• Title/Summary/Keyword: Multiple implant

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Clinical and patient-reported outcomes after recession coverage using modified vestibular incision subperiosteal tunnel access with a volume-stable collagen matrix as compared to a coronally advanced flap with a subepithelial connective tissue graft

  • Chun-Teh Lee;Marlena Lange;Alain Jureidini;Nurit Bittner;Ulrike Schulze-Spate
    • Journal of Periodontal and Implant Science
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    • v.52 no.6
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    • pp.466-478
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    • 2022
  • Purpose: Coronally advanced split-or full-thickness (CAST or CAFT) flaps in combination with subepithelial connective tissue grafts (SCTGs) are commonly used in root-coverage procedures despite postoperative pain and bleeding from the graft donor site. Therefore, the modified vestibular incision subperiosteal tunnel access procedure (VISTAX) uses a novel collagen matrix (VCMX) instead of autogenous tissue to address the limitations associated with autogenous tissue grafting. This retrospective study compared the clinical outcomes of VISTAX to the results obtained after using a CAST or CAFT flap in combination with SCTG for root coverage. Methods: Patients with single or multiple adjacent recession I/II defects were included, with 10 subjects each in the VISTAX, CAFT, and CAST groups. Defect coverage, keratinized tissue width, esthetic scores, and patients' perceived pain and dentinal hypersensitivity (visual analogue scale [VAS]) were assessed at baseline, 3 months, and 6 months. Results: All surgical techniques significantly reduced gingival recession (P<0.0001). Defect coverage, esthetic appearance, and the reduction in dentinal hypersensitivity were comparable. However, the VAS scores for pain were significantly lower in the VISTAX group than in the CAFT and CAST groups, which had similar scores (P<0.05). Furthermore, the clinical results of VISTAX and CAFT/CAST generally remained stable at 6 months. Conclusions: The clinical outcomes of VISTAX, CAFT, and CAST were comparable. However, patients perceived significantly less pain after VISTAX, indicating a potentially higher patient acceptance of the procedure. A prospective trial with a longer follow-up period and a larger sample size should therefore evaluate VISTAX further.

Usability testing of a novel interlocking three-dimensional miniplate for mandibular angle fractures

  • Prasetyanugraheni Kreshanti;Aria Kekalih;Ahmad Jabir Rahyussalim;Sugeng Supriadi;Bambang Pontjo Priosoeryanto;Deni Noviana;Mendy Hatibie Oley;Chaula Luthfia Sukasah
    • Archives of Craniofacial Surgery
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    • v.25 no.4
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    • pp.171-178
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    • 2024
  • Background: We developed a novel interlocking three-dimensional (3D) miniplate design with an adjustable configuration. As this device is new, surgeons must become familiar with its application. This study evaluated the usability and learning curves associated with the novel interlocking 3D miniplate for mandibular fracture fixation. Methods: The study participants, nine plastic surgeons, were asked to apply an interlocking 3D miniplate and a standard miniplate to polyurethane mandible models. The participants had completed the Basic Craniomaxillofacial Osteosynthesis course during residency and had operated on craniomaxillofacial fractures within the past 5 years. They were instructed to place the interlocking 3D miniplate three times and the standard miniplate once. We assessed the time required for implant placement, the comfort level of the surgeons, and the biomechanical stability of the plates. Biomechanical testing was conducted by subjecting the mandible to forces ranging from 10 to 90 N and the displacement was measured. Results: The results indicate increasing comfort with each attempt at placing the interlocking 3D miniplate, with a significant difference between the first and third attempts. Additionally, a reduction in application time was noted with repeated attempts, suggesting improved efficiency. Biomechanical tests showed comparable stability between the tested plates. Conclusion: Multiple attempts at applying the interlocking 3D miniplate resulted in increased comfort and reduced application time. These findings indicate that, despite its novelty, the interlocking 3D miniplate is relatively straightforward to apply and has a short learning curve. However, surgeons must have specific qualifications to ensure proper training and minimize errors during placement.

The Effect of PDGF-Loaded Biodegradable Membrane on Early Healing Stage in Guided Tissue Regeneration (흡수성 차폐막의 치주조직 재생에 혈소판유래 성장인자가 미치는 영향)

  • Rhyu, In-Chul;Bae, Kyoo-Hyun;Seol, Yang-Jo;Ku, Young;Lee, Seung-Jin;Han, Soo-Boo;Choi, Sang-Mook;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.29 no.3
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    • pp.507-519
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    • 1999
  • The ultimate objective of periodontal treatment is to stop disease progression and to regenerate destroyed periodontal tissues and thereby regain normal function. Growth factors are naturally found polypetides which stimulate many cellular activities pertaining to wound healing by acting as signal molecule in controlling cell movement, proliferation, and matrix production. Platelet derived growth factor (PDGF) is 28,000-35,000 Da molecular weight dimeric protein with 2 long positively charged polypeptide chains connected by sulfide bonds. The purpose of this study is to evaluate histologically the initial guided tissue regeneration in a periodontal defect f a beagle dog treated with a biodegradable membrane formed with polylactic acid (poly-L-lactic acid) and polyglycolic acid loaded with 200ng/$cm^2$ platelet derived growth factor. 2 beagle dogs were used in he experiment. $5mm{\times}6mm$ alveolar bone defect was formed in upper and lower canines and third premolars and a reference notch was placed. PDGF-BB non-containing membrane was used as control. Each defect was randomly assigned to the test roup or the control group. The dogs were sacrificed 3 weeks after membrane placement. Toluidine blue and multiple staining was done for histological analysis. In the 3 week specimen in the control group, no new one formation could be seen. Small amount f bone resorption below the notch could be seen. In the notch, loose connective tissue with infiltration of inflammatory cells could be seen. Also thin discontinuous new cementum could be seen and the membrane still retained its structure. Where PDGF-BB containing membrane was used, new bone formation could be seen in the notch at weeks and also continuous thin cementum could be seen. PDL cells were observed between new bone and new cementum and some were attached to bone and cementum. These results suggest that new bone and cementum formation seen when PDGF-BB loaded membrane was used was due to inhibition of downgrowth of epithelial cells and also due to continuous release of the growth factor. Further study on the resorption characteristics of the membrane nd the release characteristics of the PDGF-BB is necessary. Also, development of a membrane easier to use clinically is necessary.

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Evaluation of Statistical Analysis of Articles in Journal of Korean Academy of Periodontology (대한치주과학회지에 게재된 학술논문의 통계분석에 대한 평가)

  • Nam, Min-Sook;Jeon, Chang-Kil;Han, Kyung-Yoon;Kim, Byung-Ock;Shin, Kwang-Yong
    • Journal of Periodontal and Implant Science
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    • v.30 no.3
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    • pp.699-707
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    • 2000
  • The purpose of this study was to analyze the statistical errors of articles in the Journal of Korean Academy of Periodontology from 1973 to 1999. Of the 662 articles examined, 263 were included which analyzed the data. They were classified into 2 groups with time lapse; group 1: 1973∼1989, group 2: 1990∼1999. Authors made checklists for analyzing the data and detecting the errors and analyzed them with professional statistician. The results were as follows: 1. Of 263 atricles which applied statistical method, 40(19.3%) was in group 1, 223(49.0%) in group2. 2. In the number of statistical method applied, 170(64.6%) were analyzed with 1 statistical method, 73(27.8%) with 2 methods, 18(6.8%) with 3 methods, and 2(0.8%) with 4 methods 3. The number of statistical methods applied was 14, and they were applied in order of 119 of ANOVA, 72 of Student t-test, 63 of Paired t-test, 36 of CORRELATION, and 21 of Mann- Whitney U test. 4. In 87(33.1%) of 263 articles and in 18 error items, statistical errors were found out. In group I, 9 items (55%) of error were found out, and were in order of 5 of Student t-test instead of Paired t-test, and 4 of unnecessary statistical analysis. In group II, 16 items (29.1%) of error were found out, and were in order of 22 of Student t-test instead of Paired t-test, 7 of no multiple comparison test after ANOVA, 6 of Student t-test instead of ANOVA, 6 of unnecessary statistical analysis, and 5 of ANOVA instead of Paired t-test. In conclusion, the results noted that statistical analyses were increased, but statistical errors were decreased with time. But authors suggest that researchers should refer to standard statistical texts and seek advice from professional statisticians to avoid the statistical errors.

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Periodontal inflamed surface area as a novel numerical variable describing periodontal conditions

  • Park, Shin-Young;Ahn, Soyeon;Lee, Jung-Tae;Yun, Pil-Young;Lee, Yun Jong;Lee, Joo Youn;Song, Yeong Wook;Chang, Yoon-Seok;Lee, Hyo-Jung
    • Journal of Periodontal and Implant Science
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    • v.47 no.5
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    • pp.328-338
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    • 2017
  • Purpose: Chronic periodontitis is an inflammatory disease induced by pathogenic bacterial accumulation. A novel index, the periodontal inflamed surface area (PISA), represents the sum of the periodontal pocket depth of bleeding on probing (BOP)-positive sites. It is advantageous for data processing and analysis because it can be treated as a continuous variable to quantify periodontal inflammation. In the present study, we evaluated correlations between PISA and periodontal classifications, and examined PISA as an index integrating the discrete conventional periodontal indexes. Methods: This study was a cross-sectional subgroup analysis of data from a prospective cohort study investigating the association between chronic periodontitis and the clinical features of ankylosing spondylitis. Data from 84 patients without systemic diseases (the control group in the previous study) were analyzed in the present study. Results: PISA values were positively correlated with conventional periodontal classifications (Spearman correlation coefficient=0.52; P<0.01) and with periodontal indexes, such as BOP and the plaque index (PI) (r=0.94; P<0.01 and r=0.60; P<0.01, respectively; Pearson correlation test). Porphyromonas gingivalis expression and the presence of serum P. gingivalis antibodies were significant factors affecting PISA values in a simple linear regression analysis, together with periodontal classification, PI, bleeding index, and smoking, but not in the multivariate analysis. In the multivariate linear regression analysis, PISA values were positively correlated with the quantity of current smoking, PI, and severity of periodontal disease. Conclusions: PISA integrates multiple periodontal indexes, such as probing pocket depth, BOP, and PI into a numerical variable. PISA is advantageous for quantifying periodontal inflammation and plaque accumulation.

The Clinical Study of the Supracondylar Fracture of the Femur (대퇴골 과상부 골절 및 치료에 대한 임상적 고찰)

  • Ahn, Jong-Chul;Kim, Se-Dong;Ahn, Myun-Whan;Seo, Jae-Sung;Lee, Dong-Chul;Lee, Young-Joo
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.197-211
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    • 1993
  • Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So complications of the supracondyle fractures including joint stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989, Dec. To 1992, Jan. The results were as follows : 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification. 4 cases were type A, 4 in type B, 12 in type C (10 in type $C_2$&$C_3$). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in conservative treatment and 67% in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.

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The Effects of Pulsatilla Koreana for Anti - Inflammatory and Cellular Activity of Periodontal Tissue (백두옹 추출물의 치주조직 세포에 활성도 및 항염 효과에 관한 연구)

  • Jung, Jin-Gwang;Chung, Chin-Hyung;Lim, Sung-Bin;Kim, Jung-Keun;So, Eun-Hee
    • Journal of Periodontal and Implant Science
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    • v.31 no.1
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    • pp.149-165
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    • 2001
  • This study was performed to define the cytotoxicity and the anti-inflammatory action of Pulsatilla koreana extracts. To analyze cytotoxic effects, gingival and periodontal ligament fibroblasts were used, and anti-inflammatory actions related to reduction of $IL-1{\beta}$ and $PGE_2$ production were performed in vitro, for the suggestion of efficacy and safety on periodontal therapeutic use of Pulsatilla koreana extracts. We extracted ethylacetate and butylalcohol from well-dried and ground Pulsatilla koreana throughout multiple processing, then used different concentration solution(0.1 %, 0.2 %, 0.4 %, 0.01 %, 0.02 %, 0.04 %, 1 %, 2 %) of ethylacetate and butylalcohol extracts to examine eytotoxic effects and anti-inflammatory actions Cytotoxic effects were examined by ELISA reader using MTT(Methyl Thiazol-2-YL-2, 5-diphenyl Tetrazolium bromide)solution following culture of human gingival and periodontal ligament fibroblasts. Synthesis of $IL-1{\beta}$was examined by $IL-1{\beta}$ enzyme-immunoassay(EIA)system after separation and culture of monocyte, and $PGE_2$ was examined by $PGE_2EIA$ system after culture of gingival fibroblasts. The results were as follows: 1. In the MTT test of gingival fibroblasts, the change of optical density was decreased significantly at 2 % of butylalcohol extracts and 0.04 %, 0.1 %, 0.2 %, 0.4 %, 1 %, 2 % of ethylacetate extracts.(p<0.05) 2. In the MTT test of periodontal ligament cells, the change of optical density were not differ significantly. but butylalcohol and ethylacetate extracts except from butylalcohol 0.01 % showed high cell cytotoxity. 3. Both ethylacetate and butylalcohol extracts from Pulsatilla koreana inhibited the synthesis of $IL-1{\beta}$and inhibition effect of ethylacetate extracts were higher than butylalcohol extracts. 4. Both ethylacetate and butylalcohol extracts from Pulsatilla koreana inhibited the synthesis of $PGE_2$, and ethylacetate extracts were higher than butylalcohol extracts. In conclusion, ethylacetate and butylalcohol extracts from Pulsatilla koreana showed little cell cytotoxity for gingival and periodontal ligament fibroblasts, and the inhibition of $IL-1{\beta}$ and $PGE_2$ sysnthesis, therefore it is considered that these extracts can be developed as the therapeutics of the periodontal disease.

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Histological healing after grafting of bilayer artificial dermis in the oral environment (치은부에 이식한 이중인공진피의 조직학적 치유)

  • Kim, Min-Jeong;Chung, Hyun-Ju;Kim, Ok-Su;Kim, Young-Joon
    • Journal of Periodontal and Implant Science
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    • v.33 no.2
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    • pp.289-299
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    • 2003
  • The autogenous free gingival graft is the most predictable procedure currently used to increase the width of the attached gingiva in periodontics. But the major disadvantage of the procedure is to create the multiple surgical wounds at both a donor site and a recipient site. The other problem is the limited amount of available graft material in oral cavity. Therefore, recent researches have been focused to develop the biomaterial to substitute the autogenous gingival tissue. The purpose of this study was to evaluate the histologic healing after grafting of bilayer artificial dermis, compared to the free gingival graft. Four non-smoking subjects (mean age, 32.5 years) in systemically healthy state and good oral hygiene were selected according to their particular needs for correction of mucogingival problems as suggested by Nabers(1966). The recipient sites were prepared through the procedure for the free gingival graft and were grouped according to the graft materials: Experimental group(n=5) - bilayer artifcia1 dermis ($Terudermis^{(R)}$; Terumo Co. Japan) and Control group(n=6) - free gingival graft with autogenous palatal mucosa. Biopsies were harvested at 1,2,3 and 6 weeks postsurgery to evaluate histologically. At the third week in the experimental group and at the second week of in the control group, the grafts has been clinically stabilized on the recipient bed and the graft border has been blended into the surrounding tissue. In the experimental group after 1 week of grafting, the epithelial migration from the adjacent tissue to graft material was seen and after 3 weeks of grafting, the : nflmmation decreased, collagen layer of the artificial dermis was lost and the basement membrane of epithelium was formed. After 6 weeks of grafting, both groups demonstrated orthokeratinized epithelium and increased thickness of epithelial tissue and the rete peg formation, similar to the adjacent tissue, Histologic evaluation revealed a biologic acceptance and incorporation of the collagen layers of the graft tissue to the host tissue, without foreign body reaction. In conclusion, a bilayer artificial dermis is essentially similar to autogeneous free gingival graft in the correction of mucogingival problems, and has the advantages of decreased patient morbidity (no donor site) and availability of abundant amounts of graft material when needed.

Comparison of patient satisfaction with digital and conventional impression for prosthodontic treatment (보철 치료 시 디지털 및 전통적 인상채득에 대한 환자 만족도 비교 연구)

  • Yoon, Hyung-In;Lee, Su-Min;Park, Eun-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.4
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    • pp.379-386
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    • 2016
  • Purpose: The present study aims at researching the subjective satisfaction of patients who have experienced both conventional impression taking and digital impression taking to measure the possibility of wide clinical application of digital impression. Materials and methods: The study surveyed 170 adult patients over the age of 20, between October 2015 and April 2016, who voluntarily consented to participation and who experienced both conventional impression and digital impression at five dental hospitals that use intraoral digital impression. A total of 128 surveys were used for data analysis, involving frequency analysis, multiple response frequency analysis, descriptive statistics, and contingency table analysis, with the significance level set at 0.05. Results: Responses on the reason for taking impressions using the digital method appeared in the order of 'for implant treatment' (43.8%), 'for crown treatment' (30.5%), and 'for inlay treatment' (15.6%). Patients satisfaction was higher for digital impression taking than conventional impression taking (P<.05). As the preferred choice of impression, digital impression (60.2%) was higher than conventional impression (11.7%). Responses on the reason for choosing digital impression taking appeared in the order of 'no vomiting reflex' (35.1%), 'reliability of 3D digital scanning' (33.8%), and 'short time' (33.8%). Conclusion: The patients preferred digital impression taking to conventional impression taking in terms of satisfaction.

Effects of Substance P on the Release of Cytokines from Immune Cell Lines (면역세포의 cytokine 유리에 미치는 substance P의 영향)

  • Lee, Jin-Yong;Kim, Soo-Ah;Seo, Seok-Ran;Kim, Hyong-Seop
    • Journal of Periodontal and Implant Science
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    • v.27 no.2
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    • pp.425-441
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    • 1997
  • The neuropeptide substance P(SP) has been implicated in the mediation of inflammation and immune-mediated disease such as arthritis. Recently, it was reported that SP was markedly increased around the blood vessels in inflamed gingiva as well as in close association with the inflammatory cell infiltrate. These results support that SP may contribute to the pathophysiology of neuronal inflammation in human periodontal tissues. SP may regulate inflammatory/immune responses by stimulating the proliferation of human T cells, differentiation and antibody-secreting potential of B cells, macrophage respiratory burst, connective tissue proliferation, and the secretion of cytokines from monocytes and T cells. Here, I studied potential role of SP as a costimulatory chemical signal in inflammatory/immune responses, by determining the released proinflammatory cytokines such as $MIP-1{\alpha}$, $IL-1{\beta}$, and IL-6 from culture supernatants of homogeneous immune cell lines. Serum free cell supernatants were concentrated with TCA precipitation, fractionated with SDS-PAGE, and subjected into western blot analysis. Among 15 cell lines tested, macrophage/monocyte cell line RAW264.7 and WRl9m.1 showed the highest level of induction of $MIP-1{\alpha}$ when stimulated with LPS. Discrete IL-6 bands with multiple forms of molecular mass were detected from supernatants of B cell lines A20(32kDa), Daudi(32, 35kDa), and SKW6.4(29kDa), which were expressed constitutively. $IL-1{\beta}$ could not be detected by the method of western blot analysis from supernatants of all cell lines tested except RAW264.7, WRl9m.1, and erythroid cell line K562 which showed the least amount of $IL-{\beta}$ secretion. SP $10^{-9}M$ with suboptimal dose of LPS treatment showed synergistic induction of $MIP-1{\alpha}$ release from RAW264.7 or WR19m.1, and also IL-6 release from A20, but this synergism is not the case in costimulation of RAW264.7 or WRl9m.1 with SP $10^{-9}M$ and TPA. Although treatment of T cell line CTLL-R8 with SP $10^{-7}M$ or PHA+TPA induced modest level of $MIP-1{\alpha}$ secretion, synergism was not observed when they are applied together. These findings all together suggest the possibility of a regulatory role of SP in inflammatory/immune reaction through differential modulation of bioactivities of other chemical cosignals.

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