• The Journal of Advanced Prosthodontics
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• v.7 no.6
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• pp.484-495
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• 2015

PURPOSE. This study was to evaluate the effects of bacterial cellulose (BC) membranes as a barrier membrane on guided bone regeneration (GBR) in comparison with those of the resorbable collagen membranes. MATERIALS AND METHODS. BC membranes were fabricated using biomimetic technology. Surface properties were analyzed, Mechanical properties were measured, in vitro cell proliferation test were performed with NIH3T3 cells and in vivo study were performed with rat calvarial defect and histomorphometric analysis was done. The Mann-Whitney U test and the Wilcoxon signed rank test was used (${\alpha}<.05$). RESULTS. BC membrane showed significantly higher mechanical properties such as wet tensile strength than collagen membrane and represented a three-dimensional multilayered structure cross-linked by nano-fibers with 60 % porosity. In vitro study, cell adhesion and proliferation were observed on BC membrane. However, morphology of the cells was found to be less differentiated, and the cell proliferation rate was lower than those of the cells on collagen membrane. In vivo study, the grafted BC membrane did not induce inflammatory response, and maintained adequate space for bone regeneration. An amount of new bone formation in defect region loaded with BC membrane was significantly similar to that of collagen membrane application. CONCLUSION. BC membrane has potential to be used as a barrier membrane, and efficacy of the membrane on GBR is comparable to that of collagen membrane.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.6
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• pp.648-653
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• 2007

This case study investigated the clinical effect of guided bone regeneration(GBR) using $Regenaform^{(R)}\;and\;Ossix^{(R)}$ membrane and the histology of the new bone that formed just under the membranes. $Regenaform^{(R)}$ transplantation and covering with $Ossix^{(R)}$ membrane were performed to repair bone defects around implants after implantation in three patients. After $3{\sim}4$ months, the membranes were removed in a second operation, and a biopsy was taken under the membrane. The biopsies showed a bone density of $23{\sim}42%$, and subsequent prosthetic treatments were successful in all cases.

• Journal of Periodontal and Implant Science
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• v.25 no.2
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• pp.321-340
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• 1995

The regeneration of destructed periodontal tissues is one of the ultimate objectives of periodontal therapy. Guided tissue regeneration technique was developed for the ideal regeneration of periodontal tissues. In order to investigate the role of fibronectin, laminin and tenascin in the regenerating process of periodontal tissues, the expanded PTFE barrier membranes(Gore Associates, USA) removed from the patients who had been treated by guided tissue regeneration(GTR) and guided bone regeneration(GBR) techniques were fixed in neutral formalin for 6-24 hours, embedded with paraffin, sectioned at $4-6{\mu}m$ in thickness, and immunohistochemically processed by Avidin-Biotin peroxidase complex method for detecting fibronectin, laminin and tenascin. Monoclonal mouse anti-human fibronectin antibody(Oncogene Science, USA., 1:100), monoclonal mouse anti-human laminin antibody(Oncogene Science, USA., 1:50) and mouse anti-human tenascin antibody(Oncogene Science, USA, 1:10) were used as primary antibodies. The light microscopic findings were as follows: (1) The distribution of fibronectin, laminin and tenascin was various according to the area of barrier membranes. (2) The distribution of fibronectin in case of GBR was extensive in the tissue on the outer surface of barrier membranes, and rare in the intervening space and on the inner surface. In case of GTR it was extensive on the outer surface and in the intervening space, and rare on the inner surface. (3) The distribution of laminin was rare in the tissue on the outer, the inner surface and intervening space of barrier membranes, regardless of GBR or GTR. (4) In case 'of GBR rare distribution of tenascin was observed on the outer surface only, except the inner surface and the intervening space of barrier membranes. In case of GTR the distribution of tenascin was extensive in the tissue on the outer surface, rare in intervening space and the inner surface. The results suggest that fibronectin, laminin and tenascin may play a important role in the regenerating process of periodontal tissue, and they may affect the outcome of healing.

• Journal of Periodontal and Implant Science
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• v.48 no.5
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• pp.305-316
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• 2018

Purpose: The aim of the present study was to evaluate the biocompatibility and barrier function of mussel adhesive protein (MAP)-loaded collagen membranes in guided bone regeneration (GBR). Methods: Eight male New Zealand white rabbits were used. Four circular defects (diameter: 8 mm) were created in the calvarium of each animal. The defects were randomly assigned to 1) a negative control group, 2) a cyanoacrylate (CA)-loaded collagen membrane group (the CA group), 3) a MAP-loaded collagen membrane group (the MAP group), and 4) a group that received a polycaprolactone block with MAP-loaded collagen membrane (the MAP-PCL group). Specimens were harvested at 2 weeks (n=4) and 8 weeks (n=4) postoperatively for observational histology and histometric analysis. Results: In the histologic analysis, MAP was completely absorbed without any byproducts. In contrast, some of the CA adhesive remained, showing an inflammatory reaction, at 8 weeks. In the MAP-PCL group, the MAP-loaded collagen membranes served as a barrier membrane despite their fast degradation in GBR. No significant difference was found in the amount of new bone between the MAP-PCL and MAP groups ($1.82{\pm}0.86mm^2$ and $2.60{\pm}0.65mm^2$, respectively). Conclusions: The MAP-loaded collagen membrane functioned efficiently in this rabbit calvarial GBR model, with excellent biocompatibility. Further research is needed to assess clinical applications in defect types that are more challenging for GBR than those used in the current model.

• Journal of Korean Dental Science
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• v.17 no.2
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• pp.53-63
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• 2024

Purpose: To investigate the effects of simultaneous soft and hard tissue augmentation and the addition of polydeoxyribonucleotide (PDRN) on regenerative outcomes. Materials and Methods: In five mongrel dogs, chronic ridge defects were established in both mandibles. Six implants were placed in the mandible, producing buccal dehiscence defects. The implants were randomly allocated to one of the following groups: 1) control: no treatment; 2) GBR: guided bone regeneration (GBR) only; 3) GBR/PDRN: GBR+PDRN application to bone substitute particles; 4) GBR/CTG: GBR+connective tissue grafting (CTG); 5) GBR/VCMX: GBR+soft tissue augmentation using volume stable collagen matrix (VCMX); and 6) group GBR/VCMX/PDRN: GBR+VCMX soaked with PDRN. The healing abutments were connected to the implants to provide additional room for tissue regeneration. Submerged healing was achieved. The animals were euthanized after four months. Histological and histomorphometric analyses were then performed. Results: Healing abutments were gradually exposed during the healing period. Histologically, minimal new bone formation was observed in the dehiscence defects. No specific differences were found between the groups regarding collagen fiber orientation and density in the augmented area. No traces of CTG or VCMX were detected. Histomorphometrically, the mean tissue thickness was greater in the control group than in the other groups above the implant shoulder (IS). Below the IS level, the CTG and PDRN groups exhibited more favorable tissue thickness than the other groups. Conclusion: Failure of submerged healing after tissue augmentation deteriorated the tissue contour. PDRN appears to have a positive effect on soft tissues.

• The Journal of the Korean dental association
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• v.39 no.10 s.389
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• pp.819-824
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• 2001

충분한 골양이 존재해야 한다는 것은 임프란트를 식립하는데 있어서 중요힌 선결조건이므로, 임프란트를 식립하기 전이나 식립하는 도중에 치조제의 높이와 고경을 증대시키기 위하여 조직유도재생술 (Guided Tissue Regeneration, GTR)의 생물학적 원리에 기초를 둔 골유도재생술(Guided Bone Regeneration, GBR)이 필요하다. 이 장에서는 임프란트치료시 골유도재생술을 이용하여 임프란트 주위의 골결손부에 대한 치료로서 현재 이용되고 있는 이식재의 종류와 그 임상적 응용, 그리고 결손부 주위에서 골 생성을 향상시크는 방법에 대하여 살펴보고자 한다.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.191-198
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• 2008

Purpose: Guided bone regeneration(GBR) has emerged as a treatment in the management of osseous defects associated with dental implants. But several studies have reported different degrees of success of guided bone regeneration, depending upon the type of barrier selected, presence or absence of an underlying graft material, types of graft material, feasibility of technique, and clinician's preference. The aim of the present study was to evaluate bone formation following dental implant placement with augmentation materials at dehiscence defects in dogs. Material and Methods: Standardized buccal dehiscence defects($3{\times}5\;mm$) were surgically 2 Mongrel dog's mandibles, each 8 SLA surface, 8 anodizing surface implants. Each buccal dehiscence defect received flap surgery only(no treatment, control), $Cytoflex^{(R)}$ membrane only, Resolut $XT^{(R)}$ membrane only, Resolut $XT^{(R)}+Osteon^{TM}$. Animals were sacrificed at 8 weeks postsurgery and block sections were harvested for histologic analysis. Resuts: All experimental group resulted in higher bone formation than control. Resolut $XT^{(R)}+Osteon^{TM}$ group resulted appeared highest defect resolution. There was no difference between SLA and anodizing surface, nonresorbable and resorbable membrane. Conclusion: GBR results in rapid and clinically relevant bone closure on dehiscence defects of the dental implants.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.3
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• pp.229-236
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• 2006

The biologic principle of guided bone regeneration(GBR) has been studied extensively in hopes of regenerating alveolar bone. Various materials have been utilized as regenerative membranes and grafting materials in implant surgery. To improve the ability of membranes, several types of membrane have been developed. Various materials have been utilized as regenerative membranes; however, all materials have disadvantages, and the ideal membrane material is yet to be identified. In these cases, a homologous gelatinized bone matrix(GBM) were used as a regenerative material in conjunction with the placement of endosseous root implants. 22 patients participated in this study, and 42 implants were inserted. The result of 1st operative surgery was uneventful, inflammatory reaction and dehiscences were not observed except for only one case. After the final protheses, all implants were functioning successfully. The major advantages in the use of GBMs for guided bone regeneration are of very wide application such as membrane and graft material, and that a second procedure to remove the material is not necessary, and the GBMs are accepted by the surrounding tissues without complications. The purpose of this study was to observe the usefulness of GBMs in dental implant surgery.

• Journal of Korean Dental Science
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• v.14 no.1
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• pp.12-25
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• 2021

Purpose: (i) To evaluate the biologic properties of a bi-layered 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride-cross-linked collagen membrane (CCM) in vitro. (ii) To assess the efficacy of CCM for localized bone regeneration in vivo. Materials and Methods: Biodegradation of CCM compared to a native collagen membrane (NCM) was assessed in vitro. In vivo, twelve male New Zealand White rabbits were used. Four calvarial, circular defects (diameter 8 mm) were created in each animal. The sites were randomly allocated to i) CCM+biphasic calcium phosphate (BCP) (CCM-BCP group), ii) CCM alone (CCM), iii) BCP alone (BCP) and, iv) negative control (control). Animals were sacrificed at 2 (n=6) and 8 weeks (n=6). Outcome measures included: micro-computed tomography (μCT) analysis (total augmented volume [TAV], new bone volume) and histomorphometry (total augmented area [TAA], newly formed bone, remaining membrane thickness [RMT]). Result: CCM was more resistant to degradation than NCM. μCT analysis showed CCM-BCP (196.43±25.30 mm³) and BCP (206.23±39.13 mm³) groups had significantly (P<0.01) larger TAV than the control (149.72±12.28 mm³) after 8 weeks. Histomorphometrically, CCM-BCP group (17.75±5.97 mm²) had significantly (P<0.01) greater TAA compared to the CCM group (7.74±2.25 mm²) and the control (8.13±1.81 mm²) after 8 weeks. After 8 weeks, RMT was reduced by 67%. Conclusion: CCM can be a favorable choice of barrier membrane when performing guided bone regeneration (GBR) in localized bone defects. CCM has better resistance to degradation than the natural collagen membrane, in vitro. In vivo, CCM provides an advantageous integration of prolonged barrier function and biocompatibility for GBR.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.2
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• pp.91-98
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• 2021

Objectives: Hyaluronoglucosaminidase (hyaluronidase) increases the local intercellular permeability of the peripheral lymphatic channel and capillaries, which may help reduce edema. In the present study, the effects of hyaluronidase on postoperative edema and pain reduction were evaluated. Materials and Methods: The study included 38 patients who underwent guided bone regeneration (GBR) surgery before implantation. Patients were randomly assigned to either the control group (n=20) or the test group (n=18). Hyaluronidase was injected into the GBR site of subjects in the test group. Postoperative edema was evaluated by measuring the distance between specific facial landmarks immediately after surgery (T1) and 2-4 days after surgery (T2). The degree of pain at T2 and at 10-14 days after surgery (T3) was assessed. Results: In the test group, the degree of swelling was lower than in the control group, however, only two measurements, from the tragus to the mouth corner and from the outer canthus to the mouth corner, showed statistically significant differences (P=0.012 and P=0.001, respectively). The anti-edema effect of hyaluronidase was more effective in the maxilla than in the mandible. In the maxilla, the percentage of facial swelling was significant for three measurements. However, in the mandible, the percentage of facial swelling was significant for only one measurement. Low levels of pain that were similar at T2 and T3 were reported in both groups. Conclusion: The results indicate the degree of swelling was lower in the test group and hyaluronidase appeared to be more effective in the maxilla. The degree of pain reduction was similar between groups. Further in vivo and randomized controlled trials with larger sample sizes are warranted.