Bone Regeneration Effect of Hyperbaric Oxygen Therapy Duration on Calvarial Defects in Irradiated Rats.

OBJECTIVE: In this study, we evaluated changes in bone remodeling in an irradiated rat calvarial defect model according to duration of hyperbaric oxygen therapy. MATERIALS AND METHODS: The 28 rats were divided into four groups. Radiation of 12 Gy was applied to the skull, and 5-mm critical size defects were formed on both sides of the skull. Bone grafts were applied to one side of formed defects. From the day after surgery, HBO was applied for 0, 1, and 3 weeks. At 6 weeks after bone graft, experimental sites were removed and analyzed for radiography, histology, and histomorphometry. RESULTS: Micro-CT analysis showed a significant increase in new bone volume in the HBO-3 group, with or without bone graft. When bone grafting was performed, BV, BS, and BS/TV all significantly increased. Histomorphometric analysis showed significant increases in %NBA and %BVN in the HBO-1 and HBO-3 groups, regardless of bone graft. CONCLUSION: Hyperbaric oxygen therapy was effective for bone regeneration with only 1 week of treatment.

Adjunctive hyperbaric oxygen therapy for irradiated rat calvarial defects.

PURPOSE: The aim of this study was to conduct a histologic evaluation of irradiated calvarial defects in rats 4 weeks after applying fibroblast growth factor-2 (FGF-2) with hyaluronan or biphasic calcium phosphate (BCP) block in the presence or absence of adjunctive hyperbaric oxygen (HBO) therapy. METHODS: Twenty rats were divided into HBO and non-HBO (NHBO) groups, each of which was divided into FGF-2 and BCP-block subgroups according to the grafted material. Localized radiation with a single 12-Gy dose was applied to the calvaria of rats to simulate radiotherapy. Four weeks after applying this radiation, 2 symmetrical circular defects with a diameter of 6 mm were created in the parietal bones of each animal. The right-side defect was filled with the materials mentioned above and the left-side defect was not filled (as a control). All defects were covered with a resorbable barrier membrane. During 4 weeks of healing, 1 hour of HBO therapy was applied to the rats in the HBO groups 5 times a week. The rats were then killed, and the calvarial specimens were harvested for radiographic and histologic analyses. RESULTS: New bone formation was greatest in the FGF-2 subgroup, and improvement was not found in the BCP subgroup. HBO seemed to have a minimal effect on new bone formation. There was tendency for more angiogenesis in the HBO groups than the NHBO groups, but the group with HBO and FGF-2 did not show significantly better outcomes than the HBO-only group or the NHBO group with FGF-2. CONCLUSIONS: HBO exerted beneficial effects on angiogenesis in calvarial defects of irradiated rats over a 4-week healing period, but it appeared to have minimal effects on bone regeneration. FGF-2 seemed to enhance new bone formation and angiogenesis, but its efficacy appeared to be reduced when HBO was applied.

Regenerated Bone Pattern Around Exposed Implants with Various Designs.

PURPOSE: The design and surface features of dental implants substantially affect the healing and remodeling of adjacent bones. This study aimed to investigate the impact of design and surface on bone regeneration using implants of two different pitches, each with three different surface features. MATERIALS AND METHODS: Custom-manufactured titanium implants (length, 10 mm; diameter, 3.5 mm) were divided along the major axis into two sections: one with 0.6-mm pitch and the other with 0.4-mm pitch. They were processed by turned, blasting and etching, and anodic oxidation surface treatments and implanted into rabbit tibia. The upper 4 mm of the inserted implants was exposed, and bone regeneration was induced around the exposed area using a titanium chamber (height: 4 mm) containing particulate autogenous and bovine bone. After a 12-week healing period, the quantity and quality of bone regeneration around the implants were evaluated. Thirty specimens-10 specimens each from the turned, blasting and etching, and anodic oxidation surface groups with 0.6- and 0.4-mm pitch sizes- were evaluated by histomophometric analysis. RESULTS: The vertical height and width of regenerated bone around blasting and etching and anodic oxidation surfaces were significantly greater than those around turned implants (P < .05); the vertical heights of regenerated bone around the 0.4-mm-pitch sections of blasting and etching and anodic oxidation surfaces were significantly greater than those around the 0.6-mm-pitch sections (P < .05). Both blasting and etching and anodic oxidation surfaces exhibited significantly greater bone-to-implant contact and bone volume at the implant thread than turned implants (P < .05). However, there was no significant difference between the 0.6- and 0.4-mm-pitch sections. CONCLUSION: The findings of this study indicate that blasting and etching and anodic oxidation surfaces with a 0.4-mm-pitch design result in greater vertical ingrowth of regenerated bone than those with a 0.6-mm-pitch design.

The role of rhFGF-2 soaked polymer membrane for enhancement of guided bone regeneration.

The purposes of this study are to confirm the role of Fibroblast Growth Factor-2 (FGF-2) in bone regeneration by adding various concentrations of FGF-2 to the collagen membrane and applying it to the Biphasic Calcium Phosphate (BCP) bone graft site for guided bone regeneration, to explore the potential of collagen membrane as FGF-2 carrier, and to determine the optimum FGF concentration for enhancement of bone regeneration. Four bone defects of 8 mm in diameter were created in 18 New Zealand rabbit calvaria. After BCP bone graft, graft material was covered with collagen membranes adding various concentration of FGF-2. The concentration of FGF-2 was set at 1.0, 0.5, 0.1 mg/ml, and same amount of saline was used in the control group. To confirm the bone regeneration over time, six New Zealand rabbits were sacrificed each at 2, 4, and 12 weeks, and the amounts of new bone and residual bone graft material were analyzed by histologic and histomorphometric analysis. Qualitative analyses are also conducted through immunohistochemistry, Tetrate-resistant acid phosphatase (TRAP) stain and Russell-Movat pentachrome stain. As the healing period increased, the formation of new bone increased and the amount of residual graft material decreased in all experimental groups. Immunohistochemistry, TRAP staining and pentachrome staining further showed that the addition of FGF-2 promoted bone regeneration in all experimental groups. It was also confirmed that polymer collagen membrane can be used as a useful carrier of FGF-2 when enhanced early stage of new bone formation is required.

Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction.

PURPOSE: On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS: Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS: The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION: Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

Morphometric analysis of maxillary alveolar regions for immediate implantation.

PURPOSE: The purpose of this study was to provide an actual guideline in determining the shape, diameter, and position of the implant in immediate implantation by the measurement of the thickness of facial and palatal plate, the thickness of cortical bone on the facial and palatal plate, the diameter of the root, and the distance between the roots in the cadavers. MATERIALS AND METHODS: The horizontal sections of 20 maxillae were measured and analyzed to obtain the average values. Resin blocks were produced and cut serially at 1 mm intervals from the cervical line to the root apex. Images of each section were obtained and the following measurements were performed: The thickness of the facial and palatal residual bone at each root surface, the thickness of the facial and palatal cortical bone at the interdental region, the diameter of all roots of each section on the faciopalatal and mesiodistal diameter, and the interroot distance. Three specimens with measurements close to the average values were chosen and 3-dimensional images were reconstructed. RESULTS: The thickness of the facial and palatal cortical bone at the interdental region in the maxilla, the buccal cortical bone was thicker in the posterior region compared to the anterior region. The interroot distance of the alveolar bone thickness between the roots increased from anterior to posterior region and from coronal to apical in the maxilla. CONCLUSION: In this study, the limited results of the morphometric analysis of the alveolar ridge using the sections of maxilla in the cadavers may offer the useful information when planning and selecting optimal implant for immediate implantation in the maxilla.

Assessment of pain and anxiety following surgical placement of dental implants.

PURPOSE: To investigate the change in 89 patients' pain and anxiety following implant surgery and to evaluate the correlation among anxiety, pain, and influencing factors. MATERIALS AND METHODS: Eighty-nine patients were included in this study. Subjective factors influencing pain perception included anxiety from the overall dental treatment (scored on the Dental Anxiety Scale [DAS]) and anxiety relative to the time from implant surgery. Objective factors were sex, age, and implant location and number. Patients completed questionnaires just before surgery (T0), immediately after surgery (T1), 1 day after surgery (T2), and 1 week after surgery (T3). RESULTS: The average pain perception was highest at T2, followed by T1 and T3. Pain perception at T1 was significantly higher in women and for a larger number of implant placements. Pain perception at T2 was significantly higher in women and when DAS and anxiety scores were high. The pain score at T3 was significantly higher in women and when anxiety scores were high. The results from multiple linear regression analysis showed that pain perception was significantly higher at T1 in women and for a larger number of implant placements, and at T3 when the dental anxiety score was high. CONCLUSION: Within the limitations of this study, a patient's anxiety represented by dental anxiety score and state of anxiety scores affected pain intensity 1 day after implant surgery. Sex and the number of implants affected pain intensity immediately after implant surgery. Patients who have high pain intensity 1 week after implant surgery showed high pain intensity at each time point.

Trabecular bone ratio of mandible using micro-computed tomography in Korean.

Cortical bone and trabecular portion play important roles in maintaining the general structure of bone. It has been reported that a decrease in bone mineral density is related with increasing age, sex, and teeth loss. However, most of the studies were done with conventional radiographic analysis. In addition, data from Korean population are rare. The aim of this study was to analyze trabecular pattern of the mandible using micro-computed tomography. Thirty-nine specimens of the mandible were prepared. Specimens were scanned with micro-computed tomography and reconstructed three-dimensionally. Sections were made parallel to the axis of each tooth. Trabecular bone ratio (TBR) was measured. Data were statistically analyzed with 1-way analysis of variance (alpha = 0.05). There was a statistically significant difference of TBR between dentate and edentulous mandibles in the molar region. Trabecular bone ratio of edentulous mandible in males was greater than that in females. Trabecular bone ratio of dentate mandibles reduced regularly with increasing age, whereas that of edentulous mandibles did not. It could be concluded that there were statistically significant differences in TBR according to presence of tooth, sex, and increasing age on specific areas.

Drying time of tray adhesive for adequate tensile bond strength between polyvinylsiloxane impression and tray resin material.

STATEMENT OF PROBLEM: Use of custom tray and tray adhesive is clinically recommended for elastomeric impression material. However there is not clear mention of drying time of tray adhesive in achieving appropriate bonding strength of tray material and impression material. PURPOSE: This study is to investigate an appropriate drying time of tray adhesives by evaluating tensile bonding strength between two types of polyvinylsiloxane impression materials and resin tray, according to various drying time intervals of tray adhesives, and with different manufacturing company combination of impression material and tray adhesive. MATERIAL AND METHODS: Adhesives used in this study were Silfix (Dentsply Caulk, Milford, Del, USA) and VPS Tray Adhesive (3M ESPE, Seefeld, Germany) and impression materials were Aquasil Ultra (monophase regular set, Dentsply Caulk, Milford, Del, USA) and Imprint II Garant (regular body, 3M ESPE, Seefeld, Germany). They were used combinations from the same manufacture and exchanged combinations of the two. The drying time was designed to air dry, 5 minutes, 10 minutes, 15 minutes, 20 minutes, and 25 minutes. Total 240 of test specimens were prepared by auto-polymerizing tray material (Instant Tray Mix, Lang, Wheeling, Il, USA) with 10 specimens in each group. The specimens were placed in the Universal Testing machine (Instron, model 3366, Instron Corp, University avenue, Nowood, MA, USA) to perform the tensile test (cross head speed 5 mm/min). The statistically efficient drying time was evaluated through ANOVA and Scheffe test. All the tests were performed at 95% confidence level. RESULTS: The results revealed that at least 10 minutes is needed for Silfix-Aquasil, and 15 minutes for VPS Tray Adhesive-Imprint II, to attain an appropriate tensile bonding strength. VPS Tray Adhesive-Imprint II had a superior tensile bonding strength when compared to Silfix-Aquasil over 15 minutes. Silfix-Aquasil had a superior bonding strength to VPS Tray Adhesive-Aquasil, and VPS Tray Adhesive-Imprint II had a superior tensile bonding strength to Silfix-Imprint II at all drying periods. CONCLUSION: Significant increase in tensile bonding strength with Silfix-Aquasil and VPS Tray adhesive-Imprint II combination until 10 and 15 minutes respectively. Tray adhesive-impression material combination from the same company presented higher tensile bonding strength at all drying time intervals than when using tray adhesive-impression material of different manufactures.

The effect of several dentin desensitizers on shear bond strength of adhesive resin luting cement using self-etching primer.

OBJECTIVES: Dentin desensitizers can inhibit the bonding between dentin and resin cements. This study examined the effect of the previous application of desensitizers on the shear bond strength of one resin cement using self-etching primer to dentin. MATERIALS AND METHODS: One hundred and twenty-five dentin exposed teeth were randomly assigned to four experimental groups and one control group of 25 teeth each. Four dentin desensitizers were applied to the four experimental groups, respectively. The dentin desensitizers used were SuperSeal (Phoenix Dental, Inc., USA), MS-Coat (Sun Medical Co. Ltd, Japan), Gluma (Heraeus Kulzer, Germany), and Copalite Varnish (Cooley & Cooley Ltd, USA). Panavia F (Kuraray Co. Ltd, Tokyo, Japan) was attached to the top of each experimental and control group teeth using an Ultradent testing jig (Ultradent Product, Inc., Utah, USA), and the shear bond strength was measured using a Universal testing machine (Model 6022, Instron Co., Canton, MA, USA). The tooth surface was examined by scanning electron microscopy (SEM, JSM-T2000, JEOL, Tokyo, Japan). RESULTS: The control group showed the greatest shear bond strength (14.74 MPa) followed by SuperSeal (12.33 MPa), Gluma (5.28 MPa), MS-Coat (4.44 MPa) and Copalite Varnishtrade mark (3.14 MPa). There was no significant difference in shear bond strength between the control group and the experimental group treated with Superseal. The shear bond strength in the other experimental groups treated with Gluma, Varnish, and MS-Coat was similar to each other but significantly lower than control or Superseal. SEM showed revealed resin tags in most of the dentinal tubules in the experimental group treated with the Superseal. CONCLUSION: Among the four dentin desensitizers, Superseal was the only one that did not interfere with the process of resin bonding. The other dentin desensitizers that contained a resin ingredient interfered with resin retention.