An ultimate goal of periodontal therapy is to stop the disease process and to regenerate a functionally-oriented periodontium destroyed as a result of periodontal disease. The purpose of this study was to observe the effect of grafting granulation tissue obtained from extraction socket on the regeneration of horizontal furcation defect. Six dogs were used in this study. All mandibular first and third premolars were extracted. At 2, 3, and 5 days after extraction, tissues were obtained from extraction socket of 1 mongrel dog and examined by light microscope. Granulation tissue obtained at 5 days after extraction was chosen as the graft material. Five days later, horizontal furcation defects were created surgically at mandibular second and fourth premolars in the right and left side of the 5 beagle dogs. The entrance area of the artificially prepared "key hole" defects were about $3\;4mm^2$. By random selections, 2 exposed furcation defects were grafted with granulation tissue obtained from extraction socket as experimental group and 1 furcation defect was as control. The flaps were replaced to their original position and sutured with 4-0 chromic cat-gut. Three dogs were sacrificed 4 weeks and two dogs 8 weeks after surgery, and the prepared specimens were examined by light microscope. At 4 weeks, furcations were filled with epithelial lining and fibrous connective tissue infiltrated with chronic inflammatory cells. New bone formation was observed in all groups. Only experimental group showed new cementum formation. At 8 weeks, new cementum, functional arrangement of new PDL fiber, root resorption, and some ankylotic union of newly formed alveolar bone and root surface were observed in all groups. Experimental group showed that epithelial downgrowth was inhibited and new bone formation was more active compared to control. The success rate of the furcation defect healing was higher in experimental group than control. These results suggested that grafting of granulation tissue obtained from extraction socket which combined with reconstructive periodontal flap surgery may promote periodontal regeneration of horizontal furcation defect.
Journal of the korean academy of Pediatric Dentistry
/
v.28
no.1
/
pp.180-184
/
2001
Cleidocranial Dysplasia(CCD) is an autosomal dominant human bone disease characterized by abnormal clavicles, patent sutures and fontanelles, and dental anomalies. Among dental anomalies, it is characterized that permanent dentition is severly disturbed due to multiple supernumerary teeth and abnormalities of tooth morphology. A eight-year-old female patient diagnosed as cleidocranial dysplasia visited in our hospital. Upon clinical oral exam, retained deciduous teeth, constriction of dental arch, anterior cross bite, and multiple dental caries were observed. In the dental panoramic radiograph, retained deciduous teeth and multiple supernumerary teeth in the maxilla and the mandible were found. In the cephalometric radiograph, open sutures and wormian bones were seen. In the chest P-A view absence of clavicles was observed. The cleidocranial dysplasia patients have eruption problems in permanent dentition both in regions with and without supernumerary teeth. The severely delayed or arrested eruption of permanent teeth has been ascribed to various factors : 1) The presence of multiple supernumerary teeth, 2) malformed roots with lack of cellular cementum, 3) the jaw bone being too dense, and 4) abnormal resorption of bone and primary teeth. Formation and maturation of primary teeth in cleidocranial dysplasia are normal, whereas the permanent dentition has various anomalies. Therefore, dentists should understand the development of dentition in cleidocranial dysplasia, and treat them in proper time.
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.
The purpose of present study is to compare the effect of treatment using $Guidor^{(R)}$ as a barrier membrane in conjunction with platelet-derived growth factor and insulin like growth factors on experimental dehiscence defects. Following the resection of premolar crowns, roots were submerged. After 12 weeks of healing period, experimental dehiscence defects of 4mm in height and 4mm in width were surgically created on the mid-facial aspect of the lower premolar roots in each of 4 adult dogs. After root planning and demineralization of the root surface with citric acid, the control groups received 4% methylcellulose gel only, the test group I received 4% methylcellulose gel and were covered by $Guidor^{(R)}$ and the test group II were treated with PDGF and IGF and 4% methylcellulose gel with $Guidor^{(R)}$ coverage. Histological and histomorphometric analysis following 8 weeks of healing revealed the following results. 1. The new bone formation showed no statistically significant difference in all groups with $0.59{\pm}0.82mm$($14.03{\pm}19.60%$) for control, $0.70{\pm}0.39mm$($16.30{\pm}9.01%$) for group I, $0.87{\pm}0.76mm$($18.74{\pm}16.03%$) for group II. 2. The new cementum formation showed no statistically significant difference in all groups with $0.54{\pm}0.48mm$($l6.38{\pm}14.57%$) for control, $0.95{\pm}0.38mm$($23.43{\pm}9.30%$) for group I, $1.01{\pm}0.75mm$($22.10{\pm}16.ll%$) for gorup II. 3. The root resorption showed statistically significant differences betweenthe control group and all test groups(p<0.05) with $2.11{\pm}0.53mm$($52.93{\pm}12.32%$) for control, $0.63{\pm}0.27mm$($15.32{\pm}7.05%$) for group I, $0.89{\pm}0.33mm$ ($19.26{\pm}7.11%$) for group II. On the bases of these results, there were no statistically difference between treatment using resorbable membrane and resorbable membrane in conjunction with PDGF and IGF in the dehiscence defects, where it was difficult to maintain space. The use of membrane seemed to be more effective in the inhibition of root resorption.
Journal of the korean academy of Pediatric Dentistry
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v.32
no.3
/
pp.403-408
/
2005
Ankylosis is defined as a fusion of cementum or dentine with alveolar bone. Due to the loss of the periodontal ligament on the ankylotic area, the tooth is incapable of continued eruption and hence is unable to follow the normal vertical development of the neighboring teeth and alveolar process. A 6-year-old female was referred to the Dept. of Pediatric Dentistry for ankylosis of primary molars and congenital missing of permanent premolars on both jaws. She had neither specific past medical history nor trauma and infection history in oral and maxillofacial region. Radiographic finding is that the maxillary primary molars were the early onset of ankylosis and had fast root resorption rate. However the mandibular primary molars were ankylosed later and being resorbed slower than maxillary primary molars. The object of treating this case is to maintain the proper alveolar bone growth and retention of deciduous molars. The point of managing this case is as follows: Proper treatment (observation, restoration, or extraction) should be established after thorough consideration of the time of onset, the root resorption rate, progression of infraocclusion and the development of alveolar bone support. We should consider the timing of extraction of the ankylosed teeth without problem of neighbouring alveolar bone growth and tilting of adjacent teeth in the view of growth spurt. Early diagnosis is important to avoid many of the complications with infraoccluded primary molars.
The rh-BMP-4 is a subgroup of TGF-${\beta}$ superfamily. The application of rh-BMP in alveolar bony defect was reported to new alveolar bone and new cementum formation. For minimized complications following tooth replantation, a operator must replant a tooth fast at the pertinent position. This study was to evaluate the effect of rh-BMP-4 on periodontal regeneration and root resorption following tooth replantation in rats. The 50 Sprague-Dawley rats weighting about 130gm were used in this study. The animals were divided into three groups. Group 1 ; immediate replantation after extraction : Group 2 ; replantation stored teeth extraction of first molar, the removal of periodontal ligament with collagenase, and etching with citric acid : Group 3 ; replantation stored teeth with treated rh-BMP-4 in mesial root. Experimental animals were sacrificed 3, 7, 14 days after replantation by heart infusion. The maxillae were removed, fixed, demineralized, dehydrated, infiltrated and embedded with JB-4 mixture. For light microscopic observation, 5 micron sections were cut and stained with toluidine blue. The results of this study were as follows : 1. After experimental 3 days, all groups were observed dead space between periodontum and root. 2. After experimental 7 days, group 1 and group 3 were observed filling periodontal fibers between alveolar bone and root but group 2 were not. 3. After experimental 7 days, group 3 were observed appearance of attached cementoblast like cell on root surface. Group 1 were observed regular arrangement of fibroblasts and collagen fibers at ${\times}400$ observation. 4. After experimental 14 days, all group were observed filling periodontal fibers between alveolar bone and root. Group 1 were observed normal arrangement of periodontal fibers. Group 3 were observed less abnormal arrangement of periodontal fibers. Group 2 were not observed functional normal arrangement of periodontal fibers. 5. After experimental 14 days, group 2 and 3 were observed several root resorption and irregular root surface but group 1 were not. These results suggest that the rh-BMP-4 can stimulate cementogenesis and enhance to attach collagen fibers.
Objectives: The aim of this study was to investigate the relationship between the apical foramen morphology and the length of merged canal at the apex in type II root canal system. Materials and Methods: This study included intact extracted maxillary and mandibular human premolars (n = 20) with fully formed roots without any visible signs of external resorption. The root segments were obtained by removing the crown 1 mm beneath the cementum-enamel junction (CEJ) using a rotary diamond disk. The distance between the file tip and merged point of joining two canals was defined as Lj. The roots were carefully sectioned at 1 mm from the apex by a slow-speed water-cooled diamond saw. All cross sections were examined under the microscope at ${\times}50$ magnification and photographed to estimate the shape of the apical foramen. The longest and the shortest diameter of apical foramen was measured using ImageJ program (1.44p, National Institutes of Health). Correlation coefficient was calculated to identify the link between Lj and the apical foramen shape by Pearson's correlation. Results: The average value of Lj was 3.74 mm. The average of proportion (P), estimated by dividing the longest diameter into the shortest diameter of the apical foramen, was 3.64. This study showed a significant negative correlation between P and Lj (p < 0.05). Conclusions: As Lj gets longer, the apical foramen becomes more ovally shaped. Likewise, as it gets shorter, the apical foramen becomes more flat shaped.
Journal of the korean academy of Pediatric Dentistry
/
v.30
no.3
/
pp.385-390
/
2003
Traumatic injuries in the young permanent dentition are common, but root fractures, defined as fractures involving dentin, cementum and pulp, are relatively uncommon. Appropriate management of root fracture involves repositioning the coronal portion of the tooth fragment and firm immobilization with a splint for 2 to 3 month. Root canal treatment should not be initiated until the sign of necrosis or resorption are apparent because in most cases, the apical fragments maintain their vitality. The following case report describes a patient with root fractures injured three times over the period of 7 years. The results, clinically and radiographically, were acceptable, but long term periodic evaluation is required.
The present study evaluates the effects of dura mater barrier membranes In class III furcation defects on the regeneration of periodontal tissues in dogs. Experimental class III furcation defects were created surgically by removing alveolar bone horizontally down to 4mm from CEJ in mandibular premolars of adult dogs. Dura mater barrier membranes were applied bucco-lingually in the test group, and flap surgery only with no membranes in the control group. The healing was evaluated clinically and histologically after 8weeks. Clinically, the test group showed slight exposures of the membranes, while the control group showed no furcation exposure, The test specimens showed new bone formation coronal to the notch, while the control specimens had new bone formation up to the level of the notch. New cementum was observed in both groups. The test specimens showed functional arrangements of connective tissue fibers between new bone and new cenentum, while irregular arrangements were observed in the controls. No root resorption or ankylosis were observed in either groups,These results suggest that dura mater resorbable barrier membranes on class III furcation defects may be effective in regeneration of alveolar bone and peridontal ligament.
Kim, Mi Hye;Choi, You Yeon;Lee, Hye Ji;Lee, Haesu;Park, Jung-Chul;Yang, Woong Mo
Journal of Periodontal and Implant Science
/
v.45
no.4
/
pp.145-151
/
2015
Purpose: The aim of this study was to investigate the therapeutic effects of a herbal formula, PerioH-035, containing Angelica sinensis, steamed Rehmannia glutinosa, Angelica dahurica, Cimicifuga heracleifolia, and Zanthoxylum piperitum on the periodontal breakdown in a well-established ligature-induced periodontitis model in rats. Methods: Sprague-Dawley rats were randomly assigned to 1 of 4 groups: NL (non-ligatured), L (ligatured), P1 (ligatured and treated with 1 mg/mL PerioH-035), P100 (ligatured and treated with 100 mg/mL PerioH-035). Periodontitis was induced by placing a ligature around the mandibular first molars. PerioH-035 was topically applied to both sides of the first molar for 2 weeks. The right side of the mandibles was retrieved for micro-computed tomography (CT) and methylene blue staining to analyze alveolar bone loss. The left side of the mandibles was histologically analyzed by TRAP and H&E staining. The MMP-9 mRNA level in gingival tissue was investigated by RT-PCR. Results: Alveolar bone resorption was significantly reduced in the PerioH-035-treated groups. The number of dense multi-nucleated cells found to be TRAP-positive by staining in the ligatured rats was markedly decreased by PerioH-035 application. In addition, periodontal tissue destruction, especially cementum demineralization, was ameliorated in the P1 and P100 groups. Moreover, gingival tissue from the PerioH-035-treated group showed a decrease in the MMP-9 mRNA level, resulting in recovery of collagen degradation. Conclusions: These results suggest that PerioH-035 has therapeutic effects on periodontitis, and thus, PerioH-035 shows promise as a treatment for periodontitis.
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