• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.86-91
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• 2009

The success of implants essentially depends on a sufficient volume of healthy bone at the recipient site during implant placement. In patients who have the severe alveolar bone resorption or pneumatized maxillary sinus, it should be performed that bone regeneration procedure before implant placement. Development of barrier membrane makes it possible that predictable result of alveolar bone reconstruction. Many kind of materials used for barrier membrane technique are introduced, non-absorbable or absorbable membranes. But, when operation site was ruptured with membrane exposure, bacterias can be grow up at the bone graft site. Then morphology and migration of fibroblast will be changed. It works as a negative factor on healing process of bone graft site. In oral and maxillofacial department of Chonbuk national university dental hospital, we use variable suture technique like as subgingival suture, vertical mattress suture, simple interrupted suture, if need, tenting suture after GBR or block bone graft. Within these suture technique, wound healing was excellent without complication, so now we take a report of suture technique in reconstruction of alveolar bone surgery.

• Journal of Korean Dental Science
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• 제17권2호
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• pp.64-74
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• 2024

This case report presents the long-term radiographic outcomes of a novel approach for simultaneous lateral augmentation and implant surgery. A 60-year-old male patient who required tooth extraction of the maxillary central and lateral incisors due to trauma visited the clinic. After tooth extraction, severe horizontal and vertical deficiencies occurred owing to atrophy of the alveolar ridge, and a simultaneous guided bone regeneration (GBR) procedure was planned along with the installation of two implants. In the present case, a modification of the conventional 'sandwich technique' was used by placing the mixture of autogenous bone chips and xenografts at the outermost layer to maximize the osteogenic potential at the coronal part of augmentation while applying solely xenografts at the inner layer. To enhance volumetric stability, an autogenous block of periosteum harvested from the maxillary tuberosity was incorporated between the two layers. Cone-beam computed tomography was performed at baseline and 3 years after the surgery to compare radiographic outcomes. Dehiscence after fixture installation was successfully observed at the re-entry of the surgery site. Three years after the surgery, average horizontal bone gains of 6.11 mm and 4.12 mm were observed in the maxillary central and lateral incisor areas, respectively. Healthy peri-implant mucosa and well maintained marginal bone levels were observed 8 years after the surgery, meeting the criteria for implant success. The findings of this case suggest that a substantial amount of horizontal bone gain can be obtained with a layered approach using autogenous bone materials and xenografts, highlighting the advantages of incorporating autogenous blocks into the simultaneous GBR procedure.

• 대한심미치과학회지
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• 제17권1호
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• pp.50-54
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• 2008

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.14.1-14.6
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• 2016

Background: In guided bone regeneration (GBR) technique, many materials have been used for improving biological effectiveness by adding on membranes. The new membrane which was constructed with chitin-fibroin-hydroxyapatite (CNF/HAP) was compared with a collagen membrane (Bio-$Gide^{(R)}$) by means of micro-computed tomography. Methods: Fifty-four rats were used in this study. A critical-sized (8 mm) bony defect was created in the calvaria with a trephine bur. The CNF/HAP membrane was prepared by thermally induced phase separation. In the experimental group (n = 18), the CNF/HAP membrane was used to cover the bony defect, and in the control group (n = 18), a resorbable collagen membrane (Bio-$Gide^{(R)}$) was used. In the negative control group (n = 18), no membrane was used. In each group, six animals were euthanized at 2, 4, and 8 weeks after surgery. The specimens were analyzed using micro-CT. Results: Bone volume (BV) and bone mineral density (BMD) of the new bone showed significant difference between the negative control group and membrane groups (P < 0.05). However, between two membranes, the difference was not significant. Conclusions: The CNF/HAP membrane has significant effect on the new bone formation and has the potential to be applied for guided bone regeneration.

• Journal of Periodontal and Implant Science
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• 제50권1호
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• pp.14-27
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• 2020

Purpose: To overcome several drawbacks of chemically-crosslinked collagen membranes, modification processes such as ultraviolet (UV) crosslinking and the addition of biphasic calcium phosphate (BCP) to collagen membranes have been introduced. This study evaluated the efficacy and biocompatibility of BCP-supplemented UV-crosslinked collagen membrane for guided bone regeneration (GBR) in a rabbit calvarial model. Methods: Four circular bone defects (diameter, 8 mm) were created in the calvarium of 10 rabbits. Each defect was randomly allocated to one of the following groups: 1) the sham control group (spontaneous healing); 2) the M group (defect coverage with a BCP-supplemented UV-crosslinked collagen membrane and no graft material); 3) the BG (defects filled with BCP particles without membrane coverage); and 4) the BG+M group (defects filled with BCP particles and covered with a BCP-supplemented UV-crosslinked collagen membrane in a conventional GBR procedure). At 2 and 8 weeks, rabbits were sacrificed, and experimental defects were investigated histologically and by micro-computed tomography (micro-CT). Results: In both micro-CT and histometric analyses, the BG and BG+M groups at both 2 and 8 weeks showed significantly higher new bone formation than the control group. On micro-CT, the new bone volume of the BG+M group (48.39±5.47 ㎣) was larger than that of the BG group (38.71±2.24 ㎣, P=0.032) at 8 weeks. Histologically, greater new bone area was observed in the BG+M group than in the BG or M groups. BCP-supplemented UV-crosslinked collagen membrane did not cause an abnormal cellular reaction and was stable until 8 weeks. Conclusions: Enhanced new bone formation in GBR can be achieved by simultaneously using bone graft material and a BCP-supplemented UV-crosslinked collagen membrane, which showed high biocompatibility and resistance to degradation, making it a biocompatible alternative to chemically-crosslinked collagen membranes.

• Journal of Periodontal and Implant Science
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• 제34권2호
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• pp.411-424
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• 2004

This study was performed to evaluate bone formation in the calvaria of rabbit by the concept of guided bone regeneration with titanium mesh membrane. Two different titanium meshes with varying number (353, 565) of pore were utilized in the study. Two surgical sites(T353, T565) were evaluated about whether or not the number of pore may have effect on the bone formation. The animal was sacrificed at 10days, 3 weeks, 6weeks, and 8 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis. 1. Titanium mesh was biocompatible and capable of maintaining the spacemaking. 2. At 3 weeks, 6 weeks, and 8 weeks after GBR procedure, bone formation was more in the T353 site than in the T565 site. 3. Soft tissue layer above the regenerated bone was better developed in the T565 site. 4. There was no difference between two membranes in bone maturity with time. Within the above results, titanium mesh with lesser pore in number might be recommended for the early bone formation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권4호
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• pp.221-226
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• 2013

Purpose: This study is to evaluate the efficacy of the autogenous tooth bone graft material, clinically and radiologically, as related to implant installation. Methods: In oral and maxillofacial surgery department of Ajou University Hospital, guided bone regeneration (GBR), implant placement combined with GBR, sinus graft, implant placement combined with sinus graft, and defect filling were performed in 46 patients, using autogenous tooth bone. Among these, 66 implants were inserted with autogenous tooth bone. Implant stability quotient (ISQ) was measured by Osstell Mentor (Integration Diagnostics, Goteborg, Sweden) on 39 implants on the operation date and 4 months later, and on 21 implants 9months on the average at the final setting of restoration. Twenty-eight implants with GBR and sinus graft (GBR group: n=14, sinus graft group: n=14) were evaluated radiologically to measure the resorption of grafted autogenous tooth bone after loading. Results: The average initial stabilization of the installed implants was 67 ISQ, and the average secondary stabilization at 4 months later was 76. The average bone loss of GBR group as measured 8.0 months after application of prosthesis loading was 0.29 mm and the average bone loss of the sinus graft group as measured 7.6 months after application of prosthesis loading was 0.66 mm, respectively. In the histological assessment, formation of the new bone and continuous trabecular bone pattern was identified around autogenous tooth bone. Conclusion: Based on these results, we concluded that autogenous tooth bone is an excellent bone graft material that can substitute the autogenous bone.

• Journal of Periodontal and Implant Science
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• 제50권6호
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• pp.379-391
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• 2020

Purpose: The aims of this study were to evaluate the 5-year cumulative survival rate (CSR) of implants placed with guided bone regeneration (GBR) compared to implants placed in native bone, and to identify factors contributing to implant failure in regenerated bone. Methods: This retrospective cohort study included 240 patients who had implant placement either with a GBR procedure (regenerated bone group) or with pristine bone (native bone group). Data on demographic features (age, sex, smoking, and medical history), location of the implant, implant-specific features, and grafting procedures and materials were collected. The 5-year CSRs in both groups were estimated using Kaplan-Meier analysis. Risk factors for implant failure were analyzed with a Cox proportional hazards model. Results: In total, 264 implants in the native bone group and 133 implants in the regenerated bone group were analyzed. The 5-year CSRs were 96.4% in the regenerated bone group and 97.5% in the native bone group, which was not a significant difference. The multivariable analysis confirmed that bone status was not an independent risk factor for implant failure. However, smoking significantly increased the failure rate (hazard ratio, 10.7; P=0.002). Conclusions: The 5-year CSR of implants placed in regenerated bone using GBR was comparable to that of implants placed in native bone. Smoking significantly increased the risk of implant failure in both groups.

• Journal of Periodontal and Implant Science
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• 제47권2호
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• pp.77-85
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• 2017

Purpose: Guided bone regeneration (GBR) is the most widely used technique to regenerate and augment bones. Even though augmented bones (ABs) have been examined histologically in many studies, few studies have been conducted to examine the biological potential of these bones and the healing dynamics following their use. Moreover, whether the bone obtained from the GBR procedure possesses the same functions as the existing autogenous bone is uncertain. In particular, little attention has been paid to the regenerative ability of GBR bone. Therefore, the present study histologically evaluated the regenerative capacity of AB in the occlusive space of a rat guided bone augmentation (GBA) model. Methods: The calvaria of 30 rats were exposed, and plastic caps were placed on the right of the calvaria in 10 of the 30 rats. After a 12-week healing phase, critical-sized calvarial bone defects (diameter: 5.0 mm) were trephined into the dorsal parietal bone on the left of the calvaria. Bone particles were harvested from the AB or the cortical bone (CB) using a bone scraper and transplanted into the critical defects. Results: The newly generated bone at the defects' edge was evaluated using micro-computed tomography (micro-CT) and histological sections. In the micro-CT analysis, the radiopacity in both the augmented and the CB groups remained high throughout the observational period. In the histological analysis, the closure rate of the CB was significantly higher than in the AB group. The numbers of cells positive for runt-related transcription factor 2 (Runx2) and tartrate-resistant acid phosphatase (TRAP) in the AB group were larger than in the CB group. Conclusions: The regenerative capacity of AB in the occlusive space of the rat GBA model was confirmed. Within the limitations of this study, the regenerative ability of the AB particulate transplant was inferior to that of the CB particulate transplant.

• 대한통합의학회지
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• 제2권2호
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• pp.41-47
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• 2014

Purpose : The aim was to compare the implant success rate according to membrane type through a clinical case of patients, who used bio-resorbable membrane and non-resorbable membrane. Methods : A survey was conducted targeting patients with the use of bio-resorbable membrane and non-resorbable membrane who visited H dental clinic in Busan for implant surgery and bone graft for 1 year from May 2010 to May 2011. A chart was made and surveyed for 100 people with non-resorbable membrane and for 75 people with bio-resorbable membrane. Results were compared. Results : 1. As for the measurement value of Periotest M${(R)}$, the value of -8~0 was measured with 92% in case of surgery by using non-resorbable membrane. The value of +1~+9 was measured with 8.0%. In case of surgery by using bio-resorbable membrane, Peiotest M(R) was measured with 78.7% as for the value of -8~0 and 16(21.3%) as for the value of +1~+9. In light of this, a case of using non-resorbable membrane was indicated to be higher(p=0.021) in success rate than a case of using bio-resorbable membrane. 2. As a result of periodontal conditions, namely, bleeding(p=0.914), swelling(p=0.500), inflammation(p=0.074), pain(p=0.571), and itch appearance(p=0.475) according to membrane type, all were insignificant. Conclusions : A case of using non-resorbable membrane is considered to be likely to be more effective than using bio-resorbable membrane during GBR(Guided Bone Regeneration) with the use of membrane in implant surgery.