• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.403-420
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• 2000

The treatment and prevention of periodontitis is focused on the reduction and the elimination of pathogenic bacteria, especially A. actinomycetemcomitans and black pigmented bacteria such as P. gingivalis. To prevent recurrent disease, the recolonization of these bacteria should be inhibited in the periodontal pocket. Since the replacement therapy was introduced in periodontics by Hillman et al, Jeong et al reported that hydrogen peroxide-producing Lactobacillus acidophilus V-20 completely inhibited P. gingivalis and A. actino - mycetemcomitans in vitro and mouth gargling with Lactobacillus acidophilus V-20 in periodontitis patients during the maintenance phase improved clinical condition and reduced the No. of P. gingivalis and A. actinomycetemcomitans at 4 weeks of treatment. Prior to replacement therapy with bacteria, dynamics of microbial colonization should be considered. This study was performed to evaluate the change in the viable cell number of Lactobacilli and P. gingivalis after oral administration of L. acidophilus V-20. In periodontal health, gargling increased the No. of Lactobacilli in saliva, buccal mucosa, supragingival plaque from the first week, which maintained for 2-3 weeks after gargling stop, and then returned to the undetectable baseline level at the ninth week. In the periodontal pocket of moderate periodontitis patients, daily irrigation for 1 week and weekly irrigation for subsequent 3 weeks decreased the viable cell number of P. gingivalis during the period of irrigation and increased the number of Lactobacilli, which was maintained from the second to the seventh week. L. acidophilus V-20 was isolated for the first 2 weeks of oral administration, and the 3 different strains of Lactobacilli were isolated continuously for remaining period and identified as L. ali - mentarius, L. casei subspecies casei and L. fructosus. The first two Lactobacilli strains completely inhibited P. gingivalis in vitro and all the isolated Lactobacilli strains reduced the artificial plaque formation by 55-63%. These results showed that mouth gargling or pocket irrigation with L. acidophilus V-20 increased the No. of intraoral Lactobacilli and caused to decrease in the No. of P. gingivalis. This suggests that the replacement therapy by these Lactobacilli might be useful in the maintenance care of periodontal patients.

• Journal of Periodontal and Implant Science
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• v.43 no.5
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• pp.215-220
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• 2013

Purpose: Cigarette smoking is a major risk factor in periodontal diseases. The pathogenesis of periodontal diseases may be affected by alterations of the inflammatory response by smoke. Nitric oxide (NO) is a gaseous, colorless, highly reactive, short-lived free radical with a pivotal role in the regulation of various physiological and pathological mechanisms in the body. It is important in host defense and homeostasis, on the one hand, whereas, on the other hand, it modulates the inflammatory response in periodontitis, leading to harmful effects. The aim of this study was to assess the levels of NO in both the serum and saliva of smokers and nonsmokers having chronic periodontitis and to compare them with periodontally healthy controls. Methods: Sixty subjects participated in the study and were divided into three groups: group I, healthy nonsmoking subjects; group II, nonsmoking patients with chronic periodontitis; group III, smoking patients with chronic periodontitis. Each group consisted of twenty subjects. The biochemical estimation of NO in the collected serum and in the saliva was performed using the Griess colorimetric reaction. Results: The results showed that the mean value of the salivary and serum NO was greater in group II than in group I, and also greater in group III than in group II. Conclusions: NO appears to play an important and rather complex role in the immuno-inflammatory process and in the remodeling and maintenance of osseous structures. It is therefore logical that modulation of this mediator has potential for the treatment of a number of inflammatory conditions including periodontal disease.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.715-724
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• 1999

The purpose of this study was to approve the possibility of clinical application of selftesting technique to confirm the cleanness status of the tooth surface after mechanical toothbrushing. Thirty-two periodontal patients who did not compromise any other systemic diseases were divided into two groups. Control group was instructed only the Bass method for toothbrushing, and then experimental group was demonstrated the Bass method and self-testing technique respectively for plaque control during this experiment. Selftesting technique is composed the comparison of roughness of the labial surface of maxillary central incisor and other toothsurface with touch sense using the tip of tongue. Plaque score and Gingival index were measured as clinical parameters at baseline and 1, 2 and 4 weeks after scaling and root planing. The results were as follows ; 1. Plaque scores and gingival index of 1, 2, and 4 weeks of two groups were statistically significant differences when compared with baseline value (p<0.05). 2. Plaque scores and gingival index of baseline and 1 week between two groups were not significant differences (p<0.05). 3. Plaque scores and gingival index of 2 and 4 weeks of test group were statistically significant difference when compared with control group (p<0.05). From the above results, self-testing technique which decides necessity of additional toothbrushing when tongue tip of subjects touch the maxillary molar buccal surfaces and mandibular molar lingual surfaces nd compares with maxillary anterior labial surfaces after toothbrushing appeared to effect the motivation of subjects. This study suggests that self-testing technique for cleanness after toothbrushing should be effect on the maintenance of oral hygiene when it is applied to clinical practice.

• Journal of Periodontal and Implant Science
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• v.33 no.4
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• pp.705-715
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• 2003

Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically compomer and Ketac Silver as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiostcal flap was elevated. Following decortication with 1/2 high speed round bur, furcation defect was made on maxillary premolar. 2 month later one premolar was filled with compomer and the other premolar was filled with Ketac Silver. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. Results were as follows. 1. Compomer & Ketac Silver restoration were encapsulated fine connective tissue. 2. In 4 weeks, compomer & Ketac Silver restoration slightly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, compomer & Ketac Silver restoration were less infiltrated iflammatory cell and encapsulated fine connective tissue. 4. Therefore, compomer & Ketac Silver filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances is possible clinical method and this technique is useful method for maxillary furcation involvement but it is thought that periodic maintenance should be needed

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.65-70
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• 2014

Purpose: The purpose of this retrospective study was to evaluate the effect of patient compliance with supportive periodontal therapy (SPT) on tooth loss in Korean adults. Methods: The periodontal records of 134 patients were reviewed for this study. They completed active periodontal treatment from 1999 to 2001 and were placed on a schedule of periodic follow-up visits for SPT. Patient compliance was classified into complete compliance (CC), erratic compliance (EC), and noncompliance (NC) groups. Re-examinations were carried out $11.0{{\pm}}0.8$ years after the active periodontal treatment. The prognosis for each tooth was determined as good, questionable, or hopeless according to the bone loss observed in pretreatment radiographs. Results: The rate of tooth loss of the CC group was significantly lower than that of the NC group. The tooth loss/patient and the tooth loss/patient/year were not significantly different between the three groups. The rates of tooth loss in the good, questionable, and hopeless prognosis groups were 6.7%, 9.5%, and 13.2%, respectively. For the teeth with a good prognosis, the rate of tooth loss of the CC group was significantly lower than that of the NC group (0.4% vs. 5.1%). For the teeth with a questionable prognosis, the CC group showed a significantly lower rate of tooth loss than did the EC group (4.1% vs. 30.7%) or the NC group (4.1% vs. 25.6%). For the teeth with a hopeless prognosis, the rates of tooth loss were not significantly different among the three groups. Conclusions: Within the limits of this study, the patients who showed a poor compliance with SPT were more likely to lose teeth than were the regularly compliant patients. However, the risk of tooth loss with a hopeless prognosis was high irrespective of the compliance.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.1
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• pp.85-92
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• 2005

Reconstruction of defect in the anterior part of the maxilla to enable implant placement or prothesis is a complicated treatment due to the anatomical position and lack of soft tissues. Two cases are presented in which autogenous iliac PMCB(particulate marrow and cancellous bone) with titanium mesh were used for premaxilla reconstruction and alveolar bone repair of the anterior maxillas prior to denture and implants fixation respectively. Cancellous bone from the anterior iliac crest was compressed and placed against a titanium mesh fixed to the bone of palate in a patient with severe defect of the anterior maxilla. There were no problem in the healing, and the anterior maxillas of two patients had increased height and width during the initial healing and remodeling. The clinical reports describe the use of titanium mesh for reconstruction of premaxilla. Autogenous bone grafts were harvested from the iliac crest and were loaded on a titanium mesh that were left in the patient's maxilla for 6 months before they were removed respectively. The radiographic analysis demonstrated that a 10mm vertical ridge augmentation had been achieved. In guided bone regeneration, the quantity of bone regenerated under the barrier has been demonstrated to be directly related to the amount of the space under the membrane. This space can diminish as a result of membrane collapse. To avoid this problem which involved the use of a titanium mesh barrier to protect the regenerating tissues and to achieve a rigid fixation of the bone segments, were used in association with autologous bone in 2 cases. The aim of this study was to evaluate the capability of a configured titanium mesh to serve as a mechanical and biologic device for restoring a vertically defected premaxilla.

• Journal of Periodontal and Implant Science
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• v.44 no.5
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• pp.251-258
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• 2014

Purpose: The preferred material for bone augmentation beyond the envelope of skeletal bone is the bone block graft, due to its dimensional stability. We evaluated the necessity of rigid fixation for the bone block graft, and compared the bone regeneration and volume maintenance associated with grafting using a synthetic hydroxyapatite block (HAB) and an autogenous bone block (ABB) without rigid fixation on rabbit calvaria over two different periods. Methods: Cylinder-shaped synthetic HAB and ABB were positioned without fixation on the rabbit calvarium (n=16). The animals were sacrificed at 4 or 8 weeks postoperatively, and the grafted materials were analyzed at each healing period using microcomputed tomography and histologic evaluation. Results: Integration of the graft and the recipient bed was observed in all specimens, although minor dislocation of the graft materials from the original position was evident in some specimens (six ABB and ten HAB samples). A tendency toward progressive bone resorption was observed in the grafted ABB but not in the grafted HAB, which maintained an intact appearance. In the HAB group, the area of new bone increased between 4 and 8 weeks postoperatively, but the difference was not statistically significant. Conclusions: The nonfixed HAB was successfully integrated into the recipient bed after both healing periods in the rabbit calvaria. In spite of limited bone formation activity in comparison to ABB, HAB may be a favorable substitute osteoconductive bone material.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.80-84
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• 2009

Purpose: The purpose of this article is to assess the efficacy of a bioabsorbable polylactide (PLA) plate and screw for treating injuries of ankle fractures. Materials and Methods: 24 patients who underwent an open reduction and internal fixation operation for ankle fractures from July 2005 to March 2007 were enrolled into the study. There were 15 men and 9 women. The average age of the patients was 44 years and the average follow-up period was 16 years and two months (16.2 months). All cases were divided into low grade fracture patient (11) who belongs in type A and B of Danis-Weber classification and high grade fracture patient (13) who belongs in type C1, C2 of Danis-Weber classification, and each groups were analyzed by clinical (Meyer score) and radiological finding at the time of their last follow-up evaluation. Results: The clinical results according to Meyer scoring system, showed that all patient with low grade fracture had good to excellent result, but only 54% of patient with high grade fracture had good to excellent result. According to Cedell's radiologic finding, there were 91% cases above fair in low grade fracture. But there were 62% of patient above fair result in high grade fracture, the reduction losses were seen in 38% of patient with high grade fracture. Conclusion: Bioabsorbable PLA plate and screw is good internal fixation device which doesn't have additional operation for removal of implant because of slow absorption within the human body. It showed sufficient strength for acquisition and maintenance of reduction in low grade fracture, but need attention to use because of many cases of reduction loss in high grade fracture. So, it seems to be safe and effective when used in heeling of low grade fracture under considering about type of fracture sufficiently.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.195-210
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• 2006

The aim of this study is to evaluate the effects of combination of rhBMP-4 and chitosan, which have osteoinductive capacity, on the regeneration of bone defects in dogs. Three beagle dogs aged over one and half years and weighed about 15Kg were used in this study. Three round defects were made by trephine bur in each side of mandibles. Each defect was filled with collagen, chitosan, rhBMP-4/chitosan. The dogs were sacrificed at 1, 3 or 8 weeks postsurgery and the results were evaluated histologically. The results of this study were as follows: 1. The sign of new bone formation, rearrangement of osteoblasts was revealed adjacent of preexisted bone or around graft materials such as chitosan. 2. The descending order of groups in bone regeneration speed was the rhBMP-4/chitosan group, chitosan group, collagen group. In the combination group, new bone was regenerated more and in better quality than others. 3. The regeneration of bone was observed in the rhBMP-4/chitosan group in 3 weeks after surgery. In 8 weeks after surgery, bone regeneration was observed in all three groups, and new bone at 8th week was denser in the chitosan and rhBMP-4/chitosan group than collagen group. In conclusion, rhBMP-4 and chitosan can be applied in the bone regeneration procedures usefully. It is considered that chitosan can be a splint for the maintenance of the defect form and produce much better effect when used with good grafting material or bone morphogenetic protein.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.437-444
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• 2008

Purpose: A number of techniques and materials have been used for periodontal regeneration and bone graft procedures with guided tissue regeneration(GTR) have been suggested as alternatives to osseous surgery in the management of local infra-bony defects. However, the long-term stability and treatment outcome following bone graft procedure of infra-bony defects is poorly documented. The purpose of this study was to assess radiographic change in infra-bony defects over 2 years after bone graft procedures with various graft materials. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients showed clinical and radiographic evidence of infra-bony defect(s). 44 sites of 34 patients aged 31 to 69 (mean age 48.3) were treated by bone graft procedure with a bone graft material. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. Result: We observed $1.15{\pm}1.95\;mm$ of bone fill, $0.40{\pm}1.19\;mm$ of crestal resorption, $1.55{\pm}1.77\;mm$ of defect resolution, and $40{\pm}44%$ of percentage of defect resolution. Deeper initial defect depth, narrower initial defect angle showed significantly greater bone fill, defect resolution, and % of defect resolution. But no significant difference was observed in graft sites and graft materials. Conclusion: If good oral hygiene maintenance and periodic recall check of patients is assured, bone graft procedure using various graft materials is one of the appropriate treatment modality for regenerative therapy of infra-bony defects.