A Multicenter Retrospective Study of Outpatient Intravenous Sedation for Dental Treatments

The BMPs expression and histomorphometric study of beta-TCP /rhBMP-2 Grafting on the rabbit cranial bone defects

OBJECTIVE: The Purpose of the study was to investigate the bone morphogenic protein expression of rhBMP-2(recombinant human bone morphogenic protein-2) as singnaling molecule and beta-TCP(Tricalcium phosphate) as a bone substitute and carrier medium of rhBMP-2. MATERIALS AND METHODS: 16 rabbits divided into 2 group of each 8 rabbit. Two standardized bone defect, round bilateral defect was made in the cranium of the 8 rabbit of first group, and was grafted with 150~500micrometer diameter beta-TCP 0.25g in one side, which was soaked with rhBMP-2, and autogenous bone was grafted on another side as a positive control. Second group of 8 rabbit, only beta-TCP was grafted with same size and same manner. After 2, 4, 8, and 12 weeks, specimen was taken for microscopic immunohiostochemical and histomorphometric analysis. RESULT: Grafting beta-TCP with rhBMP show the early formation of the bone regenerative factor (BMP-4) and more quantity of new bone formation than only use of beta-TCP (8,12 week), even show less new bone formation than autogenous bone. CONCLUSION: The experimental study result that beta-TCP graft combination with rhBMP-2 as a delivery system is an effective with osteoinductive capacity and biodegradable properties, so that provide clinical availibility of composite use in reconstruction of bony defect.

The mRNA expression of MMP-1, TIMP-1, TGF-beta1 in gingival keratocytes from gingival hyperplasia induced by cyclosporine A

PURPOSE: Cyclosporine A (CsA) is a versatile immunosuppresive agent used to prevent graft rejection syndrome and treat autoimmune disease. One of the major side effects associated with CsA is the abnormal gingival hyperplasia. The purpose of this study was to investigate the relationship between the mRNA expression of the MMP-1, TIMP-1, and TGF-beta1 and the concentration of CsA in cultured human gingival keratinocytes. MATERIALS AND METHODS: Gingival keratocytes were obtained from gingival tissues of 4 healthy donors. The cultured gingival keratocytes were incubated with increasing concentrations of CsA (0-2000 ng/ml) for 24 hours and the expression of MMP-1, TIMP-1, and TGF-beta1 were determined by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The expressions of MMP-1 and TGF-beta1 were not significantly different according to the concentrations of CsA. The expression of TIMP-1 was significantly increased at the CsA concentration of 500 ng/ml. CONCLUSION: We concluded that the gingival hyperplasia induced by CsA was more related with TIMP-1 than MMP-1 or TGF-beta1 on gingival collagen metabolism in patients treated with CsA.

The effects of beta-TCP/rhBMP-2 on bone formation in osteoblast-like cells induced from bone marrow-derived mesenchymal stem cells

The present study aimed to investigate the osteogenic potentials of differentiated osteoblast-like cells (DOCs) induced from bone marrow-derived mesenchymal stem cells (MSCs) on beta-tricalcium phosphate (beta-TCP) with recombinant human bone morphogenetic protein (rhBMP-2) in vitro. Osteoblast differentiation was induced in confluent cultures by adding 100 nM dexamethasone, 10 mM beta-glycerophosphate, 50 mM L-ascorbic acid. The Alizarin red S staining and reverse transcriptase-polymerase chain reaction (RT-PCR) were perfomed to examine the mRNA expression of alkaline phosphatase (ALP), bone sialoprotein (BSP), osteocalcin (OCN), receptor activator for nuclear factor kappaB ligand (RANKL), runt-related transcription factor 2 (RUNX2), collagen-I (COL-I). There were no significant differences in the osteogenic potentials of DOCs induced from MSCs on beta-TCP(+/-). According to the incubation period, there were significant increasing of Alizadin red S staining in the induction 3 weeks. The mRNA expression of ALP, RUNX2, and RANKL were higher in DOCs/beta-TCP(-) than DOCs/beta-TCP(+). According to rhBMP-2 concentrations, the mRNA expression of BSP was significantly increased in DOCs/beta-TCP(+) compared to that of DOCs/beta-TCP(-) on rhBMP 10 ng/ml. Our study presented the beta-TCP will have the possibility that calcium phosphate directly affect the osteoblastic differentiation of the bone marrowderived MSCs.

The effect of pulsed electromagnetic fields on beta-TCP graft in rabbit cranial bone defect

The purpose of this research was to investigate whether pulsed electromagnetic field (PEMF) stimulation applied to the rabbit cranial defects grafted with beta-tricalcium phosphate (beta-TCP) could affect the new bone formation. With 16 New Zealand white rabbits under the same condition, bilateral calvarial bone defects were formed around the sagittal suture line. The defect on the left side was grafted with beta-TCP, while on the right side was grafted by harvested autogenous bone. PEMF was applied to 8 rabbits for 8 hours per day. The bony specimen were divided into 3 groups, the group 1 was autogenous bone grafted specimen, the group 2 was beta-TCP grafted with PEMF, and the group 3 was beta-TCP grafted without PEMF. We investigated the bone regeneration and growth factor expression at 2, 4, 6, and 8 weeks. As a result, BMP 2 was expressed in the group 1 from 2 weeks, the group 2 from 4 weeks, and the group 3 from 6 weeks. BMP 4 was expressed in the group 1 from 2 weeks, in the group 2 and the group 3 from 4 weeks. 4. There was no significant difference in expression pattern of BMP 7, PDGF, VEGF, and TGF-beta1 during grafted bone regeneration in group 1, 2, and 3. According to our results, PEMF stimulation could be effective on the new bome formation in animal study, and have a feasibility of clinical use.

The experimental study of the bone regeneration on rabbit maxillary sinus grafting with beta-TCP

PURPOSE:Maxillay sinus grafting is an effective treatment procedure to improve bone height in the posterior maxillar area for implant installation. Beta-tricalciumphosphate(beta-TCP) was introduced to be grafting substitute material, providing a reasonable bio-degradation time, no need for harvesting procedure. The purpose of this study is to evaluate bone healing and regeneration phase using histomorphometric and immunohistochemical analysis. MATERIAL AND METHODS:Sixteen rabbits were divided into 4 groups. Bi-lateral maxillary sinus membranes were elevated at each rabbits, beta-TCP was augmented in left sinus, autogenous bone was augmented in right sinus. The rabbits were sacrificed at 2, 4, 8 and 12 weeks. We investigated the bone regeneration and growth factor expression. RESULTS: 1. The mean new bone volume formation was 28.99+/-6.55%, 49.54+/-5.47%, 69.09+/-8.90% in autogenous grafted area, and 22.86+/-5.56%, 24.00+/-4.09%, 34.11+/-3.37% in beta-TCP area at 4, 8, 12 weeks. Therefore, new bone formation in autogenous bone was significantly higher than beta-TCP (p<0.05). 2. The BMP 2/4 expression in autogenous bone grafted area was higher at 4, 8 weeks. 3. There was no difference in expression pattern of BMP-7/PDGF/VEGF during grafted bone regeneration. CONCLUSION:The authors we conclude that the autogenous bone graft was faster than beta-TCP in bone regeneration, and the BMP 2/4 were more important in graft bone regeneration.

The experimental study of the bone regeneration on rabbit maxillary sinus grafting with beta-TCP

PURPOSE:Maxillay sinus grafting is an effective treatment procedure to improve bone height in the posterior maxillar area for implant installation. Beta-tricalciumphosphate(beta-TCP) was introduced to be grafting substitute material, providing a reasonable bio-degradation time, no need for harvesting procedure. The purpose of this study is to evaluate bone healing and regeneration phase using histomorphometric and immunohistochemical analysis. MATERIAL AND METHODS:Sixteen rabbits were divided into 4 groups. Bi-lateral maxillary sinus membranes were elevated at each rabbits, beta-TCP was augmented in left sinus, autogenous bone was augmented in right sinus. The rabbits were sacrificed at 2, 4, 8 and 12 weeks. We investigated the bone regeneration and growth factor expression. RESULTS: 1. The mean new bone volume formation was 28.99+/-6.55%, 49.54+/-5.47%, 69.09+/-8.90% in autogenous grafted area, and 22.86+/-5.56%, 24.00+/-4.09%, 34.11+/-3.37% in beta-TCP area at 4, 8, 12 weeks. Therefore, new bone formation in autogenous bone was significantly higher than beta-TCP (p<0.05). 2. The BMP 2/4 expression in autogenous bone grafted area was higher at 4, 8 weeks. 3. There was no difference in expression pattern of BMP-7/PDGF/VEGF during grafted bone regeneration. CONCLUSION:The authors we conclude that the autogenous bone graft was faster than beta-TCP in bone regeneration, and the BMP 2/4 were more important in graft bone regeneration.

The effect of prp on the bone regeneration of beta-tcp grafted in rabbit cranial bone defect

The growth factors expression of cyclosporine induced gingival overgrowth

The study of efficiency of corticotomy in treatment of bimaxillary protrusion

Sinus augmentation with beta-TCP

Sinus floor augmentation has been proven an effective treatment procedure to increase bone volume in the posterior edentulous maxilla. Autogenous bone considered to be the best material for reconstructive bone surgery and has been successfully used as a graft material to augment posterior maxilla. However, the collection of autogenous bone required extra risks for morbidity and complaints. So, various bone graft materials included beta-tricalcium phosphate(beta-TCP) has been introduced for replacing the autogenous bone. The objective of this clinical study was to determine the predictability of endosseous implant placed in a maxillary sinus with beta-TCP grafting. We performed sinus elevation with beta-TCP to install the implant in the 10 maxillary cases. The prosthetic procedure was performed 6-9 months after. The implant-prosthetics was checked about 1 year. We checked the implant and measured the maximum bite force to evaluate the function of the implant. There was not observed the specific problem and complication in dental implant and maxillary sinus in the grafted materials. The maximum bite force was 558N in case of natural tooth, 365N in implant without grafting, 318N in implant with beta-TCP grafting. There was no significant difference between with and without sinus grafting on maximum bite force(P>0.05). As though the long term check-up is needed, the grafting of beta-TCP as a osteoconductive materials can expand the volume and induce dense new bone formation in maxillary sinus. So, this short-term results support that beta-TCP can be a suitable material for sinus augmentation.

The experimental study of the bone regeneration on beta-TCP in rabbit cranial bone

Pure-phase beta-tricalcium phosphate(beta-TCP) proved to be a bone regeneration material, providing the patient with vital bone at the defect site in a reasonable time, making a second surgical procedure for bone harvesting unnecessary. This study compares bone healing and BMP 2/4 expression in cranial defects in rabbits grafted with autogenous bone and beta-TCP. Thirty New Zealand White rabbits was divided into 3 group of 10 animals each. Bilateral calvarial defects were made in the parietal bones of each animal. beta-TCP placed in one defect and the other defects was filled with autogenous bone. The animal were sacrificed at 4, 8 and 12 weeks. Immunohistochemical analysis was used to investigate the expression of BMP 2/4. 1. The new bone formation around autogenous bone from 4 weeks and beta-TCP from 8 weeks. 2. In autogenous bone graft, BMP 2/4 expression was decreased from 4 to 12 weeks. 3. In beta-TCP graft, BMP 4 expression was increased from 8 to 12 weeks. But, BMP 2 was observed from 12 weeks. This study showed that bone healing, regeneration and, BMP 2/4 expression are delayed in grafted beta-TCP than autogenous bone.

The cephalometric study of korean mandibular angle

The contour of mandibular angle is important for facial esthetics in the oriental population, because the wide and square face is thought to have had an unhappy life. A prominent mandibular angle produces a characteristics quardrangle, coase, and muscular appearance. So, uni- or bi-lateral mandibular angle reduction is usually performed. However, there is little guideline for bi-lateral angle reduction. So, this study was to investigate the pattern of Korean mandibular angle for bi-lateral mandibular angle reduction as guideline. This study was included 66 adult men and women over 19 years old who are having the normal mandibular angle. We measured the posterior border, angle, and inferior border of mandible using cephalometric view. The results of study was as followed : 1. The ratio of posterior mandible was 96.6, 97.3% in male, and 103.0, 106.0% in female. 2. The ratio of mandibular angle(R1-Go/R1-R2) was 120.2% in male, and 117.3% in female. 3. The ratio of inferior mandible(D5, 6, 7, E, F, G/D4) was 97. 3, 90.9, 79.5, 65.2, 57.8, 46.9% in male, and 98.5, 91.2, 80.5, 67.6, 59.1, 50.2 % in female. The results of this study should be useful to decide accurate amount of reduction.

The efficiency of SAS used retraction of the anterior teeth on orthodontic treatment

The retraction of anterior teeth could be performed more easier by inducing of skeletal anchorage system rather than by conventional method on orthodontic treatment. But, we wonder how effective the system draws well without anchorage loss and draws anterior teeth aside posteriorly, and if the system can reduce the time, in comparison with the anchorage of posterior teeth. For that reason we have studied on the subject of patients, who were required the maximum anchorage on orthodontic treatment and the cases without crowding. The subjects of the experimental group are 35 areas of 20 people who were inserted miniscrews after Mx or Mn 1st premolar extracted. Also, the subjects of the control group are 81 areas of 45 people who were not inserted miniscrews. Compared the anchorage loss of experimental group with control one, we could get the result that the anchorage loss of experimental group is 1.034+/-0.891mm and control group is 2.790+/-1.882mm(P<0.01). Compared the space closing time of experimental group with control one, we could get the result that the space closing time of experimental group is 369.40+/-110.81days and control group is 406.56+/-231.63days. But the result of comparing space closing time has no significance in statistics. We recognized that the experimental group is more faster than the control group in the canine retraction velocity from the result ; the speed of a experimental group has as much as 0.60+/-0.23mm/30days while the speed of a control group has 0.44+/-0.35mm/30days(P<0.05). So, we could convince that orthodontic miniscrew is used effectively in the cases required the maximum anchorage.

Gingival overgrowth induced by immunosuppressant: case report

A Study Of Position And Size Of Cranial Base, Maxilla, And Mandible In True Skeletal Class Iii Patients

The facial patterns were expressed by the interrelation of variable factors such as heredity, function and environment. Such variable factors have an effect on the growth and development of maxillofacial bones. The malocclusions with skeletal discrepancies are caused by abnormal forms, sizes and positions of cranial base, maxilla and mandible. For the proper diagnosis and treatment planning, the analysis of such structures is necessary. Lateral cephalograms of 54 adults with class III malocclusion patients (test group) and 61 adults with normal occlusion (control group) were analyzed. Anteroposterior relations and sizes of cranial base, maxilla, mandible were estimated to compare with those of normal ones. In test group, the anterior cranial base length was within normal range, but posterior cranial base, maxilla and mandibular body were longer than those in control group, significantly. Based on the cranial base, the location of maxilla in test group was normal, but the location of mandible was more anterior than that in control. Based on the maxilla, the location of mandible was more anterior in test group than that in control. Both mandibular body and ramus anteroposterior lengths in test group were larger than those in control. Both mandibular plane angle and upper gonial angle were within normal range, but lower gonial angle was significantly high in test group.

A Study Of Effect Of Pulsed Electromagnetic Fields On Osteogenesis In Rabbit Cranial Bone Defect

Pulsed electromagnetic field (PEMF) was used first to induce osteogenesis in 1974. The appliance which was consisted of the Helmholtz coil configuration have used to osteogensis. The objective of this study was to determine whether PEMF, a frequency of 100 Hz and magnetic field strength of 38 gauss applied to the calvarial defect in rabbit, could affect the induction of osteogenesis and the healing of the graft bone. This field should not produce excitation of nerve or muscle and heating the tissue. To evaluate the effect of PEMF on osteogenesis, 16 rabbit under the same condition was divided into 8 experimental groups and 8 control groups. 10 mm calvarial bone defects were formed around sagittal suture. The defect of left side was left without graft while the defect of right side was grafted by bone harvested from left side. A pulsed electromagnetic field was applied for 8 hours per day. Each group was sacrificed after 1 week, 2 weeks, 4 weeks, 8 weeks. Microscopic specimens were obtained from the calvarial bone defects and surrounding tissue using Hematoxylin-Eosin staining method. The results were as follows. 1. In the group which pulsed electromagnetic field was applied, new bone formation filled up the defect was observed after 4 and 8 weeks effectively. 2. There are no difference in the healing period for the fusion between the bone and graft bone. According to the result, the PEMF with 38 Gauss, 100 Hz was very effective in the healing of bone defect and new bone formation. So The PEMF will be useful in clinical aspect for oseteogenesis.

A Study Of Mandibular Anatomy For Orthognathic Surgery In Koreans

Anatomical shape of the mandibular ramus, which includes the area from the rear of the mandibular second molar to the mandibular posterior border and from the mandibular sigmoid notch to the inferior mandibular border, must be carefully considered to perform orthognathic surgery. The locations of the lingula and mandibular foramen in medial side of mandibular ramus are one of the most important factors to decide the location of the horizontal medial osteotomy in sagittal split ramus osteotomy and to select the line of vertical osteotomy in intraoral vertical ramus osteotomy. Sixty-five different Korean human dry mandibles were surveyed. All mandible have permanent dentition including complete eruption of the mandibular second molar. The locations of the lingula and mandibular foramen in medial side of the ramus were identified and following results were obtained. Anterior ramal horizontal distance from lingula was 16.13+/-3.53mm(range:8.6~24.3mm), anterior ramal horizontal distance from mandibular foramen was 23.91+/-4.79mm(range: 14.1~39.7mm), horizontal width of mandibular foramen was 2.79+/-0.95mm(range: 1.5 ~6.1mm), height of lingula was 10.51+/-3.84mm(range: 3.1~22.4mm), vertical distance from sigmoid notch to lingula was 19.82+/-5.11mm(range: 9.1~35.3mm). From this study, the result could be used to select the location of osteotomy lines and to decide amount of periosteal elevation to avoid injury of neurovascular bundle, and to accomplish the appropriate split in Korean patients in mandibular orthognathic surgery.

A Immunohistochemical Study Of Proliferating Cell Nuclear Antigen(Pcna) In Oral Malignant Melanoma

A Clinical Study of Periapical Lesions