• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.221-226
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• 2013

Purpose: This study is to evaluate the efficacy of the autogenous tooth bone graft material, clinically and radiologically, as related to implant installation. Methods: In oral and maxillofacial surgery department of Ajou University Hospital, guided bone regeneration (GBR), implant placement combined with GBR, sinus graft, implant placement combined with sinus graft, and defect filling were performed in 46 patients, using autogenous tooth bone. Among these, 66 implants were inserted with autogenous tooth bone. Implant stability quotient (ISQ) was measured by Osstell Mentor (Integration Diagnostics, Goteborg, Sweden) on 39 implants on the operation date and 4 months later, and on 21 implants 9months on the average at the final setting of restoration. Twenty-eight implants with GBR and sinus graft (GBR group: n=14, sinus graft group: n=14) were evaluated radiologically to measure the resorption of grafted autogenous tooth bone after loading. Results: The average initial stabilization of the installed implants was 67 ISQ, and the average secondary stabilization at 4 months later was 76. The average bone loss of GBR group as measured 8.0 months after application of prosthesis loading was 0.29 mm and the average bone loss of the sinus graft group as measured 7.6 months after application of prosthesis loading was 0.66 mm, respectively. In the histological assessment, formation of the new bone and continuous trabecular bone pattern was identified around autogenous tooth bone. Conclusion: Based on these results, we concluded that autogenous tooth bone is an excellent bone graft material that can substitute the autogenous bone.

• Journal of Periodontal and Implant Science
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• v.36 no.4
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• pp.797-808
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• 2006

Objective : The purpose of this study was to evaluate the physicochemical properties and cytocompatibility of microporous, spherical biphasic calcium phosphate(BCP) ceramics with a 60/40 $hydroxyapatite/{\beta}$ -tricalcium phosphate weight ratio for application as a bone graft substitute. Materials and Methods : Microporous, spherical BCP granules(MGSB) were prepared and their basic characteristics were compared with commercially available BCP(MBCP; Biomatlante, France) and deproteinized bovine bone mineral(Bio-Oss; GBistlich-Pharma, Switzerland, BBP; Oscotec. Korea), Their physicochemical properties were evaluated by scanning electron microscopy, X-ray diffractometry, Fourier-transform infrared spectroscopy, inductively coupled plasma atomic emission spectrometer, and Brunauer-Emmett-Teller method. Cell viability and proliferation of MC3T3-El cells on different graft materials were evaluated. Results : MGSB granules showed a chemical composition and crystallinity similar with those in MBCP, they showed surface structure characteristic of three dimensionally, well-interconnected micropores. The results of MTT assay showed increases in cell viablity with increasing incubation times. At 4d of incubation, MGSB, MBCP and BBP showed similar values in optical density, but Bio-Oss exhibited significantly lower optical density compared to other bone substitutes(p <0,05). MGSB showed significantly greater cell number compared to other bone substitutes at 3, 5, and 7d of incubation(p <0,05), which were similar with those in polystyrene culture plates. Conclusion: These results indicated the suitable physicochemical properties of MGSB granules for application as an effective bone graft substitute. which provided compatible environment for osteoblast cell growth. However, further detailed studies are needed to confirm its biological effects on bone formation in vivo.

• Journal of Periodontal and Implant Science
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• v.52 no.4
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• pp.312-324
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• 2022

Purpose: The role of hard-type crosslinked hyaluronic acid (HA) with particulate bone substitutes in bone regeneration for combined inlay-onlay grafts has not been fully investigated. We aimed to evaluate the effect of hard-type crosslinked HA used with bone substitute in terms of new bone formation and space maintenance. Methods: A 15-mm-diameter round defect was formed in the calvaria of 30 New Zealand White rabbits. All animals were randomly assigned to 1 of 3 groups: the control group (spontaneous healing without material, n=10), the biphasic calcium phosphate (BCP) graft group (BCP, n=10), and the BCP graft with HA group (BCP/HA, n=10). The animals were evaluated 4 and 12 weeks after surgery. Half of the animals from each group were sacrificed at 4 and 12 weeks after surgery. Samples were evaluated using micro-computed tomography, histology, and histomorphometry. Results: The BCP group showed higher bone volume/tissue volume (BV/TV) values than the control and BCP/HA groups at both 4 and 12 weeks. The BCP and BCP/HA groups showed higher bone surface/tissue volume (BS/TV) values than the control group at both 4 and 12 weeks. The BCP group showed higher BS/TV values than the control and BCP/HA groups at both 4 and 12 weeks. No statistically significant difference in newly formed bone was found among the 3 groups at 4 weeks. The BCP group showed significantly higher new bone formation than the BCP/HA group at 12 weeks. Conclusions: Hard-type crosslinked HA did not show a positive effect on new bone formation and space maintenance. The negative effect of hard-type crosslinked HA may be due to the physical properties of HA that impede osteogenic potential.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.66-71
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• 1997

The all inside anterior cruciate ligament reconstruction technique places an anterior ligament substitutes within two bony sockets rather than hone tunnel. This approach is accomplished through arthroscopic three portal which avoids the surgical exposure and morbidity associated with creating traditional bone tunnel. This technique has several distinct advantages when compared with the traditional ACL reconstruction through the bone tunnels. It offers the surgeon a less morbid method for ACL reconstruction that positions an ACL substitute at the anatomic attachment sites of the original ACL with two bone sockets, obviating the need for traditional bone tunnels. Graft fixation at or near the anatomic attachment points of the original ACL minimizes creep with early range of motion and reduces the abrasive 'wind-shield wipe' motion of the graft which occur with bone plugs positioned inside bone tunnels. The sagittal posterior angle to the tibial socket increases fixation strength to pullout with anterior translation force for the tibia on the femur. This technique is not graft specific and can accomodate any graft in which graft length can be customized to the intraarticular native ACL length.

• The Journal of Advanced Prosthodontics
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• v.6 no.6
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• pp.521-527
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• 2014

This case series evaluated the clinical efficacy of autogenous tooth bone graft material (AutoBT) in alveolar ridge preservation of an extraction socket. Thirteen patients who received extraction socket graft using AutoBT followed by delayed implant placements from Nov. 2008 to Aug. 2010 were evaluated. A total of fifteen implants were placed. The primary and secondary stability of the placed implants were an average of 58 ISQ and 77.9 ISQ, respectively. The average amount of crestal bone loss around the implant was 0.05 mm during an average of 22.5 months (from 12 to 34 months) of functional loading. Newly formed tissues were evident from the 3-month specimen. Within the limitations of this case, autogenous tooth bone graft material can be a favorable bone substitute for extraction socket graft due to its good bone remodeling and osteoconductivity.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.31-37
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• 2003

Introduction: The purpose of this study is to assess the efficacy of calcium sulfate as a bone graft substitute in the treatment of benign bone tumor. Materials and Method: Between December 2000 and November 2001, 18 patients with a benign bone tumor were treated with crettage and the defects were filled with calcium sulfate (Osteoset$^{(R)}$:Wright Medical Co. USA) as a bone graft substitute. Average age was 28.4 years and mean follow up period was 12.3 months. Calcium sulfate mixed with autograft was used in 6 cases, calcium sulfate with allograft in 2 cases, and calcium sulfate alone was used in 10 cases. The degree of absorption of calcium sulfate and new bone formation at plain radiograph was analyzed at immediate postoperative and postoperative 3 months and 6 months follow up. Results: At 3 months postoperatively, 92% of calcium sulfate was absorbed, and at 6 months postoperatively, 89% of new bone formation was observed. There was no difference in the resorption and new bone formation between the group using bone graft and the group osteoset$^{(R)}$ alone, different preoperative diagnosis and even different locations. There was no complication. Conclusion: Calcium sulfate(Osteoset$^{(R)}$) is a safe and effective bone graft substitute in the treatment of benign bone tumors, especially for the children in whom autograft is not recommandable.

• The Korean Journal of Health Service Management
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• v.13 no.4
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• pp.133-144
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• 2019

Objectives: To analyze the radiologic results of patients treated with bone defects treated with beta-tricalcium phostphate (β-TCP) in orthopedic surgery. Methods: Medical records of 49 patients, consisting of 24 (49.0%) men and 25 (51.0%) women were retrospectively reviewed. Graft incorporation was evaluated based on Irwin's radiologic staging. Results: The explanatory power of the total regression equation in Irwin's stage at 3 months postoperatively according to three explanatory variables, namely graft tightness, age at diagnosis, and lesion volume, was 65.6%; the explanatory power of Irwin's stage at 6 months postoperatively according to two variables, namely lesion volume and graft tightness, was 32.9%; and the explanatory power of Irwin's stage at 9 months postoperatively for two variables, namely longitudinal lesion length and graft tightness in the total regression, was 30.8%. Conclusions: Graft tightness, lesion volume, age at diagnosis, and longitudinal lesion length are the common factors affecting graft incorporation.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.169-177
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• 2020

Purpose: To assess the effectiveness of mixed grafts in lumbar posterolateral fusion (PLF) by comparing the bone union rates of an autobone with a bone substitute mixed graft. Materials and Methods: The patients were followed-up for at least two years after PLF and divided into four groups according to the mixed graft retrospectively. Group I was 48 cases using a femoral head allobone. Group II was 38 cases using β-tricalcium phosphate. Group III was 92 cases using biphasic calcium phosphate. Group IV was 38 cases using biphasic calcium phosphate and autologous bone marrow. Union was evaluated by the work up simple radiographs after two years from PLF. Union was defined if the radiographs demonstrated a bilateral continuity in the fusion mass between the cephalad and caudal transverse processes with less than 2° of angular motion and no translation between the vertebrae at the level of fusion on the lateral flexion-extension radiographs. Results: According to simple radiographs after two years from PLF, the rate of union was highest in Group IV using local autobone, biphasic calcium phosphate and autologous bone marrow mixed graft. Conclusion: Biphasic calcium phosphate is an osteoconductive bone substitute that increases the bio-absorbability and mechanical strength. Autologous bone marrow has osteoinductive and osteogenic properties. These features can increase the rate of bone union. Therefore, a local autobone, biphasic calcium phosphate and autologous bone marrow mixed graft can be considered an effective bone graft substitute for lumbar PLF instead of an autobone graft.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.1
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• pp.34-42
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• 2019

Objectives: Various bone graft substitute materials are used to enhance bone regeneration in the maxillofacial skeleton. In the recent past, synthetic graft materials have been produced using various synthetic and natural calcium precursors. Very recently, eggshell-derived hydroxyapatite (EHA) has been evaluated as a synthetic bone graft substitute. To assess bone regeneration using EHA in cystic and/or apicectomy defects of the jaws through clinical and radiographic evaluations. Materials and Methods: A total of 20 patients were enrolled in the study protocol (CTRI/2014/12/005340) and were followed up at 4, 8, 12, and 24 weeks to assess the amount of osseous fill through digital radiographs/cone-beam computed tomography along with clinical parameters and complications. Wilcoxon matched pairs test, means, percentages and standard deviations were used for the statistical analysis. Results: The sizes of the lesions in the study ranged from 1 to 4 cm and involved one to four teeth. The study showed significant changes in the formation of bone, the merging of material and the surgical site margins from the first week to the first month in all patients (age range, 15-50 years) irrespective of the size of the lesions and the number of teeth involved. Bone formation was statistically significant from the fourth to the eighth week, and the trabecular pattern was observed by the end of 12 weeks with uneventful wound healing. Conclusion: EHA showed enhancement of bone regeneration, and healing was complete by the end of 12 weeks with a trabecular pattern in all patients irrespective of the size of the lesion involved. The study showed enhancement of bone regeneration in the early bone formative stage within 12 weeks after grafting. EHA is cost effective and production is environment friendly with no disease transfer risks. Thus, natural bioceramics will play an important role in the reduction of costs involved in grafting and reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.2
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• pp.220-229
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• 2008

Purpose: The present study was aimed to examine the effect of acellular dermal matrix ($AlloDerm^{(R)}$) grafted to the experimental tissue defect on tissue regeneration. Materials and Methods: Male albino rabbits were used. Soft tissue defects were prepared in the external abdominal oblique muscle. The animals were then divided into 3 groups by the graft material used: no graft, autogenous dermis graft, and $AlloDerm^{(R)}$ graft. The healing sites were histologically examined at weeks 4 and 8 after the graft. In another series, critical sized defects with 8-mm diameter were prepared in the right and left iliac bones. The animals were then divided into 5 groups: no graft, grafted with autogenous iliac bone, $AlloDerm^{(R)}$ graft, $AlloDerm^{(R)}$ graft impregnated with rhBMP-2, and $AlloDerm^{(R)}$ graft with rhTGF-${\beta}1$. The healing sites of bone defect were investigated with radiologic densitometry and histological evaluation at weeks 4 and 8 after the graft. Results: In the soft tissue defect, normal healing was seen in the group of no graft. Inflammatory cells and foreign body reactions were observed in the group of autogenous dermis graft, and the migration of fibroblasts and the formation of vessels into the collagen fibers were observed in the group of $AlloDerm^{(R)}$ graft. In the bone defect, the site of bone defect was healed by fibrous tissues in the group of no graft. The marked radiopacity and good regeneration were seen in the group of autogenous bone graft. There remained the traces of $AlloDerm^{(R)}$ with no satisfactory results in the group of $AlloDerm^{(R)}$ graft. In the groups of the $AlloDerm^{(R)}$ graft with rhBMP-2 or rhTGF-${\beta}1$, there were numerous osteoblasts in the boundary of the adjacent bone which was closely approximated to the $AlloDerm^{(R)}$ with regeneration features. However, the fibrous capsule also remained as in the group of $AlloDerm^{(R)}$ graft, which separated the $AlloDerm^{(R)}$ and the adjacent bone. Conclusions: These results suggest that $AlloDerm^{(R)}$ can be useful to substitute the autogenous dermis in the soft tissue defect. However, it may not be useful as a bone graft material or a carrier, since the bone defect was not completely healed by the bony tissue, regardless of the presence of osteogenic factors like rhBMP-2 or rhTGF-${\beta}1$.