• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.249-262
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• 1997

The present study investigates the effects of calcium sulfate graft on the periodontal healing in intrabony periodontal defects of dogs. Following the general anesthesia with 30mg/kg pentobarbital injected intravenously, the first premolar was extracted and full-thickness periodontal flap was elevated from the second premolar to the fourth premolar. The portion of premolars coronal to the alveolar crest was removed and mesial and distal roots were separated. Exposed root canals were sealed with Caviton and covered completely with flaps sutured. Following the healing period of 12 weeks, the surgical sited were uncovered and $4{\times}4mm$ intrabony defects were surgically created. Those defects with calcium sulfate graft following the root planing was designated as the test sites and those with flap surgery-only were designated as control sites. The animals were sacrificed after 8 weeks and the healing was histologically analyzed. The results were as follows. 1. No foreign body reaction or inflammation were observed in either groups. Calcium sulfate was completely resorbed in the test sites. 2. New cementum was observed coronal to the notch in both groups. Connective tissue fibers were oriented parallel to the root surface in the controls. Connective tissues were formed in large amount in the sites. 3. Test sites showed marked amount of new bone formation while the control sites showed minimal bone gain. 4. Root resorption was observed in coronal portions of th control Sites. The results suggest that calcium sulfate is a biocompatible graft material with a potential for new bone and cementum formation.

• Journal of Periodontal and Implant Science
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• v.50 no.6
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• pp.406-417
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• 2020

Purpose: This study investigated whether the placement of ribose cross-linked collagen (RCLC) membranes without primary soft tissue closure predictably resulted in sufficient alveolar ridge preservation in contained and non-contained extraction sockets. Methods: Membranes were positioned across extraction sockets, undermining full-thickness flaps, and the gingival margins were fixed by double-interrupted sutures without crossed horizontal mattress sutures for 1 week. In non-contained sockets, a bone substitute was used to support the membrane within the bony envelope. Radiographs and clinical images obtained 4 months later were analyzed by ImageJ software using non-parametric tests. Results: In 18 patients, 20 extraction sockets healed uneventfully and all sites received standard-diameter implants (4.1, 4.8, or 5.0 mm) without additional bone augmentation. Soft tissues and the muco-gingival border were well maintained. A retrospective analysis of X-rays and clinical photographs showed non-significant shrinkage in the vertical and horizontal dimensions (P=0.575 and P=0.444, respectively). The new bone contained vital bone cells embedded in mineralized tissues. Conclusions: Within the limitations of this pilot study, open healing of RCLC membranes may result in sufficient bone volume for implant placement without additional bone augmentation in contained and non-contained extraction sockets.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.86-91
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• 2009

The success of implants essentially depends on a sufficient volume of healthy bone at the recipient site during implant placement. In patients who have the severe alveolar bone resorption or pneumatized maxillary sinus, it should be performed that bone regeneration procedure before implant placement. Development of barrier membrane makes it possible that predictable result of alveolar bone reconstruction. Many kind of materials used for barrier membrane technique are introduced, non-absorbable or absorbable membranes. But, when operation site was ruptured with membrane exposure, bacterias can be grow up at the bone graft site. Then morphology and migration of fibroblast will be changed. It works as a negative factor on healing process of bone graft site. In oral and maxillofacial department of Chonbuk national university dental hospital, we use variable suture technique like as subgingival suture, vertical mattress suture, simple interrupted suture, if need, tenting suture after GBR or block bone graft. Within these suture technique, wound healing was excellent without complication, so now we take a report of suture technique in reconstruction of alveolar bone surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.3
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• pp.189-199
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• 2006

Purpose of study: Partial thickness skin graft is the golden standard regimen for full-thickness skin defect caused by burn or trauma. However, in case of extensive burns of more than 50% of total body surface area, the donor site is not sufficient to cover all defects. As a second choice, allograft, xenograft and synthetic materials have been used to treat skin defect. Among them the amniotic membrane(AM) was used as a biological dressing for centuries because of its potential for wound healing. In this study, quantification of EGF in AM and effect of AM-collagen complex on full thickness skin defects was examined. Materials & Methods: The concentration of EGF in fresh, deep frozen and freeze-dried AM was evaluated by ELISA. EGF-R immunostaining was performed in freeze-dried AM. SD rats weighing 250${\sim}$300g was used for wound healing experiment. Three full thickness skin defects(28mm diameter) were made on dorsal surface of SD rat. The control group was covered by Vaselin gauze and AM-collagen complex and $Terudermis^{(R)}$. was grafted in two other defects. Healing area, Cinamon's score were evaluated before biopsy. Grafted sites were retrieved at 3 days, 1 week, 2 weeks and 4 weeks after operation. H & E and Factor VIII immunohistochemical stain was performed to evaluate the microscopic adhesion and structural integrity and microvessel formation. Results: 1. EGF concentration of fresh, deep frozen and freeze-dried AM showed similar level and EGF-R was stained in epithelial layer of freeze-dried AM. 2. At 4 weeks after grafting, the healing area of AM-collagen and Terudermis group was 99.29${\pm}$0.71% and 99.19${\pm}$0.77 of original size. However, that of control group was 24.88${\pm}$2.90. 3. The Cinamon's score of AM-Collagen and $Terudermis^{(R)}$. group at 4 weeks was 15.6${\pm}$1.26 and 14.6${\pm}$3.13 and that of control group was 3.7${\pm}$0.95. Significant difference was observed among control and experimental groups(p<0.05). 4. Histologic examination revealed that AM protected leukocyte infiltration and epithelial migration was nearly completed at 4 weeks. $Terudermis^{(R)}$. group showed mild neutrophil infiltration until 2 weeks and completion of epithelization at 4 weeks. Control group showed massive leukocyte infiltration until 4 weeks. 5. Microvessels were increased sharply at 1 week and control group at 1 and 4 week showed significant differences with $Terudermis^{(R)}$. group of same interval(p<0.05) but no differences were found with AM group(p<0.05). Conclusion: EGF and EGF-R were well preserved in freeze-dried AM. AM attached to collagen acted as excellent biologic dressing which had similar effect with $Terudermis^{(R)}$. AM showed anti-inflammatory action and healing was completed at 4 weeks after full-thickness skin defect.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.509-518
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• 2010

Purpose: Major drawbacks of conventional bone marrow stromal cells (BSCs) transplantation method are mainly caused by direct transplanted cell to host cell interactions. We hypothesized that separation of the transplanted cells by a microporous membrane might inhibit most of the potential adverse effects and induce superior effect. The purpose of the study is to determine the optimal condition of the microporous membrane. Methods: First, BSCs were placed in polyethylene terephthalate (PET) transwell inserts with 3, 8, or $12{\mu}m$ pore size, and cultured in 24 well culture plates. After 5 days, bottoms of the plates were observed for presence of attached BSCs in monolayer and cell numbers were evaluated. Second, BSCs were placed PET, polycarbonate (PCT), and mixed cellulose esters (MCE) transwell inserts with 3 and $8{\mu}m$ pore size, and cultured in 24 well culture plates. After 3 days, the supernatants of the media left in culture plate were analyzed for collagen, vascular endothelial growth factor (VEGF), platelet derived growth factor BB (PDGF-BB), and basic fibroblast growth factor (bFGF). Third, BSCs were placed in 15% and 70% of the PET membrane with $3{\mu}m$ pore size. All the experimental conditions and methods were same as the second study. Results: The optimal pore sizes to prevent BSC leakage were $3{\mu}m$ and $8{\mu}m$. The amounts of type I collagen and three growth factors tested did not show significant differences among PET, PCT, and MCE groups. However, the collagen, VEGF, and bFGF levels were much higher in the high (70%) density group than in the low (15%) density group. Conclusion: This study revealed that the optimal pore size of membrane to prevent direct BSC to recipient cell contact is in between $3{\mu}m$ and $8{\mu}m$. Membrane materials and pore sizes do not influence the collagen and growth factor passage through the membrane. The most striking factor for collagen and growth factor transport is pore density of the membrane.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.666-671
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• 2000

Objectives: This study evaluated the availability of mandibular symphysis corticocancellous block grafts in patients treated for reconstruction of intraoral jaw defects. Materials & Methods: 8 patients with mandibular and maxillary bony defects were treated with corticocancellous block of symphysis. The types of defects included 4 pathologic jaw defects and 4 vertical and/or horizontal alveolar deficiencies. The age ranged from 13 to 45 years. Additional treatments such as plate fixation, alloplastic bony substitutes, and/or barrier membrane application were perfomred. They were evaluated for complications and healing of defects. Follow-up period ranged from 6 to 15 months. Results: 2 patients experienced complications such as wound dehiscence and mild resorption of exposed bone. None of the patients needed secondary operation. Paresthesia of lip, chin, and teeth were recovered completely by 6 months postoperatively. Reconstructed wound showed favorable healing and bony consolidation. Conclusion: Corticocancellous block of mandibular symphysis can be used for the reconstruction of a variety of intraoral local jaw defects selectively. Advantages were easy fixation of graft, possibility of restoration of original alveolar contour, and decreased donor site morbidity.

• Journal of Life Science
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• v.9 no.1
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• pp.17-21
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• 1999

Chitosan derivitives, a sulfated N-acetylchitosan was synthesized, and artificial skin of sulfated N-acetylchitosan and N-carboxyl butyl chitosan were investigated. Sulfated derivatives of chitosan were analyzed by {TEX}${13}^C${/TEX}-NMR and the structure on N-acetyl chitosan 3,6-O-disulfate were confirmed. Rabbits underwent a midline laparotomy followed either by a bilateral peritoneal sidewall abraison(3.0×1.5cm). The injured surface was then covered with 0.2mm thick sulfated N-acetyl chitosan membrane. Sulfated N-acetyl chitosan membrane was found to reduce postsurgical bleeding after abraison of peritoneal surface treated with sulfated N-acetyl chitosan membrane. Sulfated N-acetyl chitosan implanted rabbit showed quick wound healing than N-carboxybutyl chitosan. With a sterilization procedure of chemical sterilization, sulfated N-acetyl chitosan seem to be better substitutes than N-carboxybutyl chitosan.

• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.611-632
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• 1998

Chitosan has been known as a wound healing agent. The purpose of this study was to evaluate the biocompatibility and guided bone regenerative effect of chitosan and chitosan-cellulose membranes. The effects of chitosan and chitosan-cellulose membranes on the growth and survival of human periodontal ligament cells were examined by rapid colorimetric MTT(tetrazolium) assay, and the tissue response and resorption pattern were observed by implanting the membranes into the subcutaneous tissue of the back of rats for 6 weeks. To evaluate the guided bone regenerative potential of membranes, the amount of newly formed bone in the rat calvarial defects(8mm in diameter) was measured by histomorphometry and radiomorphometry 1,2 and 4 weeks after implantation of membranes. Chitosan and chitosan-cellulose membranes showed no adverse effect on the growth and survival of human periodontal ligament cells. When membranes were subcutaneously implanted, inflammatory reaction was observed at 1 week and which gradually subsided 2weeks after implantation. Membranes remained intact throughout the experimental period of 6 weeks. Radiomorphometric analysis of the craniotomy sites revealed that chitosan and chitosan-cellulose membrane implanted sites showed increased radiopacity over control. Statistically significant differences with control were found in chitosan-cellulose membrane implanted group at 2 and 4 weeks, and chitosan membrane implanted group at 4 weeks(P<0.05). Histomorphometric data indicated a pattern of osseous healing similar to radiomorphometric analysis. There was a statistically significant difference between control and chitosan-cellulose membrane implanted group at 4 weeks(P<0.05). These results implicate that chitosan and chitosan-cellulose membrane might be useful for guided bone regeneration.

• Journal of Periodontal and Implant Science
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• v.27 no.3
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• pp.633-645
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• 1997

The recent trend of research and development on guided tissue regeneration focuses on the biodegradable membranes, which eliminate the need for subsequent surgical removal. They have demonstrated significant and equivalent clinical improvements to the ePTFE membranes. This study evaluate guided tissue regeneration wound healing in surgically induced intrabony periodontal defects following surgical treatment with a synthetic biodegradable membranes, made from a copolymer of glycolide and lactide, in 8 beagle dogs. After full thickeness flap reflection, exposed buccal bone of maxillary and mandibular canine and premolar was removed surgically mesiodistally and occlusoapically at $6mm{\times}6mm$ in size for preparation of periodontal defects. In experimental sites a customized barrier was formed and fitted to cover the defect. Flap was replaced slightly coronal to CEJ and sutured. Plaque control program was initiated and maintained until completion of the study. In 4, 8, 16 and 24 weeks after surgery, the animals were sacrificed and then undecalcified specimens were prepared for histologic evaluation. Histologic examination indicated significant periodontal regeneration characterized by new connective tissue attachment, cementum formation and bone formation. These membranes showed good biocompatibility throughout experiodontal period. The barriers had been completely resorbed with no apparent adverse effect on periodontal wound healing at 24 weeks. These results implicated that present synthetic biodegradable membrane facilitated guided tissue regeneration in periodontal defect.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.495-500
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• 2008

Purpose: Adequate tissue oxygenation is considered as an essential factor for wound healing. In the non-diabetic population, an uncompromised macrocirculation generally leads to adequate tissue oxygenation. On the contrary, the macrocirculation in diabetic patients may not correlate with tissue oxygenation because of structural changes in the capillary basement membrane. Nevertheless, many medical professionals in Korea rely on macrocirculation evaluation when predicting wound healing potential of the diabetic ulcers. The purpose of this study is to compare reliability of two common macrocirculation assessment methods, Doppler probing and CT angiography, on tissue oxygenation in diabetic foot patients. Methods: Doppler and CT angiography scores were given according to the patency of the anterior and posterior tibial arteries. Tissue oxygenation was measured by transcutaneous partial oxygen tension($TcpO_2$). Doppler and CT angiography scores were statistically analyzed against $TcpO_2$ values. Sixty-eight diabetic foot ulcer patients were included in this study. Results: The test was carried out on Doppler score and $TcpO_2$ variables displayed a p-value of 0.0202, and concluded that the two variables were statistically dependent. The test used to determine for linear trends between Doppler scores and $TcpO_2$ variables displayed a p-value of 0.0149, displaying statistical linear trend between the two variables. On the contrary, the tests between CT angiography scores and $TcpO_2$ variables showed p-values of 0.1242 and 0.6590, that means no correlation between CT angiography and $TcpO_2$ scores. Conclusion: Doppler probing is more reliable than CT angiography in predicting tissue oxygenation of diabetic foot ulcers.