• 제목/요약/키워드: hard tissue regeneration

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Bone Regeneration in the Extraction Socket Filled with Atelocollagen: Histological and Radiographic Study in Beagle Dogs

  • Lee, Hyeonjong;Noh, Kwantae;Lee, Deok-Won
    • Journal of Korean Dental Science
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    • 제9권2호
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    • pp.55-62
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    • 2016
  • Purpose: Alveolar bone develops with tooth eruption and is absorbed following tooth extraction. Various ridge preservation techniques have sought to prevent ridge atrophy, with no superior technique evident. Collagen has a long history as a biocompatible material. Its usefulness and safety have been amply verified. The related compound, atelocollagen, is also safe and displays reduced antigenicity since telopeptides are not present. Materials and Methods: The current study evaluated whether the $Rapiderm^{(R)}$ atelocollagen plug (Dalim Tissen, Seoul, Korea) improves tissue healing of extraction sockets and assessed the sequential pattern of bone regeneration using histology and microcomputed tomography in six beagle dogs. To assess the change of extraction socket, hard tissues were examined 2, 4, 6, and 8 weeks after tooth extraction. Result: The experimental groups showed better bone fill with slow remodeling process compared to the control groups although there was no statistical difference between groups. Conclusion: The atelocollagen seems to have a tendency to slow bone remodeling in the early phase of healing period and maintain remodeling capacity until late phase of remodeling. Also, use of atelocollagen increased the bone-to-tissue ratio compared to healing of untreated extraction socket.

회전형 타이타늄 브러쉬를 이용한 임플란트 주위염 재생술식: 2년 추적결과 증례 보고 (Regenerative procedure using rotary titanium brush for surface decontamination of peri-implantitis: 3 cases with a 2-year follow-up)

  • 백민우;유정아;최성호;이동운
    • 구강회복응용과학지
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    • 제37권4호
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    • pp.259-267
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    • 2021
  • 본 증례보고에서는 임플란트 주위염으로 진단된 임플란트의 오염된 표면을 회전형 타이타늄 브러쉬로 처리후 재생적 처치를 시도한 3가지 증례에 대한 임상적 및 방사선학적 평가를 목적으로 하였다. 2년간 추적결과에서 3가지 증례의 평균변형치태지수가 1.12에서 0.19로, 변형열구출혈지수가 1.38에서 0.25로, 치주낭 깊이가 8.73 mm에서 3 mm로, 임플란트 상부와 골이 처음 접하는 부위까지의 거리값이 6.35 mm에서 2.3 mm로 감소하는 개선을 보였으며, 기존의 보철물로 유지할 수 있었다. 향후 장기적인 추적을 통해 본 술식의 효과를 뒷받침할 수 있는 근거를 마련할 것이 필요할 것이다.

The effects of hard and soft tissue grafting and individualization of healing abutments at immediate implants: an experimental study in dogs

  • Thoma, Daniel S.;Jung, Ui-Won;Gil, Alfonso;Kim, Myong Ji;Paeng, Kyeong-Won;Jung, Ronald E.;Fickl, Stefan
    • Journal of Periodontal and Implant Science
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    • 제49권3호
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    • pp.171-184
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    • 2019
  • Purpose: To evaluate the effects of intra-alveolar socket grafting, subepithelial connective tissue grafts, and individualized abutments on peri-implant hard and soft tissue outcomes following immediate implant placement. Methods: This randomized experimental study employed 5 mongrel dogs, with 4 sites per dog (total of 20 sites). The mesial roots of P3 and P4 were extracted in each hemimandible and immediate dental implants were placed. Each site was randomly assigned to 1 of 4 different treatment groups: standardized healing abutment (control group), alloplastic bone substitute material (BSS) + standardized healing abutment (SA group), BSS + individualized healing abutment (IA group), and BSS + individualized healing abutment + a subepithelial connective tissue graft (IAG group). Clinical, histological, and profilometric analyses were performed. The intergroup differences were calculated using the Bonferroni test, setting statistical significance at P<0.05. Results: Clinically, the control and SA groups demonstrated a coronal shift in the buccal height of the mucosa ($0.88{\pm}0.48mm$ and $0.37{\pm}1.1mm$, respectively). The IA and IAG groups exhibited an apical shift of the mucosa ($-0.7{\pm}1.15mm$ and $-1.1{\pm}0.96mm$, respectively). Histologically, the SA and control groups demonstrated marginal mucosa heights of $4.1{\pm}0.28mm$ and $4.0{\pm}0.53mm$ relative to the implant shoulder, respectively. The IA and IAG groups, in contrast, only showed a height of 2.6mm. In addition, the height of the mucosa in relation to the most coronal buccal bone crest or bone substitute particles was not significantly different among the groups. Volumetrically, the IA group ($-0.73{\pm}0.46mm$) lost less volume on the buccal side than the control ($-0.93{\pm}0.44mm$), SA ($-0.97{\pm}0.73mm$), and IAG ($-0.88{\pm}0.45mm$) groups. Conclusions: The control group demonstrated the most favorable change of height of the margo mucosae and the largest dimensions of the peri-implant soft tissues. However, the addition of a bone substitute material and an individualized healing abutment resulted in slightly better preservation of the peri-implant soft tissue contour.

Bone Nodule Formation of MG63 Cells is Increased by the Interplay of Signaling Pathways Cultured on Vitamin $D_3$-Entrapped Calcium Phosphate Films

  • Choi, Yong-Seok;Hong, Yoon-Jung;Hur, Jung;Kim, Mee-Young;Jung, Jae-Young;Lee, Woo-Kul;Jeong, Sun-Joo
    • Animal cells and systems
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    • 제13권4호
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    • pp.363-370
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    • 2009
  • Since vitamin $D_3$ is an important regulator of osteoblastic differentiation, a presently-established vitamin $D_3$-entrapped calcium phosphate film (VCPF) was evaluated for hard tissue engineering. The entrapped vitamin $D_3$ more rapidly induced bone nodule formation. To characterize the cellular events leading to regulations including faster differentiation, signal transduction pathways were investigated in osteoblastic MG63 cells at a molecular level. Major signaling pathways for MG63 cell proliferation including phosphatidylinositol-3-kinase, extracellular signal-regulated kinase, c-Jun N-terminal kinase and focal adhesion kinase pathways were markedly down-regulated when cells were cultured on calcium phosphate film (CPF) and VCPF. This agreed with our earlier observations of the immediate delay in proliferation of MG63 cells upon culture on CPF and VCPF. On the other hand, the p38 mitogen-activated protein kinase (p38 MAPK) and protein kinase A (PKA) pathways were significantly up-regulated on both CPF and VCPF. CPF alone could simulate differential behaviors of MG63 cells even in the absence of osteogenic stimulation and entrapment of vitamin $D_3$ within CPF further amplified the signal pathways, resulting in continued promotion of MG63 cell differentiation. Interplay of p38 MAPK and PKA signaling pathways likely is a significant event for the promotion of differentiation and mineralization of MG63 cells.

치과용 임플란트 적용을 위한 항균력을 가진 티타늄 표면의 평가 (An Evaluation of Antibacterial Titanium Surface For Dental Implant)

  • 강민경;문승균;김경남
    • 치위생과학회지
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    • 제11권5호
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    • pp.405-410
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    • 2011
  • 본 연구의 목적은 표면 거칠기를 증가시키기 위하여 알루미나와 하이드록시아파타이트를 이용하여 각각 블라스팅 처리한 뒤 염화나트륨을 전해액 내에 섞어 양극산화 방법을 이용하여 염소가 함유된 표면을 만들고 항균력을 평가하는데 있다. 그리고 표면 특성과 항균력을 평가하여 다음과 같은 결과를 얻었다. 1. SEM 표면 관찰에서는 블라스팅 처리 후 양극산화한 결과 실험군 2와 3에서 연마처리한 실험군 1에 비해 거친 요철구조를 관찰할 수 있었다. 2. EDS 조성분석 결과 실험군 2에서는 칼슘, 인, 염소 성분과 더불어 알루미늄이 관찰된 반면, 실험군 3에서는 칼슘, 인과 염소 성분만을 관찰할 수 있었다. 3. 표면 거칠기 분석 결과 평균 표면 거칠기의 값이 실험군 2, 실험군 3, 실험군 1순으로 작았으며, 실험군 2와 3 간에는 유의한 차이가 없었다(p>0.05). 4. 항균력 평가 결과 실험군 2가 가장 적은 세균수를 보여 우수한 항균력을 보였으나 이는 실험군 3과 유의한 차이가 없었다(p>0.05). 알루미나와 하이드록시아파타이트를 이용하여 각각 블라스팅 처리한 뒤 염화나트륨을 전해액 내에 섞어 양극산화 방법을 이용하여 염소가 함유된 표면을 만들 수 있었으며, 그 결과 연마처리한 시편에 비해 높은 표면 거칠기와 우수한 항균력을 보였다. 그러나 그 재료의 효과와 안정성을 입증하기 위해서는 추가적인 in vitro와 in vivo 실험이 수행되어야겠다.

치아발생 과정 중에 Ki-67, 싸이클린 A, 싸이클린 D1의 발현양상 (Expression Patterns of Ki-67, Cyclin A, and Cyclin D1 during Tooth Development)

  • 권혁제;윤경식;정한성
    • 해부∙생물인류학
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    • 제26권1호
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    • pp.41-49
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    • 2013
  • 치아발생 및 형태형성 과정에서 치아상피와 치아간엽을 구성하는 세포는 동적인 세포주기의 변화가 일어난다. 현재까지 세포증식은 치아발생에 중요한 현상으로 알려져 있지만, 치아발생 중에 일어나는 복잡한 분자적 기전과 연관해서 세포주기의 각 시기가 어떻게 관여하는지에 대해서는 충분한 연구가 이루어지지 않았다. 그러므로 본 연구는 치아발생 기전과 세포주기의 시기의 변화와의 관계를 밝히고자 하였다. 치아발생 과정에서 일어나는 형태변화를 확인하기 위해 싹시기, 모자시기, 종시기의 쥐 앞니 및 어금니 치배를 헤마톡실린-에오신으로 염색하여 조직학적으로 관찰하였다. 또한 세포주기 시기의 표지자인 Ki-67, 싸이클린 A, 싸이클린 D1의 발현양상을 관찰하기 위해 면역조직화학염색을 시행하였다. 싹시기, 모자시기, 종시기에서 증식하는 세포들은 Ki-67과 싸이클린 A를 발현하는 것을 확인하였다. 싸이클린 D1은 앞니의 상아질모세포 및 모자시기의 사기질결절에서 특이적인 발현을 보였으며, 이곳에서는 Ki-67이나 싸이클린 A가 발현되지 않는다는 것을 발견하였다. 본 연구는 치아발생 중 각 주요 시기에서 세포주기의 변화를 관찰하였으며, 이는 치아발생에 관여하는 기전에 대한 중요한 정보를 제공한다. 또한 본 연구의 결과는 지금까지의 앞니의 사기질모세포 및 사기질결절의 특성에 대한 지식을 이해하는 데에 중요한 자료가 될 것으로 사료된다.

Advanced peri-implantitis cases with radical surgical treatment

  • McCrea, Shane J.J.
    • Journal of Periodontal and Implant Science
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    • 제44권1호
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    • pp.39-47
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    • 2014
  • Purpose: Peri-implantitis, a clinical term describing the inflammatory process that affects the soft and hard tissues around an osseointegrated implant, may lead to peri-implant pocket formation and loss of supporting bone. However, this imprecise definition has resulted in a wide variation of the reported prevalence; ${\geq}10%$ of implants and 20% of patients over a 5- to 10-year period after implantation has been reported. The individual reporting of bone loss, bleeding on probing, pocket probing depth and inconsistent recording of results has led to this variation in the prevalence. Thus, a specific definition of peri-implantitis is needed. This paper describes the vast variation existing in the definition of peri-implantitis and suggests a logical way to record the degree and prevalence of the condition. The evaluation of bone loss must be made within the concept of natural physiological bony remodelling according to the initial peri-implant hard and soft tissue damage and actual definitive load of the implant. Therefore, the reason for bone loss must be determined as either a result of the individual osseous remodelling process or a response to infection. Methods: The most current Papers and Consensus of Opinion describing peri-implantitis are presented to illustrate the dilemma that periodontologists and implant surgeons are faced with when diagnosing the degree of the disease process and the necessary treatment regime that will be required. Results: The treatment of peri-implantitis should be determined by its severity. A case of advanced peri-implantitis is at risk of extreme implant exposure that results in a loss of soft tissue morphology and keratinized gingival tissue. Conclusions: Loss of bone at the implant surface may lead to loss of bone at any adjacent natural teeth or implants. Thus, if early detection of peri-implantitis has not occurred and the disease process progresses to advanced peri-implantitis, the compromised hard and soft tissues will require extensive, skill-sensitive regenerative procedures, including implantotomy, established periodontal regenerative techniques and alternative osteotomy sites.

Cone-beam computed tomographic evaluation of dimensional hard tissue changes following alveolar ridge preservation techniques of different bone substitutes: a systematic review and meta-analysis

  • Pickert, Finn Niclas;Spalthoff, Simon;Gellrich, Nils-Claudius;Tarraga, Juan Antonio Blaya
    • Journal of Periodontal and Implant Science
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    • 제52권1호
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    • pp.3-27
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    • 2022
  • Purpose: This study was conducted to evaluate and compare the effects of different graft materials used in alveolar ridge preservation on dimensional hard tissue changes of the alveolar ridge, assessed using cone-beam computed tomography (CBCT) scans. Methods: A systematic electronic search of MEDLINE and the Cochrane Central Register of Controlled Trials and a manual search were conducted from November 2019 until January 2020. Randomized controlled trials were included if they assessed at least 1 variable related to vertical or horizontal hard tissue changes measured using CBCT scans. After a qualitative analysis of the included studies, subgroups were formed according to the graft material used, and a quantitative analysis was performed for 5 outcome variables: changes in vertical alveolar bone height at 2 points (midbuccal and midpalatal/midlingual) and changes in horizontal (buccolingual) alveolar bone width at 3 different levels from the initial crest height (1, 3, and 5 mm). Results: The search resulted in 1,582 studies, and after an independent 3-stage screening, 16 studies were selected for qualitative analysis and 9 for quantitative analysis. The metaanalysis showed a significantly (P<0.05) lower reduction of alveolar ridge dimensions for the xenogenic subgroup than in the allogenic subgroup, both vertically at the midbuccal aspect (weighted mean difference [WMD]=-0.20; standard error [SE]=0.26 vs. WMD=-0.90; SE=0.22) as well as horizontally at 1 mm (WMD=-1.32; SE=0.07 vs. WMD=-2.99; SE=0.96) and 3 mm (WMD=-0.78; SE=0.11 vs. WMD=-1.63; SE=0.40) from the initial crest height. No statistical analysis could be performed for the autogenic subgroup because it was not reported in sufficient numbers. Conclusions: Less vertical and horizontal bone reduction was observed when xenogenic graft materials were used than when allogenic graft materials were used; however, the loss of alveolar ridge dimensions could not be completely prevented by any graft material.

임상가를 위한 특집 3 - Peri-implantitis의 regeneration therapy 증례 보고 (Use of Bovine-derived bone mineral (Bio-Oss Collagen$^{(R)}$) in surgical treatment of peri-implantitis: A case report)

  • 조영재
    • 대한치과의사협회지
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    • 제51권12호
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    • pp.650-657
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    • 2013
  • The aim of this study was to achieve healing of Peri-implantitis defects and hard tissue augmentation using a bovine-derived bone mineral on the defect site. Two patients were treated with the surgical approach. With a full muco-periosteal flap elevation, the implant surfaces were exposed and granulation tissue removed around the implant and between the threads. Each surface of the contaminated implant was prepared with the air-abrasive device(PerioFlow$^{(R)}$) for decontamination. Bovine-derived bone mineral(Bio-Oss collagen$^{(R)}$) was then used to fill the defects and muco-periosteal flaps sutured to achieve transmucosal healing. Radiographs and clinical photographs were taken before and after 6 months of healing and an estimate of bone fill was assessed. Within the limits of the present case report, a surgical approach in treatment of peri-implantitis defects using a collagen form of bovine bone mineral was visited. Although limited, the two cases showed the stability and biocompatibility of a bovine-derived bone mineral and effectiveness of air-abrasive device(PerioFlow$^{(R)}$) as a decontamination method.

홍화자 추출물과 키토산 병용처리에 의한 경조직 재생촉진 효과 (Therapeutic Effects of Safflower Seed Extract and Chitosan on Hard Tissue Regeneration)

  • 정세영;박준봉;권영혁;김성진;박건구
    • Biomolecules & Therapeutics
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    • 제9권4호
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    • pp.244-248
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    • 2001
  • This study was performed to investigate therapeutic effects of Carthami Semen, Paeoniae Raidx extracts and chitosan on the growth and differentiation of human periodontal ligament cell. We found that co-treatment of methanol extracts of Carthami Semen and chitosan significantly increased the growth of human periodontal ligament cell. However, the sigle treatment groups of the extracts showed only 20-30% of the growth increase. Alkaline phosphase activity, one of differentiation markers, was increased approximately 1.5- fold by co-treatment of methanol extract of Carthami Semen and chitosan and calcified nodule formation was also increased at the similar levels as the alkaline phosphatase. But the single treatment groups showed only 20-30% increases. These results suggest that Carthami Semen and chitosan co-treatment can be used efficiently for periodontium regeneration.

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