• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.108-118
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• 2010

Introduction: Maxillary posterior region, compared to the mandible or maxillary anterior region, has a thin cortical bone layer and is largely composed of cancellous bone, and therefore, it is often difficult to achieve primary stability. In such cases, sinus elevation with bone graft is necessary. Materials and Methods: In this research, 121 patients who had implant placement after bone graft were subjected to a follow-up study of 5 years from the moment of the initial surgery. The total survival rate, 5-year cumulative survival rate and the influence of the following factors on implant survival were evaluated; the condition of the patient (sex, age, general body condition), the site of implant placement, diameter and length of the implant, sinus elevation technique, closure method for osseous window, type of prosthesis and opposing teeth. Results: 1. The 5-year cumulative survival rate of total implants was 90.5%, there was no significant difference between sex, age, the site of implant placement, diameter and length of the implant, sinus elevation technique, and the type of opposing teeth. 2. Patients with diabetes mellitus < osteoporosis and smooth-surfaced machined group < hydroxyapatite (HA)-treated group and homogenous demineralized freeze dried allogenic bone (DFDB) bone graft only group had significantly lower survival rate. 3. With less than 4 mm of residual alveolar ridge height, lateral approach without closing the osseous window resulted in a significantly lower survival rate. 4. Restoration of a single implant showed a significantly lower survival rate, compared to cases where the superstructure was joined with several implants in the area. Conclusion: Patients with diabetes or osteoporosis need longer period of time for osseointegration compared to the normal, and the dentists must be prudent when choosing a surface treatment type and the bone graft material. Also, as the vertical dimension of the residual alveolar ridge can influence the result, staged implant placement should be considered when it seems difficult for the implant to gain primary stability from the residual bone with less than 4 mm of vertical dimension. It is recommended to obdurate the bone window and that the superstructure be connected with several impants in the peripheral area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.87-93
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• 2010

Introduction: In our previous studies, we isolated porcine skin-derived mesenchymal stem cells (pSDMSCs) from the ears of adult miniature pigs and evaluated the pluripotency of these pSDMSCs based on expressions of transcription factors, such as Oct-4, Sox-2, and Nanog. Moreover, the characteristic of mesenchymal stem cells was revealed by the expression of various mesenchymal stem cell markers, including CD29, CD44, CD90, and vimentin. The aim of this study was to evaluate in vivo osteogenesis after maxillary sinus lift procedures with autogenous pSDMSCs and scaffold. Materials and Methods: The autogenous pSDMSCs were isolated from the 4 miniature pigs, and cultured to 3rd passage with same methods of our previous studies. After cell membranes were labeled using a PKH26, $1{\times}10^{7}$ cells/$100{\mu}L$ of autogenous pSDMSCs were grafted into the maxillary sinus with a demineralized bone matrix (DBM) and fibrin glue scaffold. In the contralateral control side, only a scaffold was grafted, without SDMSCs. After two animals each were euthanized at 2 and 4 weeks after grafting, the in vivo osteogenesis was evaluated with histolomorphometric and osteocalcin immunohistochemical studies. Results: In vivo PKH26 expression was detected in all specimens at 2 and 4 weeks after grafting. Trabecular bone formation and osteocalcin expression were more pronounced around the grafted materials in the autogenous pSDMSCs-grafted group compared to the control group. Newly generated bone was observed growing from the periphery to the center of the grafted material. Conclusion: The results of the present study suggest that autogenous skin-derived mesenchymal stem cells grafting with a DBM and fibrin glue scaffold can be a predictable method in the maxillary sinus floor elevation technique for implant surgery.

• Polymer(Korea)
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• v.34 no.5
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• pp.398-404
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• 2010

We fabricated sponge and poly(lactide-co-glycolide)(PLGA) scaffolds impregnated demineralized bone particle(DBP)(DBP/PLGA) and investigated proper condition to proliferation and phenotype maintenance of intervertebral disc(IVD) cells by comparison between DBP/PLGA scaffold and DBP sponge. DBP/PLGA scaffolds were prepared by solvent casting/salt leaching. Human IVD cells were seeded in scaffolds of two types. Cell viability and proliferation according to scaffolds were analyzed by WST assay and SEM. RT-PCR was assessed to measure mRNA expression of aggrecan and type II collagen of human IVD cells. In WST assay results, cell viability in scaffolds impregnated DBP/PLGA scaffold were higher than DBP sponge. We could observe that disc cell mRNA expressed better in DBP/PLGA scaffold than DBP sponge. We concluded that the using of DBP/PLGA in terms of scaffold fabrication for bio-disc with human IVD cells is helpful growth of disc cells maintenance of phenotypes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.87-94
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• 2001

The present study was performed to investigate the effect of $HTR^{(R)}$ (Hard Tissue Replacement) on osteogenesis in the mandibular bone defects. Eight adult male white rabbits weighing 2.5 to 3.0kg were used. Four bone defects (8mm in diameter and 4mm in depth) were made at the both mandibular body. In the control group, the right mesial bone defect was filled with blood clot and spontaneously healed. In the DFDB group, the right distal bone defect was filled with xenogenic demineralized freeze-dried bone. In the $HTR^{(R)}$ group, the left mesial bone defect was filled with $HTR^{(R)}$. In the $HTR^{(R)}-membrane$ group, the left distal bone defect was filled with $HTR^{(R)}$ and covered with BioMesh membrane. The rabbits were sacrified at 2,4,6 and 9 weeks after the operation and microscopic examination was performed. Results obtained were as follows: In the control and DFDB groups, inflammatory cells and the fibrous connective tissue existed and the bone growth was slower than $HTR^{(R)}$ group by 6 week, and there was intervention of the soft tissue at 9 week. In the $HTR^{(R)}$ group, bone trabeculi extended between the $HTR^{(R)}$ particles without intervention of inflammatory cells and the connective tissue at 4 and 6 weeks. In addition, extensive osseous ingrowth into the $HTR^{(R)}$ particles was observed at 9 week. Bone formation was more active in the $HTR^{(R)}$ group than the control and DFDB groups. There was not obvious difference in the bone healing rate between the $HTR^{(R)}$ and the $HTR^{(R)}-membrane$ group. These results suggest that the $HTR^{(R)}$ promotes osteogenesis in the bone defects and the $HTR^{(R)}$ group has no difference in comparison with the $HTR^{(R)}-BioMesh^{(R)}$ membrane group in bone healing.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.557-564
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• 2000

The bone graft materials can be grossly divided into autogenous bone, allogenic bone, xenogenic bone, and alloplastic material. Much care was given to other bone graft materials away from autogenous bone due to its additional operation for harvesting, delayed resorption and limitation of quantity. Demineralized freeze-dried bone(DFDB) and hydroxyapatite are the representatives of bone graft materials. As resorbable hydroxyapatite is developed in these days, the disadvantage of nonresorbability can be overcome. So we planned to study on the strength and the bone formation at the rats calvarial defects of DFDB graft and those of the composite graft with DFDB and resorbable hydroxyapatite. We used the 16 male rats weighting range from 250 to 300 gram bred under the same environment during same period. After we made the 6mm diameter calvarial defect, we filled the DFDB in 8 rats and DFDB and resorbable hydroxyapatite in another 8 rats. We sacrificed them at the postoperative 1 month and 2 months with the periostium observed. As soon as the specimens were delivered, we measured the compressive forces to break the normal calvarial area and the newly formed bone in calvarial defect area using Instron(Model Autograph $S-2000^{(R)}$, Shimadzu, Japan). The rest of the specimens were stained with H&E(Hematoxylin & Eosin) and evaluated with the light microscope. So we got the following results. 1. In every rats, there was no significant difference between the measured forces of normal bone area and those of the bone graft area. 2. In 1 month, the measured forces at DFDB graft group were higher than those of the DFDB and resorbable hydroxyapatite composite graft group(P<0.05). 3. In 2 months, there was no significant differences between the measured forces of DFDB graft group and those of the DFDB and resorbable hydroxyapatite composite graft group. 4. In lightmicroscopic examination, most of the grafted DFDB were transformed into bone in 1 month and a large numbers of hydroxyapatite crystal were observed in DFDB and resorbable hydroxyapatite composite graft group in 1 month. 5. Both group showed no inflammatory reaction in 1 month. And hydroxyapatite crystals had a tight junction without soft tissue invagination when consolidated with newly formed bone. 6. In both groups, newly formed bone showed the partial bone remodeling and the lamellar bone structures and some of reversal lines were observed in 2 months. From the above results, it is suggested that DFDB and resorbable hydroxyapatite composite graft group had a better resistance to compressive force in early stage than DFDB graft group, but there would be no significant difference between two groups after some period. And it is suggested that the early stage of bone formation procedure of DFDB and resorbable hydroxyapatite composite graft group was slight slower than that of DFDB graft group, but there would be no significant difference between two groups after some period.

• Journal of dental hygiene science
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• v.16 no.4
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• pp.257-262
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• 2016

The purpose of this study was to assess the correlation between integrated mineral loss (volume % mineral${\times}{\mu}m$, ${\Delta}Z_{TMR}$) determined using transverse microradiography (TMR) and integrated reflectivity ($dB{\times}{\mu}m$, ${\Delta}R_{OCT}$) determined using optical coherence tomography (OCT) for detecting early dental caries with lesion depth more than $200{\mu}m$. Sixty tooth specimens were made from sound bovine teeth. They were immersed in a demineralized solution for 20, 30, and 40 days. The ${\Delta}R_{OCT}$ was obtained from the cross-sectional OCT image. The ${\Delta}Z_{TMR}$ was obtained from the TMR image. The correlation between ${\Delta}R_{OCT}$ and ${\Delta}Z_{TMR}$ was examined using Pearson correlation. The Bland-Altman plot was constructed using the ${\Delta}R_{OCT}$ and ${\Delta}Z_{TMR}$ values. A significant correlation between ${\Delta}R_{OCT}$ and ${\Delta}Z_{TMR}$ was confirmed (r=0.491, p=0.003). Moreover, most of the difference between ${\Delta}R_{OCT}$ and ${\Delta}Z_{TMR}$ was included in the error section of the Bland-Altman plot. Therefore, OCT could be used as a substitute for TMR when analyzing mineral loss in early dental caries.

• Journal of Periodontal and Implant Science
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• v.41 no.5
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• pp.227-233
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• 2011

Purpose: The aim of this study was to compare osteoblast behavior on zirconia and titanium under conditions cultured with bone morphogenetic protein-2. Methods: MC3T3-E1 cells were cultured on sandblasted zirconia and sandblasted/etched titanium discs. At 24 hours after seeding MC3T3-E1, the demineralized bone matrix (DBM) gel alone and the DBM gel with bone morphogenetic protein-2 (BMP-2) were added to the culture medium. The surface topography was examined by confocal laser scanning microscopy. Cellular proliferation was measured at 1, 4, and 7 days after gel loading. Alkaline phosphatase activity was measured at 7 days after gel loading. The mRNA expression of ALPase, bone sialoprotein, type I collagen, runt-related transcription factor 2 (Runx-2), osteocalcin, and osterix were evaluated by real-time polymerase chain reaction at 4 days and 7 days. Results: At 1, 4, and 7 days after loading the DBM gel alone and the DBM gel with BMP-2, cellular proliferation on the zirconia and titanium discs was similar and that of the groups cultured with the DBM gel alone and the DBM gel with BMP-2 was not significantly different, except for titanium with BMP-2 gel. ALPase activity was higher in the cells cultured with BMP-2 than in the other groups, but there was no difference between the zirconia and titanium. In ALPase, bone sialoprotein, osteocalcin, Runx-2 and osterix gene expression, that of cells on zirconia or titanium with BMP-2 gel was much more highly increased than titanium without gel at day 7. The gene expression level of cells cultured on zirconia with BMP-2 was higher than that on titanium with BMP-2 at day 7. Conclusions: The data in this study demonstrate that the osteoblastic cell attachment and proliferation of zirconia were comparable to those of titanium. With the stimulation of BMP-2, zirconia has a more pronounced effect on the proliferation and differentiation of the osteoblastic cells compared with titanium.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.684-691
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• 2008

Many operations have been carried out using the fluoride ion to prevent and reverse dental caries. It certainly encourages remineralization and also prevents dental caries. However, the remineralization developed by these means is superficial only leaving lower levels of demineralized lesion with a degree of porosity and incomplete mineralization. We must consider its toxic effects when it is ingested for overdose. The CPP-ACP paste is able to remineralize the incipient lesion and has no harmful effects when it is ingested, because it was made form casein which is from the protein of milk. The purpose of this article is to compare the remineralization effects between APF gel and the CPP-ACP paste. we applicated the APF gel and CPP-ACP paste on the artificial enamel carious lesion. After 14 days, we measured the surface microhardness and observed the remineralized lesion under polarized light microscope. The results were as follows : 1. The surface microhardness of group III was the highest, followed by group II, and I(p<0.05). 2. The surface microhardness of group III was significantly higher than those of group I, and II(p<0.05). 3. We could observe thin and irregular remineralization layer of group II, and regular and moderate remineralization layer of group III under polirized light microscope.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.2
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• pp.137-143
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• 2018

The aim of this study is to compare the differences of the demineralization resistance of resin infiltration and 1.23% acidulated phosphate fluoride in bovine teeth with artificial caries. We applied 1.23% Acidulated phosphate fluoride (APF) gel and $Icon^{(R)}$ caries infiltrant on the artificial bovine enamel carious lesion and then demineralized all samples. The depth of demineralization was measured by using Confocal Laser Scanning Microscope (CLSM) and observed the roughness and irregularity of the enamel was observed by Scanning Electron Microscope (SEM). In this experiment with demineralization resistance on smooth artificial carious lesion, less depth of demineralization, roughness, and irregularity of enamel was observed in APF gel and $Icon^{(R)}$ group than in the control group. There was no significant difference between the depth of demineralization of 1.23% APF gel and $Icon^{(R)}$ caries infiltrant group. However, resin infiltration is beneficial as less roughness and irregularity was observed on the enamel surface than when 1.23% APF gel is applied.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.967-987
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• 1996

The present study was to evaluate the healing patterns of guided tissue regeneration( GTR) using resorbable $Vicryl^{(R)}$(polyglactin 910) mesh and nonresorbable expanded polytetrafluoroethylene(ePTFE) membrane with or without bone grafting using autogeneous bone and demineralized freeze-dried bone allograft(DFDBA) in the grade II furcation defects. Mucoperiosteal flaps were reflected buccally in the mandibular 2nd, 3rd and 4th premolar areas and furcation defects were created surgically by removing $5{\times}6mm$ alveolar bone in 4 dogs. Root surfaces were thoroughly debrided of periodontal ligament and cementum, and notches were placed on root surface at the most apical bone level. In the right and left mandibular quadrant, each tooth was received $Vicryl^{(R)}$ mesh(ACE Surgical Supply Co., USA) only, $Vicryl^{(R)}$ mesh with DFDBA, $Vicryl^{(R)}$ mesh with autogeneous bone grafts, ePTFE membrane($Core-tex^{(R)}$ membrane, W.L. Gore & Associates Inc., USA) only, ePTFE membrane with DFDBA or ePTFE membrane with autogeneous bone grafts. For the fluorescent microscopic examination, fluorescent agents were injected at 2, 4 and 8 weeks after surgery. Four weeks after surgery, 2 dogs were sacrificed and ePTFE membranes were removed from remaining 2 dogs, which were sacrificed at 12 weeks after surgery. Undecalcified tissues were embedded in methylmethacrylate and $10{\mu}m$ thick sections were cut in a buccolingual direction. These sections were stained with hematoxylin-eosin stain and Masson's trichrome stain, and evaluated by descriptive histology and linear measurements. The results were as follows : 1) $Vicryl^{(R)}$ mesh group showed less connective tissue attachment than ePTFE membrane group. 2) The combination of GTR using $Vicryl^{(R)}$ mesh and osseous grafts resulted in new attachment and new bone formation more than GTR using $Vicryl^{(R)}$ mesh only. 3) GTR using ePTFE membrane, with or without osseous grafts, enhanced periodontal regeneration. 4) Root resorption and dentoalveolar ankylosis were observed in the areas treated with the combination of GTR and DFDBA. It was suggested that the effect of adjunctive bone grafting in GTR procedure depends on the materials and the physical properties of barrier membranes. $Vicryl^{(R)}$ mesh performed a barrier function and the use of adjunctive bone grafting may enhance the periodontal regeneration.