• 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.

• Journal of Periodontal and Implant Science
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• 제35권4호
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• pp.949-959
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• 2005

이 연구는 임플란트를 식립하기를 원하는 전신건강상태가 양호하며 구강위생상태가 좋은 14명 환자(남자:8명, 여자:6명, 평균나이 : 44세)의 20개의 발치와 내에 흡수성 차폐막(BioMesh. Sam Yang Corporation, Korea)과 함께 탈회냉동 건조동종 골(dem-ineralized freezedried bone allografts, $250-500{\mu}m$. Pacific Coast Tissue Bank, U.S.A.)과 이종골(Bovine-Bone, Bio-Oss 0.25-1.0 mm, Geistlich, Biomaterials and Osteohealth, Switzerland)을 1:1(부피)로 혼합하여 이식한 후 그 치유양상을 관찰하고자 조직학적 및 면역조직화학적으로 평가하였다. 이직재가 탈락되는 것을 방지하기 위하여 발치한 후 1개윌이 경과된 후에 이식재와 차폐막을 위치시켰다. 표본제작을 위하여 이식술을 시행한 지 약 6개윌 후에 임플란트를 식립하기 직전 식립부위에서 trephine bur로 골을 채취하였는데, 20증례 중 7증례에서 임플란트를 식립하기 전에 차폐막이 노출되었다. 차폐막이 노출되지 않은 것을 대조군으로, 노출된 것을 실험군으로 설정하였다. 조직학적인 관찰을 위하여 통상적인 방법에 따라 탈회 표본을 제작하였고, alkaline phosphotase(ALP)틀 이용하여 면역조직화학적 염색을 시행한 후 골 형성 상태를 평가하여 다음과 같은 결과를 얻었다. 본 연구에서는 발치와내에서 골유도재생술 후 나타나는 치유 형태를 5가지 형태로 분류할 수 있었다. Type I, II와 III는 새로운 골 형성을 나타내지 않았고, 면역조직화학적 검사 시 ALP 음성 소견을 나타내었다. Type V는 새로운 골 형성과 ALP 양성 소견을 나타내었으나 염증, 괴사, 결합조직의 증식 등은 없었다. Type IV와 Type V의 차이는 결합조직의 증식여부로 구분되었다. 막이 노출되지않은 증례들 중 7 증례에서는 Type V의 치유 형태를, 2증례에서는 Type IV의 치유 형태를 나타내었다. 막이 노출되었던 증례에서는 Type I, II, III의 다양한 치유 형태를 나타내었다. 본 연구결과, 발치와 내에 골유도재생술을 시행한 후 차폐막의 노출 여부가 신생골 형성에 중요한 영향을 미칠 것으로 사료되며, 본 연구에서 분류한 치유 형태가 향후 골유도재생술 후의 결과 분석에 활용될 수 있을 것으로 사료된다.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.791-803
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• 2007

The purpose of this study was to evaluate exophytically vertical bone formation in residual ridge of the beagle dog by the concept of guided bone regeneration with a titanium reinforced e-PTFE membrane combined with irradiated cancellous human bone. Twelve male beagle dogs(mean age 1.5 years and mean weight 12kg) were used for this study. The alveolar ridges after extraction of all mandibular premolars were surgically and horizontally removed. At 8 weeks after extractions, full-thickness flap was reflected and cortical bone was removed with round bur and copious irrigation. Rectangular parallelepiped(10mm in length, 5mm in width, and 4mm in height) bended with titanium-reinforced e-PTFE(TR e-PTFE) membrane was placed on the decorticated alveolar ridge, fixed with metal pins and covered with full-thickness flap and assigned as a control group. Test groups ere treated with TR e-PTFE membrane filled with irradiated cancellous human bone. Of twelve beagle dogs, four control dogs and four test dogs without membrane exposure to oral cavity were sacrificed at 8 and 16 weeks respectively. The surgical sites were dissected out, fixed in 4% buffered formaldehyde, dyed using a Villanueva staining technique, and processed for embedding in plastic resin. The cutting and grinding methods were routinely processed for histologic and histomophometric analyis of exophytic bone formation as well as statistical analysis. The results of this study were as follows: 1. Exophytic bone formation in the both of experimental groups was increased respectively after surgery from 23.40% at 8 weeks to 46.26% at 16 weeks in the control groups, from 40.23% at 8 weeks to 47.11% at 16 weeks in the test groups(p<0.05). 2. At 8 weeks after surgery, exophytic bone formation was made 40.23% in the test groups and 33.40% in the control groups. Exophytic bone formation was significantly made in the test group more than in the control group. At 16 weeks after surgery, exophytic bone formation was made 44.11% in the test groups and 46.26% in the control groups. Exophytic bone formation was made in the test groups more than in the control groups, but there was no statistically significant differences. 3. The membrane was fixed with metal pins to closely contact it to the bone surface. So, collapse and deviation of the membrane could be prevented and in growth of connective tissue also could be blocked from the periphery of the membrane. On the basis of these findings, wee suggest that intraoral experimental model for exophytic bone formation may be effective to evaluate the effect of bone graft material. And it indicates that combined use of membrane and ICB graft material is more effective than use of membrane only for exophytic bone formation.