• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.95-102
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• 2009

Purpose: The aim of this report is to investigate the efficacy of anorganic bovine bone xenograft(Bio-$Oss^{(R)}$) at maxillary sinus floor augmentation. Materials and methods: Two male patients who missed maxillary posterior teeth were included. They were performed maxillary sinus floor augmentation using anorganic bovine bone xenograft(Bio-$Oss^{(R)}$). After 10 or 13 months, the regenerated tissues were harvested using trephine drills with 2 or 4mm diameter and non-decalcified specimens were made. The specimens were examined histologically and histomorphometrically to investigate graft resorption and new bone formation. Results: Newly formed bone was in contact with Bio-$Oss^{(R)}$ particles directly without any gap between the bone and the particles. The proportions of newly formed bone were $23.4{\sim}25.3%$ in patient 1(Pt.1) and 28.8% in patient 2(Pt.2). And the proportions of remained Bio-$Oss^{(R)}$ were $29.7{\sim}30.2%$ in Pt.1 and 29.2% in Pt.2. The fixtures installed at augmented area showed good stability and the augmented bone height was maintained well. Conclusion: Anorganic bovine bone xenograft(Bio-$Oss^{(R)}$) has high osteoconductivity and helps new bone formation, so that it can be used in maxillary sinus floor augmentation.

• Journal of Veterinary Clinics
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• v.27 no.4
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• pp.325-329
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• 2010

The osteogenic potential of hydroxyapatite/poly $\varepsilon$-caprolactone composite (HA/PCL) scaffolds with matrigel was evaluated in a rat calvarial defect model. Calvarial defect formation was surgically created in Sprague Dawley rats (n = 18). HA/PCL scaffold was grafted with matrigel (M-HA/PCL group, n = 6) or without matrigel (HA/PCL group, n = 6). A critical defect group (CD group, n = 6) did not received a graft. Four weeks after surgery, bone formation was evaluated with radiography, micro computed tomography (micro CT) scanning, and histologically. No bone tissue formation was radiographically evident in the CD group. Bone tissue was radiographically evident in the HA/PCL and M-HA/PCL groups, however, there was more bone-similar opacity in the M-HA/PCL group. Micro CT analysis revealed that the bone volume of the M-HA/PCL group was higher than the HA/PCL group, however, no significant difference was found between the HA/PCL and M-HA/PCL groups. Bone mineral density in the M-HA/ PCL group was significantly higher than in the HA/PCL group (p < 0.05). Histologically, new bone was formed only from existing bone in the CD group, showing concavity without bone formation in the defect. In the HA/PCL group, new bone formation was only derived from existing bone, while in the M-HA/PCL group the largest bone formation was observed, with new bone tissue forming at the periphery of existing bone and around the HA/PCL scaffold with matrigel. The results indicate that the combination of HA/PCL scaffold with matrigel may be an effective means of enhancing bone formation in critical-sized bone defects.

• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.68-74
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• 2015

Purpose: The reconstruction of femur and tibia defects following tumor resection remains a surgical challenge. The clinical outcome of free vascularized fibula graft (VFG) reconstruction with locking plate for massive femur and tibia defects of more than 10 cm that were secondary to skeletal tumor resection is reported. Materials and Methods: Thirteen patients with a mean follow-up of 3.3 years were reviewed. Seven patients received vascularized fibula grafts in the femur and six in the tibia. The mean bony defect of the femur and tibia was more than 10 cm and the length of the grafted fibula was more than 15 cm. All defects were stabilized with long locking plates. Results: All patients were free of disease at final follow-up; All VFGs were transferred successfully. All patients had a successful outcome with bony union. Stress fractures of the grafted fibula had occurred but the locking plate stabilized the fracture and healed until the last follow-up. All patients were able to walk without a brace after a mean of 9 months postoperatively. Conclusion: VFG with locking plate is a reliable reconstructive procedure for massive femur and tibia defects.

• Journal of Periodontal and Implant Science
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• v.26 no.3
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• pp.605-624
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• 1996

Various bonegraft materials and the technique of guided tissue regeneration have been used to regenerate lost periodontal tissue. Calcium sulfate has been known as a bone graft material because of good biocompatibility, rapid resorption and effective osteoinduction. It has been known that calcium sulfate works as a binder to stabilize the defect when it is used with synthetic graft materials. The effects on the regeneration of pericxiontal tissue were studied in dogs after grafting 3-wall intrabony defects with calcium carbonate and calcium sulfate and covering with calcium sulfate barrier. The 3-wall intrabony defectstdmm width, 4mm depth, 4mm length) were created in anterior area and treated with flap operation alone(contol group), with porous resorbable calcium carbonate graft alonetexperirnental group 1), with calcium sulfate graft alonetexperimental group 2) and with composite graft of 80% calcium carbonate and 20% calcium sulfate with calcium sulfate barriertexperimental group 3). Healing responses were histologically observed after 8 weeks and the results were as follows: 1. The alveolar bone formation was $0.59{\pm}0.19mm$ in the control group, $1.80{\pm}0.25mm$ in experimental group 1, $1.61{\pm}0.21mm$ in experimental group 2 and $1.94{\pm}0.11mm$ in experimental group 3 with statistically significant differences between control group and all experimental groups(P<0.05). There were statistically significant differences between experimental group 1 and group 2 (P<0.05). 2. The new cementum formation was $0.48{\pm}0.19mm$ in the control group. $1.72{\pm}0.26mm$ in experimental group 1, $1.43{\pm}0.17mm$ in experimental group 2, $1.89{\pm}0.15mm$ in experimental group 3 with statiscally significant differences between control group and all experimental groups (p<0.05). There were statistically significant differences between experimental group 1 and group 2, and between experimental group 2 and group 3(P<0.05). 3. The length of junctional epithelium was $1.61{\pm}0.20mm$ in the contol group, $0.95{\pm}0.06mm$ in experimental group 1, $1.34{\pm}0.16mm$ in experimental group 2, $1.08{\pm}0.11mm$ in experimental group 3 with statiscally significant differences between control group and experimental group 1. and btween control group and experimental group 3(p<0.05). There were statistically significant differences between experimental group 1 ,and group 2, and between experimental group 2 and group 3(P<0.05). 4. The connective tissue adhesion was $1.67{\pm}O.20mm$ in the control group, $1.33{\pm}0.24mm$ in experimental group 1. $1.23{\pm}0.16mm$ in experimental group 2, $1.08{\pm}0.14mm$ in experimental group 3 with statistically significant differences between control group and all experimental groups(p<0.05). There were nostatistically significant differences between all experimental groups. As a result, epithelial migration was not prevented when calcium sulfate was used alone, but new bone and cementum formation were enhanced. Epithelial migration was prevented and new bone and cementum formation were also enhanced when calcium carbonate was used alone and when both calcium carbonate and calcium sulfate were used.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.19-25
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• 2011

Purpose: Addition of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) to grafting material has become widely accepted additively for bone regeneration because it can raise high expectations on it's clinical potential. The aim of this study was to evaluate the efficacy of PRP and PRF on early bone regeneration of rabbits when used in combination with beta tricalcium phosphate. Methods: In eight rabbits, the calvarium was exposed and the two marrows were penetrated. After then these artificial bone defects were augmented with ${\beta}$-TCP or ${\beta}$-TCP with PRP or ${\beta}$-TCP with PRF and covered. The animals were sacrificed after four and eight weeks. Histologic findings were observed under the light-microscope and histomorphometric analysis was performed by measuring calcified area of new bone formation within the CSD. Results: They demonstrated that new bone formation tended to be produced along the outline of graft materials. More amounts of newly bone was regenerated in ${\beta}$-TCP only and in combination of${\beta}$-TCP with PRF and it was statistically significant. In contrast, there was no significant difference between nothing apply and ${\beta}$-TCP with PRP groups in the relative amounts of newly mineralized bone. Conclusion: Within the limitation of this study, it can be concluded that PRF in combination with ${\beta}$-TCP showed a positive effect on bone regeneration and statistically it was significant.

• The Journal of the Korean dental association
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• v.55 no.10
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• pp.676-687
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• 2017

Objectives : The aim of this study was to evaluate the effects of a composite of bone substitute and collagen barrier membrane (bone patch) for local ridge augmentation at peri-implant dehiscence defects on the clinical efficacy and positional stability in dogs. Materials and methods : Implant placement and ridge augmentation procedure were performed at surgically created peri-implant dehiscence defects in canine mandible (n=6). Four treatment modalities were randomly applied: i) bone patch group, ii) Guided bone regeneration (GBR) without pin fixation group (bone graft and collagen membrane), iii) GBR with pin fixation group, and iv) negative control group. After 12 weeks, clinical, micro-CT and histological analyses were performed. Results : Histologic analysis showed that bone patch group had similar results to GBR group and GBR with fixation group in terms of new bone formation. Micro-CT analysis revealed similar results to histologic analysis in terms of total volume maintenance. Operating time was shorter in bone patch group compared to GBR group and GBR with fixation groups. Conclusions : GBR using bone patch could simplify the ridge augmentation procedure with reduced operating time and equivalent biological performance compared to the conventional procedure.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.195-210
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• 2006

The aim of this study is to evaluate the effects of combination of rhBMP-4 and chitosan, which have osteoinductive capacity, on the regeneration of bone defects in dogs. Three beagle dogs aged over one and half years and weighed about 15Kg were used in this study. Three round defects were made by trephine bur in each side of mandibles. Each defect was filled with collagen, chitosan, rhBMP-4/chitosan. The dogs were sacrificed at 1, 3 or 8 weeks postsurgery and the results were evaluated histologically. The results of this study were as follows: 1. The sign of new bone formation, rearrangement of osteoblasts was revealed adjacent of preexisted bone or around graft materials such as chitosan. 2. The descending order of groups in bone regeneration speed was the rhBMP-4/chitosan group, chitosan group, collagen group. In the combination group, new bone was regenerated more and in better quality than others. 3. The regeneration of bone was observed in the rhBMP-4/chitosan group in 3 weeks after surgery. In 8 weeks after surgery, bone regeneration was observed in all three groups, and new bone at 8th week was denser in the chitosan and rhBMP-4/chitosan group than collagen group. In conclusion, rhBMP-4 and chitosan can be applied in the bone regeneration procedures usefully. It is considered that chitosan can be a splint for the maintenance of the defect form and produce much better effect when used with good grafting material or bone morphogenetic protein.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.5
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• pp.278-286
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• 2023

Objectives: This review assessed the performance of implant-supported fixed hybrid prostheses in 21 patients who received a total of 137 implants between 2003 and 2010. The implants were evaluated for marginal bone resorption, complications, success rate, and survival rate based on their vertical angularity, type of bone graft, and measured implant stability. Materials and Methods: One-way ANOVA and chi-square tests were used to analyze the relationships among long-term evaluation factors and these variables. The mean initial bone resorption in the implant group with a vertical angle of more than 20° was 0.33 mm and mean final bone resorption was 0.76 mm. In contrast, the mean initial bone resorption in the implant group with a vertical angle of less than 10° was 1.19 mm and mean final bone resorption was 2.17 mm. Results: The results showed that mean bone resorption decreased with an increase in the vertical placement angle of the implants used in fixed hybrid prostheses, as well as in the group without additional bone grafts and those with high implant stability. The success rate of implants placed after bone grafting was found to be higher than those placed simultaneously. Conclusion: These results suggest that implant-supported fixed hybrid prostheses may be an effective treatment option for edentulous patients, and intentionally placing implants with high angularity may improve outcomes.

• Journal of Korean Foot and Ankle Society
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• v.21 no.1
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• pp.27-32
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• 2017

Purpose: Bone grafting is often necessary to maintain a reduction and prevent delayed collapse of reduced fracture in a treatment of severely displaced comminuted intra-articular calcaneal fractures. Herein, we analyzed the usefulness and necessary conditions to perform tricortical-allobone grafting in open reduction of calcaneal fracture via the Ollier approach. Materials and Methods: We performed a retrospective review of 57 intra-articular calcaneal fractures that underwent an operation via the Ollier approach between April 2009 and April 2015. They were divided into two groups: Group 1 (n=17) included those with tricortical-allobone grafts underneath the posterior facet fragment, and group 2 (n=40) included cases without a bone graft. We measured the $B{\ddot{o}}hler$ angle, Gissane angle, height, and width of the calcaneus at preoperative, postoperative, and final follow-up radiograph. We measured the sagittal rotational angle of the posterior facet fragment of preoperative computed tomography to analyze the effect and necessary conditions for bone grafting. We also reviewed the clinical results by the American Orthopaedic Foot and Ankle Society (AOFAS) scale, visual analogue scale (VAS), and any complications. Results: According to the Sanders classification, there were 3 type-II fractures, 12 type-III fractures, and 2 type-IV fractures in Group 1; whereas in Group 2, there were 26 type-II fractures, 13 type-III fractures, and 1 type-IV fracture (p=0.002). Regarding the preoperative radiologic parameters, there were significant differences in the $B{\ddot{o}}hler$ angle (p=0.006), Gissane angle (p=0.043), and rotational angle of the posterior facet fragment (p=0.001). No significant difference was observed in the preoperative calcaneal height and width, as well as postoperative radiologic parameters. There was no significant clinical difference between the two groups (p=0.546). Conclusion: We suggest that a tricortical-allobone graft may be useful in open reduction and screw fixation via the Ollier approach for displaced intra-articular calcaneal fracture with a bony defect after reduction of collapsed posterior facet fragment. This graft can contribute to the stable reduction via a small approach, even without a plate.

• Journal of Korean Neurosurgical Society
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• v.44 no.5
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• pp.303-307
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• 2008

Objective: The authors reviewed clinical and radiological outcomes in patients with three column injury of the cervical spine who had undergone posterior cervical fixation using Nitinol shape memory alloy loop in the anterior-posterior combined approach. Materials: Nine patients were surgically treated with anterior cervical fusion using an iliac bone graft and dynamic plate-screw system, and the posterior cervical fixation using Nitinol shape memory loop ($Davydov^{TM}$) at the same time. A retrospective review was performed. Clinical outcomes were assessed using the Frankel grading method. We reviewed the radiological parameters such as bony fusion rate, height of iliac bone graft strut, graft subsidence, cervical lordotic angle, and instrument related complication. Results: Single-level fusion was performed in five patients, and two-level fusion in four. Solid bone fusion was presented in all cases after surgery. The mean height of graft strut was significantly decreased from $20.46{\pm}9.97mm$ at immediate postoperative state to $18.87{\pm}8.60mm$ at the final follow-up period (p<0.05). The mean cervical lordotic angle decreased from $13.83{\pm}11.84^{\circ}$ to $11.37{\pm}6.03^{\circ}$ at the immediate postoperative state but then, increased to $24.39{\pm}9.83^{\circ}$ at the final follow-up period (p<0.05). There were no instrument related complications. Conclusion: We suggest that the posterior cervical fixation using Nitinol shape memory alloy loop may be a simple and useful method, and be one of treatment options in anterior-posterior combined approach for the patients with the three column injury of the cervical spine.