• Journal of Periodontal and Implant Science
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• 제38권1호
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• pp.97-102
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• 2008

Purpose: Periodontal intrabony defects have great deal of importance since they contribute to the development of periodontal disease. Current treatment regimens for intrabony defects involve grafting of numerous bony materials, GTR using biocompatible barriers, and biomodification of root surface that will encourage the attachment of connective tissue. Xenograft using deproteinized bovine bone particles seems to be very convenient to adjust because it doesn't require any donor sites or imply the danger of cross infections. These particles are similar to human cancellous bone in structure and turned out to be effective in bone regeneration in vivo. We here represent the effectiveness of grafting deproteinized bovine bone particles in intrabony defect and furcation involvements that have various numbers of bony walls. Materials and methods: Open flap debridement was done to remove all root accretions and granulation tissue from the defects within persisting intrabony lesions demonstrating attachment loss of over 6mm even 3 months after nonsurgical periodontal therapy have been completed. Deproteinized bovine bone particles($BBP^{(R)}$, Oscotec, Seoul) was grafted in intrabony defects to encourage bone regeneration. Patients were instructed of mouthrinses with chlorohexidine-digluconate twice a day and to take antibiotics 2-3 times a day for 2 weeks. They were check-up regularly for oral hygiene performance and further development of disease. Probing depth, level of attachment and mobility were measured at baseline and 6 months after the surgery. The radiographic evidence of bone regenerations were also monitored at least for 6 months. Conclusion: In most cases, radio-opacities increased after 6 months. 2- and 3-wall defects showed greater improvements in pocket depth reduction when compared to 1-wall defects. Class I & II furcation involvements in mandibular molars demonstrated the similar results with acceptable pocket depth both horizontally and vertically comparable to other intrabony defects. Exact amount of bone gain could not be measured as the re-entry procedure has not been available. With in the limited data based on our clinical parameter to measure pocket depth reduction following $BBP^{(R)}$ grafts, it was comparable to the results observed following other regeneration techniques such as GTR.

• Journal of Periodontal and Implant Science
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• 제32권2호
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• pp.325-338
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• 2002

Bone graft using growth factors and guided tissue regeneration have been used for the regeneration of infrabony defects which caused by periodontal disease. Calcium sulfate which is one of the resorbable barrier materials used for guided tissue regeneration. Platelet rich plasma which is a easy method to obtain the growth factors had many common points but, platelet rich plasma was still studying. This study was the comparative study between bone graft using platelet rich plasma and guided tissue regeneration using calcium sulfate barrier material in clinical view. For the study, 28 sites(2 or 3 wall infrabony defects) were treated. 14 infrabony defects were received surgical implantation of BBP-calcium sulfate composite with a calcium sulfate barrier and the others received BBP mixed with platelet rich plasma. Clinical outcome was accessed 3 and 6 months of postsurgery. 1. There was no statistical difference between CS group and PRP group in pocket depth, gingival recession, clinical attachment level, and probing bone level at baseline. 2. There was statistically significant reduction in probing depth, clinical attachment level, and probing bone level at 3 and 6 months postsurgery(p<0.05). 3. In the probing depth and clincial attachment level PPR group had less improvement than CS group, but there was no statistically difference at 3 and 6 months postsurgery. 4. In the recession PPR group had less recession than CS group, but there was no statistically difference at 3 and 6 months postsurgery. 5. In the probing bone level PPR group had less improvement than CS group, but there was no statistically difference at 6 months postsurgery. In conclusion bone graft using platelet rich plasma and guided tissue regeneration using calcium sulfate barrier showed similar clinical improvement for the treatment of 2 or 3 wall infrabony defects.

• 대한수의학회지
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• 제20권2호
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• pp.127-134
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• 1980

This study was performed to obtain an accurate methods of diagnosis in early stage of traumatic pericarditis and myocarditis in ruminants. Korean native goats were used as experimental animal and traumatic pericarditis and myocarditis were induced by surgical intervention. The changes in clinical signs, hematological values, blood enzymes and electrocardigrams were observed for 14 days after operation. The results obtained were as follows: 1. Body temperature in experimental group of induced traumatic pericarditis and myocarditis was slightly increased than control group that was rumenotomized. Heart rate was increased in both groups but the increased rate was noticed remarkably in experimental group. There was no change in respiratory rate in experimental and control group. 2. Total leucocytes counts and neutrophil percentage maintained higher level after operation and lymphocytes percentage noticed reversed proportion to neutrophil in both groups. 3. Serum total protein concentration and alkaline phosphatase activities after operation showed a little lower levels than these values prior to operation. Serum glutamic oxaloacetic transaminase and lactic dehydrogenase activities in control group showed slight increase through all the experimental period, while in experimental group these activities were markedly elevated and an increase in serum lactic dehydrogenase activities was more remarkable comparing to serum glutamic oxaloacetic transaminase. 4. Electrocardiograms in control group did not show any abnormalities except for slight increase in heart rate. In experimental group the amplitude of QRS complex was increased in duration of experimental period. The transference from QRS complex to T wave was uncertain and S-T segment moved upward obliquely through electrical zero line.

• 대한치과의료관리학회지
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• 제5권1호
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• pp.1-12
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• 2017

치과의료가 새로운 재료와 기자재, 기술의 등장으로 지속적으로 변화하지만 구강보건인력의 업무 범위는 법적 개정이 쉽지 않은 현실이다. 특히 치과위생사의 경우 업무가 체계화 되고 않고 있으며 업무범위에 대한 이견이 존재한다. 본 연구의 목적은 치과의사와 치위생학과에 재학 중인 학생들 간의 치과위생사의 현재와 미래의 업무 범위에 대한 인식의 차이를 알아보아 치과위생사의 법적 업무범위에 대한 검토 자료로 제공하고자 한다. 일개지역 치과의원, 치과병원에 종사하는 치과의사와 치위생학과 4학년에 재학 중인 학생을 대상으로 하였으며 개원치과의사 42명, 치위생학과 4학년 30명이 설문조사에 응하였으며 통계검정은 피셔의 정확검정을 시행하였다. 치과의사와 치위생학과 학생간의 업무 범위 이견은 진료기록부 작성하기, 치주낭 측정, 활력징후 측정하기, 구강위생관리 계획하기, 러버댐장착하기, 도포마취하기, 침윤마취하기, 수술 후 처치하기, 건강보험 청구하기, 치근활택하기, 치주기구 관리하기, 매트릭스 밴드 장착하기, 임시충전하기, 와동내 충전하기, 근관 처치하기, 보철물장착하기, 개인트레이 제작하기, 치면열구전색하기, SP crown 및 제작 및 장착하기, 치간이개하기, 교정용브라켓장착하기, 와이어결찰하기, 엘라스틱 걸기, 고정성교정장치 제거하기, 인력채용참여하기, 인력 교육 및 관리하기에서 나타났다. 치과의사와 치위생학과 학생간의 업무범위에 관해 의견이 차이가 없는 것은 구내외 방사선 촬영 및 현상, 예진하기, 구강보건교육, 진료 후 주의사항 전달하기, 알지네이트 인상채득하기, 모형 만들기, 진료준비하기, 진료보조하기, 감염관리학기, 환자상담하기, 스케일링하기, 연마하기, 치은압배하기, 정밀인상채득하기, 임시치아만들기, 시멘트 제거하기, 불소도포하기, 치과진료비 관리하기, 치과재료 구매하기, 치과기구 관리하기, 치과재료 및 기구 사용상태 기록하기, 폐기물 관리하기, 진료기록부 관리하기이었다. 따라서, 치과의사와 치위생학과 학생은 치과위생사 업무범위에 관한 이견이 존재하므로 관련 단체들의 논의와 합의가 필요할 것으로 사료되었다.

• 대한소아치과학회지
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• 제34권2호
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• pp.322-328
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• 2007

제1대구치는 저작과 혼합치열기 이후의 수직적 교합관계형성에 핵심적인 역할을 하고 악골의 성장발육에 관여한다. 제1대구치의 매복은 하안면 고경의 감소, 낭의 형성, 치관 주위염, 인접치의 치근 흡수, 부정 교합 등의 문제점을 야기할 수 있다. 치료방법으로는 주기적 관찰, 외과적 노출술, 교정적 견인, 외과적 재위치술, 발치 등이 있으며 이중 외과적 노출술이 가장 기본이 되는 술식이다. 외과적 노출술시에는 맹출로의 개방성을 유지하는 것이 중요하며 개방성을 유지시키기 위한 방법으로는 레진관의 접착, 산화 아연 유지놀 시멘트, 치주포대 등을 노출된 부위에 충전시키는 방법 등이 있다. 본 증례에서는 매복된 하악 제1대구치에서 장애물의 제거와 외과적 노출술을 시행한 결과 자발적인 맹출을 관찰할 수 있었다. 또한 surgical pack과 투명상유지장치를 사용하여 간편하고 효과적으로 맹출로의 개방성을 유지할 수 있었다.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.27-46
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• 1996

The purpose of this study was designed to compare with the effects of 4 different surface active bioceramics on the healing process of alveolar bone defects in dogs. Artificial alveolar bone defects depth 4-6mm, width 3-4mm) were created with # 6 round bur at interproximal areas of maxillary canine, maxillary 2nd premolar, mandibular canine, and mandibular 3rd premolar. porous hydroxyapatite(Interpore $200^R$) , 45S5 bioglass, CJ4/lOC crystalline glass, and JJ crystalline glass were implanted in intrabony defects randomly. Experimental groups were divided into 4 categories according to its implant material. After implantation, all groups were examined postoperatively 4 weeks to 12 weeks. 3 dogs was selected randomly and sacrificed after vascular perfusion with 2.5% glutaraldehyde at every 4 weeks. Tissue blocks with surroundig alveolar bone and soft tissues were removed and immersed in formaldehyde/glutaraldehyde fixative. After 20 weeks decalcification with EDTA and formic acid, sections were made and observed under light microscope and transmission electron microscope. In all experimental groups, the encapsulation of inactive connective tissue was observed around graft particles in 4 weeks. As time elapsed, the thickness of surrounding connective tissue was decreased. Osteoconductive bone growth pattern was seen apparently in all groups. CJ4/lOC crystalline glass showed the most active bone formation until 8 weeks. 45S5 bioglass was, however, the most active in new bone formation at 12 weeks. Though there was difference in resorption rate among grafting materials, the size of graft particles was decreased gradually. 45S5 bioglass was resorbed faster than the others. On the other hand, porous hydroxyapatite was degraded most slowly. Phagocytosed particulate matters was observed in the cytoplasm of multinuclear multinuclear giant cell and macrophage under transmission electron microscope. The results suggested suggested that 45S5 bioglass and CJ4/lOC crystalline glass may have some enhanced reparative potential when compared to porous hydroxapatite in the treatment of periodontal defeds. JJ crystalline glass reguires a further investigation of the safety of its use.

• Journal of Periodontal and Implant Science
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• 제23권3호
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• pp.359-373
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• 1993

The ultimate objective of periodontal therapy is not only stopping the progression of periodontal disease, but also promoting the regeneration of lost periodontal tissue. Guided Tissue Regeneration, which is based on the principle that the goal of periodontal regeneration can be achieved by preventing apical migration of gingival epithelium and blocking cells originating from connective tissue, has been developed and used as a clinical procedure, and although it has shown excellent results in connective tissue healing, there have not been many studies showing its effect on the regeneration of alveolar bone loss due to periodontal disease. The objectives of this study are to investigate the result of 12 months-long treatment following guided tissue regeneration using expanded polytetrafluoroehylene membrane, and to observe the presence of regenerated alveolar bone. Forty-one teeth from 28 patients with clinical diagnosis of periodontitis has been selected. In fifteen of those interproximal intrabony defects, only flap operation had been carried out, and designated as the control group. Twenty-six intrabony defects received e-PTFE membrane following flap operation, and designated as the experimental group. Eleven teeth whose membrane had been exposed were excluded from the experiment. Various measurements including probing depth, loss of attachment, probing bone level and gingival recession have been recorded at 6th month and 12th month, and the significance of the changes has been analyzed. The results are as follows: 1. Probing depth at 6th and 12th month has shown a significant decrease in both groups (p<0.01), but significantly higher decrease was found in the experimental group compared to the control at the month(p<0.05). 2. Loss of attachment at 6th and 12th month has shown a significant decrease in both groups, but significantly higher decrease was found in the experimental group compared to the control (p<0.05). 3. Probing bone level at 6th and 12th month has shown a insignificant decrease in the control group and significant decrease in the experimental group (p<0.01). Significantly higher decrease in probing bone level was found in the experimental group (p<0.05). 4. Gingival recession at 6th and 12th month has shown a statistically significant increase (p<0.05), and the control group showed higher increase compared to the experimental group although no statistical significance was found. As these results have shown, the use of e-PTFE membrane in intrabony pockets results in marked decrease in the loss of attachment and probing bone level. This seems to indicate that e-PTFE membrane may play a role in alveolar bone regeneration in intrabony defects.

• Journal of Periodontal and Implant Science
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• 제38권1호
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• pp.51-58
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• 2008

Purpose: In dental clinical fields, various periodontal membranes are currently used for periodontal regeneration. The periodontal membranes are categorized into two basic types: resorbable and non-resorbable. According to the case, clinician select which membrane is used. Comparing different membranes that are generally used in clinic is meaningful. For this purpose, this study evaluates histological effects of various membranes in canine one wall intrabony defect models and it suggest a valuation basis about study model. Material and Method: The membranes were non-resorbable TefGen $Plus^{(R)}$, resorbable Gore Resolut $XT^{(R)}$ and resorbable $Osteoguide^{(R)}$. One wall intrabony defects were surgically created at the second and the mesial aspect of the fourth mandibular premolars in either right or left jaw quadrants in two dogs. The animals were euthanized 8 weeks post-surgery when block sections of the defect sites were collected and prepared for histological evaluation. Results: 1. While infiltration of inflammatory cells were observed in control, TefGen $Plus^{(R)}$ and Gore Resolut $XT^{(R)}$, it was not observed in $Osteoguide^{(R)}$. 2. TefGen $Plus^{(R)}$ had higher integrity than others and $Osteoguide^{(R)}$ was absorbed with folding shape. Gore Resolut $XT^{(R)}$ was divided everal parts during resorbtion and it was also absorbed from inside. 3. Quantity of new bone and new cementum was not abundant in all membranes. 4. For histologic evaluation of membranes we should consider infiltration of inflammatory, migration of junctional epithelium, integrity of membrane, quantity of new bone and new cementum, connective tissue formation and aspect of resorption. Conclusion: This histologic evaluation suggests that $Osteoguide^{(R)}$ provides periodontal regenerative environment with less inflammatory state. It is meangful that this study model suggests a valuation basis about other study model.

• Journal of Periodontal and Implant Science
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• 제31권2호
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• pp.489-499
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• 2001

Bone graft and guided tissue regeneration have been used for the regeneration of periodontal tissue which is the ultimate goal of periodontal treatment. Recently, it was reported that some kind of growth factors were used for regeneration. Platelet rich plasma was researched that it could increase the density of bone and the rate of bone regeneration. For that, 25 patients which have pocket depth more than 5mm at any of 6 surfaces, of healthy patient without any systemic disease were treated. $Biogran^{?}$ Were grafted into 14 infrabony pockets as controls, and $Biogran^{(R)}$ with PRP were inserted into 31 infrabony pockets. And then, follwing evaluations were made at the end of 1, 3 and 6 months. 1. There was no statistical difference between control and experimental group in pocket depth, gingival recession, minimum probing attachment level and maximum probing attachment level at preoperation(p>0.05). 2. Decrease in probing pocket depth were reduced to 3.32mm for experimental group and 2.71mm for control group. The decrease was evident at the end of 1 month, they were 2.97mm and 2.29mm,and it was statistically difference(p<0.05). 3. Gingival recession was increased by 0.55mm in experimental group and 0.50mm in control group, it was evident at the end of 1 month. And it was statistically difference(p<0.05). 4. Minimum probing attachment level was increased by 0.35mm in experimental group and 0.36mm in control group, it was statistically difference(p<0.05). 5. Maximum probing attachment level was decreased by 3.19mm in experimental group and 2.93mm in control group, it was statistically difference(p<0.05). 6. There was no statistical difference between control and experimental group in pocket depth, gingival recession, minimum probing attachment level and maximum probing attachment level(p>0.05). There was statistical difference in decrease of pocket depth between pre-operation and 1 month after post-operation(p<0.05). In conclusion, bone graft using $Biogran^{?}$ and bone graft using $Biogran^{?}$ With platelet rich plasma were both effective in treatment of infrabony pocket, bone graft using $Biogran^{?}$ With platelet rich plasma was more effective in early soft tissue healing.

• Journal of Periodontal and Implant Science
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• 제32권2호
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• pp.429-455
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• 2002

There are numerous kind of materials and techniques to regenerate the periodontal tissue which has been lost due to destructive periodontal disease, including bone graft material. Many bone graft materials have been reported and among these materials, synthetic material has been developed fin the long time because of its sufficient supply economically. Calcium sulfate which was evaluated as including much calcium, has been used in the clinical field. In the dental field calcium sulfate has been used as bone graft material and Kim reported that improved bone formation and more amount of new attachment after grafting calcium sulfate. but, because calcium sulfate has the problem that it generates the heat in setting period and resolves fast, we need to evaluate the effect of the improved calcium sulfate on periodontal tissue. The present study evaluates the effect of paste type calcium sulfate on the epithelial migration, alveolar bone regeneration, cementum formation and gingival connective tissue attachment in intrabony defect in dogs. Four millimeter deep and four millimeter wide 3-wall defects were surgically created in the mesial or distal aspects of premolars or molars. the test group received paste-type calcium sulfate with a flap procedure and the control group underwent flap procedure only. Histologic analysis after 8 weeks of healing revealed the following results : 1. The length of epithelial growth(the distance from CEJ to the apical end of JE) was 0.52${\pm}$0.26mm in the control and 0.56${\pm}$0.25mm in the test group. there was no statistically significant difference between the two groups. 2. The length of connective tissue adhesion was 1.74${\pm}$1.06mm in the control and 1.28${\pm}$0.57mm in the test group. there was no statistically significant difference between the two groups. 3. The length of new bone was 2.01${\pm}$0.95mm in the control and 2.62${\pm}$0.81mm in the test group. there was no statistically significant difference between the two groups. 4. The length of new cementum was 1.86${\pm}$0.80mm in the control and 2.77${\pm}$ 0.86mm in the test group. there was a statistically significant difference between the two groups.(P<0.01) These results suggest that the use of paste type calcium sulfate in 3-wall intrabony defects has significant effect on new cementum formation , but doesn't have any significant effect on the prevention of junctional epithelium migration and new bone formation. Finally, the paste type calcium sulfate that is used in this study is suggested to be the material that can have a significant effect on the periodontal healing, if its biocompatibility is improved.