• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.939-948
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• 2005

The role of the periosteum on osteointegration of $Bio-Oss^{(R)}$(Geistlich, Wolhusen/Switzerland) was studied in rabbit calvarial defect. 12 New Zealand white male rabbits between 2.8 and 4 kg were included in this randomized, blinded, prospective study. Each rabbit was anesthetized with Ketamine HCl(5 mg/kg) and Xylazine HCl(1.5 ml/kg). An incision was made to the bony cranium and the periosteum was reflected. Using a 6-mm trephine bur(3i. USA), four 8-mm defects were created with copious irrigation. The defects were classified into barrier membrane($Tefgen^{(R)}$, Lifecore Biomedical. Inc, U.S.A.) only group as a control, $Bio-Oss^{(R)}$ with barrier membrane group, $Bio-Oss^{(R)}$ with periosteum covering group, and $Bio-Oss^{(R)}$ without periosteum covering group. There were 2 rabbits in each group. The wound was closed with resorbable suture materials. Rabbits were sacrificed using phentobarbital(100 mg/kg) intravenously at 1, 2, and 4 weeks after surgery. The samples were fixed in 4% paraformaldehyde, and decalcified in hydrochloric acid decalcifying solution(Fisher Scientific, Tustin, CA) at $4^{\circ}C$ for 2-4 weeks. It was embedded in paraffin and cut into 6 ${\mu}m$ thickness. The sections were stained with H & E and observed by optical microscope. The results were as follows; 1. The periosteum played an important role in osteointegration of $Bio-Oss^{(R)}$ in bone defects. 2. When the periosteum remained intact and $Bio-Oss^{(R)}$ was placed on the defect, $Bio-Oss^{(R)}$ with periosteum covering has been incorporated into the newly formed bone from 2-week postoperatively. 3. When the periosteum was removed at the surgical procedure, invasion of connective tissue took place among the granules, and new bone formation was delayed compared to periosteum covering group. Therefore, when the bone grafting was performed with periosteal incision procedure to achieve tension-free suture, the integrity of the overlying periosteum should be maintained to avoid fibrous tissue ingrowth.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.191-198
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• 2008

Purpose: Guided bone regeneration(GBR) has emerged as a treatment in the management of osseous defects associated with dental implants. But several studies have reported different degrees of success of guided bone regeneration, depending upon the type of barrier selected, presence or absence of an underlying graft material, types of graft material, feasibility of technique, and clinician's preference. The aim of the present study was to evaluate bone formation following dental implant placement with augmentation materials at dehiscence defects in dogs. Material and Methods: Standardized buccal dehiscence defects($3{\times}5\;mm$) were surgically 2 Mongrel dog's mandibles, each 8 SLA surface, 8 anodizing surface implants. Each buccal dehiscence defect received flap surgery only(no treatment, control), $Cytoflex^{(R)}$ membrane only, Resolut $XT^{(R)}$ membrane only, Resolut $XT^{(R)}+Osteon^{TM}$. Animals were sacrificed at 8 weeks postsurgery and block sections were harvested for histologic analysis. Resuts: All experimental group resulted in higher bone formation than control. Resolut $XT^{(R)}+Osteon^{TM}$ group resulted appeared highest defect resolution. There was no difference between SLA and anodizing surface, nonresorbable and resorbable membrane. Conclusion: GBR results in rapid and clinically relevant bone closure on dehiscence defects of the dental implants.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.5
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• pp.383-393
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• 2007

The aim of the present study is to investigate the effect of anodized surface of osseointegration implants by using of resonance frequency analysis (RFA) and histomorphometric analysis. A total of 96 screw-shaped implants were devided into 4 groups. Seventy-two implants were prepared by electrochemical oxidation with 3 different ways; Group 1 (n=24) were prepared at galvanostatic mode in 0.25M sulfuric acid and phosphoric acid, Group 2 (n=24) were prepared at galvanostatic mode in calcium glycerophosphate and calcium acetate, and Group 3 (n=24) were prepared at galvanostatic mode in 0.25M sulfuric acid and phosphoric acid followed by Calcium metaphosphate(CMP) coating. Control group (n=24) were the RBM surfaced implants. The implants were placed in the mandibles of 12 mini pigs. Bone tissue responses were evaluated by resonance frequency analysis(RFA) and histomorphometric analysis that were undertaken at 2, 4 and 6weeks after implant placement. The following result were obtained. 1. Twenty-two of 96 implants (4 in control group, 5 in group 1, 7 in group 2, and 6 in group 3) were failed due to faliure of osseoitegration. The failure rate of osseointegration was 22.9%. 2. The mean values of RFA in control, group 2 and groups 3 showed the similar values, but there was no significant difference among groups. 3. Histomorphometric evaluation demonstrated significantly higher bone-to-implant contact ratio in group 2 at 3 and 4 weeks after implant placement than other groups (p<0.05), but there was no significant difference among groups at 6weeks after implant placement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.6
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• pp.481-491
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• 2005

Purpose: The aim of the present study is to evaluate the effect of autogenous bone and allograft material coverd with a bioresorbable membrane on bone regeneration after a simultaneous installation of implant. Materials and methods: Twelve healthy rabbits, weighing about $3{\sim}4$ kg, were used in this experiment. Following impalnt(with 3.25 mm diameter and 8 mm length) site preparation by surgical protocol of $Oraltronics^{(R)}$, artificial bony defect, 5mm sized in height and depth, was created on femoral condyle using trephine drill(with 5 mm diameter and 5 mm length). Then implant was inserted. In the experimental group A, the bony defect was filled with autogenous particulated bone and coverd with $Lyoplant^{(R)}$ resorbable membrane. In the experimental group B, the bony defect was filled with allograft material(Orthoblast $II^{(R)}$) containing demineralized bone matrix and covered with $Lyoplant^{(R)}$. In the control group, without any graft materials, the bony defect was covered with $Lyoplant^{(R)}$. The experimental group A and B were divided into each 9 cases and control group into 3 cases. The experimental animals were sacrificed at 3, 6 and 8 weeks after surgery and block specimens were obtained. With histologic and histomorphometric analysis, we observed the histologic changes of the cells and bone formation after H-E staining and then, measured BIC and bone density with KAPPA Image $Base^{(R)}$ system. Results: As a result of this experiment, bone formation and active remodeling process were examined in all experimental groups and the control. But, the ability of bone formation of the experimental group A was somewhat better than any other groups. Especially bone to-implant contact fraction ranged from 12.7% to 43.45% in the autogenous bone group and from 9.02% to 29.83% in DBM group, at 3 and 8 weeks. But, bone density ranged from 15.67% to 23.17% in the autogenous bone group and from 25.95% to 46.06% in DBM group at 3 and 6 weeks, respectively. Although the bone density of DBM group was better than that of autogenous bone group at 3 and 6weeks, the latter was better than the former at 8 weeks, 54.3% and 45.1%, respectively. Therefore these results showed that DBM enhanced the density of newly formed bone at least initially.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.515-529
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• 2006

Periodontal regeneration refers to the restoration of bone, cementum and periodontal ligament to their original levels before damage from periodontal disease process. Various surgical techniques to the promotion of periodontal regeneration have been used. Bone graft and guided tissue regeneration have used for the regeneration of furcation involvements which caused by periodontal disease. Fibrin adhesive is agents that have been shown to be effective in periodontal regeneration and biological carrier. Calcium sulfate which is one of the resorbable barrier materials has used for guided tissue regeneration. The purpose of this study was to compare the clinical effects between bone graft using fibrin adhesive and calcium sulfate barrier in the mandibular class II furcation involvement. For the study, twenty-six class II furcation involved teeth were surgically treated. 13 furcation defects(test group) were treated with bonegraft and fibrin adhesive and the others(control group) were treated with bone graft and calcium sulfate barrier. Pocket depth, clinical attachment level and gingival recession were measured at baseline, postoperative 3 and 6 months. The results of the study are as follows: 1. The change of pocket depth and clinical attachment level in both groups was decreased significantly at 3, 6 months than at baseline(p<0.05). 2. The change of gingival recession in both groups was increased significantly at 3, 6 months than at baseline(p<0.05). 3. The change of pocket depth and clinical attachment level in both groups was decreased at 3, 6 months, and the change of gingival recession in both groups was increased at 3, 6 months but there were no statistically or clinically significant differences with both groups. 4. The significant reduction of the pocket depth and clinical attachment level exhibited marked changes at 3 months in both groups. In conclusion, the results of this study suggest that there are no statistically or clinically significant differences between fibrin adhesive and calcium sulfate barrier in the treatment of class II furcations using xenograft.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.413-428
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• 2008

Purpose: Given the predictability of dental implant procedure from the studies of successful osseointegration, implant dentistry is often the treatment of choice to replace missing teeth in edentulous patient instead of the fixed prosthesis or removable denture. The $Renova^{(R)}$ dental implant has a RBM(Resorbable Blast Media) surface, internal hex prosthetic connection and a tapered design. At this study gives the analysis of the implant and the short term survival rate of the implant. Material and Methods: In this study, a multilateral analysis was performed on the subjects undergoing placement with $Renova^{(R)}$ implant between August 2006 and February 2008 in Yonsei University dental hospital. 96 implants were placed in 56 patients and they were surveyed for cumulative survival rate. Among them 78 implants in 44 patients were surveyed for the rest analyses. Result: 1. The cumulative survival rate was 96.88% of 96 implants in 56 patients. 2. The mean marginal bone loss was 0.803mm and the marginal bone loss in augmentation group has higher value than the marginal bone loss in non augmentation group. 3. The health scale for the implants were 87% in success group, 9% in satisfactory survival group, 1% in compromised survival group, and 3% in failure group. 4. Two implants placed in poor bone posterior area by 2-stage failed during prosthetic procedure. Conclusion: $Renova^{(R)}$ dental implant showed high cumulative survival rate in installation on partial edentulous ridge and could be a predictable implant system.

• Journal of Periodontal and Implant Science
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• v.42 no.2
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• pp.59-63
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• 2012

Purpose: This study evaluated the surface characteristics and bond strength produced using a novel technique for coating hydroxyapatite (HA) onto titanium implants. Methods: HA was coated on the titanium implant surface using a super-high-speed (SHS) blasting method with highly purified HA. The coating was performed at a low temperature, unlike conventional HA coating methods. Coating thickness was measured. The novel HA-coated disc was fabricated. X-ray diffraction analysis was performed directly on the disc to evaluate crystallinity. Four novel HA-coated discs and four resorbable blast medium (RBM) discs were prepared. Their surface roughnesses and areas were measured. Five puretitanium, RBM-treated, and novel HA-coated discs were prepared. Contact angle was measured. Two-way analysis of variance and the post-hoc Scheffe's test were used to analyze differences between the groups, with those with a probability of P<0.05 considered to be statistically significant. To evaluate exfoliation of the coating layer, 7 sites on the mandibles from 7 mongrel dogs were used. Other sites were used for another research project. In total, seven novel HA-coated implants were placed 2 months after extraction of premolars according to the manufacturer's instructions. The dogs were sacrificed 8 weeks after implant surgery. Implants were removed using a ratchet driver. The surface of the retrieved implants was evaluated microscopically. Results: A uniform HA coating layer was formed on the titanium implants with no deformation of the RBM titanium surface microtexture when an SHS blasting method was used. Conclusions: These HA-coated implants exhibited increased roughness, crystallinity, and wettability when compared with RBM implants.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.209-221
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• 2007

Recently, immediately after losing teeth. implant placement has been greatly attempted. Implant can help restoration of tooth functions within short time. This study was an attempt to examine the extent of osseointergation when the implants will be placed immediately after teeth extraction using domestic implant systems. Implants were inserted in beagle dogs and evaluated the clinical, radiological, histological and histomorphometric assay at 6 weeks and 12 weeks. For experimental materals, $STAGE-1^{(R)}$($4.1{\times}8mm$, Lifecore, USA), $SS-III^{(R)}$($4.0{\times}8mm$, OSSTEM, Korea) and $IFI^{(R)}$($4.0{\times}8mm$, Dio, Korea) implants treated with RBM were placed. All the placed site showed normal results without fail and inflammation clinically and radiologically. As a result of measurement by periotest, it showed $-2\;{\sim}\;-5$ and stable status comprehensively. There was no statistically significant difference among implants(p<0.05). Bone tissue adjacent to implant showed increased marrow tissue at 6 weeks. Nevertheless, osteogenic structure was not observed remarkably. In a 12 weeks opinion, bone tissue composed of osseointegration along implant interface showed significantly decreased marrow tissue containing central vessels unlike a 6 weeks opinion and matured compact bone whose osteogenic structure is well formed. BIC were 42.4%, 32.0% and 34.9%, respectively in 6 weeks and there was no statistically significant difference among group(p<0.05). In 12 weeks, BIC were 58.8%, 61.9% and 57.5%. respectively and there was no statistically significant difference among groups(p<0.05). It is considered that all 3 implant systems are suitable for immediate implant placement.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.438-444
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• 2011

Purpose: Adipose-derived stromal cells (ASCs) are readily harvested from lipoaspirated tissue or subcutaneous adipose tissue fragments. The stromal vascular fraction (SVF) is a heterogeneous set of cell populations that surround and support adipose tissue, which includes the stromal cells, ASCs, that have the ability to differentiate into cells of several lineages and contains cells from the microvasculature. The mechanisms that drive the ASCs into the osteoblast lineage are still not clear, but the process has been more extensively studied in bone marrow stromal cells. The purpose of this study was to investigate the osteogenic capacity of adipose derived SVF cells and evaluate bone formation following implantation of SVF cells into the bone defect of human phalanx. Methods: Case 1 a 43-year-old male was wounded while using a press machine. After first operation, segmental bone defects of the left 3rd and 4th middle phalanx occurred. At first we injected the SVF cells combined with demineralized bone matrix (DBM) to defected 4th middle phalangeal bone lesion. We used P (L/DL)LA [Poly (70L-lactide-co-30DL-lactide) Co Polymer P (L/DL)LA] as a scaffold. Next, we implanted the SVF cells combined with DBM to repair left 3rd middle phalangeal bone defect in sequence. Case 2 was a 25-year-old man with crushing hand injury. Three months after the previous surgery, we implanted the SVF cells combined with DBM to restore right 3rd middle phalangeal bone defect by syringe injection. Radiographic images were taken at follow-up hospital visits and evaluated radiographically by means of computerized analysis of digital images. Results: The phalangeal bone defect was treated with autologous SVF cells isolated and applied in a single operative procedure in combination with DBM. The SVF cells were supported in place with mechanical fixation with a resorbable macroporous sheets acting as a soft tissue barrier. The radiographic appearance of the defect revealed a restoration to average bone density and stable position of pharyngeal bone. Densitometric evaluations for digital X-ray revealed improved bone densities in two cases with pharyngeal bone defects, that is, 65.2% for 4th finger of the case 1, 60.5% for 3rd finger of the case 1 and 60.1% for the case 2. Conclusion: This study demonstrated that adipose derived stromal vascular fraction cells have osteogenic potential in two clinical case studies. Thus, these reports show that cells from the SVF cells have potential in many areas of clinical cell therapy and regenerative medicine, albeit a lot of work is yet to be done.

• Implantology
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• v.22 no.4
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• pp.220-235
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• 2018

Sinus lift procedure is frequently required for the maxillary molar implant placement. Previous studies have demonstrated alveolar ridge preservation (ARP) can maintain the dimensions of ridge height and width. However, there is a lack of studies which evaluated the effect of ARP to avoid sinus lift procedure. Purpose of this study is to describe a method reducing the need of sinus lift surgery by ARP in maxillary molar areas and to assess the feasibility clinically, radiologically and histologically. Ten maxillary molars in ten patients had severe vertical bone resorption with minimal residual bone height. They were considered having the high possibility of the necessity of sinus lift procedure for dental implant after the extraction. After extraction, open healing ARP with deproteinized bovine bone mineral mixed with 10% collagen and resorbable collagen membranes was performed. After sufficient healing, dental implants were placed, and evaluated clinically and radiologically. Histological observation was conducted just before the implantation in one patient. Implants were successfully placed without sinus lift in all ten cases. All the implants were restored with no sign of complications, and patients are now in a close follow-up up to 20 months post-loading. Histological observation showed minimal inflammatory reaction and newly formed bone was substantially noted. The ARP technique has successfully avoided the sinus lift surgeries. It appears that this procedure may improve the simplicity of the clinical process for the clinicians and reduce the discomfort of patients.