• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.485-493
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• 2007

Introduction: Although several types of calcium-phosphate coumpound have been frequently applied to osseous defects at maxillofacial area for many years, there is a controversy about its efficiency on bone conductivity comprared to xenograft bone substitute. Alloplastic carbonapatite has been introduced to improve disadvantages of hydroxyapatite and to mimic natural bone containing carbon elements. However, a preclinical study about its efficiency of osteoconductivity has not been reported. This study was performed to evaluate the early osteoconductive potential of synthetic carbonapatite with multiple pores relative to anorganic bovine xenograft. Materials and methods: Total 5 beagle dogs were used for maxillary augmentation model. The control (anorganic bovine xenograft) and experimental groups (synthetic carbonapatite) were randomly distributed in the mouth split design. After bone graft, all animals were sacrificed 4 weeks after surgery. Histological specimens with Masson Trichrome staining were made and histomorphometrically analysed with image analyser. The statistical analysis was performed using paired t-test. Results: In both groups, all animals had no complications. The experimental group showed relatively much new bone formation around and along the bone substitutes, whereas it was clearly reduced in the control group. The ratios of new bone area to total area, to material area and to the residual area excluding materials were higher in the experimental group ($0.13{\pm}0.03,\;0.40{\pm}0.13,\;0.20{\pm}0.06$ respectively) than in the control group ($0.01{\pm}0.01,\;0.03{\pm}0.02,\;0.03{\pm}0.03$, respectively). And the differences between both groups were statistically significant (p<0.001, <0.01, <0.01, respectively), while the ratio of material area to total area in two groups was not significant. Conclusion: Carbonapatite showed a high osteoconductivity in the early stage of bone healing compared to bovine derived anorganic bone substitute. This study suggests that this bone materials can be applied as a reliable bone substitute in the clinical treatment.

• Journal of Periodontal and Implant Science
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• v.47 no.6
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• pp.388-401
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• 2017

Purpose: The physicochemical properties of a xenograft are very important because they strongly influence the bone regeneration capabilities of the graft material. Even though porcine xenografts have many advantages, only a few porcine xenografts are commercially available, and most of their physicochemical characteristics have yet to be reported. Thus, in this work we aimed to investigate the physicochemical characteristics of a porcine bone grafting material and compare them with those of 2 commercially available bovine xenografts to assess the potential of xenogenic porcine bone graft materials for dental applications. Methods: We used various characterization techniques, such as scanning electron microscopy, the Brunauer-Emmett-Teller adsorption method, atomic force microscopy, Fourier-transform infrared spectroscopy, X-ray diffraction, and others, to compare the physicochemical properties of xenografts of different origins. Results: The porcine bone grafting material had relatively high porosity (78.4%) and a large average specific surface area (SSA; $69.9m^2/g$), with high surface roughness (10-point average roughness, $4.47{\mu}m$) and sub-100-nm hydroxyapatite crystals on the surface. Moreover, this material presented a significant fraction of sub-100-nm pores, with negligible amounts of residual organic substances. Apart from some minor differences, the overall characteristics of the porcine bone grafting material were very similar to those of one of the bovine bone grafting material. However, many of these morphostructural properties were significantly different from the other bovine bone grafting material, which exhibited relatively smooth surface morphology with a porosity of 62.0% and an average SSA of $0.5m^2/g$. Conclusions: Considering that both bovine bone grafting materials have been successfully used in oral surgery applications in the last few decades, this work shows that the porcinederived grafting material possesses most of the key physiochemical characteristics required for its application as a highly efficient xenograft material for bone replacement.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.16.1-16.9
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• 2016

Background: The association of biomaterial combined with repair factor-like platelet-rich plasma (PRP) has prospective values. Bovine-derived xenograft has been identified as an osteoconductive and biocompatible grafting material that provides osseointegration ability. PRP has become a valuable adjunctive agent to promote healing in a lot of dental and oral surgery procedures. However, there are controversies with respect to the regenerative capacity of PRP and the real benefits of its use in bone grafts. The purpose of this study was to assess the influence of PRP combined with xenograft for the repair of peri-implant bone defects. Methods: Twelve rabbits were used in this study, and the experimental surgery with implant installation was performed simultaneously. Autologous PRP was prepared before the surgical procedure. An intrabony defect (7.0 mm in diameter and 3.0 mm deep) was created in the tibia of each rabbit; then, 24 titanium dental implants (3.0 mm in diameter and 8.5 mm long) were inserted into these osteotomy sites. Thus, a standardized gap (4.0 mm) was established between the surrounding bony walls and the implant surface. The gaps were treated with either xenograft alone (control group) or xenograft combined with PRP (experimental group). After healing for 1, 2, 3, 4, 5, and 6 weeks, the rabbits were sacrificed with an overdose of KCl solution. Two rabbits were killed at each time, and the samples including dental implants and surrounding bone were collected and processed for histological analysis. Results: More newly formed bone and a better bone healing process were observed in control group. The histomorphometric analysis revealed that the mean percentage of bone-to-implant contact in the control group was significantly higher than that of the experimental group (25.23 vs. 8.16 %; P < 0.05, independent-simple t test, analysis of variance [ANOVA]). Conclusions: The results indicate that in the addition of PRP to bovine-derived xenograft in the repair of bone defects around the implant, PRP may delay peri-implant bone healing.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.3
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• pp.230-237
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• 2017

Regenerative therapy in an interproximal intrabony defect is a challenge due to unaesthetic appearance after surgery. In this article, we introduce a case series of additional use of autogenous periosteal barrier membrane combined with bovine bone mineral and enamel matrix derivative (EMD) in interproximal periodontal intrabony defects to overcome an aforementioned shortcoming. During the periodontal regenerative surgery, autogenous periosteal membrane was additionally adopted besides xenograft material and EMD. Clinical and radiographic examinations were performed before surgery and 6 months after surgical treatment. All clinical parameters were improved and the intrabony defects were resolved on the radiography 6 months after surgery. Moreover, soft tissue esthetics such as the contour of interdental papilla was better than that of conventional regenerative therapy. Periodontal regenerative therapy using several graft materials and bioactive materials was effective in the treatment of periodontal intrabony defect. Moreover, using of autogenous periosteal barrier membrane combined with xenograft and EMD has additional effect for the treatment of an interproximal intrabony defect in terms of augmentation of interdental soft tissue volume.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.3
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• pp.225-228
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• 2011

This study evaluated the mineral crystalline structure of an autogenous tooth bone graft material. The crystalline structures of the autogenous tooth bone graft material enamel (AutoBT E+), dentin (AutoBT D+), xenograft (BioOss), alloplastic material (MBCP), allograft (ICB) and autogenous mandibular cortical bone were compared using XRD. The XRD pattern of AutoBT dentin and ICB was similar to that of autogenous bone.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.2
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• pp.51-67
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• 2019

As dental implant surgery and bone grafts were widely operated in Korean dentist, many bone substitutes are commercially available, currently. For commercially used in Korea, all bone substitutes are firstly evaluated by the Ministry of Health and Welfare (MOHW) for safety and efficacy of the product. After being priced, classified, and registration by the Health Insurance Review and Assessment Service (HIRA), the post-application management is obligatory for the manufacturer (or representative importer) to receive a certificate of Good Manufacturing Practice by Ministry of Food and Drug Safety. Currently, bone substitutes are broadly classified into C group (bone union and fracture fixation), T group (human tissue), L group (general and dental material) and non-insurance material group in MOHW notification No. 2018-248. Among them, bone substitutes classified as dental materials (L7) are divided as xenograft and alloplastic bone graft. The purpose of this paper is to analyze alloplastic bone substitutes of 37 products in MOHW notification No. 2018-248 and to evaluate the reference level based on the ISI Web of Knowledge, PubMed, EMBASE (1980-2019), Cochrane Database, and Google Scholar using the criteria of registered or trademarked product name.

• Journal of Periodontal and Implant Science
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• v.51 no.3
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• pp.179-188
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• 2021

Purpose: Due to the difficulty of the hygienic care and sanitary management of abutment teeth and subpontic areas associated with fixed dental prostheses (FDPs), intrabony defects occur and accelerate due to the accumulation of plaque and calculus. This study aimed to evaluate the efficacy of regenerative periodontal surgery for intrabony defects associated with FDPs. Methods: The study inclusion criteria were met by 60 patients who underwent regenerative treatment between 2016 and 2018, involving a total of 82 intrabony defects associated with FDPs. Periodontal osseous lesions were classified as 1-, 2-, and 3-wall intrabony defects and were treated with an enamel matrix derivative in combination with bone graft material. The changes in clinical (pocket probing depth [PPD] and clinical attachment level [CAL]) and radiographic (defect depth and width) outcomes were measured at baseline and at 6, 12, and 24 months. Results: Six months after regenerative treatment, a significant reduction was observed in the PPD of 1-wall (P<0.001), 2-wall (P<0.001), and 3-wall (P<0.001) defects, as well as a significant reduction in the CAL of 2-wall (P<0.001) and 3-wall (P<0.001) intrabony defects. However, there was a significant increase in the CAL of 1-wall intrabony defects (P=0.003). Radiographically, a significant reduction in the depth of the 3-wall (P<0.001) defects and a significant reduction in the width of 2-wall (P=0.008) and 3-wall (P<0.001) defects were observed. The depth decreased in 1-wall defects; however, this change was not statistically significant (P=0.066). Conclusions: Within the limitations of the current study, regenerative treatment of 2- and 3-wall intrabony defects associated with FDPs improved clinical and radiological outcomes. Additional prospective studies are necessary to confirm our findings and to assess long-term outcomes.

• Korean Journal of Microbiology
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• v.52 no.2
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• pp.140-147
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• 2016

A process for manufacturing virally-safe porcine bone hydroxyapatite (HA) has been developed to serve as advanced xenograft material for dental applications. Porcine bone pieces were defatted with successive treatments of 30% hydrogen peroxide and 80% ethyl alcohol. The defatted porcine bone pieces were heat-treated in an oxygen atmosphere box furnace at $1,300^{\circ}C$ to remove collagen and organic compounds. The bone pieces were ground with a grinder and then the bone powder was sterilized by gamma irradiation. Morphological characteristics such as SEM (Scanning Electron Microscopy) and TEM (Transmission Electron Microscopy) images of the resulting porcine bone HA (THE Graft$^{(R)}$) were similar to those of a commercial bovine bone HA (Bio-Oss$^{(R)}$). In order to evaluate the efficacy of $1,300^{\circ}C$ heat treatment and gamma irradiation at a dose of 25 kGy for the inactivation of porcine viruses during the manufacture of porcine bone HA, a variety of experimental porcine viruses including transmissible gastroenteritis virus (TGEV), pseudorabies virus (PRV), porcine rotavirus (PRoV), and porcine parvovirus (PPV) were chosen. TGEV, PRV, PRoV, and PPV were completely inactivated to undetectable levels during the $1,300^{\circ}C$ heat treatment. The mean log reduction factors achieved were $${\geq_-}4.65$$ for TGEV, $${\geq_-}5.81$$ for PRV, $${\geq_-}6.28$$ for PRoV, and $${\geq_-}5.21$$ for PPV. Gamma irradiation was also very effective at inactivating the viruses. TGEV, PRV, PRoV, and PPV were completely inactivated to undetectable levels during the gamma irradiation. The mean log reduction factors achieved were $${\geq_-}4.65$$ for TGEV, $${\geq_-}5.87$$ for PRV, $${\geq_-}6.05$$ for PRoV, and $${\geq_-}4.89$$ for PPV. The cumulative log reduction factors achieved using the two different virus inactivation processes were $${\geq_-}9.30$$ for TGEV, $${\geq_-}11.68$$ for PRV, $${\geq_-}12.33$$ for PRoV, and $${\geq_-}10.10$$ for PPV. These results indicate that the manufacturing process for porcine bone HA from porcine-bone material has sufficient virus-reducing capacity to achieve a high margin of virus safety.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.529-536
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• 2010

Purpose: The Purpose of this study is to show the total survival rate of implants with maxillary sinus grafting and the effects that reach the survival rate by classifying types of graft materials, implant type, operation method, residual bone height and evaluate graft material resorption rate after sinus grafting Patients and Methods: 61 dental implants placed with sinus bone grafting in 24 patients at Wonkwang University Sanbon Dental Hospital were installed simultaneously or after regular healing. Various bone grafts (autograft, xenograft, allograft, alloplast) and fourth implant type (GSII, Xive, Implantium, Novel biocare) were used. All implants were investigated clinically and radiographically, being with average 20 months follow-up period after installation. Results: 3 fixtures were lost, resulting in 95.1% cumulative survival rate of 61 osseointegrated dental implant. Survival rate according to bone material type, Implant type, operation method, residual bone height, have no statistically significant differencies. The mean preoperative residual alveolar bone height was 4.75 mm, average postoperative height of graft materials 10.8 mm, vertical bone resorption rate was 10% after 2 years. Resorption rate according to operation method was 7% (simultaneous) and 5% (delayed) after 1 year. Conclusion: It can be suggested that maxillary sinus grafting may have predictable result with various bone graft materials and implant type, residual bone height, operation method

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.6
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• pp.442-450
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• 2009

Purpose: Simultaneous implantation has been traditionally limited to patients with at least 5 mm of residual bone to ensure that the implant is completely stabilized. This is considered to be one of the most critical factors for primary implant stability and parallelism and, subsequently osseointegration. Recently, improved initial implant stability is provided by advancement of surgical techniques, implant designs and surface treatments. This has led surgeons to extending simultaneous treatment option to patients with below 4 mm of residual bone height, despite the lack of much data. The purpose of this study was to retrospectively evaluate and compare the status of implants which are installed by delayed and simultaneous methods. Material and methods: The subjects were patients(121 patients, 278 implants) who had been operated with sinus lifting from 2003 to 2007 in Sun Dental Hospital. Lateral window approach with autograft and xenograft(1:1 ratio) were carried out for all sinus lifting. 4 types of implant were used. The mean follow up period was 26.3 months(19 - 58 months) in delayed group, and 22.8 months(18 - 43 months) in simultaneous group. Results: The survival rate of implant restoration of this study was 98.2% in delayed group and 91.7% in simultaneous group. In simultaneous group, wide-platform type implants showed 100% survival rate. The total average of marginal bone loss in radiographs was $0.96\;{\pm}\;0.29\;mm$ in delayed group and $1.02\;{\pm}\;0.31\;mm$ in simultaneous group. Conclusion: Simultaneous implantation with sinus lifting(below 4mm of residual bone height) could be predictable treatment.