• Journal of Periodontal and Implant Science
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• 제50권1호
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• pp.38-47
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• 2020

Purpose: The aim of this study was to investigate the available alveolar bone height between the maxillary molars and the sinus floor according to their anatomical relationship using cone-beam computed tomographic (CBCT) images. Methods: A total of 752 maxillary first (M1) and second molars (M2) on CBCT scans of 188 patients were selected. First, each maxillary molar was categorized as type 1, 2, 3, or 4 according to the relationship of the molar root with the maxillary sinus floor. The frequency distribution of each type was analyzed. Second, the shortest vertical distance (VD) of each molar was measured from the furcation midpoints of the roots to the lowest point of the sinus floor by 2 observers. Intraclass correlation coefficients and the t-test were calculated for the VD measurements. Results: For M1, type 3 was the most frequent, followed by type 2. For M2, type 3 was the most common, followed by type 1. The VD measurements of type 1 were 9.51±3.68 mm and 8.07±2.73 mm for M1 and M2, and those of type 3 were 3.70±1.52 mm and 4.03±1.53 mm for M1 and M2, respectively. The VD measurements of M2 were significantly higher in female patients than in male patients. Conclusions: Type 3 was the most frequent anatomical relationship in the maxillary molars, and showed the lowest alveolar bone height. This information will help clinicians to prevent complications related to the maxillary sinus during maxillary molar treatment and to predict the available bone height for immediate implant planning.

• Journal of Periodontal and Implant Science
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• 제24권2호
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• pp.271-282
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• 1994

Active treatment of periodontal disease consists of plaque control by the patient, with root planing and surgery perfomed by the dental practitioner. Chlorhexidine rinse has been the most effective antiplaque agent available today and tetracycline has been the most favored antibiotics. Therefore, the purpose of this study was compared the different effect among groups(saline mouthrinse[group I], 0.125% chlorhexidine mouthrinse [groupII], and 0.125% chlorhexidine mouthrinse containing tetracycline[groupIII]) during the immediate post periodontal therapy. We assessed plaque index, gingival index, papillary bleediing index, gingival crevicular volume, periodontal attachment loss, and periodontal pocket depth in 3 sites per subject. The assessment was made at baseline. At 1 week after scaling, and at 2 weeks after curettage. All groups were clinically and statistically reduced plaque score, gingival score, papillary bleeding score, and gingival crevicular volume at 2 weeks after curettage. Group II was significantly reduced periodontal pocket depth.(P<0.05) At 1 week after scaling, al clinical index scores were reduced but not singificantly difference between the groups.(p>0.05) At 2 weeks after curettage, plaque score, gingival score and papillary bleeding score were significantly difference between the groups.(P<0.05) During the experimental period, gingiva was not damaged and stain of the tongue or teeth were not noted in all groups.

• Journal of Periodontal and Implant Science
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• 제47권5호
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• pp.264-272
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• 2017

Purpose: This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002-2013. Methods: A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence). Results: The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance. Conclusions: The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.41.1-41.6
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• 2016

Background: The goal of this study was to retrospectively evaluate the prognosis of minimal invasive horizontal ridge augmentation (MIHRA) technique using small incision and subperiosteal tunneling technique. Methods: This study targeted 25 partially edentulous patients (10 males and 15 females, mean age $48.8{\pm19.7years$) who needed bone graft for installation of the implants due to alveolar bone deficiency. The patients took the radiographic exam, panoramic and periapical view at first visit, and had implant fixture installation surgery. All patients received immediate or delayed implant surgery with bone graft using U-shaped incision and tunneling technique. After an average of 2.8 months, the prosthesis was connected and functioned. The clinical prognosis was recorded by observation of the peri-implant tissue at every visit. A year after restoration, the crestal bone loss around the implant was measured by taking the follow-up radiographs. One patient took 3D-CT before bone graft, after bone graft, and 2 years after restoration to compare and analyze change of alveolar bone width. Results: This study included 25 patients and 39 implants. Thirty eight implants (97.4 %) survived. As for postoperative complications, five patients showed minor infection symptoms, like swelling and tenderness after bone graft. The other one had buccal fenestration, and secondary bone graft was done by the same technique. No complications related with bone graft were found except in these patients. The mean crestal bone loss around the implants was 0.03 mm 1 year after restoration, and this was an adequate clinical prognosis. A patient took 3D-CT after bone graft, and the width of alveolar bone increased 4.32 mm added to 4.6 mm of former alveolar bone width. Two years after bone graft, the width of alveolar bone was 8.13 mm, and this suggested that the resorption rate of bone graft material was 18.29 % during 2 years. Conclusions: The bone graft material retained within a pouch formed using U-shaped incision and tunneling technique resulted with a few complications, and the prognosis of the implants placed above the alveolar bone was adequate.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권3호
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• pp.243-248
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• 2009

Purpose: Rehabilitation of the edentulous posterior maxilla with dental implants often poses difficulty because of insufficient bone volume caused by pneumatization of the maxillary sinus and by crestal bone resorption. Sinus grafting technique was developed to increase the vertical height to overcome this problem. The present study was designed to evaluate the sinus floor augmentation with anorganic bovine bone (Bio-$cera^{TM}$) using histomorphometric and clinical measures. Patients and methods: Thirteen patients were involved in this study and underwent total 14 sinus lift procedures. Residual bone height was ${\geq}2mm$ and ${\leq}6mm$. Lateral window approach was used, with grafting using Bio-$cera^{TM}$ only(n=1) or mixed with autogenous bone from ramus and/or maxillary tuberosity(n=13). After 6 months of healing, implant sites were created with 3mm diameter trephine and biopsies taken for histomorphometric analysis. The parameters assessed were area fraction of new bone, graft material and connective tissue. Immediate and 6 months after grafting surgery, and 6 months after implantation, computed tomography (CT) was taken and the sinus graft was evaluated morphometric analysis. After implant installation at the grafted area, the clinical outcome was checked. Results: Histomorphometry was done in ten patients.Bio-$cera^{TM}$ particles were surrounded by newly formed bone. The graft particles and newly formed bone were surrounded by connective tissue including small capillaries in some fields. Imaging processing revealed $24.86{\pm}7.59%$ of new bone, $38.20{\pm}13.19%$ connective tissue, and $36.92{\pm}14.51%$ of remaining Bio-$cera^{TM}$ particles. All grafted sites received an implant, and in all cases sufficient bone height was achieved to install implants. The increase in ridge height was about $15.9{\pm}1.8mm$ immediately after operation (from 13mm to 19mm). After 6 months operation, ridge height was reduced about $11.5{\pm}13.5%$. After implant installation, average marginal bone loss after 6 months was $0.3{\pm}0.15mm$. Conclusion: Bio-$cera^{TM}$ showed new bone formation similar with Bio-$Oss^{(R)}$ histomorphometrically and appeared to be an effective bone substitute in maxillary sinus augmentation procedure with the residual bone height from 2 to 6mm.

• 구강회복응용과학지
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• 제36권2호
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• pp.88-94
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• 2020

목적: 본 연구는 한국인에서 상악 전치의 치근 위치를 시상면에서 분석하고, 분류에 따른 빈도를 보고함으로써 즉시 식립 임플란트를 위한 방사선학적 자료를 수집하기 위함이다. 연구 재료 및 방법: 콘빔형 전산화단층영상(cone-beam CT)을 촬영한 환자 중 연구 기준에 적합한 120명(남성 60명, 여성 60명)을 대상으로 후향적 분석을 시행하였다. 축의 방향설정을 시행한 후에, 상악 전치부 치아와 치조골 사이의 관계에 대한 시상 치근 위치를 분석하였다. 치근이 치조골의 협측, 중앙, 구개측으로 위치한 경우 각각 Class I, II, III로 분류하였으며, 치근이 협측과 구개측 모두에서 피질골판에 2/3 이상 닿아있는 경우에는 Class IV로 하였다. 다음으로, 치아의 장축과 치조골의 장축 사이의 각도를 측정하였다. 기술적 분석 및 Kruskal-Wallis 분석을 시행하였으며, 치아의 위치 및 분류에 따른 시상각을 비교하였다. 결과: 상악 전치부의 시상 치근 위치에 대한 빈도분석 결과, Class I은 81.1%, Class II는 10.3%, Class III는 1.9%, 그리고 Class IV는 6.7%로 나타났다. 상악 전치부의 77.5%에서 시상각이 20도 이하로 나타났다. 그러나 견치의 경우, 42.7%에서 20도 이상의 시상각을 보였다. 분류에 따라서는 Class I (16.19)에서 Class II (8.72) 및 Class III (9.93)에 비해 통계학적으로 유의하게 높은 시상각을 보였으며, Class IV (3.79)에서 낮았다. 결론: 본 제한된 연구의 결과를 근거로, 상악 전치의 치근은 일반적으로 협측 치조골에 가깝게 위치하고 있으나, 일부 치아는 매우 얇은 치조골을 가지고 있으며, 30도 이상의 큰 시상각을 보였다. 따라서 적절한 치과 임플란트 치료 계획 수립을 위해 시상 치근 위치 및 시상각에 대한 cone-beam CT 분석이 필요할 것이다.

• 구강회복응용과학지
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• 제20권2호
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• pp.121-134
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• 2004

진단과 치료과정을 통해서 후천적으로 습득된 부정교합을 가진 부분무치악자 성인에게서, 교합고경을 회복해 줌으로써 3급 부정교합 안모에서 정상교합상태의 안모와 기능을 부여할 수 있었다. 대부분의 부분무치악자에서 치조골의 위축, 그리고 감소된 교합고경 인해 이루어진 부정교합자에게서 교합고경의 수복은 매우 어려운 작업이다. 적절한 안모의 심미는 대체로 interlabial gap이 약 0-2mm일 때 얻어진다. 이것과 함께, 제한된 입술 지지도(lip competence)가 교합고경 수복과 적절한 안모의 심미를 위한 지표로 사용될 수 있다. 소개된 증례의 경우는, 7년 이상의 계속 관찰 결과, 성공적인 치료였다고 판단된다. 교합고경을 증가시킨 경우이긴 하지만, 사실은 원래의 정상 교합고경으로 회복 시켜주었다고 하는 것이 더욱 옳은 표현일 것 같다. 교합고경을 증가시키는 작업은 안모의 수복, 절치부의 외상성 교합을 수정하고 하악을 후퇴시키는데 매우 어렵고도 중요한 일이다. 최종적으로, 3급 부정교합이 수정되고, 적절한 교합고경을 가지게 되었으며, 위축된 구치 무치악부가 rigid support 개념으로 제작된 가철성 의치로 수복되었다. 부분 무치악부를 가진 후천적 부정교합자의 치료의 결과로 획득한 치아 및 안모의 심미와 이것의 장기간 안정성은 다음의 관계를 잘 고려함으로써 지속될 수 있을 것으로 사료된다: 1) 이상적인 교합고경에서의 교합수복, 2) 상,하악골 관계에서 기능적으로 유도되는 최종 교합의 허용, 3) lip competence (입술 적응) 한계 내에서 기능적으로 유도되는 최종교합.

• Journal of Periodontal and Implant Science
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• 제47권4호
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• pp.211-218
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• 2017

Purpose: The purpose of the present study was to perform a pattern analysis in patients with temporomandibular disorder (TMD) resulting from unilateral mastication due to chronic periodontitis. Methods: Thirty participants with signs or symptoms of TMD who engaged in unilateral mastication due to periodontitis-related discomfort (test group) were selected. Another 30 subjects exhibiting signs or symptoms of TMD resulting from unilateral mastication not due to chronic periodontitis (control group) were also recruited. An interview-based questionnaire was administered, and an examination of the temporomandibular joint (TMJ) with determination of periodontal status was performed. Results: The duration of unilateral mastication was significantly longer in the control group than in the test group. There was a significant negative correlation between the duration of unilateral mastication and the Community Periodontal Index score. Using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I algorithms, all the subjects were assigned to 3 main groups. The test group exhibited significantly a higher diagnostic distribution of group III (arthralgia, osteoarthritis, or osteoarthrosis), and in both the test and control groups, the number of diagnoses was larger for the non-chewing side. The control group showed a significantly higher diagnostic distribution of group I (myofacial pain), and in both the test and control groups, the number of diagnoses was larger for the chewing side. Conclusions: The results of the present study indicate that unilateral mastication due to chronic periodontitis could induce not only pain but also structural TMJ changes if adequate treatment is not administered and supported within a short time from the onset of the condition. Therefore, immediate treatment of chronic periodontitis is recommended to prevent not only the primary progress of periodontal disease, but also secondary TMJ-related problems. Furthermore, subjects who have suffered chronic long-term periodontitis without treatment should be urged to undergo a TMJ examination.

• Journal of Periodontal and Implant Science
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• 제41권1호
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• pp.10-16
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• 2011

Purpose: Avulsed tooth can be completely recovered, if sound periodontal ligament (PDL) of tooth is maintained. Although a lot of storage solutions have been explored for the better storage of avulsed tooth, there is a shortcoming that the preservation time is much short. On the other hand, there has been studies that (-)-epigallocatechin-3-gallate (EGCG), the most abundant polyphenol in green tea, which is related to the anti inflammatory, antioxygenic, and antibacterial effects, allows the successful preservations of tissues and cells. This study evaluated the effect of EGCG on avulsed-teeth preservation of Beagle dogs for a period of time. Methods: The atraumatically extracted teeth of Beagle dogs were washed and preserved with 0/10/$100\;{\mu}M$ of EGCG at the time of immediate, period 1 (4 days in EGCG-contained media and additional 1 day in EGCG-free media), period 2 (8 days in EGCG-contained media and additional 2 days in EGCG-free media) and period 3 (12 days in EGCG-contained media and additional 2 days in EGCG-free media). Then, the cell viabilities of preserved teeth was calculated by dividing optical density (OD) of 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay with OD of eosin assay to eliminate the measurement errors caused by the different tissue volumes. Results: From the results, the immediately analyzed group presented the highest cell viability, and the rate of living cells on teeth surface decreased dependent on the preservation period. However, the $100\;{\mu}M$ of EGCG-treated group showed statistically significant positive cell activity than EGCG-free groups throughout preservation periods. Conclusions: Our findings showed that $100\;{\mu}M$ EGCG could maintain PDL cell viability of extracted tooth. These results suggest that although EGCG could not be a perfect additive for tooth preservation, it is able to postpone the period of tooth storage. However, further in-depth studies are required for more plausible use of EGCG.

• Journal of Periodontal and Implant Science
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• 제29권4호
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• pp.893-914
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• 1999

Tooth mobility may be the decisive factor that determines whether dental treatment of any kind is undertaken. Although tooth mobility in isolation says little in itself, the finding of increased tooth mobility is of both diagnostic and prognostic importance. Only the detection of an increase or decrease in mobility makes an evaluation possible. Thus prior to treatment, we must understand the pathologic process causing the observed the tooth mobility and decide whether the pattern and degree of observed tooth mobility is reversible or irreversible. And then it must be decided whether retention and treatment or extraction and replacement. The purpose of this study was to compare tooth mobility at different time period during root planing and flap operation and to relate changes in mobility to each treatment method. Twenty-one patients (287 teeth) with chronic adult periodontitis were treated with root planing(control group) and flap operation(experimental group), and each group was divided 3 subgroups based upon initial probing pocket depth (1-3mm, 4-6mm, 7mm and more). Tooth mobility was measured with $Periotest^{(R)}$ at the day of operation, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 8 weeks, 12 weeks after each treatment. Tooth mobility, attachment loss, radiographic bone loss, and bleeding on probing were measured at the day of operation, 4 weeks, 8 weeks and 12 weeks after treatment. 1. In group initial probing depth was 1-3mm, tooth mobility had no significant difference after root planing and flap operation. 2 . In group initial probing depth was 4-6mm, 7mm and more, tooth mobility had decreased in 12 weeks after root planing(p<0.01). And the mobility had increased after flap operation(p<0.01) and was at peak in 1 week, and decreased at initial level in 4 weeks, below the initial level in 12 weeks(p<0.01). 3. In 1 week, significant difference in tooth mobility between control and experimental group was found(p<0.01) but, in 12 weeks no difference between two groups was found. 4. Change of immediate tooth mobility after treatment was more larger in deep pocket than in shallow one. In group with the same probing pocket depth, the change of tooth mobility in molar group was greater than that of premolar group. 5. Tooth mobility before treatment was more strongly correlated with radiographic bone loss (r=0.5325) than probing depth, attachment loss and bleeding on probing, in 12 weeks after treatment, was more strongly correlated with attachment loss($r^2$=0.4761) than probing depth and bleeding on probing. Evaluation of the treatment effect and the prognosis after root planing and flap operation were meaningful on tooth initial probing depth 4mm and more. After flap operation, evaluation of the prognosis should be performed at least in 4 weeks and in 12 weeks after treatment, no difference in tooth mobility between two groups was observed. Radiographic bone loss and attachment loss were good clinical indicators to evaluate tooth mobility.