Hydroxyapatite($Ca_10(PO_4)_6(OH)_2$)는 생체친화성이 뛰어나고 인체의 뼈와 성분이 비슷하여 생체이식재료로 많이 사용되고 있다. 한편 HAp는 소결후 낮은 강도 때문에 HAp자체만으로는 생체이식재료로서의 강도를 기대할 수가 없다. 그러나 알루미나는 생리화학적인 환경에서 높은 강도와 매우 안정한 성질을 가지고 있기 때문에 알루미나 위에 HAp를 coating시켜 사용하려는 시도가 있었다. 본 연구는 알루미나와 HAp의 장점만을 이용하고, HAp에 항균성 물질을 첨가하여 항균효과를 나타내도록 하였다. 항균test는 생체재료이식시 가장 많은 감염을 일으키는 bacteria를 사용하여 실시하였다. 먼저 HAp에서 $Ag^+$와 $Ca^{2+}$이 이온교환을 시키기 위하여 20ppm, 100ppm의 $AgNO_3$용액에 48시간동안 처리하고, 이 재료를 사용하여 항균test를 하였다. 항균test에 사용된 bacteria는 gram negative bacteria인 Escherichia coli와 Pseudomonas aeruginosa, gram positive bacteria인 Staphylococcus epidermidis를 사용하였고, 항균test결과는 매우 좋은 것으로 나타났다. $AgNO_3$용액에서 처리한 sample들은 SEM과 XRD를 사용하여 표면구조와 성분을 조사하고, 유사생체용액(Simulated Body Fluid)에서 Ag release curve를 조사하였다.
Titanium and its alloys have been used in the field dental and orthopedic implants because of their excellent mechanical properties and biocompatibility. Despite these attractive properties, their passive films were somewhat bioinert in nature so that sufficient adhesion of bone cells to implant surface was delayed after surgical treatment. Recently, plasma electrolyte oxidation (PEO) of titanium metal has attracted a great deal of attention is a comparatively convenient and effective technique and good adhesion to substrates and it enhances wear and corrosion resistances and produces thick, hard, and strong oxide coatings. Silicon(Si), Zinc(Zn), and Manganese(Mn) have a beneficial effect on bone. Si in particular has been found to be essential for normal bone and cartilage growth and development. And, Zn has been shown to be responsible for variations in body weight, bone length and bone biomechanical properties. Also, Mn influences regulation of bone remodeling because its low content in body is connected with the rise of the concentration of calcium, phosphates and phosphatase out of cells. The objective of this work was research on bone-like apatite morphology on Si-Zn-Mn-hydroxyapatite coating on Ti-6Al-4V alloy by plasma electrolytic oxidation. Anodized alloys were prepared at 280V voltage in the solution containing Si, Zn, and Mn ions. The surface characteristics of PEO treated Ti-6Al-4V alloy were investigated using XRD, FE-SEM, and EDS.
The purpose of this study was to evaluate the effects of Nd:YAG laser treatment on removal of smear layer and exposure of dentinal tubules. The experimental specimens were obtained from root planed surface of 30 human teeth which were extracted due to severe periodontal disease. The specimens were assigned randomly of three groups: root planed group, Tetracycline HCl(100mg/ml, 5min) group, and Nd:YAG laser ($Laser-35^{TM}$, U.S.A. 5 seconds )group. Nd:YAG laser group was divided into 4 subgroups according to 3.0W, 3.5W, 4.0W, 4.5W of power. The surface change of specimens were evaluated by scanning electron microscopy. The number of exposed dentinal tubules and percentage of area occupied by dentinal tubule orifices per unit area between each group was statistically analyzed by paired Student t-test. The results were as follows: 1. By root planing only, dentinal tubule was not exposed, but scale-like smear layer and parallel instrument tracks were resulted. 2. Tetracycline HCl treated surfaces exhibited the small number of partially exposed dentinal tubules with long orifices. The number($3.80{\pm}0.79$) of exposed dentinal tubules on Tetracycline HCl group was significantly less than that in laser groups above 3.5W of power(P<0.001), and the percentage ($0.68{\pm}0.19$) of area occufied by dentinal tubule orifices per unit area($192\;{\mu}m^2$) was significantly lower than that of any laser group(P<0.001). 3. The laser group irradiated with 4.5W of power showed both the most number($10.60{\pm}0.97$) of exposed dentinal tubules among the experimental groups, and the highest percentage($3.75{\pm}0.55\;%$) of area occupied by dentinal tubule orifices. 4. Energy Surge during laser pulsing and overlapping passes of the fiber resulted in melted and resolidified surface textures with lava-like appearance.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제32권4호
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pp.348-351
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2006
Purpose The purpose of this study was to evaluate the success rate of dental implant on post-traumatic region to rehabilitate missing teeth. Patients and Methods 5 patients who had been treated due to maxillofacial trauma during 2000 to 2004 at samsung medical center were selected for this study. 22 dental implants were installed to them for restoring missing teeth. The success rate of these dental implants was evaluated with criteria by T. Albrektsson. We divided installed 22 implants into 2 categories. One category consisted rough surface implants group and smooth surface implants group. And the other category consisted more healing group and less healing group. The healing time was calculated from point of trauma. Results The success rate of dental implants is 68.2% that is lower than other studies because of poor vascularity of bone bed and mechanical stress according to trauma. Rough surface implants group and More healing group showed superior success rate to others. (P < 0.05). Conclusion We found that to increase success rate, it may need rough surface implants and longer healing period.
The barrier membranes for GTR procedure could be affected bY bacterial contamination after exposure to oral environment. This study was done to evaluate whether the tetracycline impregnated barrier membranes could inhibit bacterial attachment and penetration into membranes. The resorbable membrane(polylactic and polyglycolide copolymer, $Resolute^{(R)}$, W.L Gore and Associates, Inc..USA) and the non-resorbable membrane(e-PTFE; Gore-TexTM, W.L. Gore & Associates, Inc.,USA) were cut into 4mm discs and trated with 5% tridodecylmethylammonium chloride solution in ethanol and dried in air. The membranes were immersed in tetracycline(TC) solution (100mg/ml, pH 8.0) and dried. To the maxillary canine-premolar region in six periodontally healthy volunteers, removable acrylic devices were inserted, on which 8 cylindrical chambers were glued with TC impregnated and non-impregnated discs, the membrane discs were examined for bacterial attachment and penetration, and structural changes under SEM and LM. From the 1st day to the 7th day, membranes showed bacterial plaque formation composed of cocci and rods. Thereafter, filamentous bacteria appeared and the plaque thickness increased. The TC impregnated e-PTFE membranes showed less bacterial attachment and delayed in bacterial plaque maturation than non-treated membranes. As for bacterial penetration, the TC impregnated e-PTFE membranes showed superficial invasion and infrequent presence of bacteria in unexposed inner surface at the 4th week. while the non-treated e-PTFE membranes showed deep bacterial invasion at the 2nd week and frequent presence of internal bacteria at the 4th week. The resorbable membranes started to be resorbed at the 2nd week and were perforated at the 4th week, regardless of TC treatment. In conclusion, bacterial plaque formation and penetration was efficiently delayed in TC impregnated e-PTFE membranes, whereas resorbable membranes were similar in bacterial invasion due to membrane degradation and perforation, regardless of TC treatment.
Reports on the comparison of clinical effect between non-surgical and surgical therapy, and the change of the clinical parameters during maintenance phase have been rarely presented in Korea. This study was to observe the clinical changes during maintenance phase of 6 months in patients with chronic periodontitis treated by non-surgical or surgical therapy in Department of Periodontics, Chonnam National University Hospital. Among the systemically healthy and non-smoking patients with moderate to severe chronic periodontitis, twenty eight patients (mean age: 47.5 years) treated by non-surgical therapy (scaling and root planning) and nineteen patients (mean age: 47.3 years) treated by surgical therapy (flap surgery) were included in this study. The periodontal supportive therapy including recall check and oral hygiene reinforcement was started as maintenance phase since 1 month of healing after treatment. Probing depth, gingival recession. clinical attachment level and tooth mobility were recorded at initial, baseline and 1, 2, 3 and 6 month of maintenance phase. The clinical parameters were compared between the non-surgical and surgical therapies using Student t-test and repeated measure ANOVA by initial probing depth and surfaces. Surgical therapy resulted in greater change in clinical parameters than non-surgical therapy. During the maintenance phase of 6 months, the clinical effects after treatment had been changed in different pattern according to initial probing depth and tooth surface. During maintenance phase, probing depth increased more and gingival recession increased less after surgical therapy, compared to non-surgical therapy. The sites of initial probing depth less than 3 mm lost more clinical attachment level, and the sites of initial probing depth more than 7 mm gained clinical attachment level during maintenance phase after non-surgical therapy, compared to surgical therapy. Non-surgical therapy resulted in greater reduction of tooth mobility than surgical therapy during maintenance phase. These results indicate that the clinical effects of non-surgical or surgical therapy may be different and may change during the maintenance phase.
Dani Rotman;Jorge Rojas Lievano;Shawn W. O'Driscoll
Clinics in Shoulder and Elbow
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제26권3호
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pp.287-295
/
2023
Background: Posterolateral rotatory instability (PLRI) is a common mechanism of recurrent elbow instability. While the essential lesion is a deficiency in the lateral ulnar collateral ligament (LUCL), there are often associated concomitant bony lesions, such as an Osborne-Cotterill lesions (posterior capitellar fractures) and marginal radial head fractures, that compromise stability. Currently, there is no standard treatment for posterior capitellar deficiency associated with recurrent PLRI. Methods: We conducted a retrospective review of five patients with recurrent PLRI of the elbow associated with a posterior capitellar impaction fracture engaging with the radial head during normal range of motion. The patients were treated surgically with LUCL reconstruction or repair and off-label reconstruction of the capitellar joint surface using a small metal prosthesis designed for metatarsal head resurfacing (HemiCAP toe classic). Results: Five patients (three adolescent males, two adult females) were treated between 2007 and 2018. At a median follow-up of 5 years, all patients had complete relief of their symptomatic instability. No patients had pain at rest, but two patients had mild pain (visual analog scale 1-3) during physical activity. Three patients rated their elbow as normal, one as almost normal, and one as greatly improved. On short-term radiographic follow-up there were no signs of implant loosening. None of the patients needed reoperation. Conclusions: Recurrent PLRI of the elbow associated with an engaging posterior capitellar lesion can be treated successfully by LUCL reconstruction and repair and filling of the capitellar defect with a metal prosthesis. This treatment option has excellent clinical results in the short-medium term. Level of evidence: IV.
The purpose of this present study was to investigate the effect of autogenous bone with histological evaluation of regenerated bone after sinus elevation. The study involved genaral healthy 6 patients participated in this study and were treated with 2-stage sinus elevation procedures using a combination of demineralized freezed-dried bone allograft (DFDBA) and coralline calcium carbonate with or without autogenous bone. At 6months after sinus elevation, bone specimens were obtained and stained with Hematoxylin-Eosin for light microscopic evaluation. The results of this study were as follows : 1. Autogenous bone grafts present trabecular patterns at 6 months in test groups, consist of woven bone and lamellar bone, but more compact than control groups. 2. Resorption of bone graft particles, osteoblast-like cells, newly formed osteoid tissue were observed at 6 months in test groups, but seems to be more frequently than control groups. 3. New osteoid tissue was formed from the surface of graft materials and gradually expanded around them. 4. The appearance of connective tissue around graft materials was densely formed, but more prominent in test groups than control groups. 5. Bone graft particles were resorbed incompletely and slight inflammatory infiltrate, newly formed capillaries, and adipocytes were observed. From the above results, autogenous bone is effective in bone regeneration after sinus elevation, could provide favorable conditions in implant placement.
The purpose of this study was to evaluate the biocompatibility of the Nd:YAG lased root surface followed by root planing and/or tetracyline-HCI(T.C.-HCI) conditioning. $30,4mm{\times}4mm$ root segments were obtained from unerupted third molars and 21, periodontally involved root segments. The treatment groups were as follows : (1) healthy root cementum surface groups : 1) control(non-treated group), 2) lased only, 3) lased/root planed, and 4) lased/T.C.-HCI. (2) diseased root cementum surface groups : 1) control(root planed only), 2) lased/root planed, and 3) lased/root planed/T.C.-HCI. The specimens were treated with a Nd:YAG laser using a $320{\mu}m$ noncontact optic fiber handpiece with an energy setting of 1.5W($114.6J/cm^2$), 2.0W($152.9J/cm^2$), 5.0W($382J/cm^2$) for one minute. The fiber was held perpendicular to the petri dish(NUNC) 2cm apart in an attempt to expose the entire root segments equally. Human gingival fibroblasts were cultured from explants of normal interdental gingival tissue obtained during third morlar extraction. The attachment assay was performed with third-generation fibroblasts. The numbers of gingival fibroblasts attached to the root surface were counted on each specimen under the light microscope, and were statistically analyzed by the oneway ANOVA followed by Tukey's test in SPSS/PC+programs. The results were as follows : 1) In healthy root cementum surfaces, lased/root planed groups exhibited a significantly increased fibroblast attachment compared to controls, lased only, and lased/T.C.-HCI groups(p<0.05), 2) In diseased root cementum surfaces, laser treatment followed by root planing and/or T.C.HCl groups exhibited a increased tendency of fibroblast attachment compared to root planed only group. The results suggest that laser treatment followed by root planing and/or T.C.-HCl would appear necessary so as to render the root surface biocompatible.
It is known that growth factors function as potent biologic mediators regulating numerous activities of wound healing via cell proliferation, migration and extracellular matrix formation and they also promote periodontal regeneration. But, method of growth factor application is controversial yet. So purpose of this study is to evaluate the effect of demineralized root surface as one of method of growth factor application. The ginigival fibroblasts were primary cultured and fifth or sixth subpassages were used in these experiments. In first experiment, root surface blocks demineralized with 100mg/ml tetracycline for 5 minutes and pH 1 citric acid for 3 minutes(experimental groups) and nonteminerilized root surface blocks (control groups) were placed in 100ng/ml PDGF-BB for 5 minutes. Then the cells were seeded on each root surface blocks and cultured for 6, 24, 48, 72 hours. In second experiment, root surface blocks deminerilized with tetracycline and citric acid and nondemineralized root surface blocks were placed in 200ng/ml PDGF-BB for 5 minutes and another non-demineralized root surfcae blocks were placed in DMEM without PDGF-BB. At 1, 2, 4, 6, 8 days, the cells were seeded in 24-well plate and using of each eluent, cultured for 72 hours. The results of the four determinants were presented as mean and S.D.. The results were as follows : The attachment and proliferation of human gingival fibroblast on root surface were more increased when PDGF-BB was applicated on root surfrace demineralized with tetracycline or citric acid than non-demineralized root surface. And, in comparision tetracycline with citric acid, there were more attachment and proliferation of human gingival fibroblast on root surface demineralized with tetracycline than citric acid, and proliferation of human gingival fibroblast on demineralized root surface was increased time dependently 1 day to 3 days. In second experiment using eluent, proliferation of human gingival fibroblast was more increased to 6 days when human gingival fibroblast was cultured in eluent that PDGF-BB was applicated on demineralized root surface than two control groups, and degree of proliferation was decreased time dependently 1 day to 6 days. Proliferation of human gingival fibroblast cultured in eluent without PDGF-BB was constant 1 day to 6 days. After 6 days, degree of proliferation of human gingival fibroblast was similar in four groups. This means that release duration of PDGF-BB from demineralized root surface is 6 days. And in comparision tetracycline with citric acid, there was more proliferation of human gingival fibroblast in tetracycline-treated group than citric acid. In conclusion, demineralized root surface as primary site for PDGF-BB application, especially demineralized with tetracycline has important roles in attachment and proliferation of human gingival fibroblast, and may be useful clinical applications in periodontal regenerative procedures.
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