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Min, Cheon‐,Ki,Wikesjö,, Ulf M. E.,Park, Jung‐,Chul,Chae, Gyung‐,Joon,Pippig, Susanne D.,Bastone, Patrizia,Kim, Chang‐,Sung,Kim, Chong‐,Kwan Blackwell Publishing Ltd 2011 Journal of Clinical Periodontology Vol.38 No.3
<P>Min C‐K, Wikesjö UME, Park J‐C, Chae G‐J, Pippig SD, Bastone P, Kim C‐S, Kim C‐K. Wound healing/regeneration using recombinant human growth/differentiation factor‐5 in an injectable poly‐lactide‐co‐glycolide‐acid composite carrier and a one‐wall intra‐bony defect model in dogs. J Clin Peridontol 2011; 38: 261–268. 38: 261–268. doi: 10.1111/j.1600‐051X.2010.01691.x.</P><P><B>Abstract</B></P><P><B>Objective: </B> The purpose of this study was to evaluate the effect of recombinant human growth/differentiation factor‐5 (rhGDF‐5) on periodontal wound healing/regeneration using an injectable poly‐lactide‐co‐glycolide‐acid (PLGA) composite carrier and an established defect model.</P><P><B>Methods: </B> Bilateral 4 × 5 mm (width × depth) one‐wall, critical‐size, intra‐bony periodontal defects were surgically created at the second and the fourth mandibular pre‐molar teeth in 15 Beagle dogs. The animals were randomized to receive (using a split‐mouth design; defect sites in the same jaw quadrant getting the same treatment) rhGDF‐5 high dose (188 <I>μ</I>g/defect) <I>versus</I> sham‐surgery control (five animals), rhGDF‐5 mid dose (37 <I>μ</I>g/defect) <I>versus</I> carrier control (five animals), and rhGDF‐5 low dose (1.8 <I>μ</I>g/defect) <I>versus</I> treatment reported elsewhere (five animals). The animals were euthanized for histometric analysis following an 8‐week healing interval.</P><P><B>Results: </B> Clinical healing was uneventful. The rhGDF‐5/PLGA construct was easy to assemble and apply. The rhGDF‐5 high dose supported significantly increased bone formation compared with the low‐dose, sham‐surgery, and carrier controls (<I>p</I><0.05) and induced significantly increased cementum formation compared with the controls (<I>p</I><0.05). Root resorption/ankylosis or other aberrant healing events were not observed.</P><P><B>Conclusion: </B> rhGDF‐5 appears to effectively support periodontal wound healing/regeneration in a dose‐dependent order; the PLGA composite appears to be an effective ease‐of‐use candidate for carrier technology.</P>
Periodontal and endodontic pathology delays extraction socket healing in a canine model
김정훈,구기태,Joseph Capetillo,김정주,유정민,Heithem Ben Amara,박정철,Frank Schwarz,Ulf M.E. Wikesjö 대한치주과학회 2017 Journal of Periodontal & Implant Science Vol.47 No.3
Purpose: The aim of the present exploratory study was to evaluate extraction socket healing at sites with a history of periodontal and endodontic pathology. Methods: The mandibular 4th premolar teeth in 5 adult beagle dogs served as experimental units. Periodontal and endodontic lesions were induced in 1 premolar site in each animal using wire ligatures and pulpal exposure over 3 months (diseased sites). The contralateral premolar sites served as healthy controls. The mandibular 4th premolar teeth were then extracted with minimal trauma, followed by careful wound debridement. The animals were sacrificed at days 1, 7, 30, 60, and 90 post-extraction for analysis, and the healing patterns at the healthy and diseased extraction sites were compared using radiography, scanning electron microscopy, histology, and histometry. Results: During the first 7 days of healing, a significant presence of inflammatory granulation tissue was noted at the diseased sites (day 1), along with a slightly accelerated rate of fibrin clot resolution on day 7. On day 30, the diseased extraction sites showed a greater percentage of persistent fibrous connective tissue, and an absence of bone marrow formation. In contrast, healthy sites showed initial signs of bone marrow formation on day 30, and subsequently a significantly greater proportion of mature bone marrow formation on both days 60 and 90. Radiographs exhibited sclerotic changes adjoining apical endodontic lesions, with scanning electron microscopy showing collapsed Volkmann canals protruding from these regions in the diseased sites. Furthermore, periodontal ligament fibers exhibited a parallel orientation to the alveolar walls of the diseased sites, in contrast to a perpendicular arrangement in the healthy sites. Conclusions: Within the limitations of this study, it appears that a history of periodontal and endodontic pathology may critically affect bone formation and maturation, leading to delayed and compromised extraction socket healing.
Kim, Tae-Gyun,Wikesjö,, Ulf M. E.,Cho, Kyoo-Sung,Chai, Jung-Kiu,Pippig, Susanne D.,Siedler, Michael,Kim, Chong-Kwan Blackwell Publishing Ltd 2009 Journal of Clinical Periodontology Vol.36 No.7
<P>Abstract</P><P>Aim</P><P>Recombinant human growth/differentiation factor-5 (rhGDF-5) is being evaluated as a candidate therapy in support of periodontal regeneration. The objective of this study was to evaluate cementum and alveolar bone formation, and aberrant healing events following surgical implantation of rhGDF-5 in an absorbable collagen sponge (ACS) carrier using an established periodontal defect model.</P><P>Materials and Methods</P><P>Bilateral 4 × 5 mm (width × depth), one-wall, critical-size, intrabony periodontal defects were surgically created at the mandibular second and fourth pre-molar teeth in 15 Beagle dogs. Five animals received 1 <I>μ</I>g/defect and five animals 20 <I>μ</I>g/defect rhGDF-5 in unilateral defect sites. Contralateral sites received treatments reported elsewhere. Five animals received rhGDF-5/ACS with 0 (buffer control) and 100 <I>μ</I>g/defect rhGDF-5 in contralateral defect sites. The animals were euthanized at 8 weeks post-surgery for histologic and histometric evaluation.</P><P>Results</P><P>Surgical implantation of rhGDF-5 stimulated significant periodontal regeneration. Cementum formation was significantly enhanced in sites implanted with rhGDF-5 (1 and 100 <I>μ</I>g) compared with control (<I>p</I><0.05). Similarly, bone formation height was significantly greater in sites receiving rhGDF-5 (1 and 100 <I>μ</I>g) compared with control (<I>p</I><0.05). There were no significant or remarkable differences in bone and cementum formation within the selected dose interval (1, 20 and 100 <I>μ</I>g rhGDF-5). None of the control or the rhGDF-5 sites exhibited root resorption, ankylosis, or other aberrant tissue reactions.</P><P>Conclusion</P><P>Surgical implantation of rhGDF-5/ACS may be used safely to support periodontal wound healing/regeneration in intrabony periodontal defects without complications.</P>
rhBMP-2를 이용한 조직공학;치과 임프란트에서의 골 재건
울프비케쇼,올리버하니쉬,마이클데니쉬마이어,조규성,김종관,Wikesj, Ulf ME.,Hanisch, Oliver,Danesh-Meyer, Michael J.,Cho, Kyoo-Sung,Kim, Chong-Kwan 대한치주과학회 1999 Journal of Periodontal & Implant Science Vol.29 No.3
The preclinical and clinical studies reviewed herein show that rhBMP-2 induces normal physiologic bone in relevant defects in the craniofacial skeleton. The newly formed bone assumes characteristics of the adjacent resident bone, and allows placement and osseointegration of dental implants. Clearly, the bone inducing capacity of rhBMP-2 is carrier and site dependent. rhBMP-2 in an absorbable collagen sponge carrier induces relevant bone formation in space providing defects. Space providing carries extends this possibility to non-space providing sites. Notably, some ceramic and polymeric biomaterials may substantially interfere with rhBMP-2 induced osteogenesis.
Kim, Chang-Sung,Choi, Seong-Ho,Cho, Kyoo-Sung,Chai, Jung-Kiu,Wikesjö,, Ulf ME.,Kim, Chong-Kwan Munksgaard 2005 Journal of Clinical Periodontology Vol.32 No.6
<P>Abstract</P><P>Aim</P><P>Autogenous bone grafts and bone biomaterials are being used as part of protocols aiming at reconstruction of periodontal defects. There is a limited biologic information on the effect of such materials on periodontal healing, in particular aberrant healing events that may prevent their general use. The objective of this study was, using histological techniques, to evaluate periodontal healing with focus on root resorption and ankylosis following implantation of autogenous bone and a coral-derived biomaterial into intra-bony defects in dogs.</P><P>Methods</P><P>One-wall intra-bony periodontal defects were surgically created at the distal aspect of the second and the mesial aspect of the fourth mandibular premolars in either right or left jaw quadrants in four Beagle dogs. Each animal received particulated autogenous bone and the resorbable calcium carbonate biomaterial into discrete one-wall intra-bony defects. The mucoperiosteal flaps were positioned and sutured to their pre-surgery position. The animals were euthanized 8 weeks post-surgery when block sections of the defect sites were collected and prepared for qualitative histological analysis.</P><P>Results</P><P>There were no significant differences in periodontal healing between sites receiving autograft bone and the coral-derived biomaterial. A well-organized periodontal ligament bridging new bone and cementum regeneration was observed extending coronal to a notch prepared to delineate the apical extent of the defect. Osteoid and bone with enclosed osteocytes were formed onto the surface of both autograft and coral particles. Although small resorption pits were evident in most teeth, importantly none of the biomaterials provoked marked root resorption. Ankylosis was not observed.</P><P>Conclusion</P><P>Particulated autogenous bone and the coral-derived biomaterial may be implanted into periodontal defects without significant healing aberrations such as root resorption and ankylosis. The histopathological evaluation suggests that the autogenous bone graft has a limited osteogenic potential as demonstrated in this study model.</P>
Effects of Implant Drill Wear, Irrigation, and Drill Materials on Heat Generation in Osteotomy Sites
Koo, Ki-Tae,Kim, Min-Ho,Kim, Hae-Young,Wikesjö,, Ulf M. E.,Yang, Jae-Ho,Yeo, In-Sung American Academy of Implant Dentistry 2015 The Journal of oral implantology Vol.41 No.2
<P>This study evaluated the effects of drill wear on bone temperature during osteotomy preparation with 3 types of drills and compared heat production between drills. The drills used in this study were titanium nitride-coated metal, tungsten carbide carbon-coated metal, and zirconia ceramic drills. An osteotomy 11 mm in depth was formed in bovine scapular bone following the manufacturer's recommended drill sequences. Drilling was performed without irrigation and repeated 20 times; temperature was measured every 5 times. Next, 200 rounds of drilling during irrigation were performed for each drill, with temperature change monitored until round 200. Analysis of variance statistics were used for analyses of the measured data. Drilling without irrigation showed significant thermal increase at all time points compared to drilling with irrigation (P < .001). No significant difference was found between drill materials. Under irrigation, the frequency of previous drilling had minimal effects on thermal change. The repeated-measures analysis of variance revealed major thermal change at the initial time point (P < .0001), and the multiple comparison tests revealed a significant difference in temperature between the initial drills that had been used 50 or fewer times and those that had been used more than 50 times, irrespective of the drill material. The results of this study indicate that the initial drill should be changed in osteotomy preparation with irrigation after they have been used 50 times. Irrigation may be a more critical factor for the control of temperature elevation than is the drill material.</P>