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Xiong N, Yang HJ, Kim SM, Hwang SJ. Long-term Stability Over 2 Years After Isolated Maxillary Orthognathic Surgery Combined With Mandibular Autorotation in Risk Patients for Condylar Resorption. J Craniofac Surg 2023; 34:e743-e749. [PMID: 37463306 DOI: 10.1097/scs.0000000000009546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 05/21/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE Counterclockwise rotation of mandible can cause condylar resorption and condylar displacement posteroinferiorly after maxillary orthognathic surgery with mandibular in patients with high-angle mandibular retrognathism. This study was aimed to evaluate long-term stability >2 years and postoperative changes of condylar displacement. MATERIALS AND METHODS In 15 patients who underwent Le Fort I osteotomy with mandibular autorotation, postoperative stability was cephalometrically investigated until 2 years. Condylar changes were analyzed with transcranial temporomandibular joint projection. Correlation between condylar displacement and surgical movement was analyzed. RESULTS Significant clockwise relapse of mandible ( P <0.01 for SNB reduction and backward movement of point B) was observed between 6 months and >2 years after surgery, even though the values were small (0.5±0.1 degrees and 1.14±0.13 mm, respectively). The condyle was displaced posteroinferiorly immediately after surgery; however, it achieved a stable position at postoperative 6 weeks. The amount of vertical condylar displacement was significantly correlated with surgical change in mandibular posterior border sagittal angle, palatal plane angle, facial height ratio, and point B in the horizontal dimension. Greater mandibular rotation prompted more vertical condylar displacement. CONCLUSIONS Small mandibular relapse in long term should be considered after maxillary orthognathic surgery with mandibular autorotation, although it is regarded as a surgical maneuver to minimize mandibular instability in patients susceptible to postoperative condylar resorption.
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Affiliation(s)
- Ni Xiong
- Department of Orthodontic, School of Dentistry, Seoul National University
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University
- Dental Research Institute, Seoul National University
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University
- Dental Research Institute, Seoul National University
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University
- MACS Dental Clinic for Oral and Maxillofacial Surgery, Seoul, Republic of Korea
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Kim TW, Hwang SJ, Wu T. Treatment of anterior open bite and an ankylosed incisor by applying multiloop edgewise archwire, mini-implants, and dentoalveolar distraction. Angle Orthod 2023:491024. [PMID: 36856738 DOI: 10.2319/070122-472.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/01/2022] [Indexed: 03/02/2023] Open
Abstract
An 18.7-year-old female patient with an anterior open bite and an ankylosed left maxillary central incisor was referred from a private orthodontic clinic. Canine relationships were Class II and molar relationships were Class I. The open bite was closed with the multiloop edgewise archwire and up-and-down elastics. The maxillary left central incisor was extruded by dentoalveolar distraction assisted with mini-implants. Active treatment took 2 years and 1 month, and the treatment result remained stable 14 months after debonding.
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Kwon IJ, Hwang SJ. Posterior ostectomy of a mandibular distal segment for nerve bundle traction to tensionless anastomosis of an inferior alveolar nerve. J Stomatol Oral Maxillofac Surg 2022; 124:101374. [PMID: 36587845 DOI: 10.1016/j.jormas.2022.101374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/25/2022] [Accepted: 12/28/2022] [Indexed: 12/30/2022]
Abstract
Tensionless adaptation of nerve ends is a challenging task in the repair of damaged inferior alveolar nerve (IAN). A new technique is introduced with posterior ostectomy of a mandibular distal segment after sagittal splitting for nerve bundle traction to tensionless anastomosis of nerve ends. We were able to create tensionless anastomosis of an IAN defect without autogenous or alloplastic graft using this method. This method is suitable for neurorrhaphy after neuroma removal in cases of IAN damage during dental procedures.
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Affiliation(s)
- Ik-Jae Kwon
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Republic of Korea; Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea; MACS Dental Clinic for Oral and Maxillofacial Surgery, Seoul, Republic of Korea.
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Song HG, Ahn JH, Koh JS, Bae JS, Park YW, Hwang SJ, Hwang JY, Jeong YH. Prognostic implication of residual inflammatory risk according to disease status in patients treated with percutaneous coronary intervention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Compared with stable angina, acute myocardial infarction (AMI) phenotype is related with the elevated inflammatory activity. However, time-dependent change of inflammatory level and its prognostic implication has not been fully understood according to the disease entity.
Methods
We enrolled total 4,263 patients who underwent percutaneous coronary intervention (PCI) with serial measurement of high-sensitivity C-reactive protein (hsCRP) at on-admission and 1-month post-PCI. The risks of MACE (a composite of death, MI or stroke), and major bleeding were evaluated up to 4 years after procedure.
Results
Compared with the non-AMI group (n=1,887), the AMI group (n=2,376) showed the significant decrease of hs-CRP during 1 month (∇0.5 vs. ∇0.1 mg/L; P<0.001). However, 1-month hs-CRP value still was higher in the AMI group than in the non-AMI group (median: 1.0 vs. 0.9 mg/L; P=0.001). During 1-month follow-up, high vs. low inflammatory risk (upper vs. lower tertile of hs-CRP) was significantly associated with increased rate of MACE in the AMI group (HR: 7.66; 95% CI: 2.29–25.59; P<0.001), but not in the non-AMI group (HR: 0.74; 95% CI: 0.12–4.40; P=0.736). From 1-month to 4-years, patients with high inflammatory risk showed the greater rate of MACE compared to those with low inflammatory risk, in both the AMI (HR: 2.40; 95% CI: 1.73–3.45; P<0.001) and non-AMI (HR: 2.67; 95% CI: 1.80–3.94; P<0.001) groups.
Conclusion
In PCI-treated patients, patients presented with AMI showed the greater values of inflammatory activity and its prognostic implication during the early phase, but combined inflammatory risk appeared similar across the disease entity during the late phase. This result may support that clinical benefit of post-PCI anti-inflammatory treatment would be constant regardless of the disease entity during the stabilized phase.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H G Song
- Department of Cardiology, Heart-Brain Hospital, Chung-Ang University Gwang-Myeong Medical Center , Gwang-Myeong , Korea (Republic of)
| | - J H Ahn
- Cardiovascular Center, Gyeongsang National University Changwon Hospital , Changwon , Korea (Republic of)
| | - J S Koh
- Cardiovascular Center, Gyeongsang National University Hospital , Jin-Ju , Korea (Republic of)
| | - J S Bae
- Cardiovascular Center, Gyeongsang National University Changwon Hospital , Changwon , Korea (Republic of)
| | - Y W Park
- Cardiovascular Center, Gyeongsang National University Changwon Hospital , Changwon , Korea (Republic of)
| | - S J Hwang
- Cardiovascular Center, Gyeongsang National University Hospital , Jin-Ju , Korea (Republic of)
| | - J Y Hwang
- Cardiovascular Center, Gyeongsang National University Hospital , Jin-Ju , Korea (Republic of)
| | - Y H Jeong
- Department of Cardiology, Heart-Brain Hospital, Chung-Ang University Gwang-Myeong Medical Center , Gwang-Myeong , Korea (Republic of)
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Han JJ, Moon JE, Lee EH, Yang HJ, Hwang SJ. Clinical and radiographic outcomes of dental implant after maxillary sinus floor augmentation with rhBMP-2/hydroxyapatite compared to deproteinized bovine bone. PLoS One 2022; 17:e0273399. [PMID: 36007001 PMCID: PMC9409565 DOI: 10.1371/journal.pone.0273399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/24/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives This study aimed to evaluate the clinical and radiographic outcomes of early implant placement and functional loading in maxillary sinus floor augmentation (MSFA) using recombinant human bone morphogenetic protein 2/hydroxyapatite (rhBMP-2/HA) and to compare these outcomes with those of the conventional protocol in MSFA using deproteinized bovine bone (DBB). Materials and methods The rhBMP-2/HA and DBB groups consisted of 14 and 13 patients who underwent MSFA with BMP and DBB, respectively. After placement of 22 implants and 21 implants in the rhBMP-2/HA and DBB groups, respectively, abutment connections were performed 3 months after implant placement for the rhBMP-2/HA group and 6 months after implant placement for the DBB group. Changes in grafted sinus height (GSH), marginal bone loss (MBL), and implant stability were evaluated up to one year after functional loading. Results Survival rates for the rhBMP-2/HA and DBB groups after one year of functional loading were 90.9% and 90.5%, respectively. Both groups exhibited no significant time-course changes in GSH until one year of functional loading (rhBMP-2/HA, p = 0.124; DBB, p = 0.075). Although significant MBL occurred after one year of functional loading for both groups (rhBMP-2/HA, p < 0.001; DBB, p < 0.001), there were no significant differences in time-course changes in MBL between the two groups (p = 0.450). The mean implant stability quotient values in the rhBMP-2/HA and DBB groups were 75.3 and 75.4 after one year of functional loading, respectively, and there were no significant differences between the two groups (p = 0.557). Conclusions MSFA using rhBMP-2/HA allowed implant rehabilitation with early implant placement and functional loading and led to a comparable survival rate and implant stability after 1 year of functional loading with acceptable MBL and stable maintenance of GSH compared to the MSFA using DBB with 6 months of healing after implant placement.
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Affiliation(s)
- Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Ji Eun Moon
- Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Eun-Hyuk Lee
- Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Republic of Korea
- * E-mail:
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Hwang Soon Jung’s Dental Clinic for Oral and Maxillofacial Surgery, Seoul, Republic of Korea
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Han JJ, Yang HJ, Hwang SJ. Enhanced Bone Regeneration by Bone Morphogenetic Protein-2 after Pretreatment with Low-Intensity Pulsed Ultrasound in Distraction Osteogenesis. Tissue Eng Regen Med 2022; 19:871-886. [PMID: 35594008 DOI: 10.1007/s13770-022-00457-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Bone morphogenetic protein 2 (BMP-2) and low-intensity pulsed ultrasound (LIPUS) have been used to enhance bone healing in distraction osteogenesis (DO). The aim of this study was to assess the synergistic effect of BMP-2 and LIPUS on bone regeneration in DO and to determine the optimal treatment strategy for enhanced bone regeneration. METHODS Rat mesenchymal stromal cells were treated with various application protocols of BMP-2 and LIPUS, and cell proliferation, alkaline phosphatase activity, and osteogenesis-related marker expression were evaluated. In vivo experiments were performed in a rabbit DO model according to the application protocols with different timings of BMP-2 and LIPUS application. RESULTS Application of BMP-2 after LIPUS pretreatment (BMP-2 after LIPUS) showed greater cell proliferation than LIPUS treatment alone, and higher ALP activity than all other treatment protocols. BMP-2 after LIPUS also exhibited increased gene expression levels of ALP, Cbfa1, and Osterix compared with LIPUS treatment alone. In vivo experiments revealed no significant differences in bone healing based on the timing of LIPUS treatment in DO. The combination of BMP-2 and LIPUS resulted in increased bone volume and bone mineral density compared with BMP-2 or LIPUS. Regarding the timing of BMP-2 application, the application of BMP-2 after LIPUS pretreatment led to greater bone volume than the application of BMP-2 before LIPUS. CONCLUSION The results of this study suggest that the combined treatment of BMP-2 and LIPUS can lead to enhanced bone healing in DO and that effective bone healing can be achieved through the application of LIPUS before BMP-2.
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Affiliation(s)
- Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, 03080, Republic of Korea
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, 03080, Republic of Korea
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, 03080, Republic of Korea. .,Hwang Soon Jung's Dental Clinic for Oral and Maxillofacial Surgery, 349, Woonam Building 2, 3F, Gangnam-daero, Seocho-gu, Seoul, 06626, Republic of Korea.
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7
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Han JJ, Chang AR, Ahn J, Jung S, Hong J, Oh HK, Hwang SJ. Efficacy and safety of rhBMP/β-TCP in alveolar ridge preservation: a multicenter, randomized, open-label, comparative, investigator-blinded clinical trial. Maxillofac Plast Reconstr Surg 2021; 43:42. [PMID: 34928477 PMCID: PMC8688599 DOI: 10.1186/s40902-021-00328-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this multicenter, randomized, open-label, comparative, investigator-blinded study was to investigate the efficacy and safety of recombinant human bone morphogenetic protein 2 (rhBMP-2) combined with β-TCP (rhBMP-2/β-TCP) in alveolar ridge preservation. Materials and methods Eighty-four subjects from three centers were enrolled in this clinical trial. After tooth extraction, rhBMP-2/β-TCP (n = 41, test group) or β-TCP (n = 43, control group) were grafted to the extraction socket with an absorbable barrier membrane for alveolar ridge preservation. Using computed tomography images obtained immediately after and 12 weeks after surgery, changes in the alveolar bone height and width were analyzed for each group and compared between the two groups. Results Both the test and control groups showed a significant decrease in alveolar bone height in the 12 weeks after surgery (both groups, p < 0.0001). However, the test group exhibited a significantly lower decrease in alveolar bone height than the control group (p = 0.0004). Alveolar bone width also showed significantly less resorption in the test group than in the control group for all extraction socket levels (ESL) (p = 0.0152 for 75% ESL; p < 0.0001 for 50% ESL; p < 0.0001 for 25% ESL). There were no statistically significant differences in the incidence of adverse events between the two groups. No severe adverse events occurred in either group. Conclusions The results of this study suggest that rhBMP-2/β-TCP is a safe graft material that provides a high alveolar bone preservation effect in patients receiving dental extraction. Trial registration Clinicaltrials.gov, NCT02714829, Registered 22 March 2016
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Affiliation(s)
- Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ah Ryum Chang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jaemyung Ahn
- Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seunggon Jung
- Department of Oral and Maxillofacial Surgery, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Jongrak Hong
- Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee-Kyun Oh
- Department of Oral and Maxillofacial Surgery, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, Republic of Korea
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea. .,Hwang Soon Jung's Dental Clinic for Oral and Maxillofacial Surgery, 349, Woonam Building 2, 3F, Gangnam-daero, Seocho-gu, Seoul, 06626, Republic of Korea.
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8
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Kang MG, Kim KH, Park HW, Koh JS, Hwang SJ, Hwang JY, Park JR. Percutaneous coronary intervention in patients with peripheral artery disease and adverse cardiovascular adverse event and bleeding. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Peripheral artery disease (PAD) increase the risk of comorbidity and mortality in coronary artery disease (CAD).
Objectives
We evaluate influence of PAD on prognosis in patients undergoing percutaneous coronary intervention (PCI).
Methods
We analyzed all consecutive patients included in our dedicated local registry for PCI between January 2011 and December 2016. Presence of PAD was defined by decreased ankle-brachial index (<0.9). Major adverse cardiovascular event (MACE) was defined as a composite of cardiovascular death, non-fatal myocardial infarct, revascularization, and ischemic stroke. Major bleeding was defined as Bleeding Academic Research Consortium 3 or 5.
Results
Among the 4,747 patients who underwent the PCI, 12.9% (n=610) of PAD were identified. Old age (>60 years), renal dysfunction, reduced ejection fraction, and presence of PAD were predictors with both MACE and major bleeding event. Among them, presence of PAD was an independent risk factor of MACE and major bleeding (MACE, HR 8.26, 95% CI 2.33- 29.41, p=0.036; major bleeding, HR 3.11, 95% CI 1.10–10.63, p=0.040, respectively). The MACE and major bleeding rate at 5-year was significantly increased in patients with PAD (MACE, 30.0% vs. 15.8%, log rank test p<0.001; major bleeding, 6.7 vs. 3.6%, log rank test p=0.003, respectively) (Figure).
Conclusion
Presence of PAD was strongly associated with higher rate of long-term MACE and major bleeding. These findings could have a clinical relevance in requiring individualized pharmacologic strategies to reduce the burden of cardiovascular disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M G Kang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - K H Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - H W Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J R Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
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Kang MG, Kim KH, Park HW, Koh JS, Park JR, Park YH, Hwang SJ, Jeong YH, Kwak CH, Ahn JH, Song HN, Hwang JY. Impact of active and stable cancer on survival in patients undergoing percutaneous coronary intervention. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
With advances in treatment of ischemic heart disease and cancer treatment, use of percutaneous coronary intervention (PCI) in cancer survivors and patients with active cancer (AC) is expanding.
Objectives
The purpose of this study was to determine the impact of cancer on survival and major cardiovascular events (MACE) in a long-term, single-center cohort of patients treated with PCI.
Methods
Patients treated with PCI between January 2010 and December 2017 were grouped as follows: controls (patients without cancer), stable cancer (SC), and AC. AC was included patients with cancer diagnosed within the past 6 months, patients who had cancer-related therapy within the past 6 months, active metastatic disease, or active recurrence of the cancer. The primary endpoints were 5-year survival and a secondary endpoint was 5-year MACE.
Results
A total of 6,743 patients (age 66±12 years, 68.4% men) treated with PCI were included: 6,404 (95.0%) controls, 245 (3.6%) SC, and 94 (1.4%) AC. Predominant malignancies were gastrointestinal (37.4%), lung (22.7%), and genitourinary cancer (14.7%). No differences were observed between patients with AC, SC and controls regarding 5-year MACE (total MACE, 33.2% vs. 28.1% vs. 17.5%, p=0.072; cardiac death, 13.6% vs. 9.1% vs. 6.7%, p=0.066; non-fatal myocardial infarction, 2.9% vs. 7.5% vs. 7.8%, p=0.820; revascularization, 17.9% vs. 17.6% vs. 11.6%, p=0.794, respectively). Patients with AC and SC had reduced 5-year survival compared with controls (62.0% vs. 81.5% vs. 89.8%, p<0.001) (Figure). AC was associated with a 1.76 (95% CI 1.22 to 2.54, p=0.002) fold increased risk of all-cause 5-year mortality in multivariable adjusted models.
Conclusions
Cumulative incidence of 5-year survival was discriminated by concurrent status of cancer following PCI. Individualized decision making is needed in the routine practice of PCI regarding concurrent cancer-specific treatment and prognosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M G Kang
- Gyeongsang National University Hospital, Jinju, Korea (Republic of)
| | - K H Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - H W Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J R Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - Y H Park
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - Y H Jeong
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - C H Kwak
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - J H Ahn
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - H N Song
- Gyeongsang National University Hospital, Jinju, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
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10
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Lee SJ, Yoo JY, Woo SY, Yang HJ, Kim JE, Huh KH, Lee SS, Heo MS, Hwang SJ, Yi WJ. A Complete Digital Workflow for Planning, Simulation, and Evaluation in Orthognathic Surgery. J Clin Med 2021; 10:jcm10174000. [PMID: 34501449 PMCID: PMC8432567 DOI: 10.3390/jcm10174000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study was to develop a complete digital workflow for planning, simulation, and evaluation for orthognathic surgery based on 3D digital natural head position reproduction, a cloud-based collaboration platform, and 3D landmark-based evaluation. We included 24 patients who underwent bimaxillary orthognathic surgery. Surgeons and engineers could share the massive image data immediately and conveniently and collaborate closely in surgical planning and simulation using a cloud-based platform. The digital surgical splint could be optimized for a specific patient before or after the physical fabrication of 3D printing splints through close collaboration. The surgical accuracy was evaluated comprehensively via the translational (linear) and rotational (angular) discrepancies between identical 3D landmarks on the simulation and postoperative computed tomography (CT) models. The means of the absolute linear discrepancy at eight tooth landmarks were 0.61 ± 0.55, 0.86 ± 0.68, and 1.00 ± 0.79 mm in left–right, advance–setback, and impaction–elongation directions, respectively, and 1.67 mm in the root mean square direction. The linear discrepancy in the left–right direction was significantly different from the other two directions as shown by analysis of variance (ANOVA, p < 0.05). The means of the absolute angular discrepancies were 1.43 ± 1.06°, 0.50 ± 0.31°, and 0.58 ± 0.41° in the pitch, roll, and yaw orientations, respectively. The angular discrepancy in the pitch orientation was significantly different from the other two orientations (ANOVA, p < 0.05). The complete digital workflow that we developed for orthognathic patients provides efficient and streamlined procedures for orthognathic surgery and shows high surgical accuracy with efficient image data sharing and close collaboration.
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Affiliation(s)
- Sang-Jeong Lee
- Dental Research Institute, Seoul National University, Seoul 03080, Korea;
| | - Ji-Yong Yoo
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 08826, Korea; (J.-Y.Y.); (S.-Y.W.)
| | - Sang-Yoon Woo
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 08826, Korea; (J.-Y.Y.); (S.-Y.W.)
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea
- Correspondence: (H.J.Y.); (W.-J.Y.)
| | - Jo-eun Kim
- Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital, Seoul 03080, Korea;
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (K.-H.H.); (S.-S.L.); (M.-S.H.)
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (K.-H.H.); (S.-S.L.); (M.-S.H.)
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (K.-H.H.); (S.-S.L.); (M.-S.H.)
| | - Soon Jung Hwang
- Hwang Soon Jung’s Dental Clinic for Oral and Maxillofacial Surgery, Seoul 06626, Korea;
| | - Won-Jin Yi
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 08826, Korea; (J.-Y.Y.); (S.-Y.W.)
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (K.-H.H.); (S.-S.L.); (M.-S.H.)
- Correspondence: (H.J.Y.); (W.-J.Y.)
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11
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Han JJ, Woo SY, Yi WJ, Hwang SJ. Robot-Assisted Maxillary Positioning in Orthognathic Surgery: A Feasibility and Accuracy Evaluation. J Clin Med 2021; 10:jcm10122596. [PMID: 34208399 PMCID: PMC8231103 DOI: 10.3390/jcm10122596] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022] Open
Abstract
Several methods enabling independent repositioning of the maxilla have been introduced to reduce intraoperative errors inherent in the intermediate splint. However, the accuracy is still to be improved and a different approach without time-consuming laboratory process is needed, which can allow perioperative modification of unoptimized maxillary position. The purpose of this study is to assess the feasibility and accuracy of a robot arm combined with intraoperative image-guided navigation in orthognathic surgery. The experiments were performed on 12 full skull phantom models. After Le Fort I osteotomy, the maxillary segment was repositioned to a different target position using a robot arm and image-guided navigation and stabilized. Using the navigation and the postoperative computed tomography (CT) images, the achieved maxillary position was compared with the planned position. Although the maxilla showed mild displacement during the fixation, the mean absolute deviations from the target position were 0.16 mm, 0.18 mm, and 0.20 mm in medio-lateral, antero-posterior, and supero-inferior directions, respectively, in the intraoperative navigation. Compared with the target position using postoperative CT, the achieved maxillary position had a mean absolute deviation of less than 0.5 mm for all dimensions and the mean root mean square deviation was 0.79 mm. The results of this study suggest that the robot arm combined with the intraoperative image-guided navigation may have great potential for surgical plan transfer with the accurate repositioning of the maxilla in the orthognathic surgery.
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Affiliation(s)
- Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul 03080, Korea;
| | - Sang-Yoon Woo
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 03080, Korea;
| | - Won-Jin Yi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul 03080, Korea
- Correspondence: (W.-J.Y.); (S.J.H.); Tel.: +82-2-2072-3049 (W.-J.Y.); +82-2-595-4737 (S.J.H.); Fax: +82-2-744-3919 (W.-J.Y.); +82-2-525-4738 (S.J.H.)
| | - Soon Jung Hwang
- Hwang Soon Jung’s Dental Clinic for Oral and Maxillofacial Surgery, Woonam Building, 2,3 F, 349, Gangnam-daero, Seocho-gu, Seoul 06626, Korea
- Correspondence: (W.-J.Y.); (S.J.H.); Tel.: +82-2-2072-3049 (W.-J.Y.); +82-2-595-4737 (S.J.H.); Fax: +82-2-744-3919 (W.-J.Y.); +82-2-525-4738 (S.J.H.)
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12
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Yang HJ, Hwang SJ. Effects of 17β-Estradiol Deficiency and Mechanical Overload on Osseous Changes in the Rat Temporomandibular Joint. J Oral Maxillofac Surg 2020; 78:214.e1-214.e14. [DOI: 10.1016/j.joms.2019.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/14/2019] [Accepted: 10/05/2019] [Indexed: 11/17/2022]
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13
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Kim K, Kim HR, Kang MG, Park HY, Koh JS, Hwang SJ, Hwang JY, Park JR. P1416 Clinical importance of consecutive transthoracic echocardiography in the patients with hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
nothing
OnBehalf
nothing
Background
prediction of outcomes Hypertrophic cardiomyopathy (HCM) have been robustly analyzed with echocardiography. However, there is limited data of serial follow-up (FU) transthoracic echocardiography (TTE) to predict outcomes in patients with HCM.
Objectives
This study aim is to discover clinical predictors associated with consecutive TTE follow-up in patients with HCM.
Methods
From 2010 to 2016, 162 patients with HCM were enrolled retrospectively. Concentric LVH and others systolic disease related to wall thickness were excluded. Index TTE (baseline) was measured when firstly admitted in our hospital. FU TTE was analyzed at the end of follow-up, defined as the last recorded value in patients who did not develop events or the last recorded value before events developed.
Results
The average of FU TTE and clinical FU period was 3.7 ± 2.0 years. Clinical outcomes were defined as stroke, syncope, heart failure, arrhythmia and death. Interestingly, only baseline TR V max was a predictor for clinical outcome whereas the others echo parameters were not associated with events (Table 1). KM curve showed the TR Vmax ≥2.5m/s was also significant (log rank = 0.008, Fig 1.)
Conclusions Our study showed short-term FU TTE did not bring clinician with clinical benefits in the aspect of prediction for events. Only baseline TR V max was good correlation with cardiovascular outcomes and even in the survival analysis.
Serial TTE and changed values Total N = 162 index TTE (baseline) FU TTE Change of FU per year event no event p-value event no event p-value event no event p-value IVDd, mm 14 ± 4 15 ± 5 0.500 15 ± 5 14 ± 5 0.758 0.23 ± 0.51 -0.07 ± 1.27 0.200 LVIDd, mm 47 ± 5 48 ± 6 0.256 47 ± 7 48 ± 6 0.560 -0.22 ± 2.79 0.10 ± 2.27 0.444 LVEF, % 62 ± 5 61 ± 7 0.379 61 ± 6 61 ± 10 0.927 -0.43 ± 3.10 -0.04 ± 4.94 0.620 LAVI 43 ± 9 43 ± 8 0.879 57 ± 27 58 ± 23 0.849 0.53 ± 14.5 3.11 ± 7.2 0.134 EA ratio 0.9 ± 0.6 0.9 ± 0.6 0.782 1.0 ± 0.8 0.9 ± 0.6 0.595 -0.02 ± 0.76 0.003 ± 0.027 0.594 DT,ms 196 ± 58 201 ± 62 0.603 203 ± 91 217 ± 89 0.370 17 ± 57 5 ± 40 0.154 septal e` 4.4 ± 2.1 4.2 ± 1.6 0.585 4.4 ± 1.6 4.6 ± 1.7 0.438 0.24 ± 0.91 0.05 ± 0.65 0.190 E of e` 17 ± 11 17 ± 23 0.993 15 ± 9 15 ± 6 0.726 -0.48 ± 4.42 -1.66 ± 22.78 0.728 TR velocity 2.6 ± 0.5 2.4 ± 0.4 0.012 2.7 ± 0.6 2.6 ± 0.4 0.604 0.05 ± 0.30 0.04 ± 0.18 0.905 Max wall thickness 17 ± 3 18 ± 3 0.137 17 ± 4 17 ± 3 0.888 -0.01 ± 2.19 -0.18 ± 1.14 0.522
Abstract P1416 Figure. TR Vmax and CV outcomes in the KM curve
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Affiliation(s)
- K Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - H R Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - M G Kang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - H Y Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J R Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
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Lee K, Hwang SJ. Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite. Maxillofac Plast Reconstr Surg 2019; 41:51. [PMID: 31824889 PMCID: PMC6877677 DOI: 10.1186/s40902-019-0230-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/23/2019] [Indexed: 11/10/2022] Open
Abstract
Purpose It has been reported before that the amount of pharyngeal airway space (PAS) significantly decreases following mandibular setback (MS) surgery in patients with mandibular prognathism (MP). Further, MP patients with an anterior open-bite (AOB) presentation may show a larger decrease in PAS compared with those without AOB. However, studies on postoperative PAS changes in MP patients with AOB remain rare. This study sought to evaluate changes in PAS and hyoid bone positioning following MS surgery in MP patients with and without AOB. Patients and methods Twenty patients who underwent two jaw surgery involving MS movement were included. Patients were divided into a non-AOB group (n = 10; overbite > 2 mm) and an AOB group (n = 10; overbite < - 4 mm). Three-dimensional changes in PAS and hyoid bone positioning were compared and statistically evaluated pre- and postoperatively using computed tomography (CT). Results The mean magnitude of MS was 6.0 ± 2.8 mm and 5.6 ± 3.2 mm in the non-AOB group and AOB group, respectively. The oropharyngeal volume and upper hypopharyngeal volume were significantly reduced after surgery in both the groups (p = 0.006 and p = 0.003), while the retroglossal cross-sectional area was significantly reduced only in the AOB group (p = 0.028). Although the AOB group showed a larger decrease in PAS, the difference was not statistically significant between the groups. The position of the hyoid bone showed significant posterior and inferior displacement only in the AOB group, while the vertical displacement of the hyoid bone showed a statistically significant difference between the two groups. Conclusion PAS was significantly decreased after MS in both the groups, while only the AOB group presented a statistically significant reduction in the retroglossal cross-sectional area. Vertical displacement of the hyoid bone showed a statistically significant difference between the groups, while the PAS change was not. Surgeons should be aware of potential postoperative airway problems that may arise when performing MS surgeries.
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Affiliation(s)
- Kyungjin Lee
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Soon Jung Hwang
- HSJ Dental Clinic for Oral and Maxillofacial Surgery, Wannam Building 2,3F, 349 Gangnam-daero, Seocho-gu, Seoul, 06626 Republic of Korea
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15
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Lee SY, Park Y, Hwang SJ. Effect of bFGF and fibroblasts combined with hyaluronic acid-based hydrogels on soft tissue augmentation: an experimental study in rats. Maxillofac Plast Reconstr Surg 2019; 41:47. [PMID: 31750275 PMCID: PMC6834819 DOI: 10.1186/s40902-019-0234-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 10/03/2019] [Indexed: 11/28/2022] Open
Abstract
Background Hyaluronic acid (HA) has been applied as a primary biomaterial for temporary soft tissue augmentation and as a carrier for cells and the delivery of growth factors to promote tissue regeneration. Although HA derivatives are the most versatile soft tissue fillers on the market, they are resorbed early, within 3 to 12 months. To overcome their short duration, they can be combined with cells or growth factors. The purpose of this study was to investigate the stimulating effects of human fibroblasts and basic fibroblast growth factors (bFGF) on collagen synthesis during soft tissue augmentation by HA hydrogels and to compare these with the effects of a commercial HA derivative (Restylane®). Methods The hydrogel group included four conditions. The first condition consisted of hydrogel (H) alone as a negative control, and the other three conditions were bFGF-containing hydrogel (HB), human fibroblast-containing hydrogel (HF), and human fibroblast/bFGF-containing hydrogel (HBF). In the Restylane® group (HGF), the hydrogel was replaced with Restylane® (R, RB, RF, RBF). The gels were implanted subdermally into the back of each nude mouse at four separate sites. Twelve nude mice were used for the hydrogel (n = 6) and Restylane® groups (n = 6). The specimens were harvested 8 weeks after implantation and assessed histomorphometrically, and collagen synthesis was evaluated by RT-PCR. Results The hydrogel group showed good biocompatibility with the surrounding tissues and stimulated the formation of a fibrous matrix. HBF and HF showed significantly higher soft tissue synthesis compared to H (p < 0.05), and human collagen type I was well expressed in HB, HF, and HBF; HBF showed the strongest expression. The Restylane® filler was surrounded by a fibrous capsule without any soft tissue infiltration from the neighboring tissue, and collagen synthesis within the Restylane® filler could not be observed, even though no inflammatory reactions were observed. Conclusion This study revealed that HA-based hydrogel alone or hydrogel combined with fibroblasts and/or bFGF can be effectively used for soft tissue augmentation.
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Affiliation(s)
- Su Yeon Lee
- 1Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 110-768 South Korea
| | - Yongdoo Park
- 2Department of Biomedical Engineering, Korea University Medical College, Seoul, Republic of Korea
| | - Soon Jung Hwang
- HSJ Dental Clinic for Oral and Maxillofacial Surgery, Wannam Building 2,3F 349 Gangnam-daero, Seocho-gu Seoul, 06626 Republic of Korea
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16
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Jang JY, Ahn JH, Bae JS, Kang MG, Kim K, Park HW, Koh JS, Park Y, Hwang SJ, Kwak CH, Hwang JY, Jeong YH. P3637Relationship between serial measurements of NT-proBNP and cardiovascular events in patients with acute coronary syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Increased level of natriuretic peptides has been known as an important predictors of adverse cardiovascular (CV) outcomes in patients with acute coronary syndrome (ACS). We sought to evaluate clinical implication of N-terminal pro-brain natriuretic peptide (NT-proBNP) measured at initial and follow-up periods.
Methods
Serial NT-proBNP levels (on-admission and one-month post-PCI) were measured in ACS patients undergoing PCI (n=2,290). High NT-proBNP levels were determined according to the predefined age-specific criteria. Patients were stratified into 4 groups according to NT-proBNP levels (on-admission & one-month): (1) normal-normal group (n=1234, 53.9%); (2) high–normal group (n=257, 11.2%); (3) normal-high group (n=376, 16.4%); and (4) high-high group (n=423, 18.5%). Clinical events were defined as all-cause death and MACE (a composite of CV death, non-fatal MI, and ischemic stroke).
Results
With a median follow-up of 35.9 (IQR: 16.8, 54.5) months, all-cause death and MACE were occurred in 4.1% and 7.2%, respectively. NT-proBNP on-admission vs. at one-month did not differ significantly (median 391.6 [IQR: 143.9, 1402.3] vs. median 619.1 [IQR 240.1, 1616.1]; p=0.622), but the prevalence of high NT-proBNP was increased over time (25.3% to 34.9%; p<0.001). The rates of all-cause death and MACE significantly increased only in the high-high group compared with other groups (log-rank test, all p values <0.001, Figure). After adjustment, the high-high group remained significantly risky in terms with the occurrence of all-cause death (HR, 2.99; 95% CI, 1.65 to 5.41; p<0.001) and MACE (HR, 1.96; 95% CI, 1.28 to 3.01; p=0.002).
Figure 1
Conclusion
Serial measurements of NT-proBNP at on-admission and follow-up can help to stratify the risks of all-cause death and adverse CV events following PCI in ACS patients. About two-fifths of patients having high NT-proBNP level during hospitalization can be classified into the low-risk group for all-cause death and adverse CV events.
Acknowledgement/Funding
None
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Affiliation(s)
- J Y Jang
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - J H Ahn
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - J S Bae
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - M G Kang
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - K Kim
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - H W Park
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - Y Park
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - C H Kwak
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - Y H Jeong
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
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Joo Yang H, Hwang SJ. Bone forming strategy of low‐intensity pulsed ultrasound and BMP‐2 in distraction osteogenesis. Clin Oral Implants Res 2019. [DOI: 10.1111/clr.128_13509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hoon Joo Yang
- Seoul National University Dental Hospital, Korea, Republic of (South Korea)
| | - Soon Jung Hwang
- Seoul National University Dental Hospital, Korea, Republic of (South Korea)
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Yang HJ, Hwang SJ. Comparison of low‐intensity pulsed ultrasound and PEMF for bone formation in DO. Clin Oral Implants Res 2019. [DOI: 10.1111/clr.129_13509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Hoon Joo Yang
- Seoul National University Dental Hospital, Korea, Republic of (South Korea)
| | - Soon Jung Hwang
- Seoul National University Dental Hospital, Korea, Republic of (South Korea)
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Yang HJ, Hwang SJ. Void space and long-term volumetric changes of maxillary sinus floor augmentation with comparison between hydroxyapatite soaked with bone morphogenetic protein 2 and anorganic bovine xenograft alone. J Craniomaxillofac Surg 2019; 47:1626-1632. [PMID: 31395420 DOI: 10.1016/j.jcms.2019.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/07/2019] [Accepted: 07/14/2019] [Indexed: 11/17/2022] Open
Abstract
PURPOSE We hypothesized that the void volume after maxillary sinus floor augmentation (MSFA) with recombinant human bone morphogenetic protein-2 (rhBMP-2) would be larger than that without rhBMP-2, and filled with bone in the long term. The aim of this study was to analyze the occurrence of void space and long-term volumetric changes after MSFA with rhBMP-2 and hydroxyapatite (BMP-2/H). MATERIAL AND METHODS In 25 subjects, MSFA was performed with BMP-2/H (group I) or an anorganic bovine xenograft (group II). Computed tomography scans were taken twice, at 3 months (T1) and at least 24 months (T2) after surgery. Total volume (TV), bone volume (BV), and void volume (VV) were measured and analysed statistically. RESULTS While similar amounts of graft material were used, the TV was significantly larger in group I than in group II (p = 0.014). The VV showed a tendency to be larger in group I than in group II. VV reduction up to T2 was significantly greater in group I than in group II. Consequently, the BV at T2 was significantly greater in group I than in group II by 36% (p = 0.014). CONCLUSION This study showed that our hypothesis was valid. rhBMP-2 is effective for long-term bone regeneration after MSFA.
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Affiliation(s)
- Hoon Joo Yang
- Orthognathic Surgery Center, Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Soon Jung Hwang
- Hwang Soon Jung's Dental Clinic for Oral and Maxillofacial Surgery, Woonam Building, 2,3 F, 349, Gangnam-daero, Seocho-gu, Seoul, 06626, Republic of Korea.
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Lee SJ, Yang HJ, Choi MH, Woo SY, Huh KH, Lee SS, Heo MS, Choi SC, Hwang SJ, Yi WJ. Real-time augmented model guidance for mandibular proximal segment repositioning in orthognathic surgery, using electromagnetic tracking. J Craniomaxillofac Surg 2018; 47:127-137. [PMID: 30447987 DOI: 10.1016/j.jcms.2018.10.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/17/2018] [Accepted: 10/18/2018] [Indexed: 10/28/2022] Open
Abstract
It is essential to reposition the mandibular proximal segment (MPS) as close to its original position as possible during orthognathic surgery. Conventional methods cannot pinpoint the exact position of the condyle in the fossa in real time during repositioning. In this study, based on an improved registration method and a separable electromagnetic tracking tool, we developed a real-time, augmented, model-guided method for MPS surgery to reposition the condyle into its original position more accurately. After virtual surgery planning, using a complex maxillomandibular model, the final position of the virtual MPS model was simulated via 3D rotations. The displacements resulting from the MPS simulation were applied to the MPS landmarks to indicate their final postoperative positions. We designed a new registration body with 24 fiducial points for registration, and determined the optimal point group on the registration body through a phantom study. The registration between the patient's CT image and physical spaces was performed preoperatively using the optimal points. We also developed a separable frame for installing the electromagnetic tracking tool on the patient's MPS. During MPS surgery, the electromagnetic tracking tool was repeatedly attached to, and separated from, the MPS using the separable frame. The MPS movement resulting from the surgeon's manipulation was tracked by the electromagnetic tracking system. The augmented condyle model and its landmarks were visualized continuously in real time with respect to the simulated model and landmarks. Our method also provides augmented 3D coronal and sagittal views of the fossa and condyle, to allow the surgeon to examine the 3D condyle-fossa positional relationship more accurately. The root mean square differences between the simulated and intraoperative MPS models, and between the simulated and postoperative CT models, were 1.71 ± 0.63 mm and 1.89 ± 0.22 mm respectively at three condylar landmarks. Thus, the surgeons could perform MPS repositioning conveniently and accurately based on real-time augmented model guidance on the 3D condyle positional relationship with respect to the glenoid fossa, using augmented and simulated models and landmarks.
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Affiliation(s)
- Sang-Jeong Lee
- Department of Biomedical Radiation Sciences (Head: Sung-Joon Ye, PhD), Graduate School of Convergence Science and Technology, Seoul National University, South Korea
| | - Hoon Joo Yang
- Orthognathic Surgery Center (Head: Soon Jung Hwang, DDS, MD, PhD), Seoul National University Dental Hospital, South Korea
| | - Min-Hyuk Choi
- Department of Biomedical Radiation Sciences (Head: Sung-Joon Ye, PhD), Graduate School of Convergence Science and Technology, Seoul National University, South Korea
| | - Sang-Yoon Woo
- Department of Biomedical Radiation Sciences (Head: Sung-Joon Ye, PhD), Graduate School of Convergence Science and Technology, Seoul National University, South Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology (Head: Min-Suk Heo, DDS, PhD), School of Dentistry and Dental Research Institute, Seoul National University, South Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology (Head: Min-Suk Heo, DDS, PhD), School of Dentistry and Dental Research Institute, Seoul National University, South Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology (Head: Min-Suk Heo, DDS, PhD), School of Dentistry and Dental Research Institute, Seoul National University, South Korea
| | - Soon-Chul Choi
- Department of Oral and Maxillofacial Radiology (Head: Min-Suk Heo, DDS, PhD), School of Dentistry and Dental Research Institute, Seoul National University, South Korea
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery (Head: Jin-Young Choi, DDS, MD, PhD), School of Dentistry, Dental Research Institute, BK21 Plus, Seoul National University, South Korea.
| | - Won-Jin Yi
- Department of Biomedical Radiation Sciences (Head: Sung-Joon Ye, PhD), Graduate School of Convergence Science and Technology, Seoul National University, South Korea; Department of Oral and Maxillofacial Radiology (Head: Min-Suk Heo, DDS, PhD), School of Dentistry and Dental Research Institute, Seoul National University, South Korea.
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Yang HJ, Han JJ, Hwang SJ. Accuracy of 3D reproduction of natural head position using three different manual reorientation methods compared to 3D software. J Craniomaxillofac Surg 2018; 46:1625-1630. [DOI: 10.1016/j.jcms.2018.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 05/26/2018] [Accepted: 06/07/2018] [Indexed: 11/27/2022] Open
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22
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Park YW, Jeong YH, Hwang JY, Kwack CH, Hwang SJ. P1714Risk stratification for ischemic and bleeding events in patients using a potent P2Y12 inhibitor. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y W Park
- Gyeongsang National University Hospital, Jinju, Korea Republic of
| | - Y H Jeong
- Gyeongsang National University Hospital, Jinju, Korea Republic of
| | - J Y Hwang
- Gyeongsang National University Hospital, Jinju, Korea Republic of
| | - C H Kwack
- Gyeongsang National University Hospital, Jinju, Korea Republic of
| | - S J Hwang
- Gyeongsang National University Hospital, Jinju, Korea Republic of
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Kim KH, Jang HG, Kang YM, Kang MG, Park HW, Koh JS, Park JR, Hwang SJ, Hwang JY. P3681Syntax-I score can predict in-hospital mortality among the patients with ST segment elevation myocardial infarction and cardiogenic shock. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K H Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - H G Jang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - Y M Kang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - M G Kang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - H W Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - J S Koh
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - J R Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - S J Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - J Y Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
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24
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Kim RY, Seong Y, Cho TH, Lee B, Kim IS, Hwang SJ. Local administration of nuclear factor of activated T cells (NFAT) c1 inhibitor to suppress early resorption and inflammation induced by bone morphogenetic protein-2. J Biomed Mater Res A 2018; 106:1299-1310. [PMID: 29316218 DOI: 10.1002/jbm.a.36332] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/15/2017] [Accepted: 01/05/2018] [Indexed: 11/05/2022]
Abstract
Nuclear factor of activated T cells (NFAT)-c1 is known as a key regulator in osteoclast differentiation and immune response. This study is a follow-up to our previous study showing the antiresorptive activity of VIVIT, a peptide type NFATc1 inhibitor, using absorbable collagen sponge (ACS). This study aimed to investigate the effective concentration range of local VIVIT that suppresses early excessive osteoclast activation and inflammation induced by high-dose recombinant human bone morphogenetic protein (rhBMP)-2 and concomitantly enhances bone healing in a rat critical-sized calvaria defect model. High-dose rhBMP-2 (40 μg/defect) alone significantly increased in vivo osteoclast activation and expression of the inflammatory cytokines interleukin-1β and transforming necrosis factor-α on the scaffold at 7 days after surgery. However, rhBMP-2 had no direct effect on osteoclast activation in vitro. Osteoclast activation by rhBMP-2 was significantly suppressed by combined treatment with VIVIT at concentrations of 75 and 150 μM, but not at 15 μM, whereas suppression of inflammation occurred at all doses of VIVIT. Microcomputed tomography at 4 and 8 weeks after implantation revealed that the combination of rhBMP-2 and VIVIT at 75 μM VIVIT led to a greater bone fraction at the initial defect area, compared with rhBMP-2 alone. These findings revealed that local administration of VIVIT at certain concentrations has multiple positive effects that weaken early excessive osteoimmunological responses and enhance bone healing after rhBMP-2 administration. VIVIT has the potential to expand the therapeutic area of high-dose rhBMP-2 therapy to inflammatory bone loss. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1299-1310, 2018.
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Affiliation(s)
- Ri Youn Kim
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 110-749, Republic of Korea
| | - Yeju Seong
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 110-749, Republic of Korea
| | - Tae Hyung Cho
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 110-749, Republic of Korea
| | - Beomseok Lee
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 110-749, Republic of Korea
| | - In Sook Kim
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 110-749, Republic of Korea
| | - Soon Jung Hwang
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, 110-749, Republic of Korea.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, 110-749, Republic of Korea
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25
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Cho TH, Kim IS, Lee B, Park SN, Ko JH, Hwang SJ. Early and Marked Enhancement of New Bone Quality by Alendronate-Loaded Collagen Sponge Combined with Bone Morphogenetic Protein-2 at High Dose: A Long-Term Study in Calvarial Defects in a Rat Model. Tissue Eng Part A 2017; 23:1343-1360. [DOI: 10.1089/ten.tea.2016.0557] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tae Hyung Cho
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Clinical Dental Research Institute, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - In Sook Kim
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Beomseok Lee
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Si-Nae Park
- Regenerative Medicine Research Center, Dalim Tissen Co., Ltd., Seoul, Republic of Korea
| | - Jae-Hyung Ko
- Regenerative Medicine Research Center, Dalim Tissen Co., Ltd., Seoul, Republic of Korea
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Clinical Dental Research Institute, Seoul National University Dental Hospital, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, School of Dentistry, BK21 Plus Program, Seoul National University, Seoul, Republic of Korea
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26
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Chang AR, Cho TH, Hwang SJ. Receptor Activator of Nuclear Factor Kappa-B Ligand-Induced Local Osteoporotic Canine Mandible Model for the Evaluation of Peri-Implant Bone Regeneration. Tissue Eng Part C Methods 2017; 23:781-794. [DOI: 10.1089/ten.tec.2017.0196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Ah Ryum Chang
- Department of Oral and Maxillofacial Surgery, BK 21 Plus, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Tae Hyung Cho
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, BK 21 Plus, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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27
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Hwang SJ, Cho TH, Lee B, Kim IS. Bone-healing capacity of conditioned medium derived from three-dimensionally cultivated human mesenchymal stem cells and electrical stimulation on collagen sponge. J Biomed Mater Res A 2017; 106:311-320. [PMID: 28884512 DOI: 10.1002/jbm.a.36224] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/02/2017] [Accepted: 08/24/2017] [Indexed: 12/29/2022]
Abstract
Continuing from our previous study, we hypothesized that combining electrical stimulation (ES) and three-dimensional (3D) culture would be a useful strategy to obtain more bioactive factors in conditioned medium (CM) derived from human mesenchymal stem cells (hMSC). Our aim in this study was to investigate the bone-healing capacity of CM derived from hMSC after 4 days of culture on a collagen sponge-exposed (CM-ES) or unexposed (CM-control; CM-CON) to ES in comparison with that of hMSC implantation. A cytokine assay of both CMs revealed the presence of cytokines, growth factors, and trophic factors. In vitro evaluation of both CMs showed increased cell growth and alkaline phosphatase activity of the hMSC, with little difference between CMs. We investigated the bone-healing effect using two bone disease models: bone defect and inflammatory bone loss. The calvaria defect was implanted with whole CM or 3D-precultured hMSC unexposed to ES. Microcomputed tomography analysis after 4 weeks indicated a twofold greater bone volume in the CM-CON and CM-ES groups than in the hMSC and vehicle groups, though we found no difference between the CM groups. However, CM-ES enhanced the bone healing of interleukin-1-induced bone loss to a level comparable with hMSC, whereas CM-CON did not. These results show that 3D-cultured CM had a greater or similar capacity for bone healing as treatment using hMSC transplantation, and CM-ES was especially effective against inflammatory bone loss. Thus, 3D-cultured CM with or without ES presents an encouraging alternative to MSC-based bone healing. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 311-320, 2018.
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Affiliation(s)
- Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Tae Hyung Cho
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Beomseok Lee
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - In Sook Kim
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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28
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Kim HY, Lee SJ, Kim SM, Myoung H, Hwang SJ, Choi JY, Lee JH, Choung PH, Kim MJ, Seo BM. Extensive Surgical Procedures Result in Better Treatment Outcomes for Bisphosphonate-Related Osteonecrosis of the Jaw in Patients With Osteoporosis. J Oral Maxillofac Surg 2016; 75:1404-1413. [PMID: 28039736 DOI: 10.1016/j.joms.2016.12.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 12/06/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To identify the risk factors associated with relapse or treatment failure after surgery for bisphosphonate-related osteonecrosis of the jaw (BRONJ) in patients with osteoporosis. PATIENTS AND METHODS We performed a retrospective cohort study of BRONJ in patients with osteoporosis who had undergone surgical procedures from 2004 to 2016 at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The predictor variables were a set of heterogeneous variables, including demographic (age, gender), anatomic (maxilla or mandible, or both, affected location), clinical (disease stage, etiology, comorbidities, history of intravenous bisphosphonate intake), time (conservative treatment before surgery, bisphosphonate treatment before the development of BRONJ, discontinuation of the drug before surgery, interval to final follow-up, interval to reoperation in the case of relapse or treatment failure), and perioperative variables (type of anesthesia, type of surgical procedures). The primary outcome variable was relapse after surgery that required reoperation (yes vs no). The descriptive and bivariate statistics were computed to assess the relationships between the study variables and the outcome. To determine the risk factors, we conducted a survival analysis using the Cox model. RESULTS The final sample included 325 subjects with a median age of 75 years, and 97% were women. After surgery, 30% of patients did not completely recuperate and underwent repeat surgery. The interval from the first surgery to reoperation ranged from 10 days to 5.6 years. Relapse or treatment failure most often occurred immediately after surgery. The type of surgical procedure and mode of anesthesia were the most important factors in the treatment outcome. A drug holiday did not appear to influence the likelihood of relapse after surgery. CONCLUSIONS Treatment of BRONJ in patients with osteoporosis might benefit from more careful and extensive surgical procedures rather than curettage performed with the patient under local anesthesia.
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Affiliation(s)
- Hui Young Kim
- Postgraduate Student, Department of Oral and Maxillofacial Surgery, Graduate School, Seoul National University, Seoul, Korea
| | - Shin-Jae Lee
- Professor, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Soung Min Kim
- Professor, Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry and Dental Research Institute, Seoul, Korea
| | - Hoon Myoung
- Professor, Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry and Dental Research Institute, Seoul, Korea
| | - Soon Jung Hwang
- Professor, Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry and Dental Research Institute, Seoul, Korea
| | - Jin-Young Choi
- Professor, Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry and Dental Research Institute, Seoul, Korea
| | - Jong-Ho Lee
- Professor, Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry and Dental Research Institute, Seoul, Korea
| | - Pill-Hoon Choung
- Professor, Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry and Dental Research Institute, Seoul, Korea
| | - Myung Jin Kim
- Professor, Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry and Dental Research Institute, Seoul, Korea
| | - Byoung Moo Seo
- Professor, Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry and Dental Research Institute, Seoul, Korea.
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29
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Lim SS, Lee B, Kim IS, Hwang SJ. Differential modulation of zoledronate and etidronate in osseous healing of an extracted socket and tibia defect. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:8-19. [PMID: 27727104 DOI: 10.1016/j.oooo.2016.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 08/03/2016] [Accepted: 08/08/2016] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Osteonecrosis of the jaw has been increasing after dentoalveolar surgery in patients treated with an antiresorptive bisphosphonate (BP), especially strong zoledronate (ZA). The pathophysiology underlying why osteonecrosis occurs exclusively in the jaw bone remains unclear. This study investigated skeletal site-specific bone healing during the use of BPs to explore the preferential incidence of osteonecrosis of the jaw bone. STUDY DESIGN Extraction of mandibular molar and creation of a tibia defect were performed in rats 2 weeks after weekly intravenous injections with the potent ZA and the weaker BP etidronate. Bone healing was evaluated radiographically and histologically 1 and 4 weeks after defect creation. RESULTS Bone healing at the extracted socket showed that resorption precedes bone formation, while it was the opposite at the tibia defect. ZA use potentially suppressed bone remodeling, which led to impaired healing at the extracted socket but full regeneration of the tibia defect. However, etidronate showed less suppression of bone remodeling and resulted in increased bone formation at the extracted socket and full regeneration of the tibia defect. CONCLUSIONS These results suggest that skeletal site-dependent differences in the bone healing process underlie BP-related preferential occurrence of osteonecrosis of the jaw bone.
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Affiliation(s)
- Shin Saeng Lim
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Beomseok Lee
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - In Sook Kim
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
| | - Soon Jung Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea; Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
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30
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Fouque D, Chen J, Chen W, Garneata L, Hwang SJ, Kalantar-Zadeh K, Kopple JD, Mitch WE, Piccoli G, Teplan V, Chauveau P. Adherence to ketoacids/essential amino acids-supplemented low protein diets and new indications for patients with chronic kidney disease. BMC Nephrol 2016; 17:63. [PMID: 27388899 PMCID: PMC4936289 DOI: 10.1186/s12882-016-0278-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 06/14/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Low protein diets (LPD) have long been prescribed to chronic kidney disease patients with the goals of improving metabolic abnormalities and postpone the start of maintenance dialysis. METHODS We reviewed the recent literature addressing low protein diets supplemented with ketoacids/essential aminoacids prescribed during chronic kidney disease and their effects on metabolic, nutritional and renal parameters since 2013. RESULTS We show new information on how to improve adherence to these diets, on metabolic improvement and delay of the dialysis needs, and preliminary data in chronic kidney disease associated pregnancy. In addition, data on incremental dialysis have been reviewed, as well as potential strategies to reverse protein energy wasting in patients undergoing maintenance dialysis. CONCLUSION These recent data help to better identify the use of low protein diets supplemented with ketoacids/essential aminoacids during chronic kidney disease.
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Affiliation(s)
- Denis Fouque
- UCBL, Centre Hospitalier Lyon-Sud, University Lyon, Carmen, Cens, F-69622, Lyon, France. .,Department Nephrology, Centre Hospitalier Lyon Sud, Chemin du grand revoyet, 69495, Pierre Bénite, France.
| | - Jing Chen
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wei Chen
- Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Beijing, China
| | - Liliana Garneata
- Department Nephrology and Internal Medicine, Dr Carol Davila Hospital of Nephrology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - S J Hwang
- Division Nephrology, Kaohsiung Medical University Hospital, Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kamyar Kalantar-Zadeh
- Division Nephrology and Hypertension, University of California Irvine School of Medicine, Irvine, CA, USA.,Deparment Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Joel D Kopple
- Division Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.,David Geffen School of Medicine at UCLA, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - William E Mitch
- Nephrology Division, Baylor College of Medicine, Houston, TX, USA
| | - Giorgina Piccoli
- SS Nephrology, ASOU San Luigi, Departmentt of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - Vladimir Teplan
- Department Nephrol, Institute Clin Exp Med, Transpl Centre, Prague, Czech Republic
| | - Philippe Chauveau
- Service de Néphrologie, CHU de Bordeaux & Aurad-Aquitaine, Bordeaux, France
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31
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Kim RY, Lee B, Park SN, Ko JH, Kim IS, Hwang SJ. Is Heparin Effective for the Controlled Delivery of High-Dose Bone Morphogenetic Protein-2? Tissue Eng Part A 2016; 22:801-17. [DOI: 10.1089/ten.tea.2015.0537] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ri Youn Kim
- BK21 2nd Program for Craniomaxillofacial Life Science, Department of Maxillofacial Cell and Developmental Biology, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Beomseok Lee
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Si-Nae Park
- Regenerative Medicine Research Center, Dalim Tissen Co., Ltd., Seoul, Republic of Korea
| | - Jae-Hyung Ko
- Regenerative Medicine Research Center, Dalim Tissen Co., Ltd., Seoul, Republic of Korea
| | - In Sook Kim
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Soon Jung Hwang
- BK21 2nd Program for Craniomaxillofacial Life Science, Department of Maxillofacial Cell and Developmental Biology, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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32
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Kim SK, Cho TH, Han JJ, Kim IS, Park Y, Hwang SJ. Comparative study of BMP-2 alone and combined with VEGF carried by hydrogel for maxillary alveolar bone regeneration. Tissue Eng Regen Med 2016; 13:171-181. [PMID: 30603397 DOI: 10.1007/s13770-015-0046-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 07/16/2015] [Accepted: 07/22/2015] [Indexed: 10/22/2022] Open
Abstract
The effect of vascular endothelial growth factor (VEGF) combined with bone morphogenetic protein-2 (BMP-2) for bone regeneration is still controversial as to whether or not VEGF has a synergistic or additive effect. This study attempted to evaluate the synergistic effect of VEGF and BMP-2 compared to BMP-2 alone for maxillary alveolar bone regeneration using collagen sponge/hydrogel complex sheets in a canine model. After mixing BMP-2 and VEGF with a hyaluronic acid-based hydrogel (HAH), the collagen sponge/hydrogel complex was transplanted into maxillary alveolar bone defects (n=14) after the extraction of canine upper first molars on both sides. Bone regeneration was evaluated in three groups (control group without growth factors, experimental groups I and II with BMP-2 alone and BMP-2 and VEGF, respectively) using micro-computed tomography and histological staining. The total amount of new bone formations and bone mineral density were significantly higher in the group with BMP-2 only and the group with BMP-2 combined with VEGF than it in the control group. The area with positive staining of von Willebrand factor bone defect was significantly greater in the group with BMP-2 only and with dual growth factors than the control. BMP-2 released from the HAH promoted new bone formation. However, the combination of BMP-2 and VEGF did not show a synergistic or additive effect on bone regeneration at canine maxillary alveolar bone defects.
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Affiliation(s)
- Sook Kyoung Kim
- 1Department of Biomedical Engineering, College of Medicine, Korea University, Seoul, Korea
| | - Tae Hyung Cho
- 2Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jeong Joon Han
- 2Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
| | - In Sook Kim
- 3Dental Research Institute, BK 21 Plus, Seoul National University, Seoul, Korea
| | - Yongdoo Park
- 1Department of Biomedical Engineering, College of Medicine, Korea University, Seoul, Korea
| | - Soon Jung Hwang
- 2Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea.,3Dental Research Institute, BK 21 Plus, Seoul National University, Seoul, Korea
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33
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Lee SJ, Woo SY, Huh KH, Lee SS, Heo MS, Choi SC, Han JJ, Yang HJ, Hwang SJ, Yi WJ. Virtual skeletal complex model- and landmark-guided orthognathic surgery system. J Craniomaxillofac Surg 2016; 44:557-68. [PMID: 27012762 DOI: 10.1016/j.jcms.2016.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 01/30/2016] [Accepted: 02/19/2016] [Indexed: 11/26/2022] Open
Abstract
In this study, correction of the maxillofacial deformities was performed by repositioning bone segments to an appropriate location according to the preoperative planning in orthognathic surgery. The surgery was planned using the patient's virtual skeletal models fused with optically scanned three-dimensional dentition. The virtual maxillomandibular complex (MMC) model of the patient's final occlusal relationship was generated by fusion of the maxillary and mandibular models with scanned occlusion. The final position of the MMC was simulated preoperatively by planning and was used as a goal model for guidance. During surgery, the intraoperative registration was finished immediately using only software processing. For accurate repositioning, the intraoperative MMC model was visualized on the monitor with respect to the simulated MMC model, and the intraoperative positions of multiple landmarks were also visualized on the MMC surface model. The deviation errors between the intraoperative and the final positions of each landmark were visualized quantitatively. As a result, the surgeon could easily recognize the three-dimensional deviation of the intraoperative MMC state from the final goal model without manually applying a pointing tool, and could also quickly determine the amount and direction of further MMC movements needed to reach the goal position. The surgeon could also perform various osteotomies and remove bone interference conveniently, as the maxillary tracking tool could be separated from the MMC. The root mean square (RMS) difference between the preoperative planning and the intraoperative guidance was 1.16 ± 0.34 mm immediately after repositioning. After surgery, the RMS differences between the planning and the postoperative computed tomographic model were 1.31 ± 0.28 mm and 1.74 ± 0.73 mm for the maxillary and mandibular landmarks, respectively. Our method provides accurate and flexible guidance for bimaxillary orthognathic surgery based on intraoperative visualization and quantification of deviations for simulated postoperative MMC and landmarks. The guidance using simulated skeletal models and landmarks can complement and improve conventional navigational surgery for bone repositioning in the craniomaxillofacial area.
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Affiliation(s)
- Sang-Jeong Lee
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Sang-Yoon Woo
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Soon-Chul Choi
- Department of Oral and Maxillofacial Radiology, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
| | - Won-Jin Yi
- Department of Oral and Maxillofacial Radiology, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
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Jin IG, Kim JH, Wu HG, Hwang SJ. Effect of mesenchymal stem cells and platelet-derived growth factor on the healing of radiation induced ulcer in rats. Tissue Eng Regen Med 2016; 13:78-90. [PMID: 30603388 DOI: 10.1007/s13770-015-0055-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 07/26/2015] [Accepted: 08/24/2015] [Indexed: 01/05/2023] Open
Abstract
Radiation-induced skin ulceration is a frequent complication of radiation therapy. This study investigated the effects of rat mesenchymal stem cells (rMSCs) and platelet-derived growth factor (PDGF) on the healing of radiation-induced soft tissue injury. Sprague-Dawley rats (n=17) were irradiated on the right and left buttocks with a single dose of 50 Gy. The right buttocks were administered with phosphatebuffered solution as a control. The left buttocks were administered with either rMSCs (2×106 cells), PDGF (8 µg), or PDGF combined with rMSCs. Administration was done at three weeks after irradiation. Wound healing was analyzed by calculating the percentage of residual ulcerated skin area compared to the total irradiated area during the five week healing period after administration. Modified skin scores were also assessed. Finally, skin lesions were histologically evaluated. More than 40% of the irradiated skin area within the irradiated zone underwent ulceration within 16 days postirradiation, with peak ulceration exceeding 50% around three weeks post-irradiation. Administration of rMSCs or PDGF alone did not confer any significant healing effect. The combined rMSCs+PDGF treatment significantly reduced the wound size compared with the nontreated control up to two weeks postinjection. Regarding the histological examination, lesions administered with PDGF (either alone or mixed with rMSCs) resulted in a greater deposition of highly organized collagen fibers throughout the dermis layer, compared with the control. In conclusion, the combined administration of rMSCs and PDGF efficiently enhanced the healing of radiation-induced skin ulceration.
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Affiliation(s)
- Im Geon Jin
- 1Department of Oral & Maxillofacial Surgery, School of Dentistry, Brain Korea 21 Plus, Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jin Ho Kim
- 2Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
| | - Hong-Gyun Wu
- 2Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
| | - Soon Jung Hwang
- 1Department of Oral & Maxillofacial Surgery, School of Dentistry, Brain Korea 21 Plus, Dental Research Institute, Seoul National University, Seoul, Korea
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Park JH, Jung YE, Kim MJ, Hwang SJ. Periimplant bone regeneration in hydroxyapatite block grafts with mesenchymal stem cells and bone morphogenetic protein-2. Tissue Eng Regen Med 2016; 13:437-445. [PMID: 30603425 DOI: 10.1007/s13770-015-0049-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 07/12/2015] [Accepted: 07/14/2015] [Indexed: 11/25/2022] Open
Abstract
Hydroxyapatite (HA) blocks as an alternative material for autogenous onlay bone grafts are regarded as an insufficient substitute for osseointegration of dental implant. In this study, we evaluated the effects of dog mesenchymal stromal cells (dMSCs) with or without bone morphogenetic protein-2 (BMP) on new peri-implant bone formation after HA block graft. In four mandibular bone defects (8×8×6 mm each) in five beagle dogs, dental implants were placed with HA block loaded with autogenous dMSCs with or without BMP-2. Animals were sacrificed at eight weeks, and bone healing was evaluated among four groups consisting of 1) HA alone as a control, 2) HA+dMSCs, 3) HA+BMP-2, and 4) HA+dMSCs+BMP-2. According to histomorphometric evaluation, the MSC+BMP-2 group and the BMP-2 group showed significantly higher bone-implant-contact (BIC) length than the MSC group, while there was no significant difference in new bone formation among the groups. According to micro-CT analysis, bone volume and bone mineral density were significantly higher in the MSC+BMP-2 group compared with the control group (p<0.01 and p<0.05, respectively). BIC was significantly higher in the MSC+BMP-2 group than both the control and MSC groups (p<0.01 and p<0.05, respectively). In conclusion, our results showed that bone regeneration at peri-implant bone defects grafted with HA blocks was significantly increased by dual delivery of MSCs and BMP-2. Conversely, HA blocks with MSC or BMP-2 alone did not allow for efficient peri-implant bone regeneration.
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Affiliation(s)
- Jee-Hyun Park
- 1Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
| | - Young-Eun Jung
- 1Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
| | - Myung-Jin Kim
- 1Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
- 3Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080 Korea
| | - Soon Jung Hwang
- 1Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, Seoul, Korea
- 2Dental Research Institute, BK 21 Plus, Seoul National University, Seoul, Korea
- 3Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080 Korea
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Han JJ, Hwang SJ. Three-dimensional analysis of postoperative returning movement of perioperative condylar displacement after bilateral sagittal split ramus osteotomy for mandibular setback with different fixation methods. J Craniomaxillofac Surg 2015; 43:1918-25. [DOI: 10.1016/j.jcms.2015.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 07/04/2015] [Accepted: 08/10/2015] [Indexed: 10/23/2022] Open
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Han JJ, Hwang SJ. Relocation of the mandibular monocortical segment for reconstruction of a defect of the mandibular angle. Br J Oral Maxillofac Surg 2015; 54:473-4. [PMID: 26456338 DOI: 10.1016/j.bjoms.2015.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 09/14/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, 501-757, Republic of Korea; Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, 110-768, Republic of Korea
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, 110-768, Republic of Korea.
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Jin IG, Kim JH, Wu HG, Kim SK, Park Y, Hwang SJ. Effect of bone marrow-derived stem cells and bone morphogenetic protein-2 on treatment of osteoradionecrosis in a rat model. J Craniomaxillofac Surg 2015. [DOI: 10.1016/j.jcms.2015.06.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
The use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for the purpose of promoting bone regeneration is emerging; however, the high dose of rhBMP-2 required in humans is accompanied by several limitations, including bone resorption and swelling. To reduce the dose of rhBMP-2 required, the applicability of pulsed electromagnetic fields (PEMF) was evaluated using a rat calvarial defect model. After creating an 8-mm-diameter calvarial bone defect, a collagen sponge soaked in different concentrations (0, 2.5, 5, 10 μg) of rhBMP-2 was implanted at the defect area. One week after surgery, PEMF was applied for 8 h/day over 5 days in an experimental group of animals (n = 28) using a width of 12 μs, a pulse frequency of 60 Hz, and a magnetic intensity of 10 G. Animals were sacrificed 4 weeks after surgery and assessed by microcomputed tomography and histological and immunohistochemical analyses. In the absence of application of PEMF, bone volume, bone mineral density, trabecular thickness, trabecular number, and trabecular separation, all showed statistically significant differences, depending on the concentration of rhBMP-2 utilized (p < 0.001). PEMF accelerated bone regeneration in the groups that received 0, 2.5, and 5 μg rhBMP-2 (p < 0.05). In contrast, administration of 10 μg rhBMP-2 resulted in no additive effect on bone regeneration in combination with PEMF. Groups receiving no rhBMP-2 showed distinct bone regeneration in the central zone of the bone defect when treated with PEMF, whereas they failed to bridge the defect space without PEMF. Among the groups without PEMF, soft tissue infiltrations from the outer surface on the skin side were common. Among groups with PEMF, the groups receiving 5 and 10 μg rhBMP-2 displayed denser bone with significantly reduced dead spaces. The application of PEMF did not result in an accelerated effect on bone regeneration in groups treated with 10 μg rhBMP-2. Therefore, our data demonstrate that PEMF can promote bone regeneration in animals treated with a low concentration of rhBMP-2.
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Affiliation(s)
- Hoon Joo Yang
- 1 Department of Oral and Maxillofacial Surgery, Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, BK 21 Plus, Seoul National University , Seoul, Korea
| | - Ri Youn Kim
- 2 Department of Maxillofacial Cell and Developmental Biology, Dental Research Institute, School of Dentistry, BK 21 Plus, Seoul National University , Seoul, Korea
| | - Soon Jung Hwang
- 1 Department of Oral and Maxillofacial Surgery, Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, BK 21 Plus, Seoul National University , Seoul, Korea.,2 Department of Maxillofacial Cell and Developmental Biology, Dental Research Institute, School of Dentistry, BK 21 Plus, Seoul National University , Seoul, Korea
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Kim SK, Lee J, Song M, Kim M, Hwang SJ, Jang H, Park Y. Combination of three angiogenic growth factors has synergistic effects on sprouting of endothelial cell/mesenchymal stem cell-based spheroids in a 3D matrix. J Biomed Mater Res B Appl Biomater 2015; 104:1535-1543. [PMID: 26268584 DOI: 10.1002/jbm.b.33498] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 07/22/2015] [Accepted: 07/27/2015] [Indexed: 12/22/2022]
Abstract
Combinations of angiogenic growth factors have been shown to have synergistic effects on angiogenesis and natural wound healing in various animal models. Each growth factor has unique roles during angiogenesis; vascular endothelial growth factor (VEGF) plays a key role during the initial step of angiogenesis, whereas PDGF functions in the maturation of blood vessels. We used a combination of three angiogenic growth factors to increase angiogenesis in vitro and in vivo. We chose VEGF as a basic factor and added platelet-derived growth factor (PDGF) and fibroblast growth factor (FGF) to induce angiogenesis in three in vitro and in vivo models: 3D angiogenesis assay, 3D co-culture, and matrigel plug implantation assay. Cell proliferation was significantly higher in co-cultured cells treated with PDGF + VEGF + FGF than in the control, single, or dual combination groups. mRNA expression of α-smooth muscle actin (α-SMA), von Willebrand factor (vWF), and CD105 was higher in the triple group (PDGF + VEGF + FGF) than in control, single, or dual combination groups. In the PDGF + VEGF + FGF group, the length and number of branches of spheroids was also significantly higher than in the control, single, or dual combination groups. Furthermore, in a nude mouse model, α-SMA expression was significantly higher in the PDGF + VEGF + FGF group than in other groups. In conclusion, the addition of PDGF and FGF to VEGF showed synergistic effects on angiogenesis in vitro and in vivo. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1535-1543, 2016.
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Affiliation(s)
- Sook Kyoung Kim
- Department of Biomedical Engineering, Medical College, Korea University, Seoul, Korea
| | - Jaeyeon Lee
- Department of Biomedical Engineering, Medical College, Korea University, Seoul, Korea
| | - Myeongjin Song
- Department of Biomedical Engineering, Medical College, Korea University, Seoul, Korea
| | - Mirim Kim
- Department of Biomedical Engineering, Medical College, Korea University, Seoul, Korea
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, School of Dentistry, Dental Research Institute, BK 21 Plus, Korea
| | - Hwanseok Jang
- Department of Biomedical Engineering, Medical College, Korea University, Seoul, Korea
| | - Yongdoo Park
- Department of Biomedical Engineering, Medical College, Korea University, Seoul, Korea.
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Yang HJ, Hwang SJ. Bone mineral density and mandibular advancement as contributing factors for postoperative relapse after orthognathic surgery in patients with preoperative idiopathic condylar resorption: a prospective study with preliminary 1-year follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:112-8. [DOI: 10.1016/j.oooo.2015.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/01/2015] [Accepted: 03/09/2015] [Indexed: 11/26/2022]
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Kim RY, Yang HJ, Song YM, Kim IS, Hwang SJ. Estrogen Modulates Bone Morphogenetic Protein-Induced Sclerostin Expression Through the Wnt Signaling Pathway. Tissue Eng Part A 2015; 21:2076-88. [PMID: 25837159 DOI: 10.1089/ten.tea.2014.0585] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Clinical data show that estrogen levels are inversely associated with the production of sclerostin, a Wnt antagonist that recently attracted great attention over the use of its antibody in the anabolic treatment of osteoporotic conditions. However, the molecular link between sclerostin expression and estrogen signaling is not yet known. We investigated the mechanisms by which estrogen modulates sclerostin (SOST) gene expression at the cellular level in human osteoblast cells in association with bone morphogenetic protein (BMP)2 signaling given that BMP2 is a potential inducer of SOST in human mesenchymal stromal cells (hMSCs). 17β-Estradiol (E2) alone had no effect on SOST expression, which was significantly induced by treatment with BMP2 in hMSCs and osteoblasts derived from the mandibles of female donors. However, E2 suppressed the induction of SOST and other BMP2 target genes by BMP2 in hMSCs. E2 signaling was independent of the Smad pathway, which plays a critical role in SOST induction mediated by BMP2. Instead, E2 increased the transcriptional expression of β-catenin and levels of its activated form. Silencing of the gene encoding estrogen receptor (ER)α decreased E2 activity in β-catenin activation and the suppression of SOST induction by BMP2, but had no influence on BMP2-mediated SOST induction in the same conditions. Similar results were obtained after treatment with ERα antagonist as a Wnt inhibitor. In human osteoblasts, the effect of E2 on SOST expression was either suppressive or absent, depending on the cell donor. Interestingly, the SOST expression pattern after treatment with BMP2 or BMP2/E2 in human osteoblasts showing a pattern of E2 suppression on SOST induction by BMP2 correlated with the ratio of receptor activator of nuclear factor kappa-B ligand (RANKL) to osteoprotegerin (OPG) expression. These results demonstrate that estrogen signaling in osteoblasts negatively regulates SOST expression in an indirect manner through interaction with BMP2 signaling and that this regulation involves the Wnt/ERα and β-catenin pathways. This study highlights several interactions between estrogen and BMP cascades in osteoblasts that may provide a basis for therapeutic intervention for the modification of bone mass density.
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Affiliation(s)
- Ri Youn Kim
- 1 Department of Maxillofacial Cell and Developmental Biology, School of Dentistry, Seoul National University , Seoul, Republic of Korea
| | - Hoon Joo Yang
- 2 Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University , Seoul, Republic of Korea
| | - Yun Mi Song
- 3 Dental Research Institute, School of Dentistry, Seoul National University , Seoul, Republic of Korea
| | - In Sook Kim
- 3 Dental Research Institute, School of Dentistry, Seoul National University , Seoul, Republic of Korea
| | - Soon Jung Hwang
- 1 Department of Maxillofacial Cell and Developmental Biology, School of Dentistry, Seoul National University , Seoul, Republic of Korea.,2 Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University , Seoul, Republic of Korea.,3 Dental Research Institute, School of Dentistry, Seoul National University , Seoul, Republic of Korea
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Chang AR, Han JJ, Kim DS, Yi WJ, Hwang SJ. Evaluation of intra-articular distance narrowing during temporomandibular joint movement in patients with facial asymmetry using 3-dimensional computed tomography image and tracking camera system. J Craniomaxillofac Surg 2015; 43:342-8. [PMID: 25648068 DOI: 10.1016/j.jcms.2014.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 11/18/2014] [Accepted: 12/30/2014] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Functional overloading can lead to disc displacement in the temporomandibular joint (TMJ), and a high incidence of disc displacement has been reported in patients with facial asymmetry. The aim of this study was to assess the dynamic condylar movement in patients (n = 26) with facial asymmetry using a simulation system with 3-dimensional computed tomographic images and tracking camera system. MATERIAL AND METHODS The intra-articular distance (IAD) between the condyle and glenoid fossa was recorded during TMJ movement as a parameter for functional overloading and compared between Group I with severe asymmetry and Group II with mild asymmetry. RESULTS The average IAD was shorter in Group I than Group II, especially at the lowest point (P < 0.05). The ratio of IAD narrowing in Group I was significantly larger than in Group II (P < 0.05). The mean IAD were slightly smaller on the deviated side (3.41 mm) than on the nondeviated side (3.55 mm) in Group I, even though there was no statistical significance. The maximum displacement in Group I was longer than in Group II and had no significant difference between deviated side and nondeviated side. CONCLUSION We suggested that the reduced IAD resulting from TMJ overloading can lead to internal derangement in severe facial asymmetry.
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Affiliation(s)
- Ah Ryum Chang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Republic of Korea
| | - Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Republic of Korea
| | - Dae-Seung Kim
- Interdisciplinary Program in Radiation, Applied Life Science Major, College of Medicine, BK21, and Dental Research Institute, Seoul National University, Republic of Korea
| | - Won-Jin Yi
- Department of Oral and Maxillofacial Radiology, BK21, and Dental Research Institute, School of Dentistry, Seoul National University, Republic of Korea.
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Republic of Korea.
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Kim DS, Yang HJ, Huh KH, Lee SS, Heo MS, Choi SC, Hwang SJ, Yi WJ. Three-dimensional natural head position reproduction using a single facial photograph based on the POSIT method. J Craniomaxillofac Surg 2014; 42:1315-21. [DOI: 10.1016/j.jcms.2014.03.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/15/2014] [Accepted: 03/20/2014] [Indexed: 10/25/2022] Open
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Kor HS, Yang HJ, Hwang SJ. Relapse of skeletal class III with anterior open bite after bimaxillary orthognathic surgery depending on maxillary posterior impaction and mandibular counterclockwise rotation. J Craniomaxillofac Surg 2014; 42:e230-8. [DOI: 10.1016/j.jcms.2013.08.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 06/13/2013] [Accepted: 08/28/2013] [Indexed: 10/26/2022] Open
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Yang HJ, Hwang SJ. Change in condylar position in posterior bending osteotomy minimizing condylar torque in BSSRO for facial asymmetry. J Craniomaxillofac Surg 2014; 42:325-32. [DOI: 10.1016/j.jcms.2013.05.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 05/28/2013] [Accepted: 05/28/2013] [Indexed: 10/26/2022] Open
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Kim IS, Lee B, Yoo SJ, Hwang SJ. Whole Body Vibration Reduces Inflammatory Bone Loss in a Lipopolysaccharide Murine Model. J Dent Res 2014; 93:704-10. [PMID: 24810275 DOI: 10.1177/0022034514534856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 04/16/2014] [Indexed: 11/16/2022] Open
Abstract
Whole body vibration (WBV) stimulation has a beneficial effect on the recovery of osteoporotic bone. We aimed to investigate the immediate effect of WBV on lipopolysaccharide (LPS)-mediated inflammatory bone loss by varying the exposure timing. Balb/C mice were divided into the following groups: control, LPS (L), and LPS with vibration (LV). The L and LV groups received LPS (5 mg/kg) by 2 intraperitoneal injections on days 0 and 4. The LV group was exposed to WBV (0.4 g, 45 Hz) either during LPS treatment (LV1) or after cessation of LPS injection (LV2) and then continued WBV treatment for 10 min/d for 3 d. Evaluation based on micro-computed tomography was performed 7 d after the first injection, when the L group showed a significant decrease in bone volume (-25.8%) and bone mineral density (-33.5%) compared with the control group. The LV2 group recovered bone volume (35%) and bone mineral density (19.9%) compared with the L group, whereas the LV1 group showed no improvement. This vibratory signal showed a suppressive effect on the LPS-mediated induction of inflammatory cytokines such as IL-1β or TNF-α in human mesenchymal stem cells in vitro. These findings suggest that immediate exposure to WBV after the conclusion of LPS treatment efficiently reduces trabecular bone loss, but WBV might be less effective during the course of treatment with inflammatory factor.
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Affiliation(s)
- I S Kim
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - B Lee
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - S J Yoo
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - S J Hwang
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Abstract
Functional activation of stem cells after transplantation is a main concern in stem cell therapy. For local transplantation, mesenchymal stem cells (MSCs) are usually administered via scaffolds, either by direct implantation or after preculturing of cells, and it is unclear which is better for the activation of transplanted cells. In this study, we investigated the in vivo gene expression activity of human MSCs (hMSCs) transplanted into calvarial defects either directly post-seeding on collagen sponges (Group 1) or after overnight in vitro culturing post-seeding (Group 2). Real-time reverse transcription-polymerase chain reaction at days 7 and 14 after transplantation identified a time-dependent, rapid decrease in gene expression by the hMSCs, which in Group 1 was slightly more attenuated than in Group 2. Both groups exhibited a limited range of human-specific gene expression, which involved type I collagen (ColI), fibronectin, stromal cell-derived factor (SDF-1), and osteoprotegerin. Among these, ColI expression was the most efficient, with higher levels in Group 1 than Group 2. There was a lack of evidence for the expression of osteoblast differentiation-related markers or trophic factors, while resident cells showed clear expression of those genes. Rat-specific β-actin expression in Group 2 was least among the scaffold control, Group 1, and Group 2, and this pattern was repeated in the expression of other rat osteogenic genes. Group 1 transplants positively influenced the osteogenic process of the defect tissue in part, and rat IGF-1 expression was significantly increased in Group 1. This tendency of gene expression by hMSCs in a rat model was very similar to what was observed in transplantations using immunodeficient mice. The current study showed that a main gene expressed by transplanted hMSCs during the initial weeks following transplantation is ColI, with a lack of differentiation-related markers or growth factor expression by hMSCs. Our data suggest that direct transplantation of hMSCs loaded on a collagen sponge is more efficient for gene activation in transplanted hMSCs, and more favorable to the local host tissue than transplantation after preculturing of cells.
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Affiliation(s)
- Soon Jung Hwang
- 1 Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University , Seoul, Republic of Korea
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Lee SY, Yang HJ, Han JJ, Hwang SJ. Effect of perioperative buccal fracture of the proximal segment on postoperative stability after sagittal split ramus osteotomy. J Korean Assoc Oral Maxillofac Surg 2014; 39:217-23. [PMID: 24471048 PMCID: PMC3858141 DOI: 10.5125/jkaoms.2013.39.5.217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 08/14/2013] [Accepted: 08/28/2013] [Indexed: 01/08/2023] Open
Abstract
Objectives Buccal fracture of the mandibular proximal bone segment during bilateral sagittal split ramus osteotomy (SSRO) reduces the postoperative stability. The primary aim of this study is to evaluate the effect of this type of fracture on bone healing and postoperative stability after mandibular setback surgery. Materials and Methods Ten patients who experienced buccal fracture during SSRO for mandibular setback movement were evaluated. We measured the amount of bone generation on a computed tomography scan, using an image analysis program, and compared the buccal fracture side to the opposite side in each patient. To investigate the effect on postoperative stability, we measured the postoperative relapse in lateral cephalograms, immediately following and six months after the surgery. The control group consisted of ten randomly-selected patients having a similar amount of set-back without buccal fracture. Results Less bone generation was observed on the buccal fracture side compared with the opposite side (P<0.05). However, there was no significant difference in anterior-posterior postoperative relapse between the group with buccal fracture and the control group. The increased mandibular plane angle and anterior facial height after the surgery in the group with buccal fracture manifested as a postoperative clockwise rotation of the mandible. Conclusion Bone generation was delayed compared to the opposite side. However, postoperative stability in the anterior-posterior direction could be maintained with rigid fixation.
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Affiliation(s)
- Sang-Yoon Lee
- Department of Oral and Maxillofacial Surgery, Seoul National Unversity Dental Hospital, School of Dentistry, Brain Korea Plus, Seoul National Unversity, Seoul, Korea
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, Seoul National Unversity Dental Hospital, School of Dentistry, Brain Korea Plus, Seoul National Unversity, Seoul, Korea. ; Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jeong-Joon Han
- Department of Oral and Maxillofacial Surgery, Seoul National Unversity Dental Hospital, School of Dentistry, Brain Korea Plus, Seoul National Unversity, Seoul, Korea
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, Seoul National Unversity Dental Hospital, School of Dentistry, Brain Korea Plus, Seoul National Unversity, Seoul, Korea. ; Dental Research Institute, Seoul National University, Seoul, Korea
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Han JJ, Yang HJ, Lee SJ, Hwang SJ. Relapse after SSRO for mandibular setback movement in relation to the amount of mandibular setback and intraoperative clockwise rotation of the proximal segment. J Craniomaxillofac Surg 2013; 42:811-5. [PMID: 24411469 DOI: 10.1016/j.jcms.2013.11.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 09/08/2013] [Accepted: 11/26/2013] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to evaluate the effect of the amount of setback movement and intraoperative clockwise rotation of the proximal segments on postoperative stability after orthognathic surgery to correct mandibular prognathism. Thirty-six patients with mandibular prognathism who underwent orthognathic surgery with bilateral sagittal split ramus osteotomy were evaluated. The amount of postoperative relapse was analyzed using a cephalometric analysis. Six months after surgery, the mean backward movement of the mandible at point B was 11.2 mm, the mean intraoperative clockwise rotation of the proximal segment was 4.3° and the amount of postoperative relapse at point B was 2.3 mm (20.3%) on average. The tendency of relapse did not significantly increase with the amount of setback but did increase significantly with the intraoperative clockwise rotation of the proximal segment. This study suggested that postoperative relapse after mandibular setback surgery might be more related to the degree of the intraoperative clockwise movement of the proximal segment, rather than the amount of setback movement. When the amount of mandibular setback is considerable, postoperative relapse might be minimized with adequate control of the intraoperative positioning of the proximal segments.
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Affiliation(s)
- Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Shin-Jae Lee
- Department of Orthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
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