• Journal of Periodontal and Implant Science
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• 제38권sup2호
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• pp.385-394
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• 2008

Purpose: The aim of this study was to evaluate the factors affecting healing patterns of surgically created circumferential gap defects around implants in dogs. Materials and Methods: In four mongrel dogs, all mandibular premolars were extracted. After 8 weeks of healing periods, implants were submerged. According to the surface treatment, turned surface was designated as a group A and rough surface as a group B. In each dog, surgical defects on the left side were made with a customized tapered step drill and on the right with a customized paralleled drill. Groups were also divided according to the width of the coronal gaps: 1.0mm, 1.5mm, or 2.0mm. The dogs were sacrificed following 8 weeks and the specimens were analyzed histologically and histomorphometrically. Results: During the postoperative period, healing was uneventful and implants were well-maintained. As the size of the coronal gap was increased, the amount of bone-to-implant contact was decreased. The bone healing was greater in rough surface implants compared to the turned ones. About the defect morphology, tapered shape showed much bone healing and direct bone to implant contact even in the smooth surface implants. Conclusion: Healing of the circumferential defect around dental implant is influenced by the implant surface, defect width and the morphology of the defect. When using rough surface implants, circumferential gap defects within 2 mm do not need any kinds of regenerative procedures and the healing appeared to be faster in the tapered defect morphology than the paralleled one.

• Advances in biomechanics and applications
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• 제1권2호
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• pp.95-109
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• 2014

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.

• 대한치과의사협회지
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• 제55권10호
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• pp.716-724
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• 2017

Past literatures stressed that when a gap occurred between smooth surface implant and alveolar bone, osseointegration was unsatisfactory at histologic examination regardless of clinical findings. Accordingly, standard surgical approach in the early days of implant surgery was to place the implant after all gap was healed. However, Botticelli et al.(2004) reported high degree of osseointegration at the gap with SLA surface implant. From then, the era of immediate implantation has begun because SLA surface implant make gap healing possible. There are two main disadvantages of immediate implantation: (1) surgical technique is sensitive for primary implant stability, (2) Implant placement at the accurate position that predicts external change of extraction wound is required. Immediate implantation has outstanding advantages in all perspectives except for the above-mentioned disadvantages. Therefore, it would be unwise to abandon the option of immediate implantation simply due to surgical difficulties. The purpose of this paper is to describe the necessity of immediate implantation and to present scientific evidence for immediate implantation and accurate implant position by literature review.

• The Journal of Korean Physical Therapy
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• 제27권3호
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• pp.140-146
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• 2015

Purpose: To determine the effects of 630 nm light emitting diode (LED) on full-thickness wound healing. Methods: Twelve male Sprague-Dawley rats were randomly divided into LED (n=6) and control group (n=6). Two $19.63mm^2$ wounds were created on the mid dorsum. LED group received a 630 nm LED irradiation with $3.67mW/cm^2$ for 30 minutes ($6.60J/cm^2$) for 7 days, while control group received sham LED irradiation. Epithelial gap, collagen density, ${\alpha}$-SMA fibroblast and PCNA keratinocyte were measured on histochemical and immunohistochemical staining using image analysis system. An independent t-test was conducted to compare the difference between groups. Results: The wound closure rate, collagen density, ${\alpha}$-SMA fibroblast number, epithelial gap and PCNA keratinocyte number have shown no significant difference between LED and control group at day 3 after the treatment. At day 7 after the treatment, the wound closure rate in LED group was increased when compared with control group (p<0.05). The collagen density (p<0.05) and ${\alpha}$-SMA immunoreactive fibroblast number (p<0.001) were increased when compared with control group at day 7. The epithelial gap in LED group was significantly shorten than control group at day 7 (p<0.01). The PCNA positive cell number in LED group was higher than control group at day 7 (p<0.01). Conclusion: 630 nm LED with $3.67mW/cm^2$, $6.60J/cm^2$ accelerate collagen deposition by stimulating fibroblasts, and enhance wound contraction by differentiating myofibroblasts in the dermis, and accelerate keratinocyte proliferation by facilitating DNA synthesis in the epidermis. It may promote the healing process in proliferation stage of wound healing.

• Archives of Plastic Surgery
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• 제34권3호
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• pp.285-290
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• 2007

Purpose: Many clinical trials have shown the effectiveness of platelet releasate on chronic wounds. However, a large volume of blood must be aspirated from a patient and a platelet separator is required. Here, we hypothesized that platelet concentrate obtained from a blood bank (PCBB) would be also effective at stimulating wound healing. The purpose of this study was to investigate the effectiveness of PCBB on accelerating healing of diabetic wounds in vivo. Methods: Round wounds of 5 mm diameter were made at four sites(two wounds on the left and two on the right side) on the backs of nine diabetic mice. Three hundred million platelets suspended in 0.05 ml fibrinogen were dispersed on each wound on left sides. Same amount of fibrinogen without platelets was dispersed on right side control wounds. Thereafter, 0.05 ml thrombin was applied to the each wound. Ten days after wound treatment, healed wounds were excised and the extent of wound healing in each group was compared. Results: Quantitative histologic analysis of epithelial gap distances revealed that PCBB treatment had greatly accelerated wound healing. Mean epithelial gap distances for PCBB treated and control wounds were $2.5{\times}0.6mm\;and\;3.6{\times}0.5mm$, respectively(p<0.05). Conclusion: Our results suggest that PCBB has potential to accelerate the healing of diabetic wounds.

• Journal of Periodontal and Implant Science
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• 제38권sup2호
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• pp.373-384
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• 2008

Purpose: The aim of this study is to compare the healing response of various Hydroxyapatite(HA) coated dental implants by Ion-Beam Assisted Deposition(IBAD) placed in the surgically created circumferential gap in dogs. Materials and methods: In four mongrel dogs, all mandibular premolars and the first molar were extracted. After an 8 weeks healing period, six submerged type implants were placed and the circumferential cylindrical 2mm coronal defects around the implants were made surgically with customized step drills. Groups were divided into six groups : anodized surface, anodized surface with 150nm HA and heat treatment, anodized surface with 300nm HA and heat treatment, anodized surface with 150nm HA and no heat treatment, and anodized surface with 150nm HA, heat treatment and bone graft, anodized surface with bone graft. The dogs were sacrificed following 12 weeks healing period. Specimens were analyzed histologically and histomorphometrically. Results: During the healing period, healing was uneventful and implants were well maintained. Anodized surface with HA coating and $430^{\circ}C$ heat treatment showed an improved regenerative characteristics. Most of the gaps were filled with newly regenerated bone. The implant surface was covered with bone layer as base for intensive bone formation and remodeling. In case that graft the alloplastic material to the gaps, most of the coronal gaps were filled with newly formed bone and remaining graft particles. The bone-implant contact and bone density parameters showed similar results with the histological findings. The bone graft group presented the best bone-implant contact value which had statistical significance. Conclusion: Within the scope of this study, nano-scale HA coated dental implants appeared to have significant effect on the development of new bone formation. And additional bone graft is an effective method in overcoming the gaps around the implants.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권4호
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• pp.397-400
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• 2007

In an open reduction of the mandibular angle fracture, it is crucial to approximate each fracture segment as closer as possible for the reduction of the healing period. In this case report, we proposed a new technique for the mandibular angle fracture. This was designed to minimize the gap between two separated segments using mini-implants and surgical wires. Mini-implants were placed around the fracture line, followed by wire ligation to minimize the fracture gap. And then internal fixation was easily employed with plates and screws. The advantages of this technique were reduced time for operation, the promotion of healing, rapid functional recovery, and few complications.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.426-431
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• 2007

Purpose: The aim of this study is to compare the effects of bone marrow stromal cells(BSCs) and fibroblasts on wound healing activity in vivo, especially on epithelization. Methods: The fibroblasts and BSCs were harvested from patients and cultured. Ten Spague-Dawley white rats were used. A 5 mm punches were made to excise skin and subcutaneous tissue in a round fashion at six sites on the back area of each rat. Four hundred thousand cells suspended in 0.05 ml fibrinogen were applied to the created wounds. The cells in group I, II, and III were no cells, fibroblasts and BSCs. The lengths of epithelial gap at the widest wound site were compared with autopsy specimens obtained on the 6th day after cell therapy under light microscope. Statistical comparisons were performed using the Mann-Whitney U-test, and the p value < 0.05 was considered statistically significant. Results: The best epithelization was also seen in the BSC group, followed by fibroblast and no cell groups.Conclusion: These results demonstrate that BSC has superior effect on stimulating wound healing than fibroblast, which is currently used for wound healing.

• Journal of Periodontal and Implant Science
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• 제29권1호
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• pp.233-249
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• 1999

Primary fixation is one of the most important factor in establishing adequate osseointegration between implant and bone. To evaluate the initial healing response of bone around implants without primary bone contact, this study was designed to create considerable space between implant and bone in 5 mongrel dogs, about 1-year old. After 3 holes of 6.0mm in diameter were prepared at the femur neck of the dogs, commercially pure titanium thread type implants(STERI-$OSS^{(R)}$), 8mm in length and 3.8mm, 5.0mm and 6.0mm in diameter, were inserted. Implants were supported by only nonresorbable membrane($Teflon^{(R)}$), and the penetration of upper soft tissue into the gap was inhibited by it. The each implant was positioned in the center of the drilled hole. 9 implants with different diameters were inserted in 3 dogs for histologic observation, and 12 were inserted in 2 dogs for mobility test and removal torque test.Fluorescent dyes were injected in order of Doxycycline, Alizarin Red S, and Calcein at intervals of 2 weeks. At 4-, 8-, and 12-week after placement, 3 dogs were sacrificed for histologic observation, and at 8- and 12-week after placement, 2 dogs were sacrificed for mobility test using $Periotest^{(R)}$ (Simens AG, Bensheim, Germany) and torque test using Autograph AGS-1000D $series^{(R)}$(Japan). The result were as follows: 1. The wider the gap between bone and implant was, the less bone maturity was, and the later osseointegration was occurred. Trabecular direction of new bone around implant was changed from parallel to perpendicular to the implant, and the gap was filled with new bone, over time. 2. There was a decreasing tendency over time in the mobility of all implants, but the wider gap between bone and implant was, the smaller decrease of the mobility was. 3. There was a increasing tendency over time in the removal torque gauge of all implants, and the wider gap was, the smaller increase of the removal torque gauge was. The results suggest that osseointegration in case of implant without primary bone contact may be obtained by guided bone regeneration technique with prolonged healing period, but the time of second surgery should be considered carefully.

• Journal of Periodontal and Implant Science
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• 제29권2호
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• pp.415-433
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• 1999

Implant stability is the key to long-term successful outcome for osseointegrated implants. To evaluate the initial healing response of bone around HA-coated implants without primary bone contact. 21 HA-coated thread type implants(STERI-OSS?) were placed in the femurs of 5 mongrel dogs, about 1-year old. Implants, 8 mm in length and 3.8mm(experimental 1group), 5.0mm(experimental 2group) and 6.0mm(control group) in diameter, were inserted after 3 holes of 6.0mm in diameter and 10mm in depth were prepared in the surgical sites each dog. Implants were supported by only nonresorbable membrane($Teflon^{(R)}$), in order to prevent the ingrowth of upper soft tissue into the gap between bone and implant, and to maintain each implant to be positioned in the center of the drilled hole. 9 implants with different diameters were inserted in 3 dogs for histologic observation, and 12 implants were inserted in 2 dogs for mobility test and removal torque test. Fluorescent dyes were injected for the observation of new bone formation in order of $Terramycin^{(R)}$, Arizarin $Red^{(R)}$, and $Calcein^{(R)}$ at an interval of 2 weeks. 3 dogs were sacrificed for histologic observation at 4, 8, and 12-week after placement. Light microscopy and confocal laser scanning microscopy were used to qualitatively characterize the bone around HA-coated implant. 2 dogs were sacrificed for mobility test($Periotest^{(R)}$, Simens AG, Bensheim, Germany) and removal torque test($Autograph^{(R)}$ AGS-1000D series, Japan) at 8 and 12-week after placement The results were as follows: 1. Histologic observation showed that osseointegration occurred to both control and experimental groups as time lapse, but delayed bone healing was revealed in 3.8mm group (experimental 1group), compared to contrtol group and 5.0mm group (experimental 2group). 2. The mobility test showed that the experimental groups had no distinguishable movement during experimental periods of 8 and 12-week, and there was no difference in mobility depending on the gap between bone and implant, and time lapse. 3. The removal torque forces were increased depended on the gaps decreasing between bone and implant, and time lapse. The results suggest that HA-coated implant without primary bone contact, based on guided bone regeneration could obtain its stability in all experimental groups as time lapse, but bone healing was delayed in experimental group of 3.8mm. And the results suggested that studies on correlationship between mobility test and removal torque test for implant stability would be necessary.