• Journal of Periodontal and Implant Science
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• v.52 no.4
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• pp.298-311
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• 2022

Purpose: The aim of this study was to evaluate the clinical outcomes of periodontal granulation tissue preservation (PGTP) in access flap periodontal surgery. Methods: Twenty patients (stage III-IV periodontitis) with 42 deep periodontal pockets that did not resolve after non-surgical treatment were consecutively recruited. Access flap periodontal surgery was modified using PGTP. The clinical periodontal parameters were evaluated at 9 months. The differences in the amount of granulation tissue width (GTw) preserved were evaluated and the influence of smoking was analyzed. Results: GTw >1 mm was observed in 97.6% of interproximal defects, and the granulation tissue extended above the bone peak in 71.4% of defects. At 9 months, probing pocket depth reduction (4.33±1.43 mm) and clinical attachment gain (CAG; 4.10±1.75 mm) were statistically significant (P<0.001). The residual probing depth was 3.2±0.89 mm. When GTw extended above the interproximal bone peak (i.e., the interproximal supra-alveolar granulation tissue thickness [iSUPRA-GT] was greater than 0 mm), a significant CAG was recorded in the supra-alveolar component (1.67±1.32 mm, P<0.001). Interproximal gingival recession (iGR) was significant (P<0.05) only in smokers, with a reduction in the interdental papillary tissue height of 0.93±0.76 mm. In non-smokers, there was no increase in the iGR when the iSUPRA-GT was >0 mm. The clinical results in smokers were significantly worse. Conclusions: PGTP was used to modify access flap periodontal surgery by preserving affected tissues with the potential for recovery. The results show that preserving periodontal granulation tissue is an effective and conservative procedure in the surgical treatment of periodontal disease.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.155-163
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• 2000

Osteoporosis is the consequence of an imbalance between osteoclastic and osteoblastic activity, coupled with an increased rate of bone turnover observed with menopause. Estrogen is generally considered to maintain bone mass through suppression of bone resorption. The purpose of this study was to evaluate the rat femoral trabecular change not only in the deficiency of estrogen but also in the administration of estrogen following ovariectomy(OVX). 30 female Sprague-Dawley rats were subjected to bilateral OVX or sham surgery(control). Groups of OVX were divided into 4 groups. The first group was injected daily with vehicle alone for 20 days after 20 weeks following OVX. The additional groups of OVX was injected daily with low, medium, or high doses of $17{\beta}-estradiol$(10, 25 or $50{\mu}g/kg$ BW, respectively). All rats were sacrified 23 weeks after OVX, and their femur were processed for H&E, MT stain and histomorphometry. The results were as follows; 1. In the histomorphometric analysis, the trabecular bone volume/tissue volume, trabecular thickness and trabecular seperation were respectively $31.2{\pm}8.3%$, $54.3{\pm}4.8{\mu}m$ and $280.7{\pm}16.4{\mu}m$ in vehicle treated OVX group and $48.6{\pm}7.3%$, $90.4{\pm}4.5{\mu}m$ and $126.3{\pm}5{\mu}m$ in sham operation group, and they showed statistical significance compare to control group. 2. The trabecular bone volume/tissue volume, trabecular thickness and trabecular separation were respectively $44.4{\pm}4.3%$, $109.5{\pm}12.3{\mu}m$ and $94.9{\pm}8.5{\mu}m$ in low doses of $17{\beta}-estradiol$ injected group and they showed statistical significance compare to OVX group. 3. The trabecular bone volume/tissue volume, trabecular thickness and trabecular separation were respectively $44.4{\pm}4.3%$, $109.5{\pm}12.3{\mu}m$ and $94.9{\pm}8.5{\mu}m$ in medium doses of $17{\beta}-estradiol$ injected group and they showed statistical significance compare to OVX group, but they didn't show statistical significance compare to low doses of $17{\beta}-estradiol$ injected group. 4. The trabecular bone volume/tissue volume, trabecular thickness and trabecular separation were respectively $46.4{\pm}4.5%$, $154.4{\pm}13.2{\mu}m$ and $113.7{\pm}12.8{\mu}m$ in high doses of $17{\beta}-estradiol$ injected group and they also showed statistical significance compare to OVX group, but they didn't show statistical significance compare to other experimental groups. From the above results, metaphyseal bone formation was markedly reduced in OVX rate but treatment of OVX rats with $17{\beta}-estradiol$ resulted in normalization of femur trabecular bone volume. But they didn't show statistical significance the effect of bone formation according to the dose dependency.

• Journal of Periodontal and Implant Science
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• v.48 no.3
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• pp.152-163
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• 2018

Purpose: To determine whether the swelling and mechanical properties of osmotic self-inflating expanders allow or not the induction of intraoral soft tissue expansion in dogs. Methods: Three different volumes (0.15, 0.25, and 0.42 mL; referred to respectively as the S, M, and L groups) of soft tissue expanders (STEs) consisting of a hydrogel core coated with a silicone-perforated membrane were investigated in vitro to assess their swelling behavior (volume swelling ratio) and mechanical properties (tensile strength, tensile strain). For in vivo investigations, the STEs were subperiosteally inserted for 4 weeks in dogs (n=5). Soft tissue expansion was clinically monitored. Histological analyses included the examination of alveolar bone underneath the expanders and thickness measurements of the surrounding fibrous capsule. Results: The volume swelling ratio of all STEs did not exceed 5.2. In tensile mode, the highest mean strain was registered for the L group ($98.03{\pm}0.3g/cm$), whereas the lowest mean value was obtained in the S group ($81.3{\pm}0.1g/cm$), which was a statistically significant difference (P<0.05). In addition, the S and L groups were significantly different in terms of tensile strength ($1.5{\pm}0.1g/cm$ for the S group and $2.2{\pm}0.1g/cm$ for the L group, P<0.05). Clinical monitoring showed successful dilatation of the soft tissues without signs of inflammation up to 28 days. The STEs remained volumetrically stable, with a mean diameter in vivo of 6.98 mm, close to the in vitro post-expansion findings (6.69 mm). Significant histological effects included highly vascularized collagen-rich fibrous encapsulation of the STEs, with a mean thickness of $0.67{\pm}0.12mm$. The bone reaction consisted of resorption underneath the STEs, while apposition was observed at their edges. Conclusions: The swelling and mechanical properties of the STEs enabled clinically successful soft tissue expansion. A tissue reaction consisting of fibrous capsule formation and bone loss were the main histological events.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.447-472
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• 1999

The preclinical and clinical studies reviewed herein show that rhBMP-2 induces normal physiologic bone in relevant defects in the craniofacial skeleton. The newly formed bone assumes characteristics of the adjacent resident bone, and allows placement and osseointegration of dental implants. Clearly, the bone inducing capacity of rhBMP-2 is carrier and site dependent. rhBMP-2 in an absorbable collagen sponge carrier induces relevant bone formation in space providing defects. Space providing carries extends this possibility to non-space providing sites. Notably, some ceramic and polymeric biomaterials may substantially interfere with rhBMP-2 induced osteogenesis.

• Journal of Biomedical Engineering Research
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• v.26 no.2
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• pp.101-110
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• 2005

Periosteum and periosteum-derived progenitor cells have demonstrated the potential for stimulative applications in repairs of various musculoskeletal tissues. It has been found that the periosteum contains mesenchymal progenitor cells capable of differentiating into either osteoblasts or chondrocytes depending on the culture conditions. Anatomically, the periosteum is a heterogeneous multi-layered membrane, consisting of an inner cambium and an outer fibrous layer. The present study was designed to elucidate the cellular phenotypic characteristics of cambium and fibrous layer cells in vitro, and to assess whether structural integrity of the tendon in the bone tunnel can be improved by periosteal augmentation of the tendon­bone interface. It was found the cells from each layer showed distinct phenotypic characteristics in a primary monolayer culture system. Specifically, the cambium cells demonstrated higher osteogenic characteristics (higher alkaline phosphatase and osteocalcin levels), as compared to the fibrous cells. Also in vivo animal model showed that a periosteal augmentation of a tendon graft could enhance the structural integrity of the tendon-bone interface, when the periosteum is placed between the tendon and bone interface with the cambium layer facing toward the bone. These findings suggest that extra care needs to be taken in order to identify and maintain the intrinsic phenotypes of the heterogeneous cell types within the periosteum. This will improve our understanding of periosteum in applications for musculoskeletal tissue repairs and tissue engineering.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.35-48
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• 1991

Installation periods of implants in Mx. and Mn., is related to pattern of bone formation. The purpose of this study was to observe histologic response in osseointegration at root formed implant-tissue interface at Mx. and Mn., the other is comparison of osseointegration level between Mx. and Mn. at 8 weeks. In this study, unilateral upper & lower molars were extracted in dog. After allowing to heal for 4 months, two kinds of osseointegrated implants Swedevents, Corevents-were inserted in dog. The specimens were treated by conventional method. The interface zones between bone and implant were investiigated using X-rays, light microscope. The following results were obtained from this study. 1. Around titanium implants that were installed in Ma and Mn., Radio lucencies don't exist 2. There are not inflammation and mobility of titanium implants that were installed in Mx. and Mn. Most of implant surface are covered by bony tissued partly by bone-marrow tissues. 3. Titanium implants installed in Mx, in contrast to same implants in Mn., shows more coverage by bone marrow tissue and lack of apposition lamellar bone, which lead to the assumption that bone formation in Mn. is faster than in Mx.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.2
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• pp.112-123
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• 2013

This study aims to investigate the clinical outcome following treatment of peri-implantitis lesions. Five subjects with 7 implants were treated with surgical approach. Four subjects with 6 implants were initially treated with non-surgical approach or hygiene control. However, inflammation was not resolved and more bone loss was found. Therefore, surgical treatment was performed. After surgical exposure of the defect, granulation tissue was removed and implant surface was treated using tetracycline and chlorhexidine. Then, the flaps were sutured. The wound healing was performed in a non-submerged mode. The present finding demonstrates stable results without progression of bone loss. In one subject, deep V shaped bone defect was filled with bone substitute (ICB, CanCellous Bone, Rockey Mountain Tissue Bank, USA), and resorbable membrane (Lyoplant$^{(R)}$, B.Braun Aesculap AG, Germany) was placed over the grafted defect and healing abutment was connected. However, the inflammation was not resolved and more bone loss was found. At one month after regenerative surgery, the implant was removed.

• Advances in biomechanics and applications
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• v.1 no.1
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• pp.15-22
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• 2014

Computed tomography (CT) is being utilized in orthopaedics and related research to estimate bone strength. These applications benefit from calibration of Hounsfield units to mineral density typical of long bone, up to $1750mg/cm^3$. This study describes a method for establishing repeatable calibration of Hounsfield units to density, and determines the effects of imaging medium on calibration accuracy. Four hydroxyapatite standards were imaged in air on 7 occasions over 19 weeks using a helical multi-slice CT scanner. Each standard was scanned 5 times in different media: porcine soft tissue, water, and air. Calibrated densities were highly repeatable (CV<3.5%). No difference in density was observed between water and soft tissue conditions (p>0.08). This work provides a model for determining repeatable scanner-specific density calibration, demonstrates that the linear relationship between Hounsfield units and density extends to values typical of cortical bone, and supports the practice of imaging calibration standards in an environment similar to that of the target bone.

• Imaging Science in Dentistry
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• v.49 no.3
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• pp.235-240
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• 2019

Osteosarcoma is the most common primary bone tumor after plasma cell neoplasms. Osteosarcoma has diverse histological features and is characterized by the presence of malignant spindle cells and pluripotent neoplastic mesenchymal cells that produce immature bone, cartilage, and fibrous tissue. Osteosarcoma most frequently develops in the extremities of long bones, but can occur in the jaw in rare cases. The clinical and biological behavior of osteosarcoma of the jaw slightly differs from that of long-bone osteosarcoma. The incidence of jaw osteosarcoma is greater in the third to fourth decades of life, whereas long-bone osteosarcoma mostly occurs in the second decade of life. Osteosarcoma of the jaw has a lower tendency to metastasize and a better prognosis than long-bone osteosarcoma. Radiographically, osteosarcoma can present as a poorly-defined lytic, sclerotic, or mixed-density lesion with periosteal bone reaction response. Multi-detector computed tomography is useful for identifying the extent of bone destruction, as well as soft tissue involvement of the lesion. The current case report presents a fibroblastic osteosarcoma involving the left hemimandible with very unusual radiographic features.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.153-171
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• 1999

The purpose of this study was to evaluate the effect of modified calcium sulfate paste on periodontal regeneration. l-wall intrabony defect(mesio-distal width: 4mm, depth: 4mm) was surgically created on the distal side of P2 and mesial side of p4 in four dogs. The control group(GFS) was treated with conventional flap operation alone, and the experimental group(CS) was treated with conventional flap operation with modified calcium sulfate paste application. Both control and experimental groups were sacrificed after 8weeks of healing period, The results of histological and histometric observations were as follows. 1. The length of the junctional epithelium was 0.41${\pm}$0.01mm in the control groups, 0.47${\pm}$0.01mm in the experimental group. 2. The connective tissue attachment was 0.28${\pm}$0.02mm(6.15${\pm}$0.28%) in the control group, 0.18${\pm}$0.01mm(3.41${\pm}$0.14%) in the experimental group. The control group showed more connective tissue attachment. 3. The new cementum formation was 3.80${\pm}$0.06mm(84.80${\pm}$0.33%) in the control group, 4.49${\pm}$0.06mm(87.57${\pm}$0.15%) in the experimental group. Both groups showed a lot of new cementum formation. 4. The new bone formation was 1.43${\pm}$0.03mm(32.37%) in the control group, 2.04${\pm}$O.09mm(40.94%) in the experimental group. 5. The inflamatory cells were observed partially around resorbed calcium sulfate in the connective tissue of the experimental group. 6. Partially resorbed calcium sulfate were found within the connective tissue, around alveolar bone, and in the newly formed alveolar bone, On the basis of these results, newly formed calcium sulfate paste enhanced new bone formation and new cementum formation. The resorption rate of calcium sulfate seems to be controlled by the add-in compounds. Thus research about biocompatibility and adequate resorptionrate is required to develop a improved material.