In last two decades, an impressive progress has been recorded in terms of developing new materials or refining existing material composition/microstructure in order to obtain better performance in biomedical applications. The success of such efforts clearly demands better understanding of various concepts, e.g. biocompatibility, host response, cell-biomaterial interaction. In this article, we review the fundamental understanding that is required with respect to biomaterials development, as well as various materials and their properties, which are relevant in applications, such as hard tissue replacement. A major emphasize has been placed to present various design aspects, in terms of materials processing, of ceramics and polymer based biocomposites, Among the bioceramic composites, the research results obtained with Hydroxyapatite (HAp)-based biomaterials with metallic (Ti) or ceramic (Mullite) reinforcements as well as $SiO_2-MgO-Al_2O_3-K_2O-B_2O_3-F$ glass ceramics and stabilized $ZrO_2$ based bioinert ceramics are summarized. The physical as well as tribological properties of Polyethylene (PE) based hybrid biocomposites are discussed to illustrate the concept on how can the physical/wear properties be enhanced along with biocompatibility due to combined addition of bioinert and bioactive ceramic to a bioinert polymeric matrix. The tribological and corrosion properties of some important orthopedic metallic alloys based on Ti or Co-Cr-Mo are also illustrated. At the close, the future perspective on orthopedic biomaterials development and some unresolved issues are presented.
The purpose of this study is to evaluate the effect of $HTR^{TM}$ (hard tissue replacement, Bioplant Inc, U.S.A) polymer on short-term healing as a grafting material for alveolar ridge augmentation. A 48-year-old female presented insufficient bone height and width for the placement of implants. $HTR^{TM}$ polymer was used for ridge augmentation. Bone biopsy was harvested 8 months after the ridge augmentation procedure. $HTR^{TM}$ polymer displayed rapid bone regeneration and mature lamellar and trabecular bone redevelopment. Clinical and histologic observation from the treatment of the patient presented suggest that $HTR^{TM}$ polymer seems to be a appropriate material for alveolar ridge augmentation.
The present study was performed to investigate the effect of $HTR^{(R)}$ (Hard Tissue Replacement) on osteogenesis in the mandibular bone defects. Eight adult male white rabbits weighing 2.5 to 3.0kg were used. Four bone defects (8mm in diameter and 4mm in depth) were made at the both mandibular body. In the control group, the right mesial bone defect was filled with blood clot and spontaneously healed. In the DFDB group, the right distal bone defect was filled with xenogenic demineralized freeze-dried bone. In the $HTR^{(R)}$ group, the left mesial bone defect was filled with $HTR^{(R)}$. In the $HTR^{(R)}-membrane$ group, the left distal bone defect was filled with $HTR^{(R)}$ and covered with BioMesh membrane. The rabbits were sacrified at 2,4,6 and 9 weeks after the operation and microscopic examination was performed. Results obtained were as follows: In the control and DFDB groups, inflammatory cells and the fibrous connective tissue existed and the bone growth was slower than $HTR^{(R)}$ group by 6 week, and there was intervention of the soft tissue at 9 week. In the $HTR^{(R)}$ group, bone trabeculi extended between the $HTR^{(R)}$ particles without intervention of inflammatory cells and the connective tissue at 4 and 6 weeks. In addition, extensive osseous ingrowth into the $HTR^{(R)}$ particles was observed at 9 week. Bone formation was more active in the $HTR^{(R)}$ group than the control and DFDB groups. There was not obvious difference in the bone healing rate between the $HTR^{(R)}$ and the $HTR^{(R)}-membrane$ group. These results suggest that the $HTR^{(R)}$ promotes osteogenesis in the bone defects and the $HTR^{(R)}$ group has no difference in comparison with the $HTR^{(R)}-BioMesh^{(R)}$ membrane group in bone healing.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제30권5호
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pp.406-413
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2004
Progress in medical science and cell biology has resulted in the transplantation of human cells and tissues from on human into another, facilitating reproduction and the restoration of form and function, as well as enhancing the quality of life. For more than 40 years, society has recognized the medical and humanitarian value of donation and transplanting organs and tissues. The standard operating procedures of hard tissues reflect the collective expertise and conscientious efforts of tissue bank professionals to provide a foundation for the guidance of tissue banking activities. Procurement of allograft tissues from surgical bone donors is a part of tissue banking. During the past decades the use of bone allografts has become widely accepted for the filling of skelectal defects in a variety of surgical procedures. In particular in the field of orthopaedic and oral and maxillofacial surgery the demand for allografts obtained from either living or post-mortem donors has increased. Hospital-based tissue banks mainly retrieve allografts from living donors undergoing primary total hip replacement for osteoarthritis or hemi arthroplasty for hip fractures and orthgnatic surgery such as angle reduction. Although bone banks have existed for many years, the elements of organized and maintaining a hospital bone bank have not been well documented. The experience with a tissue bank at Korea Tissue Bank(KTB) between 2001 and 2004 provides a model of procurement, storage, processing, sterilization and documentation associated with such a facility. The following report describes the standard operating procedures of hard tissues such as femoral head obtained from living donors.
Tissue and paper manufacturing companies have common problems with increasing cost of imported virgin pulp and the restriction of using woods in the forest. Possibility of using bagasse pulp for solving those problems was studied. In order to reduce the production cost and study the dependency on pulps, bagasse pulp has been studied for mixing with Sw-BKP and Hw-BKP. Optimum blending ratio of wood pulps and bagasse pulp to enhance tissue properties were analyzed. Various properties of the hand sheet after blending of wood pulp and bagasse pulp were measured. As results, the bagasse pulp could substitute the hard wood pulp with similar properties of tissue. Therefore, we judged that the bagasse pulp was suitable for replacement of the hardwood pulp.
FRC/ceromer system provides the clinician with a durable, flexible, and esthetic alternative to conventional porcelain fused to metal crowns. FRC is the matrix which is silica-coated and embedded in a resin matrix. The ceromer material which is a second generation indirect composite resin contains silanized, microhybrid inorganic fillers embedded in a light-curing organic matrix. FRC/ceromer restoration has a several advantages: better shock absorption, less wear of occluding teeth, translucency, color stability, bonding ability to dental hard tissues, and resiliency. It has versatility of use including inlay, onlay, single crown, and esthetic veneers. With adhesive technique, it can be used for single tooth replacement in forms of inlay adhesion bridge. In single tooth missing case, conventional PFM bridge has been used for esthetic restoration. However, this restoration has several disadvantages such as high cost, potential framework distortion during fabrication, and difficulty in repairing fractures. Inlay adhesion bridge with FRC/ceromer would be a good alternative treatment plan. This article describes a cases restored with Targis/Vectris inlay adhesion bridge. Tooth preparation guide, fabrication procedure, and cementation procedure of this system will be dealt. The strength/weakness of this restoration will be mentioned, also. If it has been used appropriately in carefully selected case, it can satisfy not only dentist's demand of sparing dental hard tissue but also patient's desire of seeking a esthetic restorations with a natural appearance.
Jung, Hwi-Dong;Nam, Woong;Cha, In-Ho;Kim, Hyung Jun
Asian Pacific Journal of Cancer Prevention
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제13권8호
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pp.4137-4140
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2012
The authors present five cases of combined oral mucosa-mandible defects reconstructed with the vascularized internal oblique-iliac crest myoosseous free flap. This technique has many advantages compared to other conventional methods such as the radial flap, scapula flap, and fibula flap. Vascularized iliac crest flaps provide sufficient high-quality bone suitable for reconstructing segmental madibular defects. Although fibular flaps allow longer donor bone tissue to be harvested, the iliac crest can provide an esthetic shape for mandibular body reconstruction and also provides sufficient bone height for dental implants. Conventional vascularized iliac crest myoosseous flaps have excessive soft tissue bulk for reconstruction of intraoral soft tissue defects. The modification discussed in the present article can reduce soft tissue volume, resulting in better functional reconstruction of the oral mucosa. Another advantage is that complete replacement of the oral mucosa is observed in as early as one month post-operation. The final mucosal texture is much better than that obtained with other skin paddle flaps, which is especially beneficial for the placement of dental implant prostheses. Donor site morbidity looks to be similar to, if not less than that observed for other modalities in terms of function and esthetics. For combined oral mucosa-mandible defects, the vascularized internal oblique-iliac crest myoosseous free flap shows good results with respect to hard and soft tissue reconstruction.
Purpose: Pseudohypoparathyroidism is a hereditary disorder characterized by symptoms and signs of hypoparathyroidism, typically in association with distinctive skeletal and developmental defects. Hypoparathyroidism is caused by a insufficient end-organ response to PTH (parathyroid hormone). Hypoparathyroidism consists of four types in which the most common form, pseudohypoparathyroidism-Ia, accompany with Albright's hereditary osteodystrophy. We experienced a case of a woman who had been suffering from calcified mass on left foot, diagnosed Albright's hereditary osteodystrophy. Methods: We present a case of a 24-year-old Korean female who visited plastic surgery department with a painful mass on dorsum of the left foot. On the physical exam, bony hard and painful mass, fixed to dermis, was noted. Plain X-ray films demonstrate suspicious calcification on subcutaneous tissue of dorsum of the left foot. The patient was diagnosed pseudohypoparathyroidism 2 years ago at the plastic surgery department. At the visiting time, the laboratory results were within normal range even though the patient actually had a disease. The reason is because the patient has been treated with Vit.D, calcium replacement therapy and thyroid hormone therapy. Moreover, the patient has been treated with anticonvulsant agents due to epilepsy. On the brain computer tomography (CT), calcification was noted on the basal ganglia and dentate nucleus. So we decided the total excision of entire mass from the left foot. Results: We excised main mass with numerous pinhead sized masses which were scattered around the main mass. The $6.0{\times}4.0{\times}0.5\;cm$ sized main mass was bony hard, and its surface was flat and margin was irregular. The permanent biopsy was confirmed that the main mass and all the scattered tiny masses were heterotopic calcification. The patient did not suffer from the pain after the mass excision. The wound has been healed without any problem. Conclusions: Heterotrophic calcification is often accompanied with pseudohypoparathyroidism, but such a huge one is uncommon. We report a case of pseudohypoparathyroidism with heterotrophic calcification developed in dorsum of left foot who was diagnosed by excisional biopsy.
Metallic biomaterials have been mainly used for the fabrication of medical devices for the replacement of hard tissue such as artificial hip joints, bone plates, and dental implants. Because they are very reliable on the viewpoint of mechanical performance. This trend is expected to continue. Especially, Ti and Ti alloys are bioinert. So, they do not chemically bond to the bone, whereas they physically bond with bone tissue. For their poor surface biocompatibility, the surface of Ti alloys has to be modified to improve the surface osteoinductivity. Recently, ceramic-like coatings on titanium, produced by plasma electrolytic oxidation (PEO), have been developed with calciumand phosphorus-enriched surfaces. A lso included the influences of coatings, which can accelerate healing and cell integration, as well as improve tribological properties. However, the adhesions of these coatings to the Ti surface need to be improved for clinical use. Particularly Silicon (Si) has been found to be essential for normal bone, cartilage growth and development. This hydroxyapatite, modified with the inclusion of small concentrations of silicon has been demonstrating to improve the osteoblast proliferation and the bone extracellular matrix production. Strontium-containing hydroxyapatite (Sr-HA) was designed as a filling material to improve the biocompatibility of bone cement. In vitro, the presence of strontium in the coating enhances osteoblast activity and differentiation, whereas it inhibits osteoclast production and proliferation. The objective of this work was to study Morphology of bone-like apatite formation on Sr and Si-doped hydroxyapatite surface of Ti-6Al-4V alloy after plasma electrolytic oxidation. Anodized alloys was prepared at 270V~300V voltages with various concentrations of Si and Sr ions. Bone-like apatite formation was carried out in SBF solution. The morphology of PEO, phase and composition of oxide surface of Ti-6Al-4V alloys were examined by FE-SEM, EDS, and XRD.
Background: Fibrous dysplasia (FD) is characterized by the replacement of normal bone by abnormal fibro-osseous connective tissue and typically treated with surgical contouring of the dysplastic bone. When dysplastic lesions involve occlusion, not only is surgical debulking needed, orthognathic surgery for correction of dentofacial deformity is mandatory. However, the long-term stability of osteotomized, dysplastic bone segments is a major concern because of insufficient screw-to-bone engagement during surgery and the risk of FD lesion re-growth. Case presentation: This case report reviewed two patients with non-syndromic FD that presented with maxillary occlusal canting and facial asymmetry. Le Fort I osteotomy with recontouring of the dysplastic zygomaticomaxillary region had been performed. The stability of osseous segments were favorable. However, dysplastic, newly formed bone covered the previous plate fixation site and mild bony expansion was observed, which did not influence the facial profile. Including the current cases, 15 cases of orthognathic surgery for FD with dentition have been reported in the literature. Conclusion: The results showed that osteotomy did not appear to significantly reduce the long-term stability of the initial fixation insufficiency of the screw to the dysplastic bone. However, based on our results and those of the others, long-term follow-up and monitoring are needed, even in cases where the osteotomized segment shows stable results.
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