• Archives of Plastic Surgery
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• v.50 no.5
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• pp.478-487
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• 2023

Background The outcome of alveolar grafting with synthetic bone substitute (Osteon III) in various bone defect volumes is highlighted. Methods A prospective study was accomplished on 55 patients (6-13 years of age) with unilateral alveolar bone cleft. Osteon III, consisting of hydroxyapatite and tricalcium phosphate, is used to reconstruct the defect. Alveolus defect diameter was calculated before surgery (V1), after 3 months (V2), and finally after 6 months (V3) postsurgery. In the t-test, a significant difference and correlation between V1, V2, and V3 are stated. A p-value of 0.01 is considered a significant difference between parameters. Results The degree of cleft is divided into three categories: small (9 cases), medium (20 patients), and large (26 cases).The bone volume of the clefted site is divided into three steps: volume 1: (mean 18.1091 mm³); step 2: after 3 months, volume 2 resembles the amount of unhealed defect (mean 0.5109 mm³); and the final bone volume assessment is made after 6 months (22.5455 mm³). Both show statistically significant differences in bone volume formation. Conclusion An alloplastic bone substitute can also be used as a graft material because of its unlimited bone retrieval. Osteon III can be used to reconstruct the alveolar cleft smoothly and effectively.

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.863-875
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• 2005

Bovine bone-derived bone substitutes are widely used for treatment of bone defects in dental and orthopedic regenerative surgery. The purpose of this study was to evaluate the basic characteristics of deproteinized bovine bone mineral as a bone graft substitute. Commercially available products from three different bovine bone minerals-Bio-Oss(GeistlichPharma, Switzerland), BBP(Oscotec. Korea), Osteograf/N-300(Dentsply Friadent Ceramed, USA) - were investigated. They were evaluated by scanning electron microscopy(SEM), energy dispersive X-ray spectrometer(EDS), surface area analysis(BET), and Kjeldahl protein analysis. Cell viability on different products was evaluated by 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide(MTT) assay. The results of this study indicated that each bone substitute displayed distinct surface properties. Furthermore, Kjeldahl protein analysis indicated that residual crude proteins are present in deproteinized bovine bone mineral. BBP showed relatively large amount of residual protein, which indicated that the possibility of disease transmission can not be safely ruled out. Based on the results of this study, it is suggested that active quality management is strongly needed in operations that involve processing bovine bone tissue for medical use.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.139-147
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• 2003

Purpose: The purpose of this study was to determine if bony union can be obtained when a bone graft substitute is transplanted in order to treat a benign bone tumor and if there is a difference between calcium sulfate and hydroxyapatite in the healing procedure when the degree of the bony union after the bone graft are compared. Materials and Methods: This study selected 20 cases, in which a curettage on the benign bone tumors was conducted and a bone graft substitute was transplanted. The area of the focus, the new bone formation, the recurrence of the focus in the plain radiographs and histological findings were observed. Results: Twenty cases (13 males, 7 females) were evaluated. Their mean age at surgery was 15.8 years (2~45), and the mean follow-up period was 3 years. The mean area of focus was 30.7 $cm^3$ in the radiographs, and 19 cases showed successful results in the ultimate visit, while 1 case has a recurrence of the focus. Conclusion: Calcium sulfate has osteoconduction and superior bioavailability, and is absorbed in vivo in proportion to the new bone formation. On the other hand, hydroxyapatite has good osteoconduction. It can result in better bone formation when it is combined with an autologous bone graft, autologous bone marrow, and an allogenic bone graft, but is absorbed in vivo more slowly than the former.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.3
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• pp.57-62
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• 1990

Many alloplastic materials have been used as the bony substitute in large bony defects caused by fracture, periodontitis, & cyst, etc. Nowadays Hydroxyapatite(HAP) is the most usable material as the bony substitute. The reasonable properties of HAP are nontoxic, biocompatible to host tissues & have osteoconductivity. Other bioceramic materials are recommended as the bony substitute with high success rate. We have studied the clinical use of HAP as the bony substitute in the defected area caused by cyst. The reasonalbe & successful results are obtained. The results were as followed. 1. Better prognosis was obtained in the case of HAP & bone mixed graft than HAP graft only. And the best prognosis was obtained in the case of iliac bone graft. 2. Better prognosis was obtained in Mx. than in Mn. 3. It seems that the soft tissue ingrowth into the HAP granule play an important role in the success of the HAP graft. 4. Though the flap covering the HAP granules was perforated, the relative good prognosis was obtained by re-suturing the perforeated site.

• Journal of the Korean Ceramic Society
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• v.45 no.10
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• pp.618-624
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• 2008

Various calcium phosphate bioceramics are distinguished by their excellent biocompatibility and osteoconductivity. Especially, the exceptional biodegradability of $\beta$-TCP makes it a bone graft substitute of choice in many clinical applications. The activation of osteoclasts, differentiated from macrophage precursor cells, trigger a cell-mediated resorption mechanism that renders $\beta$-TCP biodegradable. Based on this evidence, we studied the biodegradation process of granular-type $\beta$-TCP bone graft substitute through in vitro and in vivo studies. Raw 264.7 cells treated with RANKL and M-CSF differentiated into osteoclasts with macrophage-like properties, as observed with TRAP stain. These osteoclasts were cultured with $\beta$-TCP nano powders synthesized by microwave-assisted process. We confirmed the phagocytosis of osteoclasts by observing $\beta$-TCP particles in their phagosomes via electron microscopy. No damage to the osteoclasts during phagocytosis was observed, nor did the $\beta$-TCP powders show any sign of cytotoxicity. We also observed the histological changes in subcutaneous tissues of rats implanted with granule-type $\beta$-TCP synthesized by fibrous monolithic process. The $\beta$-TCP bone graft substitute was well surrounded with fibrous tissue, and 4 months after implantation, 60% of its mass had been biodegraded. Also, histological findings via H&E stain showed a higher level of infiltration of lymphocytes as well as macrophages around the granule-type $\beta$-TCP. From the results, we have concluded that macrophages play an important role in the biodegradation process of $\beta$-TCP bone graft substitutes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.337-343
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• 2010

Purpose: By reviewing literature on the subject, we compared the survival rate of implants placed in various graft materials used for maxillary sinus augmentation. Materials and Methods: The search protocol used the Pubmed electronic database, with a time limit from 1998 to 2009. Keywords such as 'sinus lift,' 'sinus augmentation,' 'sinus floor elevation,' 'sinus graft,' 'bone graft,' 'implants,' 'oral implants,' and 'dental implants' were used, alone and in combination, to search the database. We selected articles and divided them into three groups by type of graft materials: Group 1. Autogenous bone group: autogenous bone alone; Group 2. Combined bone group: autogenous bone in combination with bone substitutes; and Group 3. Substitute group: bone substitutes alone or bone substitute combinations. Results: We selected 37 articles concerning a total of 2,257 patients and 7,282 implants; 417 implants failed. The total implant survival rate (ISR, %) was 94.3%. In Group 1, 761 patients and 2,644 implants were studied; 179 implants failed and the ISR was 93.2%. In Group 2, 583 patients and 1,931 implants were studied; 126 implants failed and the ISR was 93.5%. In Group 3, 823 patients and 2,707 implants were studied; 112 implants failed and the ISR was 95.9%. Conclusion: Implants inserted in grafts composed of bone substitutes alone or in grafts composed of autogenous bone in combination with bone substitutes may achieve survival rates better than those for implants using autogenous bone alone (P<0.05).

• Journal of Periodontal and Implant Science
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• v.49 no.2
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• pp.114-126
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• 2019

Purpose: The aim of this study was to evaluate the enhancement of osteogenic potential of biphasic calcium phosphate (BCP) bone substitute coated with Escherichia coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2) and epigallocatechin-3-gallate (EGCG). Methods: The cell viability, differentiation, and mineralization of osteoblasts was tested with ErhBMP-2-/EGCG solution. Coated BCP surfaces were also investigated. Standardized, 6-mm diameter defects were created bilaterally on the maxillary sinus of 10 male New Zealand white rabbits. After removal of the bony windows and elevation of sinus membranes, ErhBMP-2-/EGCG-coated BCP was applied on one defect in the test group. BCP was applied on the other defect to form the control group. The animals were sacrificed at 4 or 8 weeks after surgery. Histologic and histometric analyses of the augmented graft and surrounding tissue were performed. Results: The 4-week and 8-week test groups showed more new bone (%) than the corresponding control groups (P<0.05). The 8-week test group showed more new bone (%) than the 4-week test group (P<0.05). Conclusions: ErhBMP-2-/EGCG-coated BCP was effective as a bone graft material, showing enhanced osteogenic potential and minimal side effects in a rabbit sinus augmentation model.

• Restorative Dentistry and Endodontics
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• v.39 no.1
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• pp.51-55
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• 2014

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

• Journal of Magnetics
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• v.18 no.2
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• pp.142-149
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• 2013

We aim to monitor vascularization of early bone perfusion following rabbit lumbar intertransverse bone graft fusion surgery using magnetic resonance imaging assessment. Correlation with graft survival status was evaluated by histological method. Experimental animals were randomly divided into three groups and the model was established by operating bilateral lumbar intertransverse bone graft with different types of bone graft substitute material. The lumbar intertransverse area of three groups of rabbits was scanned via MRI. In addition, histological examinations were performed at the $6^{th}$ week after surgery and the quantitative analysis of the osteogenesis in different grafted area was carried out by an image analysis system. The MRI technique can be used for early postoperative evaluation of vascularized bone graft perfusion after transplantation of different bone materials, whereas histological examination allows direct visualization of the osteogenesis process.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.1
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• pp.55-59
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• 2013

In the oral and maxillofacial area, bone defects are created by various reasons and demand for bone grafts, while dental implant implantation has been increased consistently. To solve these problems, there has been development of autogenous tooth-bone graft material (AutoBT$^{(R)}$, Korea Tooth Bank Co., Korea), and we have collected ground reasons to substitute free autobone graft with this material in clinical use. This autogenous tooth-bone graft material is produced in powder type and block type. Block type is useful in esthetic reconstruction of the defect site and vertical and horizontal augmentation of alveolar bone because this type has high strength value, well maintained shape and is less absorbed. Therefore, the author of this study gained favorable result by grafting the block type autogenous tooth-bone graft material after dental implant implantation on the bone defects of the mandibular molar extraction site. Moreover, the author represents this case with literature review after confirming bone remodeling on the computed tomography image and by histological analysis.