• The Journal of Korean Academy of Prosthodontics
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• v.42 no.3
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• pp.307-326
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• 2004

Statement of problem. The long-term success of implants is the development of a stable direct connection between bone and implant surface, which must be structural and functional. To improve a direct implant fixation to the bone, various strategies have been developed focusing on the surface of materials. Among them, altering the surface properties can modify cellular responses such as cell adhesion, cell motility and bone deposition. Purpose. This study was to evaluate the cellular behaviors on the surface-modified titanium by morphological observation, cellular proliferation and differentiation. Material and methods. Specimens were divided into five groups, depending on their surface treatment: electropolishing(EP) anoclizing(AN), machining(MA), blasting with hydroxyapatite particle(RBM) and electrical discharge machining(EDM). Physicochemical properties and microstructures of the specimens were examined and the responses of osteoblast-like cells were investigated. The microtopography of specimens was observed by scanning electron microscopy(SEM). Surface roughness was measured by a three-dimensional roughness measuring system. The microstructure was analyzed by X-ray diffractometer(XRD) and scanning auger electron microscopy(AES). To evaluate cellular responses to modified titanium surfaces, osteoblasts isolated from neonatal rat were cultured. The cellular morphology and total protein amounts of osteoblast-like cell were taken as the marker for cellular proliferation, while the expression of alkaline phosphatase was used as the early differentiation marker for osteoblast. In addition, the type I collagen production was determined to be a reliable indicator of bone matrix synthesis. Results. 1. Each prepared specimen showed specific microtopography at SEM examination. The RBM group had a rough and irregular pattern with reticulated appearance. The EDM-treated surface had evident cracks and was heterogeneous consisting of broad sheet or plate with smooth edges and clusters of small grains, deep pores or craters. 2. Surface roughness values were, from the lowest to the highest, electropolished group, anodized group, machined group, RBM group and EDM group. 3. All groups showed amorphous structures. Especially anodized group was found to have increased surface oxide thickness and EDM group had titaniumcarbide(TiC) structure. 4. Cells on electropolished, anodized and machined surfaces developed flattened cell shape and cells on RBM appeared spherical and EDM showed both. After 14 days, the cells cultured from all groups were formed to be confluent and exhibited multilayer proliferation, often overlapped or stratified. 5. Total protein amounts were formed to be quite similar among all the group at 48 hours. At 14 days, the electropolished group and the anodized group induced more total protein amount than the RBM group(P<.05). 6. There was no significant difference among five groups for alkaline phosphatase(ALP) activity at 48 hours. The AN group showed significantly higher ALP activity than any other groups at 14 days(P<.05). 7. All the groups showed similar collagen synthesis except the EDM group. The amount of collagen on the electropolished and anodized surfaces were higher than that on the EDM surface(P<.05).

• 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.

• Journal of Periodontal and Implant Science
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• v.29 no.2
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• pp.333-350
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• 1999

The modulation of leukocyte cell surface adhesion molecules may influence the development of cellular events that determine the course of the inflammatory process. Direct interaction between activated T cells and monocytes resulted in a large production of $IL-1{\beta}$ by monocytes. In this reactions, adhesion molecules play an important part, yet the role of them in Tmonocytes interaction remain unclear. This study was undertaken in an effort to elucidate, 1) the influence of 1.25(OH)$_2D_3-induced$ differentiation on the monocyte responsiveness to direct contact with T lymphocytes, and 2) the role of adhesion molecules on the T-monocyte direct interaction. Initially, I observed that direct contact of monocyte cell line THP-1 with stimulated fixed T cell line HuT78 markedly induces IL-1${\beta}$ production by THP-1. $IL-1{\beta}$ production was higher when THP-1 had been previously exposed to 1.25(OH)$_2D_3$ as compared to control, with ${\alpha}$- 1.25(OH)$_2D_3$ dose-dependent and exposure time-dependent manner. It was shown that 1.25(OH)$_2D_3$ also increased the expression of ${\beta}_2$ integrin adhesion receptor Mac-1(CD11b/CD18) dose- and timedependently, but did not increase the expression of human leukocyte antigen- D(HLA-D) and intercellular adhesion molecule-1(ICAM-1). The $IL-1{\beta}$ producing activity of THP-1 cells correlated well with the ability to induce the Mac-1 expression on THP-1 surface. Monoclonal antibody raised against relevant cell surface glycoproteins on THP-1 were tested for their ability to block the response of THP-1 to T cells. Antibody to Mac-1 only partially blocked $IL-1{\beta}$ production by THP-1, whereas antibodies to ICAM-1 and HLA-D did not. These data indicate that regulation of Mac-1 expression on THP-1 cells can alter the responsiveness of these cells to contact by activated T cells, however other unknown structures on the THP-1 cells may be involved in this process also.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.1
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• pp.171-178
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• 1994

This paper reports histologic and histomorphometric results concerning bone healing around vent area of 16 titanium plasma sprayed IMZ implants in rabbit femurs. Bone contact around the implants 8 weeks after placement showed a great deal of variability from 14.32% to 65.94% and mean total bone contact was 33.96%. The mean percent amount of bone contact was 43.68% in inner surface of vent and 27.79% in outer surface. Histologic examination of horizontal sections of vent area showed direct contact with living lamellar bone and some woven bone. The implants surface area not in contact with bone was in contact with collagenous connective tissue. But there was no sign of foreign-body reaction.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.6
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• pp.751-763
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• 2005

Statement of problem. To improve a direct implant fixation to the bone, various strategies have been developed focusing on the surface of materials. The surface quality of the implant depends on the chemical, physical, mechanical and topographical properties of the surface. The different properties will interact with each other and a change in thickness of the oxide layer may also result in a change in surface energy, the surface topography and surface, chemical composition. However, there is limited the comprehensive study with regard to changed surface and biologic behavior of osteoblast by anodization. Purpose of study. The aim of this study was to analyze the characteristics of an oxide layer formed and to evaluate the cellular biologic behaviors on titanium by anodic oxidation (anodization) by cellular proliferation, differentiation, ECM formation and gene expression. And the phospholipase activity was measured on the anodized surface as preliminary study to understand how surface properties of Ti implant are transduced into downstream cellular events. Methods and Materials. The surface of a commercially pure titanium(Grade 2) was modified by anodic oxidation. The group 1 samples had a machined surface and other three experimental specimens were anodized under a constant voltage of 270 V(Group 2), 350 V(Group 3), and 450 V(Group 4). The specimen characteristics were inspected using the following five categories; the surface morphology, the surface roughness, the thickness of oxide layer, the crystallinity, and the chemical composition of the oxide layer. Cell numbers were taken as a marker for cell proliferation. While the expression of alkaline phosphatase and Runx2 (Cbfa1) was used as early differentiation marker for osteoblast. The type I collagen production was determined, which constitutes the main structural protein of the extracellular matrix. Phospholipase $A_2$ and D activity were detected. Results. (1) The anodized titanium had a porous oxide layer, and there was increase in both the size and number of pores with increasing anodizing voltage. (2) With increasing voltage, the surface roughness and thickness of the oxide film increased significantly (p<0.01), the $TiO_2$phase changed from anatase to rutile. During the anodic oxidization, Ca and P ions were more incorporated into the oxide layer. (3) The in vitro cell responses of the specimen were also dependant on the oxidation conditions. With increasing voltage, the ALP activity, type I collagen production, and Cbfa 1 gene expression increased significantly (p<0.01), while the cell proliferation decreased. (4) In preliminary study on the relation of surface property and phospholipase, PLD activity was increased but $PLA_2$ activity did not changed according to applied voltage. Conclusion. The anodized titanium shows improved surface characteristics than the machined titanium. The surface properties acquired by anodization appear to give rise more mature osteoblast characteristics and might result in increased bone growth, and contribute to the achievement of a tight fixation. The precise mechanism of surface property signaling is not known, may be related to phospholipase D.

• Journal of Periodontal and Implant Science
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• v.25 no.2
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• pp.301-320
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• 1995

The purpose of this study was to evaluate a new biodegradable membrane - atelocollagen as a guided tissue regeneration barrier on the dehiscence defects adjacent to the dental implants. 3 beagle dogs were selected for this study and all the mandibular premolars($P_1,P_2,P_3&P_4$) were extracted. Twelve weeks after the extraction, the edentulous ridges were formed to be placed the titanium plasma-sprayed IMZ implants. Four implant osteotomies were performed on each side of the mandible. The osteotomies were placed facially in the edentulous ridges to approximate an actual dehiscence defect as closely as possible, The standardized dehiscence defects were created 3 mm in width and 4 mm in height by osteotomy. A total 24 implants were placed. e-PTFE, ateloco11agen and $Collatape^{(R)}$ were placed to cover the defects and the one defect served as a control, not covered any membrane. By random selection, three dogs were sacrificed at 2 weeks, 4weeks and 8 weeks after fixation with 3% glutaraldehyde. A week before sacrificing, 8-week dog was infused intravenously with oxy-tetracycline 30mg/kg. The left mandibular blocks were used for full decalcified histologic preparation and the right mandibular blocks were selected for undeca1cified preparation, At 2 weeks, the regenerated bone of e-PTFE and atelocollagen groups appeared to be more dense than other groups and the percentage of bone defect fill was highest for e-PTFE and follwed by ateloco1lagen group. However, the $Collatape^{(R)}$ and control groups showed a little new bone formation. $Collatape^{(R)}$ was almost degraded within 2 weeks. At 4 weeks, the regenerated new bone were much greater and denser than at 2 weeks for e-PTFE and ateloco11agen group. Although a part of atelocollagen bagan to be degraded at the margin and surrounded by foreign body giant cells related to foreign body reaction, it was generally intact and the regenerated new bone was shown much more than at 2 weeks. The amount of new bone in $Collatape^{(R)}$ and control groups at 4 weeks were similar to that of 2 weeks group. At 8 weeks, the regenerated bone was matured and observed along the implant fixture. Direct new bone formation and calcium deposits beneath the e-PTFE were observed. No further bone growth was seen in the $Collatape^{(R)}$ and control groups. In reflected fluoromicrcocopic observation, the osteogenic activity was pronounced between e-PTFE membrane and the old bone. High osteogenic activity was also observed in atelocol1agen group. This study suggested that the ateloco11agen as well as e-PTFE could be used for guided tissue regeneration on dehiscence defects adjacent to the dental implants. But the $Collatape^{(R)}$ was completely resorbed within 2 weeks and was not a suitable membrane for guided bone regeneration.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.559-567
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• 2018

Objective : The aim of this study was to evaluate the effect for biodegradable screws containing bone morphogenetic protein-2 (BMP-2) in an osteoporotic rat model. Methods : Twenty-four female Wistar rat (250-300 g, 12 weeks of age) were randomized into four groups. Three groups underwent bilateral ovariectomy (OVX). Biodegradable screws with or without BMP-2 were inserted in the proximal tibia in two implantation groups. The extracted proximal metaphysis of the tibiae were scanned by exo-vivo micro-computed tomography. Evaluated parameters included bone mineral density (BMD), trabecular bone volume (BV/TV), trabecular number, trabecular thickness, and trabecular separation (Tb.Sp). The tibia samples were pathologically evaluated by staining with by Hematoxylin and Eosin, and trichrome. Results : Trabecular formation near screw insertion site was evident only in rats receiving BMP-2 screws. BMD and BV/TV significantly differed between controls and the OVX and OVX with screw groups. However, there were no significant differences between control and OVX with screw BMP groups. Tb.Sp significantly differed between control and OVX and OVX with screw groups (p<0.05), and between the OVX and OVX with screw BMP group (p<0.05), with no statistically significant difference between control and OVX with screw BMP groups. Over the 12 weeks after surgery, bone lamellae in direct contact with the screw developed more extensive and thicker trabecular bone around the implant in the OVX with screw BMP group compared to the OVX with screw group. Conclusion : Biodegradable screws containing BMP-2 improve nearby bone conditions and enhance ostoeintegration between the implant and the osteoporotic bone.

• Progress in Medical Physics
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• v.19 no.1
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• pp.42-48
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• 2008

Bio-implantable devices such as heart pacers, gastric pacers and drug-delivery systems require power for carrying out their intended functions. These devices are usually powered through a battery implanted with the system or are wired to an external power source. This paper describes an inductive power transmission link, which was developed for an implantable stimulator for direct stimulation of denervated muscles. The carrier frequency is around 1MHz, the transmitter coil has a diameter of 46mm, and the implant coil is 46mm. Data transmission to the implant with amplitude shift keying (ASK) and back to the transmitter with passive telemetry can be added without major design changes. We chose the range of coil spacing (2 to 30mm) to care for lateral misalignment, as it occurs in practical use. If the transmitter coil has a well defined and reliable position in respect to the implant, a smaller working range might be sufficient. Under these conditions the link can be operated in fixed frequency mode, and reaches even higher efficiencies of up to 37%. The link transmits a current of 50 mA over a distance range of 2-15 mm with an efficiency of more than 20% in tracking frequency. The efficiency of the link was optimized with different approaches. A class E transmitter was used to minimize losses of the power stage. The geometry and material of the transmitter coil was optimized for maximum coupling. Phase lock techniques were used to achieve frequency tracking, keeping the transmitter optimally tuned at different coupling conditions caused by coil distance variations.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.3
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• pp.300-318
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• 2003

Statement of problem: The success of implants depends on intimate and direct contact of implant material on bone tissue and on functional relationship with soft tissue contact. Creation and maintenance of osseointegration depend on the understanding of the tissue's healing, repairing, and remodeling capacity and these capacities rely on cellular behavior. Altering the surface properties can modify cellular responses such as cell adhesion, cell motility, bone deposition, Therefore, various implant surface treatment methods are being developed for the improved bone cell responses. Purpose: The purpose of this study was to evaluate the responses of osteoblast-like cells to surface-modified titanium. Materials and Methods: The experiment was composed of four groups. Group 1 represented the electropolished surface. Group 2 surfaces were machined surface. Group 3 and Group 4 were anodized surfaces. Group 3 had low roughness and Group 4 had high roughness. Physicochemical properties and microstructures of the discs were examined and the responses of osteoblast-like cells to the discs were investigated. The microtopography was observed by SEM. The roughness was measured by three-dimension roughness measuring system. The microstructure was analyzed by XRD, AES. To evaluate cell responses to modified titanium surfaces, osteoblasts isolated from calvaria of neonatal rat were cultured. Cell count, morphology, total protein measurement and alkaline phosphatase activities of the cultures were examined. Results and Conclusion: The results were as follows 1. The four groups showed specific microtopography respectively. Anodized group showed grain structure with micropores. 2. Surface roughness values were, from the lowest to the highest, electropolished group, machined group, low roughness anodized group, and high roughness anodized group. 3. Highly roughened anodized group was found to have increased surface oxide thickness and surface crystallinity. 4. The morphology of cells, flattened or spherical, were different from each other. In the electropolished group and machined group, the cells were almost flattened. In two anodized groups, some cells were spherical and other cells were flattened. And the 14 day culture cells of all of the groups were nearly flattened due to confluency. 5. The number of attached cells was highest in low roughness anodized group. And the machined group had significantly lower cell count than any other groups(P<.05). 6. Total protein contents showed no difference among groups. 7. The level of alkaline phosphatase activities was higher in the anodized groups than electropolished and machined groups(P<.05).

• Archives of Craniofacial Surgery
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• v.14 no.1
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• pp.30-35
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• 2013

Background: For reconstruction of the mild to moderate medial orbital wall fractures, various surgical approaches have been used. Prior existing W-shaped incision was a direct local approach through a 3 cm incision on the superior medial orbital area with a titanium mesh implant. In this study, the authors modified W-shaped incision and reconstructed the defect with silastic sheet to improve the result and the postoperative scar. Methods: This study included 20 patients who had mild to moderate size of medial wall defect and therefore relatively suitable for reconstruction with silastic sheets from July, 2009 to December, 2011. A modified W-shaped skin incision approximately 1.2 to 1.5 cm in length was made along the superior medial orbital rim from approximately 1 cm medial to the medial canthus to the lower border of the medial eyebrow. The angles of the limbs of the W ranged from 150 to 160 degrees. Results: By using soft flexible silastic sheet, the authors reduced the incision from 3 to 1.5 cm, and by widening the angle of the W limbs, scars were more effectively hided in the relaxed skin tension line. Scar assessment was done with modified patient and observer scar assessment scale and mean score from patients was 2.08 and mean score from observers was 2.12. Conclusion: Although this method will not be suitable for every case, it can be a consistent method to obtain the surgical goal in treatment of mild to moderate blowout fractures of the medial orbital wall.