• Journal of Periodontal and Implant Science
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• 제31권4호
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• pp.689-711
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• 2001

The purpose of this study was to compare clinical results of guided tissue regeneration(GTR) using either a nonresorbable ePTFE membrane or a resorbable membrane made from a synthetic copolymer of glycolide and lactide(PLGA) in the treatment of human class Ⅱ furcation defects. The ePTEE membranes were applied to 16 patients with maxillary molar buccal class Ⅱ furcation defects as Group I, PLGA membranes were applied to 15 patients with maxillary molar buccal class Ⅱ furcation defects as Group Ⅱ, ePTFE membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅲ and PLGA membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅳ and bone graft materials(DFDBA) were applied in all groups. Probing depth, gingival recession, clinical attachment level, tooth mobility and sulcus bleeding index(SBI) were measured at baseline, 3, 6 and 12months postoperatively. In addition, membrane exposure levels were measured at surgery, 1, 2 and 6weeks postoperatively and postoperative complications were evaluated. The results were as follows: In all groups, there were statistically significant differences in probing depth reduction, gain of clinical attachment and mobility reduction at values of 3, 6 and 12months postoperatively compared to values of baseline, whereas no significant differences in SBI except Group I and gingival recession(p<0.05). Membrane exposure levels were increased at 1, 2 and 6weeks postopratively compared to value of baseline in Group I(p<0.05). There were no statistically significant differences between ePTFE and PLGA membrane in probing depth, clinical attachment level and SBI. There were minimal gingival recession and membrane exposure in Group Ⅳ and pain and swelling were the most common postoperative complications in Group Ⅱ, Ⅲ(p<0.05). In conclusion, this study showed that both nonresorbable membrane and resorbable membrane were effective similarly in the treatment of class Ⅱ furcation defects, without statistical differences in clinical measurements.

• Journal of Periodontal and Implant Science
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• 제28권2호
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• pp.205-221
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• 1998

The present study invetigates the effects of root planing only(control group), DFDBA alone(test group 1) and combined use of DFDB and Dura mater(test group 2) in dehiscence defects in dogs. The results of 8weeks post-surgery by histological comparison between the three groups are as follows. 1. The contol group showed minimum regeneration of new cementum and new bone with limited migration of epitheilal cells, and healed by connective tissue attachment. 2. The test group 1 showed minimum regeneration of new cementum and new bone with limited migration of epitheilal cells, and healed by connective tissue attachment. 3. The test group 2 showed significant amount of the new cementum and new bone. 4. Both control and test groups healed without any observable root resorption and ankylosis. The above the results suggest that the use of resorbable Dura mater only does not improve the regeneration of new bone and periodontal ligament due to difficulties of space making, but the combined use with DFDB may be more effective.

• Journal of Periodontal and Implant Science
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• 제37권3호
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• pp.465-478
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• 2007

Various periodontal barrier membranes used in many clinical and experimental fields, and many recent studies of membranes have reported good results. To improve clinical results, selection of barrier membranes is an important factor. So, we need not only to evaluate various barrier mem-branes, but also to understand the property of barrier membranes appropriate to defect characteristics. For this purpose, this study reviewed available literature, evaluated comparable experimental models, and compared various barrier membranes. From above mentioned methods, the following conclusions are deduced. 1. In i-wall periodontal defect models, new bone formation showed a consistent result, almost 30% of the defect size. New cementum formations measured mostly 40% of the defect size, but showed more variations than new bone formations. This seems to be resulted form difference in experimental methods, so standardization in experimental methods is needed for future studies. 2. Application PLGA barrier membrane to periodontal defect demonstrated improved healing in new bone and new cementum. 3. There was a minimal periodontal regeneration with calcium sulfate barrier membrane only. But, there was better healing pattern in combination of calcium sulfate membrane with bone graft material, such as DFDBA, 4. There was no significant difference between the experimental group that used chitosan mem-brane only and the control group. But, in combination with bone graft material for space maintanence, periodontal regeneration was improved. Overall, Space maintenance is a critical factor for Guided tissue regeneration using barrier membranes. Also, a barrier membrane itself that has difficulty in maintaining space, achieved better result when used with graft material.

• Journal of Periodontal and Implant Science
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• 제32권3호
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• pp.565-576
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• 2002

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Intensive research is underway to identity, purify, synthesize a variety biologic modulators that may enhance wound healing and regeneration of lost tissues in periodontal therapy. The present study evaluates the effects of ABM/P-15 on the periodontal regeneration in intrabony defects of human. We used thirty four 2-wall or 3-wall osseous defects in premolars and molars of chronic peridontitis patient that have more than 5mm pockets and more than 3mm in intrabony defect. 12 negative control group underwent flap procedure only, 11 positive control group received DFDBA graft with flap procedure, and 11 experimental group received ABM/P-15 graft with flap procedure. The changes of probing pocket depth, loss of attachment and bone probing depth following 6months after treatment revealed the following results: 1. The changes of probing pocket depth showed a statistically significant decrease between after scaling and 6months after treatment in negative control(2.0${\pm}$0.9mm), positive control(3.0${\pm}$0.9mm), and experimental group (3.4${\pm}$1.5mm) (P<0.01). Significantly more reduction was seen in experimental group compared to negative control group (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after scaling and 6months after treatment in positive control(2.0${\pm}$0.6mm), and experimental group (2.2${\pm}$l.0mm) except negative control group(0.1${\pm}$0.7mm) (P<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group(P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after scaling and 6months after treatment in positive control(2.7${\pm}$l.0mm), and experimental group (3.4${\pm}$1.3mm) except negative control(0.l${\pm}$0.9mm) (9<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group (P<0.05). The results suggest that the use of ABM/P-15 in the treatment of periodontal intrabony defects can reduce loss of attachment and bone probing depth more than flap operation only. It suggests that ABM/P-15 may be an effective bone graft material for the regeneration of periodontal tissue in intrabony defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권4호
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• pp.360-365
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• 1999

낭종의 적출과 골 이식은 낭종 제거후 악골에서 발생하는 광범위한 골결손에 선택적인 치료이다. 자가 망상골이 최상의 이식재료이며 수년동안 임상적인 성공을 가져왔다. 그러나 이식재료를 얻기 위해서는 유병률이 증가되는 부가적인 외과적 시술이 요구되며, 다발성 결손 또는 이식이 광범위 할 때 자가골의 양이 불충분할지도 모른다. 변형된 방법으로 동종골 이식이 이용되어져 왔다. 동종골 이식의 한종류가 탈회 동결-건조 동종골(DFDBA)이다. 이 연구는 낭종 적출과 탈회 동결-건조 동종골 이식후 악골 결손에 일어나는 변화를 악골의 낭종 병소를 세집단으로 나누어 평가하였다. 낭종 적출 후 Group A는 탈회 동결-건조 동종골을 이식하였고, Group B는 자가골 이식을 하였으며 Group C은 다른 이식재를 이용하지 않고 낭종 적출만을 시행하였다. 세 집단은 술전, 수술 직후, 술후 6, 12, 24, 36개월의 임상적 검사와 방사선학적 골밀도를 조사하였다. Digital densitometer를 이용한 골밀도 검사에서 Group A과 Group B의 경우 비슷한 골밀도를 보였으며 Group C와 비교시 뚜렷한 증가를 볼 수 있었다. 그러므로 이 연구로부터 낭종 적출술과 같은 광범위한 악골 결손에 탈회 동결-건조 동종골 이식은 충분한 골형성을 보여 자가골 이식의 대체재료로서 고려되어질 수 있다.