significant difference between parameters. Results The degree of cleft is divided into three categories: small (9 cases), medium (20 patients), and large (26 cases).The bone volume of the clefted site is divided into three steps: volume 1: (mean 18.1091 mm³); step 2: after 3 months, volume 2 resembles the amount of unhealed defect (mean 0.5109 mm³); and the final bone volume assessment is made after 6 months (22.5455 mm³). Both show statistically significant differences in bone volume formation. Conclusion An alloplastic bone substitute can also be used as a graft material because of its unlimited bone retrieval. Osteon III can be used to reconstruct the alveolar cleft smoothly and effectively.

• The Journal of the Korean dental association
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• v.50 no.12
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• pp.743-754
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• 2012

urpose : The purpose of this study was to evaluate the US II plus/GS II Osstem$^{(R)}$ implants through the study for the clinical success rate during the installation of the Osstem¢Á implants after bone graft. Materials and Methods : This study was researched in the 4 medical institutions: Chonnam National University, Chosun University, Bundang Seoul National University Hospital, and FM dental clinic from May, 2002 to September, 2009. Based on the total number of 60 patients whose treatment was the installation of the US II plus/GS II Osstem¢Á implants after bone graft, we evaluated success rate of implants. We analysis the distribution of patient's age and gender, edentulous area, bone type, fixture length and diameter, installation and loading time, donor site, bone graft material and method, antagonistic teeth, and survival and success rate. From these analyses we got the following results. Results : 1. In this study, the total number of patients who have been installed with US II plus implant was 27, and total of 52 implants were installed. The average age was 38.9, with 16 male, and 11 female patients. 2. The total number of patients who have been installed with GS II implant was 33, and total of 54 implants were installed. The average age was 49.7, with 24 male, and 9 female patients. 3. As for bone graft method, either autogenous bone or a mix of autogenous and heterogenous bone was used(88.4%) for US II plus. Chin, iliac, and Maxillary tuberosity were the donor sites for autogenous bone graft, and onlay method of bone graft was performed. 4. Allogenic bone or a mix of autogenous and heterogenous bone was used(77.8%) for GS II. Chin, ramus, and tibia were the donor sites for autogenous bone graft, and GBR method of bone graft was performed. 5. The duration from the installation of implants to setting of final prosthesis was average of 16 months and 10 months for US II plus and GS II respectively. Also, the final follow up period was average of 31 months and 28 months respectively. During this period, one GS II implant was removed from 1 patient due to failure of early osteointegration. 6. The survival rates were 100% and 98.1%, and success rates were 94.2% and 94.4% for US II plus and GS II implant respectively. Conclusion : On the evaluation of our clinical study, both US II plus and GS II Osstem¢Á implants showed the excellent clinical results after bone graft.

• Journal of Periodontal and Implant Science
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• v.50 no.6
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• pp.418-434
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• 2020

Purpose: The purpose of the present study was to evaluate the effect of silica-calcium phosphate composite (SCPC) granules on bone regeneration in extraction sockets. Methods: Ten patients were selected for a split-model study. In each patient, bone healing in SCPC-grafted and control ungrafted sockets was analyzed through clinical, radiographic, histomorphometric, and immunohistochemical assessments 6 months postoperatively. Results: A radiographic assessment using cone-beam computed tomography showed minimal ridge dimension changes in SCPC-grafted sockets, with 0.39 mm and 1.79 mm decreases in height and width, respectively. Core bone biopsy samples were obtained 6 months post-extraction during implant placement and analyzed. The average percent areas occupied by mature bone, woven bone, and remnant particles in the SCPC-grafted sockets were 41.3%±12%, 20.1%±9.5%, and 5.3%±4.4%, respectively. The percent areas of mature bone and woven bone formed in the control ungrafted sockets at the same time point were 31%±14% and 24.1%±9.4%, respectively. Histochemical and immunohistochemical analyses showed dense mineralized bundles of type I collagen with high osteopontin expression intensity in the grafted sockets. The newly formed bone was well vascularized, with numerous active osteoblasts, Haversian systems, and osteocytes indicating maturation. In contrast, the new bone in the control ungrafted sockets was immature, rich in type III collagen, and had a low osteocyte density. Conclusions: The resorption of SCPC granules in 6 months was coordinated with better new bone formation than was observed in untreated sockets. SCPC is a resorbable bone graft material that enhances bone formation and maturation through its stimulatory effect on bone cell function.

• The Journal of Advanced Prosthodontics
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• v.2 no.1
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• pp.7-13
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• 2010

Although most researchers agree that platelet-rich plasma (PRP) is a good source of autogenous growth factors, its effect on bone regeneration is still controversial. The purpose of this study was to evaluate whether increasing angiogenic factors in the human PRP to enhance new bone formation through rapid angiogenesis. MATERIAL AND METHODS. In vitro, the human platelets were activated with application of shear stress, $20\;{\mu}g/ml$ collagen, 2 mM $CaCl_2$ and 10U thrombin/$1\;{\times}\;10^9$ platelets. Level of vascular endothelial growth factor (VEGF) and platelet microparticle (PMP) in the activated platelets were checked. In the animal study, human angiogenic factors-enriched PRP was tested in 28 athymic rat's cranial critical bone defects with $\beta$-TCP. Angiogenesis and osteogenesis were evaluated by laser Doppler perfusion imaging, histology, dual energy X-ray densinometry, and micro-computed tomography. RESULTS. In vitro, this human angiogenic factors-enriched PRP resulted in better cellular proliferation and osteogenic differentiation. In vivo, increasing angiogenic potential of the PRP showed significantly higher blood perfusion around the defect and enhanced new bone formation around acellular bone graft material. CONCLUSION. Angiogenic factor-enriched PRP leads to faster and more extensive new bone formation in the critical size bone defect. The results implicate that rapid angiogenesis in the initial healing period by PRP could be supposed as a way to overcome short term effect of the rapid angiogenesis.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.251-261
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• 2005

Alveolar ridge defects may limit or restrict placement of implants. The purpose of this study was to evaluate clinical and histopathologic results which occur following guided bone regeneration using platelet-rich plasma, bovine bone powder and e-PTFE membrane in the localized alveolar bone defects. Ten patients who required guided bone regeneration in implant placemnet, were slelected. Alveolar crest height and width were measured at baseline and, afer 2nd surgery 5 months later At 5 months , we obtained histopathological results as follows: 1. Alveolar crest height was an average of $8.20{\pm}3.74$ mm preoperatively and decreased to an average of $7.40{\pm}1.84$ mm postoperatively. There was no significant difference. 2. Alveolar crest width was an average of $4.25{\pm}2.03$ mm preoperatively and significantly increased to an average of $7.20{\pm}2.44$ mm postoperatively (P<0.01) 3. The change of Alveolar crest height and width were $0.80{\pm}1.40$ mm, $2.95{\pm}1.09$ mm 4. Histopathological evaluations revealed new bone formation with graft material and laminated bone containing the presence of osteocyte-like cell In conclusion, guided bone regeneration using platelet-rich plasma, bovine bone powder and e-PTFE membrane would provide a viable therapeutic alternative for implant placement in the localized alveolar defect or implant failure

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.249-255
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• 2011

Purpose: Placement of endosseous implants in the atrophic maxilla is often restricted because of the lack of supporting bone. In this article, augmentation of the maxillary sinus floor with deproteinized bovine bone to enable insertion of endosseous implants is described. The technique is aimed at providing a cortical layer on top of the graft to ensure a reliable seal of the maxillary sinus and to achieve optimal stability of the bone graft in case of simultaneously placement of dental implants. Methods: The procedure was used in 200 patients (839 implants), using deproteinized bovine bone. The mean follow-up was 28.5 months. No inflammation of the bone grafts nor of the maxillary sinus occurred. The patients received implant supported overdentures or bone-anchored bridges. Results: The survival rate of implant restoration of this study was 97.6%. The total average of marginal bone loss in radiographs was $0.20{\pm}0.38$ mm. Insufficient primary stability, bony quality, and infection were thought to be associated factors in the failed cases. Conclusion: This study documented that deproteinized bovine bone, when used as a grafting material for augmentation of the sinus floor, may lead to proper osseointegration of a endosseous implant.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.467-473
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• 2007

The most important factor for successful implantation is osseointegration between the implant and bone. The expression of bone morphogenetic proteins (BMPs) inducing bone formation would differ after maxillary sinus elevation. And within the same graft material. the expression of BMPs would change with time after graft. The aim of this study was to compare the relative expressions of BMP4 and BMP6 using real-time RT-PCR when maxillary sinus elevation was performed using deproteinated bovine bone powder (DBBP) as the graft material or absorbable gelatin sponge (AGS) as the filler without any graft material. Fifteen rabbits, each weighing between 3.0 to 3.5 Kg, were divided randomly into 5 groups of 3 animals each based on their time of sacrifice 0, 3, 5, 7 and 9 days). After exposure of the maxillary sinus bilaterally, bone graft was performed in the right maxillary sinus using DBBP ($BBP^{(R)}$ Oct Inc., Cheonan, Korea) and only AGS ($Gelfoam^{(R)}$ Pharmacia & Upjohn Company, Kalamazoo, MI, U.S.A) was placed into the left without any graft material. Each group of rabbits was sacrificed at 1, 3, 5, 7, or 9 days after operation and all specimens were harvested. And the following results were obtained using real-time RT-PCR from isolated total RNA of the samples. 1. The expression of BMP4 increased at postoperative 1 and 3 days in both DBBP group and AGS group. In AGS group. it decreased at postoperative 5 days. increased again at postoperative 7 days, and decreased at postoperative 9 days. In DBBP group, it increased until postoperative 7 days and decreased at postoperative 9 days. Although the expression of BMP4 was higher in DBBP group compared with AGS group, it was not statistically significant (p>0.05). 2. The expression of BMP6 increased at postoperative 1 and 3 days in both DBBP group and AGS group. In AGS group, it decreased at postoperative 5 days, increased again at postoperative 7 days, and decreased at postoperative 9 days. In DBBP group, it increased until postoperative 7 days and decreased at postoperative 9 days. Although the expression of BMP6 was higher in AGS group compared with DBBP group, it was not statistically significant (p>0.05). 3. There was no statistically significant difference in BMP expression in both groups during same period of time. It' s probably because DBBP and AGS both functioned as a space retainer so that the BMP expression in blood clot seemed to be similar. 4. Thus, DBBP would not offer many benefits for early bone regeneration compared with AGS. The expression of BMP in early bone formation seems to be more influenced by physical carrier rather than the graft type.

• 대한치주과학회:학술대회논문집
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• 2007.11a
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• pp.128-129
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• 2007