• Journal of Periodontal and Implant Science
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• v.53 no.6
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• pp.406-416
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• 2023

Purpose: No evidence exists regarding the advantages of periodontal regeneration treatment for furcation defects using soft block bone substitutes. Therefore, this randomized controlled trial aimed to assess the clinical and radiographic outcomes of regenerative therapy using porcine-derived soft block bone substitutes (DPBM-C, test group) compared with porcine-derived particulate bone substitutes (DPBM, control group) for the treatment of severe class II furcation defects in the mandibular molar regions. Methods: Thirty-five enrolled patients (test group, n=17; control group, n=18) were available for a 12-month follow-up assessment. Clinical (probing pocket depth [PPD] and clinical attachment level [CAL]) and radiographic (vertical furcation defect; VFD) parameters were evaluated at baseline and 6 and 12 months after regenerative treatment. Early postoperative discomfort (severity and duration of pain and swelling) and wound healing outcomes (dehiscence, suppuration, abscess formation, and swelling) were also assessed 2 weeks after surgery. Results: For both treatment modalities, significant improvements in PPD, CAL, and VFD were found in the test group (PPD reduction of 4.1±3.0 mm, CAL gain of 4.4±2.9 mm, and VFD reduction of 4.1±2.5 mm) and control group (PPD reduction of 2.7±2.0 mm, CAL gain of 2.0±2.8 mm, and VFD reduction of 2.4±2.5 mm) 12 months after the regenerative treatment of furcation defects (P<0.05). However, no statistically significant differences were found in any of the measured clinical and radiographic parameters, and no significant differences were observed in any early postoperative discomfort and wound healing outcomes between the 2 groups. Conclusions: Similar to DPBM, DPBM-C showed favorable clinical and radiographic outcomes for periodontal regeneration of severe class II furcation defects in a 12-month follow-up period.

• Archives of Plastic Surgery
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• v.44 no.3
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• pp.188-193
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• 2017

Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6-11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.

• 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.

• Proceedings of the Materials Research Society of Korea Conference
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• 2010.05a
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• pp.42.2-42.2
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• 2010

Recently, highly porous bone substitutes, which have interconnected open pore structure, have been focused on improving their mechanical properties and modifying their functions. Especially, it is highly required to develop functional gradient structured bone substitute which is available for controlling their material properties such as bioresorption rate and elastic modulus. Porous $ZrO_2$ scaffold was fabricated by the sponge replica method using PU sponge. After 3 times of dip coating and the subsequent oven drying, burning out and microwave sintering were carried out. Various $ZrO_2$-BCP powder mixtures were prepared depending on the ratio and coated on the $ZrO_2$ scaffold by dip coating process. X-ray diffraction analysis was performed to characterize the phase identification of the scaffolds. Microstructures of the bone substitutes were observed using scanning electron microscopy.

• Journal of Periodontal and Implant Science
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• v.40 no.3
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• pp.132-138
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• 2010

Purpose: The purpose of this study was to compare the bone regeneration effects of cortical, cancellous, and cortico-cancellous human bone substitutes on calvarial defects of rabbits. Methods: Four 8-mm diameter calvarial defects were created in each of nine New Zealand white rabbits. Freeze-dried cortical bone, freeze-dried cortico-cancellous bone, and demineralized bone matrix with freeze-dried cancellous bone were inserted into the defects, while the non-grafted defect was regarded as the control. After 4, 8, and 12 weeks of healing, the experimental animals were euthanized for specimen preparation. Micro-computed tomography (micro-CT) was performed to calculate the percent bone volume. After histological evaluation, histomorphometric analysis was performed to quantify new bone formation. Results: In micro-CT evaluation, freeze-dried cortico-cancellous human bone showed the highest percent bone volume value among the experimental groups at week 4. At week 8 and week 12, freeze-dried cortical human bone showed the highest percent bone volume value among the experimental groups. In histologic evaluation, at week 4, freeze-dried cortico-cancellous human bone showed more prominent osteoid tissue than any other group. New bone formation was increased in all of the experimental groups at week 8 and 12. Histomorphometric data showed that freeze-dried cortico-cancellous human bone showed a significantly higher new bone formation percentile value than any other experimental group at week 4. At week 8, freeze-dried cortical human bone showed the highest value, of which a significant difference existed between freeze-dried cortical human bone and demineralized bone matrix with freeze-dried cancellous human bone. At week 12, there were no significant differences among the experimental groups. Conclusions: Freeze-dried cortico-cancellous human bone showed swift new bone formation at the 4-week healing phase, whereas there was less difference in new bone formation among the experimental groups in the following healing phases.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.117-124
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• 2008

Purpose: The purpose of this study was to histomorphometrically evaluate the osteoconductivity of a new biphasic calcium phosphate ceramics with fully interconnected microporous structure. Material and Methods: Osseous defects created in the rabbit calvaria were filled with four different bone graft substitutes. Experimental sites were filled with a new fully interconnected microporous biphasic calcium phosphate with(BCP-2) or without(BCP-1) internal macropore of $4400\;{\mu}m$ in diameter. MBCP(Biomatlante, France) and Bio-Oss(Geistlich Pharma, Switzerland) were used as controls in this study. Histomorphometric evaluation was performed at 4 and 8 weeks after surgery. Result: In histologic evaluation, new bone formation and direct bony contact with the graft particles were observed in all four groups. At 4 weeks, BCP-1(15.5%) and BCP-2(15.5%) groups showed greater amount of newly formed mineralized bone area(NB%) compared to BO(11.4%) and MBCP(10.3%) groups. The amounts of NB% at 8 weeks were greater than those of 4 weeks in all four groups, but there was no statistically significant differences in NB% between the groups. Conclusion: These results indicate that new bone substitutes, BCP with interconnected microporous structure and with or without internal macroporous structures, have the osteoconductivity comparable to those of commercially available bone substitutes, MBCP and Bio-Oss.

• Journal of Periodontal and Implant Science
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• v.40 no.5
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• pp.220-226
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• 2010

Purpose: This study was performed to evaluate the periodontal wound healing effect of particulate equine bone mineral on canine alveolar bone defects. Methods: Twelve adult male beagle dogs were used as study subjects. The mandibular second and fourth premolars were extracted prior to the experimental surgery, and the extraction sites were allowed to heal for 8 weeks. After periodontal probing, two-walled defects were created at the mesial and distal sides of the mandibular third premolars bilaterally, and the defects were filled with equine particulate bone with collagen membrane or bovine particulate bone with collagen membrane, or collagen membrane alone. The defects without any treatment served as negative controls. After probing depth measurement, animals were sacrificed at 10, 16, and 24 post-surgery weeks for micro-computed tomographic and histomorphometric analysis. Results: The equine particulate bone-inserted group showed significantly decreased values of probing depth and first bone contact compared to the negative control and collagen membrane alone groups at weeks 10, 16, and 24 (P<0.05). There were no significant differences in the new cementum length, newly-formed bone area, or newly-formed bone volume between equine particulate bone- and bovine particulate bone-inserted groups, both of which showed significantly increased values compared to the negative control and collagen membrane alone groups (P<0.05). Conclusions: Equine particulate bone showed significant differences in probing depth, first bone contact, new cementum length, newly formed bone area, and bone volume fraction values when compared to the negative control and collagen membrane alone groups. There were no significant differences between equine and bovine particulate bone substitutes in these parameters; therefore, we can conclude that equine particulate bone is equivalent to bovine bone for periodontal regeneration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.15-24
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• 2001

The purpose of this study is to evaluate the tissue response in applying of various bone substitutes included toothash-plaster mixture, resorbable hydroxylapatite (HA) and demineralized freeze-dried bone and to show the clinical usefulness of toothash-plaster mixture for the repair of craniomaxillofacial bone defect. For this experiment, 100 Sprague-Dawley rats weighing 200gm or more were used. There were four experimental groups: group I, toothash-plaster mixture; group II, demineralized freeze-dried bone; group III, resorbable HA; and group IV, control group. A full thickness, round bone defect measuring 10mm in diameter was created in the midcranium, and the substitutes cited above were embedded in the experimental rats based on their group assignment. Blood clot was filled in the rats assigned to the control group. Experimental rats were sacrificed on the 1st, 3rd, 5th, 8th, 12th and 24th week after implantation and stained with the hematoxylineosin, Masson's Trichrome, using Van Gieson's stain method, and were examined under light microscope. The results were as follows: 1. In all the groups, prominent inflammatory reaction and the infiltration of multinucleated giant cells were noted during the early stage. Gradual healing decreased this reaction. 2. Among the rats in the experimental group II, which were given demineralized freeze-dried bone implants, active formation of new bone traveculae manifested. Chondroid tissues appeared, and it was suggested that the defect was filled with newly formed bone by virtue of osteoinductive activity. On the 12th week after the experiments, most of the defect was filled with newly formed bone trabeculae. 3. In experimental groups I and III, it was noted that HA manifested a healing process similar to that characterized by the toothash-plaster mixture, but inflammatory reaction was more prominent in experimental group I. Active osteoblasts were observed along the periphery of osteoid tissues, while newly formed bone trabeculae appeared adjacent to the implanted materials three weeks later. Formation increased to the extent that newly formed bone trabeculae fused directly with the host bone. Increase in new bone ingrowth into the filling materials was revealed by both experimental groups. 4. In the control group, new bone formation adjacent to the host bone was observed, but most of the defect was filled with mature connective tissue 24 weeks after the experiments.

• Imaging Science in Dentistry
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• v.48 no.1
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• pp.31-39
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• 2018

Purpose: This study aimed to evaluate the effect of field-of-view (FOV) size on the gray values derived from cone-beam computed tomography (CBCT) compared with the Hounsfield unit values from multidetector computed tomography (MDCT) scans as the gold standard. Materials and Methods: A radiographic phantom was designed with 4 acrylic cylinders. One cylinder was filled with distilled water, and the other 3 were filled with 3 types of bone substitute: namely, Nanobone, Cenobone, and Cerabone. The phantom was scanned with 2 CBCT systems using 2 different FOV sizes, and 1 MDCT system was used as the gold standard. The mean gray values(MGVs) of each cylinder were calculated in each imaging protocol. Results: In both CBCT systems, significant differences were noted in the MGVs of all materials between the 2 FOV sizes(P<.05) except for Cerabone in the Cranex3D system. Significant differences were found in the MGVs of each material compared with the others in both FOV sizes for each CBCT system. No significant difference was seen between the Cranex3D CBCT system and the MDCT system in the MGVs of bone substitutes on images obtained with a small FOV. Conclusion: The size of the FOV significantly changed the MGVs of all bone substitutes, except for Cerabone in the Cranex3D system. Both CBCT systems had the ability to distinguish the 3 types of bone substitutes based on a comparison of their MGVs. The Cranex3D CBCT system used with a small FOV had a significant correlation with MDCT results.

• 대한치주과학회:학술대회논문집
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• 2007.11a
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• pp.29-30
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• 2007