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Development of a bioactive cellulose membrane from sea squirt skin for bone regeneration - a preliminary research.

Soung Min KIM ; Jong Ho LEE ; Joung Ae JO ; Seung Cheol LEE ; Suk Keun LEE

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2005;31(5):440-453.

OBJECTIVES: To develop a bioactive membrane for guided bone regeneration (GBR), the biocompatibility and bone regenerating capacity of the cellulose membrane obtained from the Ascidians squirt skin were evaluated. MATARIALS AND METHODS: After processing the pure cellulose membrane from the squirt skin, the morphological study, amino acid analysis and the immunoreactivity of the cellulose membrane were tested. Total eighteen male Spraque-Dawley rats (12 weeks, weighing 250 to 300g) were divided into two control (n=8) and another two experimental groups (n=10). In the first experimental group (n=5), the cellulose membrane was applicated to the 8.0 mm sized calvarial bone defect and the same sized defect was left without cellulose membrane in the first control group (n=4). In the another experimental group (n=5), the cellulose membrane was applicated to the same sized calvarial bone defect after femoral bone graft and the same sized defect with bone graft was left without cellulose membrane in the another control group (n=4). Each group was sacrificed after 6 weeks, the histological study with HandE and Masson trichrome stain was done, and immunohistochemical stainings of angiogenin and VEGF were also carried out. RESULTS: The squirt skin cellulose showed the bio-inductive effect on the bone and mesenchymal tissues in the periosteum of rat calvarial bone. This phenomenon was found only in the inner surface of the cellulose membrane after 6 weeks contrast to the outer surface. Bone defect covered with the bioactive cellulose membrane showed significantly greater bone formation compared with control groups. Mesenchymal cells beneath the inner surface of the bioactive cellulose membrane were positive to the angiogenin and VEGF antibodies. CONCLUSION: We suppose that there still remains extremely little amount of peptide fragment derived from the basement membrane matrix proteins of squirt skin, which is a kind of anchoring protein composed of glycocalyx. This composition could prevent the adverse immunological hypersensitivity and also induce bioactive properties of cellulose membrane. These properties induced the effective angiogenesis with rapid osteogenesis beneath the inner surface of cellulose membrane, and so the possibilities of clinical application in dental field as a GBR material will be able to be suggested.
Animals ; Antibodies ; Basement Membrane ; Bone Regeneration* ; Cellulose* ; Glycocalyx ; Hand ; Humans ; Hypersensitivity ; Male ; Membranes* ; Osteoblasts ; Osteogenesis ; Periosteum ; Rats ; Skin* ; Transplants ; Urochordata ; Vascular Endothelial Growth Factor A

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Limited or Le fort I down fracture access for widespread osteomyelitis of maxilla.

Taek Su GO ; Won LEE ; In Soo KIM ; Hyun Suk CHA ; Hyung Uck HAN ; Woon Kyung SEO ; Su Hyun PARK ; Kyoung In YUN

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2005;31(5):436-439.

PURPOSE: To compare the case of widespread maxillary osteomyelitis treated through different approach. METHOD: We report the two case of osteomyelitis. In a case, we had gradually removed the small amount of sequestrum for several times. In the other case, intended Le Fort I fracture was done to approach the lesion. RESULT: In the gradual sequestrectomy case, bone formations were found after 4 months. In the other case, after intended Le Fort I down fracture, sequestrectomy of Lt. maxilla was done with the labiobuccal alveolar bone preserved for the prosthodontic treatment.
Maxilla* ; Osteomyelitis* ; Prosthodontics

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Action potential differences and regeneration effect after microneural suture technique and fibrin adhesive technique in rat sciatic nerve.

Tae Young JUNG ; Uk Kyu KIM ; In Kyo CHUNG ; Sang Hoon SHIN

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2005;31(5):427-435.

The purpose of this study was to compare clinical availability of fibrin adhesive technique with microneural suture technique. We applicated fibrin adhesive technique and microneural suture technique on cut sciatic nerve in rat and used to Compound muscle action potential of rat thigh muscle compartment and histologic finding for comparision of clinical availability. The results were as following. 1. Using latency and amplitude in Compound muscle action potential test, we compared microneural suture technique with fibrin adhesive technique for nerve regeneration effect. the means was slightly different between two method. but there's no statistically significant differences. 2. Histologic finding was similar in microneural suture technique and fibrin adhesive technique for regeneration of axon and myelin sheath in destruction site after nerve anastomosis. These results showed that the efficacy of fibrin adhesive technique was similar to that of conventional microneural suture technique. Moreover, fibrin adhesive technique is decreased operating time and imporved of incapability of accessment in conventional suture technique. Therefore this technique is a useful method to nerve anastomosis in nerve enervation and neurotransplantation.
Action Potentials* ; Animals ; Axons ; Fibrin Tissue Adhesive* ; Fibrin* ; Myelin Sheath ; Nerve Regeneration ; Rats* ; Regeneration* ; Sciatic Nerve* ; Suture Techniques* ; Sutures* ; Thigh

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The study on vertical stability of anterior open bite patients after bssro.

Jong Won KIM ; Ha Ryong JEON ; Jong Rak HONG

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2005;31(5):422-426.

PURPOSE: The purpose of this study was to investigate the vertical stability after BSSRO surgery in skeletal class III malocclusion patients with mild anterior open bite and to present a method to increase the stability. MATARIALS AND METHODS: 36 patients, 11 male and 25 female, who received BSSRO surgery with the diagnosis of skeletal class III with anterior open bite at the Department of Oral and Maxillofacial Surgery in Samsung Medical Center, from January 2002 to August 2003, were selected for this study. The patients were between 18 to 45 years of age. Preoperative and postoperative (immediate, 6 months, and 1 year after operation) lateral cephalograms were compared to evaluate the vertical stability by measuring the distance of nasion-menton, mandibular plane angle, and overbite. RESULTS: The nasion-menton distance decreased by 1.65mm immediately after the operation in comparison to the preoperative value. This distance further decreased by 0.60 mm at 6 months and 1.06 mm at 1 year after the operation. The mandibular plane angle increased after the operation and further increased at 6 months and 1 year. The amount of overbite increased by the operation was 2.34mm and an additional increase of 0.70mm at 6 months and 0.94 mm at 1 year were shown. CONCLUSION: Clinically, none of the patients showed relapse of anterior open bite and the vertical stability is highly influenced by orthodontic treatment after the operation. In this study, BSSRO surgery is considered to be a rather reliable procedure that restores stability to skeletal class III malocclusion patients with slight anterior open bite.
Diagnosis ; Female ; Humans ; Male ; Malocclusion ; Open Bite* ; Overbite ; Recurrence ; Surgery, Oral

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Changes of serum alkaline phosphatase after enucleation of cysts in the jaws.

Jung Ju EUNE ; Eui Seok LEE ; Jae Suk RIM ; Hyon Seok JANG ; Hyon Il WOO

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2005;31(5):417-421.

This study was to analyze the changes of levels of alkaline phosphatase before and after enucleation of jaw cysts combined with bone grafting, and to evaluate biochemically the effectiveness of the early detection of bone healing and infection as a prognostic marker. Eighteen patients (13 males, 5 females) with cystic lesions of the jaws were divided into two groups. The bone graft group underwent enucleation and bone graft. The control group underwent only enucleation. Both groups were measured levels of ALP before surgery, and plus-minus 4 weeks postoperatively. The more discriminating results were obtained in the bone graft group. The results were as follows : 1. Levels of ALP after enucleation of jaw cysts were decreased in all patients with and without bone graft. 2. The bone graft group showed more marked decrease in variation of levels of ALP than the control group.(p=0.008) This should be considered as a result of increased osteoblastic activity and new bone formation. 3. Such variation could be used as a prognostic marker for bone healing after cyst operation. In the cost/benefit ratio, measurement of ALP activity could be useful as a convenient procedure in routine clinical practice.
Alkaline Phosphatase* ; Bone Transplantation ; Humans ; Jaw Cysts ; Jaw* ; Male ; Odontogenic Cysts ; Osteoblasts ; Osteogenesis ; Transplants

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Long-term analysis of reconstructed temporomandibular joint and mandible using free fibular flap.

Kang Min AHN ; Hun Jong CHUNG ; Hak Ryol RYOM ; Hang Jin KIM ; Yoon Tae KIM ; Soon Jung HWANG ; Hoon MYOUNG ; Myung Jin KIM ; Soung Min KIM ; Jeong Won JAHNG ; Jong Ho LEE

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2005;31(5):409-416.

PURPOSE OF STUDY: The temporomandibular joint (TMJ) occupies a key functional role in mastication and contributes to normal deglutition, speech as well as cosmesis. When a large amount of mandible including the condyle head is resected, it is very difficult to reconstruct it as a functional unit. In this retrospective study, we present the functional, radiographic and cosmetic results of reconstructed temporomandibular joint using free fibular flap. PATIENTS AND METHODS: Total 12 patients (M:F = 6:6) who underwent condylar reconstruction with the fibular flap were interviewed and examined by radiographs and Bio-PAK(R). Mean follow up periods was 47.7+/-20.0 months and the average age was 38.7+/-15.3 years. Remodeling of condyle and function of TMJ were evaluated and facial contour was judged subjectively. RESULTS: All flaps were viable and no immediate postoperative complication had happened. One patient showed decreased mouth opening, so interpositional gap arthroplasty was performed. The resorption rates of reconstructed fibular were minimal and the condyle heads were changed into domeshaped neocondyle after 2 years. All patients had normal diet and no speech difficulty was reported. Nine patients were satisfied with their facial contour but three patients complained about the depression of cheek. CONCLUSION: The reconstruction of TMJ with free fibular flap was reliable methods and very effective means of restoring mandibular function. The functional and morphologic results were excellent and showed little complications.
Arthroplasty ; Cheek ; Deglutition ; Depression ; Diet ; Follow-Up Studies ; Head ; Humans ; Mandible* ; Mastication ; Mouth ; Postoperative Complications ; Retrospective Studies ; Temporomandibular Joint*

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Relative signal intensity of retrodiscal tissue in mri, and synovial fluid concentration of interleukin-6, mmp-2 and mmp-9 in temporomandibular joint disorder.

Sang Hwa LEE ; Mok Kyun CHOIE

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2005;31(5):399-408.

In the progression of the Temporomandibular Joint Disorder(TMD), not only deformation and perforation of disc occur. But also fibrotic adhesion and inflammatory changes to the retrodiscal tissue can be seen in addition to the condylar degenerative change (e.g. osteoarthritis). However, the correct diagnosis,?planning for appropriate treatment, and prediction of prognosis are limited, because there are no means to stage the progression of the disorder. In this study relative signal intensity of retrodiscal tissue in MRI and the synovial fluid concentration of matrix metalloproteinase-2 (MMP-2), MMP-9, and Interleukin-6 (IL-6) in the 23 temporomandibular joints(TMJ), from 17 patients with TMD were evaluated as a possible diagnostic marker. The relative signal intensity of retrodiscal tissue was referenced to brain gray matter with same region of interest(ROI) size. The concentrations of MMP-2, MMP-9, and IL-6 were evaluated by Enzyme Linked Immunosorbent Assay (ELISA). The collected data were compared with condylar degenerative change, joint effusion and disc position observed in MRI. The relative signal intensity of the retrodiscal tissue was increased significantly when degenerative changes were present. In addition, there was significantly high signal intensity in the presence of a disc displaced without reduction. The concentration of IL-6 was significantly increased when condylar degenerative change was no observed. And there were no changes in the levels of IL-6 according to disc position and joint effusion measurement. Moreover, there were no significant relevance between the concentration of total MMP-2 and active MMP-9 in synovial fluid, relative to degenerative changes in the mandibular condyle, to joint effusion, and to disc position observed on MRI images. In conclusion, the relative signal intensity of the retrodiscal tissue can be regarded as a mean of diagnosing the procession of TMD in a non-invasive manner. But more additional studies are required for the levels of MMP-2. MMP-9, and IL-6 to determine their potentials as a diagnostic marker for TMD.
Brain ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6* ; Joints ; Magnetic Resonance Imaging* ; Mandibular Condyle ; Matrix Metalloproteinase 2 ; Prognosis ; Synovial Fluid* ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*

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A study of skeletal and dental changes after surgicallyassisted rapid maxillary expansion.

Chang Hun HAN ; Min Suk KOOK ; Hong Ju PARK ; Hee Kyun OH

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2005;31(5):390-398.

PURPOSE: The aim of this study was to evaluate the skeletal and dentoalveolar dimensional changes following surgically-assisted rapid maxillary expansion (SARME). PATIENTS & METHODS: Thirteen adults who had been treated by SARME for transverse maxillary deficiency from May 2000 to December 2003 were evaluated. The SARME procedure was the subtotal Le Fort I osteotomy combined with pterygomaxillary separation and anterior midpalatal osteotomy. Dental study casts and posteroanterior cephalometric radiographs were taken before operation, after removal of expansion device, and follow up period. Nasal cavity width, skeletal and dentoalveolar parameters were measured pre- and post-operatively. RESULTS: 1. Mean nasal cavity width was increased 12%(0~21%) of total expansion after retention. 2. Mean maxillary interdental width was increased 70%(47~99%), 95%(84~115%), and 77%(57~94%) of total expansion in the canine, the first premolar, and the first molar region, respectively after retention. 3. Mean maxillary alveolar bone width was increased 66%(42~84%), 74%(42~94%), and 57%(31~78%) of total expansion in the canine, the first premolar, and the first molar region, respectively after retention. 4. Mean palatal vault depth was decreased 1.3 mm (0.5~2.0 mm) after retention. 5. Mean interdental and alveolar bone width of the mandibular canine and intermolar width of mandible were slight increased as maxilla was expanded after retention. 6. There were statistical differences between preoperative and postoperative values of nasal cavity, all maxillary interdental and interalveolar widths, palatal vault depth, mandibular interdental and interalveolar width of canine(paired t-test, p <0.05). 7. The maxillary interdental and alveolar bone width were decreased approximately 25% of total expansion by relapse at follow up period. CONCLUSION: In conclusion, most amounts of maxillary interdental expansions were acquired with the expansion of the maxilla by SARME. For preventing the relapse, approximately 25% of the overexpansion was needed.
Adult ; Bicuspid ; Follow-Up Studies ; Humans ; Mandible ; Maxilla ; Molar ; Nasal Cavity ; Osteotomy ; Palatal Expansion Technique* ; Recurrence

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The changes of salivary gland after the ligation of the excretory duct in submandibular glands.

Seung Man CHA ; In Kyo CHUNG

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2005;31(5):379-389.

Obstructive adenitis of the salivary gland following salivary stone or infectious disease of the gland and surrounding tissues is a common disease. It is often difficult to decide whether to perform total excision of the gland or to consider conservative treatment. The present study was designed to investigate histological, histochemical changes of submandibular gland after ligating the excretory duct for identifying the results of gland duct obstruction. A group of 40 rat of Sprague-Dawley weighing about 200~220gm were used in the present study. 30 rats had ligation of the main excretory ducts of submandibular glands just at the exit from the glands. For controls, 10 rats had a sham operation without duct ligation. They were inducted into euthanagia state by intracardial Ketamine injection in 1, 2, 3, 5, 7, 14, 21, 28, 35 and 42 days after the ligation. In each ligation period, 3 animals were used for ligation and one animal was for control. The submandibular glands were dissected out at sacrifice and stained with HandE, PAS, mucicarmine stain and histological examination were carried out under the light microscope. After examination and comparison of all specimens, the results were as follows: 1. In the features of H&E stain, acini disappeared by degrees after the ligation of the excretary duct and interstitial cells were displaced into fibrous connective tissue. Salivary gland had been atrophied with enlarging ducts and proliferating ductal cells. 2. Through total experimental period, a lot of vessels were observed and the atrophy of serous gland was severer than that of mucous gland. 3. The deep portion of submandibular glands showed severe degeneration rather than superficial portion of them after the ligation. 4. The changes which had enlarged ducts and proliferating ductal cells were observed in entire gland and more prominent in serous gland than mucous gland after the ligation. 5. Although PAS and mucicarmine reactions were decreased gradually after the ligation with the lapse of time, since 2 to 3 weeks they were strong positive reactions on entire gland, especially on duct-like structure. So, we can suggest that salivary gland will be atrophied but, survived acini will be redistributed around the ducts.
Animals ; Atrophy ; Communicable Diseases ; Connective Tissue ; Hand ; Ketamine ; Ligation* ; Lymphadenitis ; Rats ; Rats, Sprague-Dawley ; Salivary Glands* ; Submandibular Gland* ; Yemen

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The appearence of proinflammatory cytokines in temporomandibular joint disorders after arthrocentesis and lavage.

Cheol Hun KIM ; Hie Sung HWANG ; Sang Hoon SHIN ; In Kyo CHUNG ; Tae Ho HWANG

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2005;31(5):370-378.

The purpose of this study is that evaluate the distribution and biological roles of TNF-a, interleukin-1beta(IL-1beta), interleukin-6(IL-6) and tissue inhibitors of metalloproteinase-1(TIMP-1) in the synovial fliud of patients with non-inflammatory chronic temporomandibular joint(TMJ) disorders in relation to pain during joint movements and magnetic resonance imaging(MRI) findings. TMJ synovial fluids aspirates were obtained from 36 patients (36 joints) with chronic TMJ disorders and from 8 controls(8 joints). Patients were divided to four groups. The control group was from healthy volunteers(8 joints), group I(18 joints) was patients with anterior disc displacement with reduction, group II(5 joints) was patients with disc displacement without reduction and group III (5 joints) was osteoarthritis. The TNF-alpha, IL-1beta and IL-6 levels in the aspirates were determined by using an enzyme-linked immunosorbent assay and the TIMP-1 level was measured by an enzyme immunoassay. Following examinations for pain during joint movements and MRI observations, these cytokines'level and frequencies of detection were compared. The level of IL-1beta was not significant different in all groups. but the level of TNF-alpha, IL-6 and TIMP-1 were significant different among groups. The level of IL-6 and TIMP-1 were correlated to pain during movement(p <0.01) and the level of TNF-a(p <0.05). Also, the level of IL-6 was correlated to the level of TIMP-1(p <0.01). Especially, The level of the TIMP-1 level was significantly correlated to the pain during movement and showed very high levle of Pearson's correlation coefficient (r=0.833)(p <0.001). The results indicated that the TNF-alpha, IL-6 and TIMP-1 levels in the TMJ aspirates of patients with chronic TMJ disorders have been raised. Especially, IL-6 and TIMP-1 were very high levels in the patients who were degraded in the TMJ. Also, TNF-alpha, IL-6 and TIMP-1 showed the significant correlation in the chronic temporomandibular joint disorders. Therefore I suggest that these cytokines were also correlated to the pain during movement in the chronic temporomandibular joint disorders.
Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoenzyme Techniques ; Interleukin-6 ; Joints ; Magnetic Resonance Imaging ; Osteoarthritis ; Synovial Fluid ; Temporomandibular Joint Disorders* ; Temporomandibular Joint* ; Therapeutic Irrigation* ; Tissue Inhibitor of Metalloproteinase-1 ; Tumor Necrosis Factor-alpha

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