• Journal of Periodontal and Implant Science
• /
• 제38권3호
• /
• pp.437-444
• /
• 2008

Purpose: A number of techniques and materials have been used for periodontal regeneration and bone graft procedures with guided tissue regeneration(GTR) have been suggested as alternatives to osseous surgery in the management of local infra-bony defects. However, the long-term stability and treatment outcome following bone graft procedure of infra-bony defects is poorly documented. The purpose of this study was to assess radiographic change in infra-bony defects over 2 years after bone graft procedures with various graft materials. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients showed clinical and radiographic evidence of infra-bony defect(s). 44 sites of 34 patients aged 31 to 69 (mean age 48.3) were treated by bone graft procedure with a bone graft material. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. Result: We observed $1.15{\pm}1.95\;mm$ of bone fill, $0.40{\pm}1.19\;mm$ of crestal resorption, $1.55{\pm}1.77\;mm$ of defect resolution, and $40{\pm}44%$ of percentage of defect resolution. Deeper initial defect depth, narrower initial defect angle showed significantly greater bone fill, defect resolution, and % of defect resolution. But no significant difference was observed in graft sites and graft materials. Conclusion: If good oral hygiene maintenance and periodic recall check of patients is assured, bone graft procedure using various graft materials is one of the appropriate treatment modality for regenerative therapy of infra-bony defects.

• Archives of Reconstructive Microsurgery
• /
• 제4권1호
• /
• pp.43-51
• /
• 1995

In certain low-grade malignant bone tumors such as chondrosarcoma or frequent recurrent benign bone tumors as ossifying fibroma, radical treatment may provide a good chance for cure. And large bony defect after the radical treatment can be filled with the massive bone graft. Recent advances in clinical microsurgery have made free vascularized bone graft a clinical reality, and Taylor in 1975, first reported the technique of free vascularized fibula graft for the reconstruction of large tibial defect with excellent clinical results. We tried wide excision and free vascularized fibula graft in 5 patients with ossifying fibroma and one patient with chondrosarcoma from January 1984 to December 1994 and followed for more one year. The shortest bony defect was 7cm and the longest bony defect was 20cm and mean bony defect was 13cm. All patients were evaluated clinically and roentgenographycally on basis of functional recovery and bony union. All patients showed satisfactory functional recovery with sound bony union and showed bony hypertrophy. And, local recurrence was not seen.

• Journal of Periodontal and Implant Science
• /
• 제33권4호
• /
• pp.573-584
• /
• 2003

Bone remodeling results from the combined process of bone resorption and new bone formation which is regulated in part by some of Dexamethasone related proliferation & mineralization of cultured bone cell and polypeptide growth factors such as platelet derived growth factor(PDGF), which has been known to be an important local regulator of bone cell activity and participate in normal bone remodeling. To evaluate the effects of Dex and PDGF on bony healing of calvarial defect in rats, 10 ng/ml PDGF were applied on P group and 10 ng/ml PDGF and $10^7$ M Dex were applied PD group. 4 rats in each group were sacrificed at 7, 14. 21 days after operation respectively, and the tissue blocks were prepared for light microscope with H-E for evaluation of overall healing, with TRAP(tartrate resistant acid phosphatase) for evaluation of osteoclastic activity and with immunohistochemical staining for macrophages. The results were as follows : 1. In all group, healing aspects were progressed from 7 days to 21 days in soft and bony tissue, but complete repair were not observed in bony defect 2. PDGF and control group were showed similar bony healing aspect , but bony healing in combination of PDGF-BB and Dex were observed slower aspect compared to PDGF and control group from early healing times. 3. There were no significant difference on activities of osteoclast and macrophages in bony healing between control and experimental group In conclusion, PDGF were not influenced on bony healing of defect and combination of PDGF-BB and Dex were showed slower healing through early healing times. it was considered that Dex compared to PDGF did influenced on early hone formation factors in healing period

• Journal of Periodontal and Implant Science
• /
• 제29권2호
• /
• pp.355-373
• /
• 1999

Many researches have been reported that collagen as cellular stroma, matrix of grafting materials, mediator of agents for the purpose of promoting healing process invivo, but the responses in vivo were seen various. The goal of this experiment is to assess the effect of collagen on bony healing, through histological evaluation of implanted collagen on the calvarial defect in rats. 2-month-old Sprague-Dawley, 24 rats were used and 12 rats assigned to each group of control and test. Defect of 5mm in diameter was made on the calvarial bone with trephine bur. Following thorough saline rinse, defect of control group was left in empty and that of experimental group was filled with fibrillar collagen($COLLATAPE^{(R)}$, COLLA-TEC. INC. U.S.A.) soaked in saline. 3 rats in each group were sacrificed at 3, 7, 14, 21 days after operation respectively, and the tissue blocks were prepared for light microscope with H-E for evaluation of overall healing, with TRAP(tartrate resistant acid phosphatase) for evaluation of osteoclastic activity and with immunohistochemical staining for macrophages. The results were as follows : 1. In the control group, inflammatory responses were disappeared at day 14, but, in the experimental group inflammatory infiltrates were reduced at day 21. Thus, the experimental group showed more severe soft tissue inflammation than control group. 2. Both control and experimental group showed slight appositional growth at day 7 and gradual bony growth to 21th day. But, complete bony healing of the defect was not shown. There was no significant difference in bony healing between control and experimental group 3. Specific response of macrophages for implanted collagen was observed at day 14 in the experimental group. In conclusion, although fibrillar collagen caused inflammation of soft tissue during initial healing period, inflammatory responses by fibrillar collagen didn't inhibit bony regeneration and implanted collagen was biodegradaded by macrophages. Thus, we expect that fibrillar collagen can be used for useful mediator of graft materials or growth factors.

• Clinics in Shoulder and Elbow
• /
• 제14권1호
• /
• pp.117-124
• /
• 2011

목적: 골성 방카르트 병변의 여러 가지 치료 방법 중 관절경적 재건술에 대하여 문헌 고찰과 함께 대략적으로 설명하기로 한다. 대상 및 방법: 견관절 전방 불안정성의 치료에 있어 관절경적 복원술의 임상결과 향상으로 개방적 수술보다 관절경적 수술을 더욱 선호하게 되었고 점차 표준 치료법으로 인정받게 되었다. 그러나 관절와의 골 결손이 있는 경우 골 결손의 정도를 측정하는 방법은 연구자에 따라 다양하며 관절경적 복원술의 방법 또한 지속적 발전과 함께 다양하게 소개되고 있다. 결과: 골 결손의 관절경적 재건술 중 방카르트 병변의 이열 봉합술은 일열 봉합술의 단점을 보완하여 보다 견고한 고정과 해부학적 복원을 위해 최근에 소개되었으나 앞으로 많은 증례와 장기간 추시를 통해 그 결과가 입증되어야 할 것이다. 또한 관절경을 이용한 오구돌기 이전술, 즉 Bristow-Latarjet 술식 등 여러 가지 방법이 시도되고 있다. 결론: 전방 불안정성 환자의 관절경적 치료 방법은 다양하게 시도되고 있으며 지속적인 발전을 거듭하고 있다. 성공적인 결과를 얻기 위해서는 수술 전 환자의 골 결손 상태를 정확히 파악해야 하며 치료와 연관된 술 중, 술 후 요소들을 잘 알고 있어야 한다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제20권2호
• /
• pp.173-183
• /
• 1998

$TGF-{\beta}$ is one of growth factors that may be involved in the formation of bone and cartilage. Multiple studies demonstrate that $TGF-{\beta}$ is involved in regulating cell proliferation, differentiation and matrix synthesis, events observed in frature healing. The apperance of $TGF-{\beta}$ in the fracture during healing was evaluated by immunohistologic localization of $TGF-{\beta}$ using antibody. Twenty Sprauge-Dawley strain white male rats, each weiging about 150grams were used and divided two groups. The one group, the $2{\times}2mm$ bony defect was formed in the right femur. The other group, $4{\times}2mm$ bony defect was formed in right femur. Both group were sacrificed at 3day, 1, 2, 3, 4 week and femur were harvested, paraffin sections were stained with H & E, MT stain, immunihistochemical staining with $TGF-{\beta}$ antibody and observed under light microscope. The result were as follows: 1. New bone formation and cartilagenous tissue was seen at 3day. And in the $2{\times}2mm$ bony defect group, $TGF-{\beta}$ stained the cell surounding new bone. 2. The osteoclast and trabecular was seen at 1week. $TGF-{\beta}$ stained the osteoblast and in the $2{\times}2mm$ bony defect group was stained more than $4{\times}2mm$ bony defect group. 3. The lamella bone and trabecule was seen from 3, 4week, and $TGF-{\beta}$ stained almost negative. From the above finding, we could concluded that $TGF-{\beta}$ stained the osteoblast at early stage and 1week, the peak stain was seen from 1week, and then decreased, almost negative stain was seen at 3, 4week.

• Journal of Periodontal and Implant Science
• /
• 제32권1호
• /
• pp.161-172
• /
• 2002

The present study evaluated the effects of guided tissue regeneration using xenograft material(deproteinated bovine bone powder), with and without biodegradable membrane in beagle dogs. Contralateral fenestration defects (6 ${\times}$ 4mm) were created 4 mm apical to the buccal alveolar crest of maxillary premolar teeth in 5 beagle dogs. Deproteinated bovine bone powders were implanted into fenestration defect and one randomly covered biodegradable membrane (experimental group). Biodegradable membrane was used to provide GTR. Tissue blocks including defects with soft tissues which were harvested following four & eight weeks healing interval, prepared for histo-phathologic analysis. The results of this study were as follows. 1. In control group, at 4 weeks after surgery, new bony trabecular contacted with interstitial tissue and osteocytes like cell were arranged in new bony trabecule. Bony lamellation was not observed. 2. In control gruop, at 8 weeks after surgery, scar-like interstitial tissue was filled defect and bony trabecule form lamellation. New bony trabecular was contacted with interstitial tissue but defect was not filled yet. 3. In experimental group, at 4 weeks after surgery, new bony trabecular partially recovered around damaged bone. But new bony trabecular was observed as irregularity and lower density. 4. In experimental group, at 8 weeks after surgery, lamella bone trabecular developed around bone cavity and damaged tissue was replaced with dense interstitial tissue. In conclusion, new bone formation regenerated more in experimental than control groups and there was seen observe more regular bony trabecular in experimental than control groups at 4 weeks after surgery. In control group, at 8 weeks after surgery, the defects was filled with scar-like interstitial tissue but, in experimental group, the defects was connected with new bone. Therefore xenograft material had osteoconduction but could not fill the defects. We thought that the effective regeneration of periodontal tissue, could be achieved using GTR with biodegradable membrane.

• Journal of Acupuncture Research
• /
• 제18권5호
• /
• pp.135-146
• /
• 2001

Objective : Bone homeostasis is maintained by balance of bone formation and resorption. Therefore, bone related diseases arose by disturbance of this balance between osteoblast and osteoclast activities. To develop a successful screening system of the therapeutic components based on oriental medicine is essential to set out systematic approach for that purpose. Methods : This study was perforated Sprague-Dawley rat femur for bony defects(${\phi}5mm$) by the fissure bur. And experimetal group were treated with Cervi Pantotricuhum Cornu injection at both $Sh{\grave{e}}nsh{\tilde{u}}$(BL23) & $D{\grave{a}}zh{\grave{u}}(BL11)(0.2m{\ell})$. This was evaluated by radiography and histological analysis with in situ hybridization. Results : Cervi Pantotricuhum Cornu Herbal Acupuncture has weak effect on bony defect healing and this was evaluated by X-ray taking and histological analysis with in situ hybridization. Osteocalcin gene expression was not changed by Cervi Pantotricuhum Cornu Herbal Acupuncture in bony defects animal model. Conclusion : Taken together this study show that the Cervi Pantotricuhum Cornu herbal-acupuncture has a weak effect healing of bony defects, this type of approach might give a good chance to explore the favorable effects of Cervi Pantotricuhum Cornu herbal-acupuncture on bone tissue.

• 대한치과보철학회지
• /
• 제29권2호
• /
• pp.225-243
• /
• 1991

In recent years immediate implantation has been tried by a few clinicians. This study placed IMZ implants in the rabbit femur with and without bony defects around the implant for simulating fresh extraction site. And one group with bony defects used porous hydroxyapatite ganules(HA) to fill if and the other group left the bony defects around the implant. The purpose of this study was to compare the shear bond strength and the bony contact and formation around the implant. Fifteen rabbits were divided into three groups and placed 10 IMZ implants to each group. Implant sites were surgically prepared with IMZ drills kit and implants were placed(Control), artificial bony defect was created with Apaceram drills kit around the implant sites and implants were placed(Experimental I), bony defect was filled with porous hydroxyapatite granules(Experimental II). Thereafter, rabbits were sacrificed at 8th week and specimens were prepared and pushout tested for shear bond strength of bone-implant interface immediately. Undecalcified and decalcified specimens were prepared with Vilanueva and hematoxylin-eosin stain for light microscopic finding. The results of this study were as follows. 1. In the control group, mean shear strength of bone-implant interface was $2.614{\pm}0.680$ MPa, experimental I was $0.664{\pm}0.322$ MPa, and experimental II was $2.281{\pm}0.606$ MPa. There was significant difference between control and experimental I, between experimental I and experimental II, but did not show significant difference between control and experimental II statistically. 2. In the bony formation surrounding IMZ implant of the three groups, that of cortical bone is more advanced than cancellous bone area. 3. In the histological findings of undecalcified specimens, control and experimental II showed more than 50% of bony or osteoid formation at the bony-implant interface. 4. In the histological findings of undecalcified specimens, experimental I showed less than 50% of bony or osteoid formation at the interface, and observed partial bony defect in the coronal zone. 5. In the experimental II group, were observed direct bony contact to hydroxyapatite granules, and infiltration of a few giant cells. 6. No inflammatory responses were seen around the titanium implants and the hydroxyapatite granules.

• 대한치과보철학회지
• /
• 제30권3호
• /
• pp.361-378
• /
• 1992

The purpose of this investigation was to evaluate the effect of the porous hydroxyapatite particles (Interpore $200^{(R)}$) and guided tissue regeneration membrane ($Gore-Tex^{TM}$ augmentation material) on amount and shape of generating new bone adjacent to implant. Implants were placed immediately after extraction in the bilateral 3rd, 4th premolars of the mandible of the adult dogs. In all experimental groups, artificial bony defects were formed at the buccal cortex area, 3.3mm in width and 3.0mm in depth. In the control group : sutured without HA particles & membranes after placing implants, the experimental group 1 : membrane was place over the artificial bony defect, the experimental group 2 : bony defect was filled with HA particles and covered with membrane. The examination of bone-implant interfaces using light microscope and fluorescent microscope concluded as follows. 1. In all three experimental groups, osseointegration was observed without epithelial migration. 2. In the healing degree of bony defect area, the experimental group 1, 2 showed more prominent healing than control group, and the experimental group 1 showed the most excellent bone formation. 3. In fluorescent microscopic finding, bone remodeling was observed in regenerated bone tissue at defect area of experimental group 1, but in experimental group 2, irregular, discontinuous linear fluorescence was observed at the lower portion of defect area and sign of bone remodeling was weak.