• Title/Summary/Keyword: bone graft substitute

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Clinical Long-term Assessment of Bioactive Glass Graft (Bioactive glass의 장기 임상적 평가)

  • Lee, Hang-Bin;Baek, Jeong-Won;Kim, Chang-Sung;Choi, Seong-Ho;Cho, Kyoo-Sung;Kim, Chong-Kwan;Chai, Choong-Kyoo
    • Journal of Periodontal and Implant Science
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    • v.32 no.1
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    • pp.187-198
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    • 2002
  • The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Recently, bioactive glass that has been utilized in plastic surgery is being investigated for application in dental practice. But, there has not been any long-term assessment of bioactive glass when used in periodontal intrabony defects. The present study evaluates the long-term effects of bioactive glass on the periodontal regeneration in intrabony defects of human and the effect of plaqu control on long term treatment results after dividing patients into those who underwent 3-month regular check-up and those who didn't under go regular check-up The clinical effect on 74sites from 17 infrabony pockets of 11 patients were analyzed 36months after treatment. 51 sites which underwent regular check up were classified as the Follow-up group(F/U group), and 23 sites which did not undergo regular check up were classified as Non Follow-up group(Non F/U group). After comparing the probing depth, attachment loss, bone probing depth before and 36months after treatment, the following results could be concluded. 1. The changes of probing pocket depth showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.79${\pm}$0.68mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(0.61${\pm}$0.54mm) (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.44${\pm}$0.74mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(1.18${\pm}$1.54) (P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after baseline and 36 months after treatment in both F/U(1.35${\pm}$0.28) and Non F/U group(0.78${\pm}$0.55mm) (P<0.05). The results suggest that treatment of infrabony defects with bioactive glass resulted in significan reduction of attachment loss and bone probing depth 36months after the treatment. The use of bioactive glass in infrabony defects, combined with regular check-up and proper plaque control generally shows favorable clinical results. This measn that bioactive glass could be a useful bone substitute.

THE EXPERIMENTAL STUDY OF THE BONE REGENERATION ON RABBIT MAXILLARY SINUS GRAFTING WITH ${\beta}$-TCP (가토 상악동에 이식된 ${\beta}$-TCP의 골치유에 관한 실험적 연구)

  • Park, Jung-Ha;Hwang, Kyung-Gyun;Park, Chang-Joo;Choi, Yong-Soo;Ma, Pyung-Soo;Paik, Seung-Sam;Shim, Kwang-Sup
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.107-116
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    • 2006
  • Purpose:Maxillay sinus grafting is an effective treatment procedure to improve bone height in the posterior maxillar area for implant installation. Beta-tricalciumphosphate(${\beta}$-TCP) was introduced to be grafting substitute material, providing a reasonable bio-degradation time, no need for harvesting procedure. The purpose of this study is to evaluate bone healing & regeneration phase using histomorphometric and immunohistochemical analysis. Material & Methods:Sixteen rabbits were divided into 4 groups. Bi-lateral maxillary sinus membranes were elevated at each rabbits, ${\beta}$-TCP was augmented in left sinus, autogenous bone was augmented in right sinus. The rabbits were sacrificed at 2, 4, 8 and 12 weeks. We investigated the bone regeneration & growth factor expression. Results: 1. The mean new bone volume formation was 28.99${\pm}$6.55%, 49.54${\pm}$5.47%, 69.09${\pm}$8.90% in autogenous grafted area, and 22.86${\pm}$5.56%, 24.00${\pm}$4.09%, 34.11${\pm}$3.37% in ${\beta}$-TCP area at 4, 8, 12 weeks. Therefore, new bone formation in autogenous bone was significantly higher than ${\beta}$-TCP (p<0.05). 2. The BMP 2/4 expression in autogenous bone grafted area was higher at 4, 8 weeks. 3. There was no difference in expression pattern of BMP-7/PDGF/VEGF during grafted bone regeneration. Conclusion:The authors we conclude that the autogenous bone graft was faster than ${\beta}$-TCP in bone regeneration, and the BMP 2/4 were more important in graft bone regeneration.

Preparation of Biodegradable Porous Calcium Metaphosphate Matrix (생분해성 다공질 Calcium Metaphosphate Matrix의 제조)

  • 이중환;김석영
    • Journal of Biomedical Engineering Research
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    • v.19 no.5
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    • pp.449-454
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    • 1998
  • It is well known that new tissue or blood vessel is grown into a porous calcium phosphate ceramics used as a bone graft substitute due to their excellent biocompatibility. In this study, the most chemically stable porous $\beta$-crystalline form in various forms of calcium metaphosphate, Ca(PO$_3$)$_2$is prepared by the controlled thermolysis of monocalcium phosphate, Ca(H$_2$PO$_4$)$_2$.The diameter of cylindrical pores formed during cooling was controlled by a holding time at the melting point of a monocalcium phosphate and by the change of a crystallization temperature, to obtain the most appropriate size (about 200$\mu$m) of pores for the application of bone substitutes and matricuts. It was observed that the increasing holding time at the melting point of monocalcium phosphate results in the decreases of cylindrical pore sizes.

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Bone regeneration of the fluoridated hydroxyapatite and the bio-glass in the rabbit cranium defect model (가토 두개골 결손 모델에서 Bioglass가 첨가된 불소화 수산화인회석의 골재생능력)

  • Ahn, Hyo-Joon;Han, Se-Jin;Kim, Kyung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.5
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    • pp.380-385
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    • 2011
  • Introduction: Hydroxyapatite ($Ca_{10}(PO_4)_6(OH)_2$, HA) is the main inorganic phase of human hard tissue that is used widely as the repair material for bones. When HA is applied to a bony defect, however, it can be encapsulated with fibrous tissue and float in the implanted area due to a lack of consolidation. Bioceramics as allogenic graft materials are added to HA to improve the rate and bone healing capacity. Fluoridated hydroxyapatite ($Ca_{10}(PO_4)_6(OH,F)_2$, FHA), where F- partially replaces the OH- in hydroxyapatite, is considered a good alternative material for bone repair owing to its solubility and biocompatibility. Materials and Methods: This study was designed to determine the bone healing capacity of FHA newly produced as a nanoscale fiber in the laboratory. HA and FHA with bioglass was implanted in a rabbit cranium defect and the specimen was analysed histologically. Results: 1. At 4 weeks, fibrous connective tissue and little bone formation was observed around the materials of the experimental group I implanted HA and bioglass. Newly formed bone was observed around the materials in the experimental group II implanted FHA and bioglass. 2. At 8 weeks, the amount of newly formed and matured bone was higher in experimental group II than in experimental group I and the control group. Conclusion: These results suggest that FHA and bioglass is a relatively favorable bone substitute with biocompatibility and better bone healing capacity than pure HA and bioglass.

A Retrospective study of the Cumulative Survival Rate and change of peri-implant marginal bone around implants associated with maxillary sinus augmentation (상악동 골 이식술을 동반하여 식립된 임플란트의 변연골변화와 생존률에 관한 후향적 연구)

  • Ryu, Hwa-Suk;Kim, Sun-Jong;Park, Eun-Jin;Kim, Myung-Rae
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.240-246
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    • 2009
  • Statement of problem: Insertion of endosseous implants in the atrophic maxilla is often complicated because of lack of supporting bone. Augmentation of the floor of the maxillary sinus with autogenous bone & bone substitute graft has been proven to be a reliable treatment modality, at least in the short term. The aim of this study is to evaluate the factors of implant survival rate associated with maxillary sinus lift with grafts. Material and methods: The sinus floor was augmented with bone grafts derived from modified Caldwell-luctechnique(71 subject, 93 sinus, 180 implants), the autogenous bone or autogenous+Bio-oss. Before implant installation the width and height of the alveolar crest were increased in the first stage procedure in 10 patients while in the other 61 patients augmentation and implant installation could be performed simultaneously width and height of the alveolar crest > 4 mm) or delayed installation. Results: In all case bone volume was sufficients for implant insertion. 14 of 180 inserted implants were lost during follow up and the healing period Patient received implant supported overdenture(5 patients) or fixed bridge(62 patients). Conclusion: Within the limit of the result of this study, we conclude that bone grafting of the floor of the maxillary sinus floor with bone for the insertion of implants might be a reliable treatment modality and the autogenous bone graft and delayed installation method might be the factors for good results.

Various autogenous fresh demineralized tooth forms for alveolar socket preservation in anterior tooth extraction sites: a series of 4 cases

  • Kim, Eun-Suk;Lee, In-Kyung;Kang, Ji-Yeon;Lee, Eun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.27.1-27.7
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    • 2015
  • The aim of this study was to evaluate the clinical relevance of autogenous fresh demineralized tooth (Auto-FDT) prepared at chairside immediately after extraction for socket preservation. Teeth were processed to graft materials in block, chip, or powder types immediately after extraction. Extraction sockets were filled with these materials and dental implants were installed immediately or after a delay. A panoramic radiograph and a conebeam CT were taken. In two cases, tissue samples were taken for histologic examination. Vertical and horizontal maintenance of alveolar sockets showed some variance depending on the Auto-FDT and barrier membrane types used. Radiographs showed good bony healing. Histologic sections showed that it guided good new bone formation and resorption pattern of the Auto-FDT. This case series shows that Auto-FDT prepared at chairside could be a good material for the preservation of extraction sockets. This study will suggest the possibility of recycling autogenous tooth after immediate extraction.

Evaluation of calcium sulphate barrier to collagen membrane in intrabony defects

  • Budhiraja, Shilpa;Bhavsar, Neeta;Kumar, Santosh;Desai, Khushboo;Duseja, Sareen
    • Journal of Periodontal and Implant Science
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    • v.42 no.6
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    • pp.237-242
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    • 2012
  • Purpose: The aim of this study was to clinically and radiographically evaluate and compare treatment of intrabony defects with the use of decalcified freeze-dried bone allograft in combination with a calcium sulphate barrier to collagen membrane. Methods: Twelve patients having chronic periodontal disease aged 20 to 50 years and with a probing depth >6 mm were selected. Classification of patient defects into experimental and control groups was made randomly. In the test group, a calcium sulphate barrier membrane, and in control group, a collagen membrane, was used in conjunction with decalcified freeze-dried bone graft in both sides. Ancillary parameters as well as soft tissue parameters along with radiographs were taken at baseline and after 6 months of surgery. Parameters assessed were plaque index, modified gingival index, probing depth, relative attachment level, and location of the gingival margin. A Student's t-test was done for intragroup and a paired t-test for intergroup analysis. Results: Intragroup analysis revealed statistically significant improvement in all the ancillary parameters and soft tissue parameters with no statistically significant difference in intergroup analysis. Conclusions: The study concluded that a calcium sulphate barrier was comparable to collagen membrane in achieving clinical benefits and hence it can be used as an economical alternative to collagen membrane.

Effectiveness of biphasic calcium phosphate block bone substitutes processed using a modified extrusion method in rabbit calvarial defects

  • Lim, Hyun-Chang;Song, Kyung-Ho;You, Hoon;Lee, Jung-Seok;Jung, Ui-Won;Kim, Suk-Young;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.45 no.2
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    • pp.46-55
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    • 2015
  • Purpose: This study evaluated the mechanical and structural properties of biphasic calcium phosphate (BCP) blocks processed using a modified extrusion method, and assessed their in vivo effectiveness using a rabbit calvarial defect model. Methods: BCP blocks with three distinct ratios of hydroxyapatite (HA):tricalcium phosphate (TCP) were produced using a modified extrusion method:HA8 (8%:92%), HA48 (48%:52%), and HA80 (80%:20%). The blocks were examined using scanning electron microscopy, X-ray diffractometry, and a universal test machine. Four circular defects 8 mm in diameter were made in 12 rabbits. One defect in each animal served as a control, and the other three defects received the BCP blocks. The rabbits were sacrificed at either two weeks (n=6) or eight weeks (n=6) postoperatively. Results: The pore size, porosity, and compressive strength of the three types of bone block were $140-170{\mu}m$, >70%, and 4-9 MPa, respectively. Histologic and histomorphometric observations revealed that the augmented space was well maintained, but limited bone formation was observed around the defect base and defect margins. No significant differences were found in the amount of new bone formation, graft material resorption, or bone infiltration among the three types of BCP block at either of the postoperative healing points. Conclusions: Block bone substitutes with three distinct compositions (i.e., HA:TCP ratios) processed by a modified extrusion method exhibited limited osteoconductive potency, but excellent space-maintaining capability. Further investigations are required to improve the processing method.

Evaluation of the Biocompatibility of Cuttlebone in Mouse (쥐에서 오적골 생체적합성 평가)

  • Won, Sangcheol;Lee, Joo Myoung;Cheong, Jongtae;Park, Hyunjung;Seo, Jongpil
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.417-421
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    • 2015
  • Bone grafting is widely used to bridge major bone defects or to promote bone union. Natural calcium carbonate (CC) has been used as a bone substitute material and used to scaffold for bone morphogenetic protein (BMP). The aims of this study is to evaluate the biocompatibility of cuttlebone (CB) and hydroxyapatite from CB (CBHA). Each material was shaped into disks (5 mm in diameter and 2 mm in thickness). To test biocompatibility, the disks were implanted into the dorsal subcutaneous tissue in mice. Fibrous capsule thickness around each disk was evaluated histologically at 2 and 4 weeks after implantation. Concerning biocompatibility, fibrous capsule thickness of CBHA was significantly thinner than that of CB and CHA (p < 0.05) at 2 and 4 weeks after implantation. Based on the clinical and histological results, CBHA would be a safe material for use inside the body and has more effective osteoconduction than CB.

HISTOMORPHOMETRIC ANALYSIS OF MAXILLARY SINUS AUGMENTATION WITH DEPROTEINIZED BOVINE BONE(BIO-$OSS^{(R)}$) AND VARIOUS ABSORBABLE MEMBRANE (탈단백 소뼈 기질과 다양한 종류의 흡수성 막을 이용한 상악동 거상술 후의 조직-형태학적 분석)

  • Jang, Tae-Hwa;Jang, Yoon-Je;Kwon, Tae-Geon;Lee, Sang-Han
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.609-616
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    • 2007
  • Purpose: The aim of the present study was to evaluate the effect of Bio-Oss on bone formation in terms of healing period and type of membrane so that determine the most suitable condition for implant fixation in grafted maxilla. Material & Method: Forty-five biopsy specimens from graft site were evaluated. Sinus lift was performed in the patients with reduced alveolar bone height(less than 5mm). The specimen was taken at the time of implant fixation, which was performed at least 5 months after the sinus lift procedure. All specimens were stained with H&E and Trichrome staining and evaluated histomorphometrically. Result: The results showed that Bio-Oss particle was in direct contact with newly formed bone in all cases. In the present study, the amount of newly formed bone and the residual bone substitute material were not statistically different according to various membrane and different healing period. There was no difference between the histological feature of the specimen of 5 and 31 months. No statistical significance was detected between male and female. Conclusion: The result implies that Bio-Oss does not seem to be resorbed over time regardless of the type of the membranes. The further investigation is needed to clarify this issue with the extended period of follow-up.