• Journal of Periodontal and Implant Science
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• 제34권1호
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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.

• 대한정형외과학회지
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• 제55권2호
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• pp.127-134
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• 2020

목적: 이 연구의 목적은 동종 쐐기 골편의 성상과 최대압축하중과의 관계를 알아보고 동종 쐐기 골편의 최대압축하중과 경골 근위부 개방 절골술 시 측정된 개방부의 압력을 비교하는 것이다. 대상 및 방법: 경골 근위부 개방 절골술을 시행하기 전 연구에 동의한 10명의 환자가 본 연구에 포함되었다. 수술 중 절골 부위를 8 mm에서 14 mm까지 개방시키면서 1 mm 간격으로 개방부의 압력을 측정하였다. 대퇴골, 경골 및 상완골에서 U자형 동종 쐐기 골편을 채취하여 골편의 높이, 폭, 단면적 및 피질골의 두께를 측정한 뒤에 골편이 파괴되기 직전의 최대압축하중을 측정해 골편의 성상과 최대압축하중과의 관계를 평가하였다. 경골 근위부 개방 절골술 시 별도의 신연장치 없이 개방부에 동종 쐐기 골편을 삽입할 수 있는지 평가하기 위해 경골 근위부 개방 절골술 시 측정된 개방부 압력과 동종 쐐기 골편의 최대압축하중을 비교하였다. 결과: 경골 근위부 개방 절골술 중 절골부를 많이 개방할수록 개방부 압력이 증가해 14 mm 개방하였을 때 개방부의 압력(평균 282±93 N, 최대 427 N)이 가장 크게 측정되었다. 동종 쐐기 골편의 최대압축하중은 평균 13,379±6,469 N (최소값 5,868 N, 최대값 29,130 N)으로 측정되었으며 피질골의 두께(상관계수=0.693, p=0.002) 및 단면적(상관계수=0.826, p<0.001)과 유의한 상관관계를 가지고 있었다. 살균 방법에 따라 동결 건조(freeze-dried) 골편은 평균 13,406±5,928 N (최소값 5,868 N, 최대값 25,893 N), 동결(fresh frozen) 골편은 평균 13,348±7,449 N (최소값 5,916 N, 최대값 29,130 N)으로 측정되었다. 동종 쐐기 골편의 최대압축하중 최소값은 경골 근위부를 14 mm까지 개방하였을 때 측정된 개방부의 최대압력에 비해 13.7배 높았다(5,868 N vs. 427 N). 결론: 동종 쐐기 골편의 최소 압축 강도는 경골 근위부 개방 절골술 시 측정된 개방부의 최대 압력보다 충분히 큰 것으로 확인되었다. 따라서 경골 근위부 개방 절골술 중 별도의 신연장치 없이 동종 쐐기 골편을 개방부에 안전하게 삽입 가능한 것으로 판단된다.

• 대한임상검사과학회지
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• 제38권1호
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• pp.9-15
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• 2006

Peripheral bood stem cell collection (PBSCC), including peripheral blood stem cell transplantation (PBSCT), has been utilized worldwide as a very beneficial treatment method instead of allogenic Bone Marrow Transplantation (BMT) because it has many advantages such as rapid bone marrow engraftment and hematopoietic recovery, easy and safe accessibility and lower risk of rejection compared with allogenic BMT. In order to identify most the observable parameter in PBSCC, we analyzed various hematological parameters before and after PBSCC, and evaluated the correlation between the time of bone marrow engraftment and the number of CD34+ cells. Thirteen patients, who underwent 54 PBSCCs from January, 2003 to August, 2004 at Chungnam National University Hospital due to various systemic neoplasms, were analyzed in aspects of various hematological parameters including CD34+ cells using by Flow Cytometry (FCM). PBSCC harvests are described below: Mononuclear cells (MNC) $2.3{\pm}1.4{\times}10^8/kg$ and CD34+ cells $0.63{\pm}0.35{\times}10^6/kg$ on average, respectively. There was a statistical significance in Hb and Hct before and after PBSCC, but not in WBC and platelet counts. The period to reach the hematological bone marrow engraftment was 13.4(10~21) days and 19.5(11~38) days according to the criteria of absolute neutrophile counts (ANC) ${\geq}500/uL$ and platelet counts ${\geq}50,000/{\mu}L$ in peripheral blood, respectively. There was a significant correlation between the numbers of CD34+ cell and ANC (p<0.05), and a borderline significance between MNC and ANC (p=0.051). We found that a group of patients, who were infused with CD34+ cells more than $3.5{\times}10^6/kg$, reached more rapidly the period of bone marrow engraftment in platelet counts (p=0.040). This present study suggested that Hb and Hct were the most useful parameters and should be closely monitored before and after PBSCC, that a PBSCT with the dosage of more than $3.5{\times}10^6/kg$ of CD34+ cells was needed to perform successful bone marrow engraftment, and additionally that platelet counts could be more useful in indicating bone marrow engraftment than ANC.

• Tuberculosis and Respiratory Diseases
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• 제49권2호
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• pp.207-216
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• 2000

연구배경 : 동종골수이식은 난치성 혈액질환의 효과적인 치료법이나 약 40%에서 치료와 관련된 합병증으로 사망하고, 그중 10-40%가 폐합병증이 주된 사인이므로 폐합병증의 발생유무는 동종골수이식 치료성적에 중요한 영향을 미친다. 국내에서는 이식편대숙주질환이 서구보다 적고 CMV감염률이 높아 폐합병중이 서구와는 다른 양상으로 나타나리라 사료되어 국내에서 동종 골수이식 후 발생한 폐합병증의 임상양상을 알아보고자 본 연구를 시행하였다. 방법 : 1993년 12월부터 1999년 5월까지 서울중앙병원에서 동종골수이식을 시행한 100명의 성인환자를 대상으로 후향적 코호트법으로 연구하였다. 패합병증은 발생시기에 따라 골수가 생착하는 시기인 30일 전후로 나누고 다시 병인에 따라 감염성 혹은 비감염성으로 분류하였다. 감염성 합병증은 혈액이나 BAL액, 흉막액, 객담검사등에서 병원체가 증명된 경우에서나 임상적으로 감염성 합병증이 의심되는 경우에서 항균제 혹은 항진균제를 사용하여 임상적, 방사선학적 호전이 있는 경우로 정의하였다. 결과 : 1) 폐합병증은 100명중 54명에서 83건이 발생하였다. 2) 30일 이전에는 비감염성 합병증이, 30일 이후에는 감염성 합병증이 더 많이 발생 하였고, 기저질환이 재발되거나 만성 이식편대숙주질환이 없으면 1년 이후에는 감염성 합병증은 발생하지 않았다. 3) 비감염성 합병증으로는 흉막액이 27건으로 가장 많았고, 그 외 비감염성 합병증으로는 폐부종 8건, 미만성 폐포출혈 1 건, BO 2건, BOOP 1건이 있었다. 4) 감염성 합병증은 세균성 폐렴 9 건, 바이러스성 폐렴 4건, 폐결핵 3건, PCP 1건, 진균성 폐렴 5건, 결핵성 흉막염 3건이 있었다. 5) CMV감염과 호중구 회복지연은 폐합병증과 관련된 위험인자로 확인되었다. 6) 폐합병증이 발생한 경우 동종골수이식 후 사망률이 유의하게 높았다. 결론 : 동종골수이식 후 폐합병증은 54%에서 발생하였고, 폐합병증이 발생한 경우에 이식 후 사망률이 증가하였다.

• 대한치과보철학회지
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• 제33권2호
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• pp.300-316
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• 1995

Methods for restoring the posterior portion of the maxilla with delayed and simultaneous sinus lift, composite graft and placement of TPS cylinder and screw type implants are presented. Sinus grafting is needed because of minimal remaining alveolar bone and supporting posterior maxillary portion, The composite graft material uses a combination of autogeneous bone from tuberosity, dimeneralized freeze dried allogenic bone and hydroxylapatite with saline. Since 1991, feb, 1 sinus graft with delayed implantation of 3 cylinder implants and 5 sinus grafts with simultaneous placement of 4HA coated screw typed, 8 TPS cylinder typed implants have been performed for 6 patients. None of the 15 restored implants have been lost, Temporization of prosthesis was done about 2-5 months before final prosthetic work, None of them shows any severe complication.

• 대한관절경학회지
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• 제7권2호
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• pp.147-152
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• 2003

목적 : 반월상연골 동종 이식술을 시행 후 2차 관절경적 소견 및 자기 공명 영상을 통해 이식물의 관절 내 변화를 관찰 하고자 하였다. 대상 및 방법 : 1999년 10월부터 2002년 6월까지 반월상 연골 동종 이식술을 시행후 이차 관절경 검사를 9례를 대상으로 하였다. 6례에서 동결 보존(cryopreserved) 반월상 연골을, 3례에서 신선 동결(fresh-frozen)반월상 연골을 이식물로 사용하였다. 내측은 골편 고정술을, 외측은 골교 고정술을 사용하였다. 술후 평균13개월째 이차 관절경 검사를 시행 하였으며 임상적 평가는 lysholm score, 자기 공명 영상 및 이차 관절경 검사소견으로 평가 하였다. 결과 : 이식된 반월상연골은 변연부에 견고하게 고정되었고 혈관 증식 역시 양호하였다. 그러나 1례에서 후각부에 경도의 마모를 보였으며, 타원에서 시술 후 내원하였던 1례에서 비해부학적 위치에의 이식으로 인한 전각부에 파열소견이 관찰되었다. Lysholm score는 술전 평균64점에서 술후 87점으로 향상 되었다. 결론 : 2차 관절경검사상 이식한 반월상연골이 변연부에 견고하게 고정 되었음을 확인 할 수 있었으며 임상적으로도 증상이 호전되었으나, 향후 관절염의 진행을 예방 할 수 있는지의 여부는 보다 장기간의 추시관찰이 필요하리라 사료되었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.139-147
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• 1998

동종 이식골 내의 탈회 정도에 따른 잔존 칼슘치가 이소성 골형성능에 미치는 영향을 파악하고자 Sprague-dowley계 백서에서 채취한 경골 및 대퇴골의 골간부를 0.5cm 크기로 절단하여 부착 연조직은 제거한 다음, 초음파 세척장치를 이용하여 $60^{\circ}C$ 0,6N HCl용액으로 5분, 10분, 15분, 20분, 25분, 30분, 35분, 40분간 각각 처리하여 탈회 동종 이식골을 준비하였다. 이때 탈회시간에 따른 시편의 무게를 측정하였고, 각 탈회용액으로부터 1cc를 취한 다음 Sigma사의 진단용 칼슘치 측정kit를 이용하여 spectrophotometer로 600nm 파장하에서 칼슘치를 측정하였다. 그리고 탈회 정도에 따른 이식골편의 골형성 유도능을 확인하기 위하여 24마리의 Sprague-dowley계 백서를 탈회시간별로 8군으로 나누어 배부에 0.5cm 크기로 4군데의 피하낭을 형성한후 각각의 처리된 탈회 이식골편을 이식하였다. 매식된 동종 이식골편들을 술후 1, 2, 3주째 채취하여 통법에 따라 H&E염색 표본을 제작하여 광학현미경으로 관찰하였다. 이상의 실험에서 다음과 같은 결과를 얻었다. 1. 탈회 30분까지의 용출되는 칼슘 농도 변화는 평균 15.91mg/ml로, 탈회 20분 이후에 평균 99.65%의 탈회정도를 보였다. 2. 동종골 무게 변화량은 탈회시작 25분까지 뚜렷한 무게변화를 보였으나, 그 이후에는 변화의 정도가 미약하였다. 3. 탈회된 이식 통종골에의한 이소성 골형성 유도능 비교에서 20분에서 30분간 탈회된 군에서 가장 양호하였고 그 외의 군에서는 그 정도가 열등하였다. 이상의 결과는 탈회된 동종골에 있어 골형성 유도능을 극대화하기 위해서는 골기질내 무기성분의 완전한 탈회가 선행되어야 하며, 탈회골 기질의 변성이 최소화되어야 함을 시사한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권2호
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• pp.137-152
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• 1995

This study was designed to evaluate the bone formation capability of the bone substitute when compared with autogenic bone, freeze-dried demineralized allogeneic bone and bioglass into parietal bone of the rats. We made the parietal bone defects in $7{\times}7mm$ size on rats and has performed the bone graft in each experimental groups. Postoperatively 1, 2, 4, 6, 8, weeks, each specimen stained with H & E, Masson's trichrome methods. We evaluated the osteogensis capability in each groups. The result were as follow : 1. Inflammatory cell infiltration approached at 1 week and disappeared at 4 weeks in all experimental group, expecially severe in freeze-dried demineralized allogeneic bone group. 2. New capillry proliferation was increased in autogeneic bone graft group than any other groups and was increased till 2 weeks and decreased in freeze-dried demineralized allogeneic bone group and was few in bioglass group. 3. Osteoblastic activity increased in autogeneic bone and freeze-dried demineralized allogeneic bone groups till 4 weeks, and decreased in 6 weeks which no difference between these groups. But, few occurred in bioglass group till 6 weeks. 4. Initial osteoclastic activity was prominent in freeze-dried demineralized allogeneic bone group and few in autogeneic bone group. 5. New bone formation bega at 1 week in autograft and freeze-dried demineralized allogenic bone groups, but, mild new bone formation at 8 weeks in bioglass.

• 대한치과의사협회지
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• 제48권4호
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• pp.256-262
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• 2010

bone grafting is indicated in the case of bony defects and is classified into autograft, allograft, and xenograft. Synthetic bone graft is contrasted with these three categories in that it has a different donor source. Autograft is most prominent as it is known as a gold standard of all grafting procedures. Its principles and practices are well established via accumulated informations and clinical experiences, which imposes no regulations or restrictions in its clinical use. On the other hand, other bone graft procedures are under tight control for the safety and effectiveness of each product. Food and Drug Administration of the United States has a system in which the information on the approvals and clearances of bone graft materials on their internet homepage. All the bone graft materials that are under the regulations of the United States are classified into the category of medical devices, which includes allogenic bone, xenogenic bone, and synthetic bone graft materials. Each bone graft material has its own indication and the FDA approvals and clearances of medical devices contain the item of "intended use" to specify the indications of each bone graft materials. US dentists, as users of the specific bone graft materials, are provided with adequate information on the approved materials they are to utilize. As an user of these materials, Korean dentists are less provided with the information on the bone graft materials they want to use. Medical providers of the bone graft materials have to be able to provide their users with the essential information such as the intended use of the regulatory approval. Dentists must also be active in gathering informations on the material of their interest, and the system must be built in which both of the medical providers and users of bone graft materials can be satisfied in providing and getting the information, respectively.

• 대한구강악안면임플란트학회지
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• 제22권4호
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• pp.242-254
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• 2018

The aim of the current study was to evaluate the results of horizontal guided bone regeneration (GBR) with xenograf t (deproteinized bovine bone mineral, DBBM), allograf t (irradiated allogenic cancellous bone and marrow), titanium membrane, resorbable collagen membrane, and advanced platelet-rich fibrin (A-PRF) in the anterior maxilla. The titanium membrane was used in this study has a three-dimensional (3D) shape that can cover ridge defects. Case 1. A 32-year-old female patient presented with discomfort due to mobility and pus discharge on tooth #11. Three months after extracting tooth #11, diagnostic software (R2 GATE diagnostic software, Megagen, Daegu, Korea) was used to establish the treatment plan for implant placement. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM ($Bio-Oss^{(R)}$, Geistlich, Wolhusen, Switzerland), irradiated allogenic cancellous bone and marrow (ICB $cancellous^{(R)}$, Rocky Mountain Tissue Bank, Denver, USA), 3D-titanium membrane ($i-Gen^{(R)}$, Megagen, Daegu, Korea), resorbable collagen membrane (Collagen $membrane^{(R)}$, Genoss, Suwon, Korea), and A-PRF because there was approximately 4 mm labial dehiscence after implant placement. Five months after placing the implant, the second stage of implant surgery was performed, and healing abutment was connected after removal of the 3D-titanium membrane. Five months after the second stage of implant surgery was done, the final prosthesis was then delivered. Case 2. A 35-year-old female patient presented with discomfort due to pain and mobility of implant #21. Removal of implant #21 fixture was planned simultaneously with placement of the new implant fixture. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM ($Bio-Oss^{(R)}$), irradiated allogenic cancellous bone and marrow (ICB $cancellous^{(R)}$), 3D-titanium membrane ($i-Gen^{(R)}$), resorbable collagen membrane (Ossix $plus^{(R)}$, Datum, Telrad, Israel), and A-PRF because there was approximately 7 mm labial dehiscence after implant placement. At the second stage of implant surgery six months after implant placement, healing abutment was connected after removing the 3D-titanium membrane. Nine months after the second stage of implant surgery was done, the final prosthesis was then delivered. In these two clinical cases, wound healing of the operation sites was uneventful. All implants were clinically stable without inflammation or additional bone loss, and there was no discomfort to the patient. With the non-resorbable titanium membrane, the ability of bone formation in the space was stably maintained in three dimensions, and A-PRF might influence soft tissue healing. This limited study suggests that aesthetic results can be achieved with GBR using 3D-titanium membrane and A-PRF in the anterior maxilla. However, long-term follow-up evaluation should be performed.