• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.317-332
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• 2001

The purpose of this study was to investigate effects of the natural coral(NC) and the hydroxyapatite/calcium sulfate hemihydrate(HA/CS) on an early stages of wound healing in the rat periodontal fenestration defects. In this experiment, twelve male rats(Mean : 520g in BW) aged 8 to 9 months were used. Experimental periodontal fenestration defects were surgically created with tapered fissure bur at the buccal surface of the left mandibular 1st, 2nd molars. The buccal aspects of molar roots were carefully denuded of their periodontal ligament through a bony window created in the left mandibles of rats under general anesthesia. Each experimental periodontal fenestration defect was grafted with natural coral and HA/CS, randomly. An area without bone graft was assigned for negative control group. At 10,35 days, rats were serially sacrificed via intracardiac perfusion with 2.5% glutaraldehyde and specimens were processed with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows : 1. The defect areas were filled with dense connective tissues at 10 days in control group. But in the test(NC, HA/CS)groups, the connective tissues around graft materials were formed more loosely and the response of inflammation by graft materials itself was not found. 2. The defect areas were filled with new osteoid tissues and new cementum was not formed on the cut root surface at 35 days in the control group. 3. New osteoid tissue formation was more prominent at 35 days in control than test groups. 4. The NC and HA/CS particles were encapsulated by loose connective tissues at 10 days and by dense connective tissues at 35 days, respectively. 5. In the test groups, resorption of graft particles was not found through the experimental time. From the above results, natural coral and hydroxyapatite/calcium sulfate hemihydrate may be biocompatible and osteoconductive and have a weak adverse reaction to the periodontal tissues.

• Restorative Dentistry and Endodontics
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• v.44 no.3
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• pp.31.1-31.9
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• 2019

Objectives: To compare the formation of dentinal defects using stainless-steel hand K-files (HFs), rotary files, reciprocating files, and Self-Adjusting File (SAF), when used for oval root canals. Materials and Methods: One hundred and forty extracted human mandibular premolar with single root and oval canal were selected for this study. Oval canals were confirmed by exposing to mesio-distal and bucco-lingual radiographs. Teeth with open apices or anatomic irregularities were excluded. All selected teeth were de-coronated perpendicular to the long axis of the tooth, leaving roots segments approximately of 16 mm in length. Twenty teeth were left unprepared (control), and the remaining 120 teeth were divided into 6 groups (n = 20) and instrumented using HF (size 40/0.02), Revo-S (RS; size 40/0.06), ProTaper NEXT (PTN; size 40/0.06), WaveOne (WO; size 40/0.09), RECIPROC (RC; size 40/0.06), and the SAF (2 mm). Roots were then sectioned 3, 6, and 9 mm from the apex, and observed under stereomicroscope, for presence of dentinal defects. "No defect" was defined as root dentin that presented with no visible microcracks or fractures. "Defect" was defined by microcracks or fractures in the root dentin. Results: The control, HF, and SAF did not exhibit any dentinal defects. In roots instrumented by RS, PTN, WO, and RC files exhibited microcracks (incomplete or complete) in 40%, 30%, 55%, and 50%, respectively. Conclusions: The motor-driven root canal instrumentation with rotary and reciprocating files may create microcracks in radicular dentine, whereas the stainless-steel hand file instrumentation, and the SAF produce minimal or less cracks.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.117-129
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• 1989

The commercial availability of processed heterogenous bone has provided the surgeons with almost unlimited supply, avoidance of additional operation and prevention of the postoperative complications. In addition to these merits, unnecessary bone bank, easy availibility and storage have been achieved. The purpose of this study was to compare and examine the healing capacity of Kiel bone, Pyrost and Osteovit which used as the processed heterografts for the reconstruction of bony defect. Twenty rabbits weighing about 1.7-2.0 Kg were selected and divided into two groups. In experimental group A, the left mandibular defect was allowed to fill with blood, and the right defect was filled with Kiel bone. In experimental group B, the left defect was grafted with Pyrost, and the right with Osteovit. The experimental animals were sacrified after 1, 2, 4 and 8 weeks and the grafted site was studied histologically. To evaluate the strength of healed bone, 2 rabbits from each experimental group and a nonoperated control were sacrified at the 6th week after implantation and used for biometric testing on universal testing machine. The results obtained were as follows : 1. It was considered that these heterogenous bone grafts has feeble or absent immunogenicity since all of them appeared to evoke little inflammatory or forign body reaction. 2. In all experimental groups, new bone formation began from the adjacent region of host bone and extended progressively into the defect sites. New bone was partly formed within the intertrabecular space of the implant and gradually united with the bone that formed at the margin of the host bone. 3. With Pyrost bone formation was rapid and prominent comparing with other graft materials. 4. Osteovit was begun to be absorbed from 2 weeks, and Kiel bone from 4 weeks, however Pyrost was remained to be intact until the end of 8 weeks. 5. As the results of tensile test, the mean values of maximum tensile stress were 1.11${\uparrow}$ $Kgf/mm^{2}$ in Pyrost implanted specimens, 0.85 $Kgf/mm^{2}$ in Osteovit, 0.42 $Kgf/mm^{2}$ in Kiel bone, 0.66 $Kgf/mm^{2}$ in blood filled specimens and 1..13 $Kgf/mm^{2}$ in control. These results indicate that heterogenous bones grafted have little antigenicity to the host tissue, and that they mediate effectively osteoconduction by providing the scaffold for the bone formation. Pyrost and Osteovit appeared to be suitable for the clinical use.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.177-193
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• 2004

Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggested that electrical currents promote osseointegration around dental implants. The purpose of this study was to determine the effect of direct microcurrent to endosseous titanium implants placed in bone defects. The right and left 2nd, 3rd and 4th mandibular premolars in ten mongrel dogs (15Kg of weight) were extracted. One monthe later, Ti-machined screw type implants(3.8 mm diameter x 8.5 mm length, $AVANA^{(R)}$, Ostem) were placed in surgically created circumferential defect area(width 5mm, depth 4mm). The implants were divided into three groups according to the treatment modalities: Control group- implants without electrical stimulation; Experimental group I- implants with allogenic demineralized freeze dried bone grafting; and Experimental group II-implants allogenic demineralized freeze dried bone grafting and electric stimulation. The animals were sacrificed in the 4th and 8th week after implant placement and un-decalcified specimens were prepared for histological and histometrical evaluation of bone-implant contact ratio (BIC) and bone formation area ratio (BFA) in defect area. Some specimens at 8 weeks after implantation were used for removal torque testing. Histologically, there was connective tissue infiltration in the coronal part of defect area in control and the experimental group I, whereas direct bone contact was found in the experimental group II without connective tissue invasion. Average BIC ratios at 4 weeks of healing were 60.1% in the experimental group II, 47.4% in the experimental group I and 42.7% in the control. Average BIC ratios at 8 weeks after implantation were 67.6% in the experimental group II, 55.9% in the experimental group I and 54.6% in the control. The average BFA ratio was 84.0% in the experimental group II, 71.8% in the experimental group I and 58.8% in the control at 4 weeks, and the BFA ratios were 89.6% in the experimental group II, 81.4% in the experimental group I and 70.5% in the control at 8 weeks after implantation. The experimental group II showed also significantly greater BIC and BFA ratios compared to the control and the experimental group I (p<0.05). The removal torque values at 8 weeks after implantation were 56 Ncm in the experimental group II, 49 Ncm in the experimental group I and 43 Ncm in the control. There was a statistically significant difference among 3 groups (p<0.05). These results suggest that electrical stimulation improve and accelerate bone healing around endosseous titanium implants in bone defect.

• Journal of Periodontal and Implant Science
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• v.41 no.4
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• pp.176-184
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• 2011

Purpose: The final goal of regenerative periodontal therapy is to restore the structure and function of the periodontium destroyed or lost due to periodontitis. However, the role of periosteum in periodontal regeneration was relatively neglected while bone repair in the skeleton occurs as a result of a significant contribution from the periosteum. The aim of this study is to understand the histological characteristics of periosteum and compare the native periosteum with the repaired periosteum after elevating flap or after surgical intervention with flap elevation. Methods: Buccal and lingual mucoperiosteal flaps were reflected to surgically create critical-size, "box-type" (4 mm width, 5 mm depth), one-wall, intrabony defects at the distal aspect of the 2nd and the mesial aspect of the 4th mandibular premolars in the right and left jaw quadrants. Animals were sacrificed after 24 weeks. Results: The results from this study are as follows: 1) thickness of periosteum showed difference as follows (P<0.05): control group ($0.45{\pm}0.22$ mm)> flap-elevation group ($0.36{\pm}0.07$ mm)> defect formation group ($0.26{\pm}0.03$ mm), 2) thickness of gingival tissue showed difference as follows (P<0.05): defect formation group ($3.15{\pm}0.40$ mm)> flap-elevation group ($2.02{\pm}0.25$ mm) > control group ($1.88{\pm}0.27$ mm), 3) higher cellular activity was observed in defect formation group and flap-elevation groups than control group, 4) the number of blood vessles was higher in defect formation group than control group. Conclusions: In conclusion, prolonged operation with increased surgical trauma seems to decrease the thickness of repaired periosteum and increase the thickness of gingiva. More blood vessles and high cellular activity were observed in defect formation group.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.3
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• pp.87-91
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• 1990

This is to report a case of secondary reconstruction after partial mandibulectomy by using of marrow-cancellous bone and cortical bone harvested from the iliac crest in the case of an ameloblastoma on the mandible. According to the past experimental studies, the marrow and cancellous bone have the marked osteogenic potential of hematopoietic. And the cortical bone has the highest activity of bone induction, which is mediated through the action of bone morphogenic protein(BMP). This grafting technique, the combination of PMCB and cortical bone, has advantage in restoring lange defect of the mandible.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.69-73
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• 2002

Temporal muscle flap is usefull for the reconstruction of tissue defect at the oral and maxillofacial area. This article reports 3 cases of temporal muscle flap for the soft tissue reconstruction of infraorbital, palatal and mandibular retromolar area after tumor ablation. The advantages and disadvantage, postoperative complications and technical variations were reviewed and our 3 cases were evaluated in this aspects.

• Archives of Reconstructive Microsurgery
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• v.23 no.1
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• pp.40-43
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• 2014

A submental artery perforator flap was applied to the defect site after surgical excision of basal cell carcinoma on the right lower face. Three points were beneficial: it was perfect for assuring the safe margin of the mandibular branch of the facial nerve as well as intact platysma muscle, functionally; harvesting the flap was much easier than that of submental artery flap, surgically; and the color and contour were well matched aesthetically.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.280-285
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• 2016

Mandible defects could be caused by congenital malformations, trauma, osteomyelitis, tumor resection. If large areas are included for reconstruction, those are primarily due to tumor resection defects. The large jaw defect results in a problem about mastication, swallowing, occlusion and phonetics, and poor esthetics causes a lot of inconvenience in daily life. It is almost impossible to be a part underwent mandibular resection completely reproduced, should be rebuilt artificially. This case is of a patient who was diagnosed with squamous cell carcinoma pT1N0M0, stage I in February 2004 and received surgery (combined mandibulectomy and neck dissection operation (COMMANDO) in oromaxillofacial surgery) in March 2004, by implant assisted removable partial denture. We could obtain good retention and stability through sufficient coverage and implant holding. Follow up period was about four years. Mandibular left third molar regions have been observed to have resorption of surrounding bone, and periodic check-ups are necessary conditions.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.447-453
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• 2010

The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and lanned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.