• Journal of Periodontal and Implant Science
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• 제42권6호
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• pp.237-242
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• 2012

Purpose: The aim of this study was to clinically and radiographically evaluate and compare treatment of intrabony defects with the use of decalcified freeze-dried bone allograft in combination with a calcium sulphate barrier to collagen membrane. Methods: Twelve patients having chronic periodontal disease aged 20 to 50 years and with a probing depth >6 mm were selected. Classification of patient defects into experimental and control groups was made randomly. In the test group, a calcium sulphate barrier membrane, and in control group, a collagen membrane, was used in conjunction with decalcified freeze-dried bone graft in both sides. Ancillary parameters as well as soft tissue parameters along with radiographs were taken at baseline and after 6 months of surgery. Parameters assessed were plaque index, modified gingival index, probing depth, relative attachment level, and location of the gingival margin. A Student's t-test was done for intragroup and a paired t-test for intergroup analysis. Results: Intragroup analysis revealed statistically significant improvement in all the ancillary parameters and soft tissue parameters with no statistically significant difference in intergroup analysis. Conclusions: The study concluded that a calcium sulphate barrier was comparable to collagen membrane in achieving clinical benefits and hence it can be used as an economical alternative to collagen membrane.

• Journal of Periodontal and Implant Science
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• 제50권6호
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• pp.406-417
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• 2020

Purpose: This study investigated whether the placement of ribose cross-linked collagen (RCLC) membranes without primary soft tissue closure predictably resulted in sufficient alveolar ridge preservation in contained and non-contained extraction sockets. Methods: Membranes were positioned across extraction sockets, undermining full-thickness flaps, and the gingival margins were fixed by double-interrupted sutures without crossed horizontal mattress sutures for 1 week. In non-contained sockets, a bone substitute was used to support the membrane within the bony envelope. Radiographs and clinical images obtained 4 months later were analyzed by ImageJ software using non-parametric tests. Results: In 18 patients, 20 extraction sockets healed uneventfully and all sites received standard-diameter implants (4.1, 4.8, or 5.0 mm) without additional bone augmentation. Soft tissues and the muco-gingival border were well maintained. A retrospective analysis of X-rays and clinical photographs showed non-significant shrinkage in the vertical and horizontal dimensions (P=0.575 and P=0.444, respectively). The new bone contained vital bone cells embedded in mineralized tissues. Conclusions: Within the limitations of this pilot study, open healing of RCLC membranes may result in sufficient bone volume for implant placement without additional bone augmentation in contained and non-contained extraction sockets.

• Restorative Dentistry and Endodontics
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• 제40권4호
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• pp.314-321
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• 2015

Tooth related factors such as palatoradicular groove can be one of the causes for localized periodontal destruction. Such pathological process may result in apicomarginal defect along with inflammation of pulp. This creates challenging situation which clinician must be capable of performing advanced periodontal regenerative procedures for the successful management. This case report discusses clinical management of apicomarginal defect associated with extensive periradicular destruction in a maxillary lateral incisor, along with histopathologic aspect of the lesion.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.47-67
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• 1996

The purpose of this study was to observe the effect of $Biocoral^R$ graft and bioglass 45S5 graft in combination with ePTFE membrane in periodontal osseous defects for new bone formation. Nine healthy dogs were used. Under general anesthesia, 3-wall defects were created on the mesial and distal surfaces of the maxillary right canines, the mesials of the maxillary right second premolars, the distals of the mandibular right canines and the mesials of the mandibular right third premolars. To induce periodontitis, a silicone rubber, $Provil^R$ light body, was injected under pressure into the defects. Ninety days later, $Provil^R$was removed and followed by thorough root planing. The followings were then applied in the mesial and distal defects of the maxillary right canines, the mesials of the maxillary right second premolars, the distals of the mandibular right canines and the mesials of the mandibular right third premolars by random selections : 1) ePTFE membrane only application, 2) $Biocoral^R$ graft, 3) $Biocoral^R$ graft and ePTFE membrane application, 4)Bioglass 45S5 graft, 5) Bioglass 45S5 graft and ePTFE membrane application. The membranes were removed 1 month later. The dogs were sacrified at 1, 2 and 3 months following the graft, and block sections were made, demineralized, embedded, stained and examined by light microscope and transmission electron microscope. On the sections from teeth treated with ePTFE membrane only, the defect demonstrated extensive connnective tissue and alveolar bone regeneration. The $Biocoral^R$ graft group demonstrated extensive bone regeneration compared with ePTFE membrane only group. In the $Biocoral^R$ graft plus ePTFE membrane group, regeneration of new alveolus and crest occurred within the defect. As the experimental period lengthened, bone regeneration was increased and bone bridge was formed among the graft particles. The but bioglass 45S5 graft group demonstrated extensive bone regeneration but the amount of new bone was less than that of the $Biocoral^R$ graft group. For the bioglass 45S5 graft plus ePTFE membrane group, the amount of new bone was also increased. As the experimental period lengthened, bone regeneration was increased. Multinucleated giant cells, fibroblasts and macrophages were observed. As the bone formation was increased, the number of such cells was decreased. In conclusion, the $Biocoral^R$ was found better than the bioglass 45S5 for new bone formation, and the use of ePTFE membrane alone or with $Biocoral^R$/bioglass 45S5 can be supported as potential methods of promoting bone formation.

• Journal of Periodontal and Implant Science
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• 제34권1호
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• pp.149-162
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• 2004

This study was performed to evaluate the effect of freeze-dried bone graft on space-making capacity and bone formation in the procedure of guided bone regeneration with titanium reinforced ePTFE membrane. After decortication in the calvaria, GBR procedure was performed on 8 rabbits with titanium reinforced ePTFE membrane filled with human FDBA(Rocky Mountain Tissue Bank,Aurora Co., USA). Decortication was performed to induce the effect of bone forming factor from bone marrow. The animals were sacrificed at 2 weeks, 4 weeks, 8 weeks and 12 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis. πle results of this study were as follows: 1. Titanium reinforced-ePTFE membrane was biocompatable and capable of maintaining the space-making. 2. FDBA particle was surrounded with connective tissues but there was no evidence on new bone formation. 3. FDBA particle resorbed continuously but it remained until 12weeks after the surgery. Within the above results, TR-ePTFE membrane could be used effectively for Guided bone regeneration but It was assumed that FDBA does not appear to contribute to bone formation.

• Journal of Periodontal and Implant Science
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• 제41권5호
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• pp.253-258
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• 2011

Purpose: Immediate implantation presents challenges regarding site healing, osseointegration, and obtaining complete soft-tissue coverage of the extraction socket, especially in the posterior area. This last issue is addressed herein using the double-membrane (collagen membrane+high-density polytetrafluoroethylene [dPTFE] membrane) technique in two clinical cases of posterior immediate implant placement. Methods: An implant was placed immediately after atraumatically extracting the maxillary posterior tooth. The gap between the coronal portion of the fixture and the adjacent bony walls was filled with allograft material. In addition, a collagen membrane (lower) and dPTFE membrane (upper) were placed in a layer-by-layer manner to enable the closure of the extraction socket without a primary flap closure, thus facilitating the preservation of keratinized mucosa. The upper dPTFE membrane was left exposed for 4 weeks, after which the membrane was gently removed using forceps without flap elevation. Results: There was considerable plaque deposition on the outer surface of the dPTFE membrane but not on the inner surface. Moreover, scanning electron microscopy of the removed membrane revealed only a small amount of bacteria on the inner surface of the membrane. The peri-implant tissue was favorable both clinically and radiographically after a conventional dental-implant healing period. Conclusions: Secondary closure of the extraction socket and immediate guided bone regeneration using the double-membrane technique may produce a good clinical outcome after immediate placement of a dental implant in the posterior area.

• Journal of Periodontal and Implant Science
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• 제36권4호
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• pp.809-816
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• 2006

Periodontal disease accompany the inflammation around periodontal tissue and generally periodontal destruction is followed, This destruction often makes the molar teeth have furcation defect. And to treat molar furcation involvement, resective surgery such as root resection and ostectomy and regenerative procedure such as guided tissue regeneration were introduced. Also implant can be considered as one of the good treatment methods, Among these treatment alternatives, root resection can be considered as a good procedure in the point of saving one's natural teeth or amount of cost. Therefore the purpose of this article is to evaluate root-resected teeth which were done at least 2 years ago. 70 root-resected teeth in 58 patient who visited Kyungpook National University Hospital were included in this study. They were evaluated by two clinical method. One is subjective evaluation and another is objective evaluation. To evaluate subjective outcome, 58 patients answered to the questionnaire if they experienced tooth extraction, bleeding, swelling, pain, mobility and chewing problem. To evaluate objective outcome, 28 teeth was evaluated according to Langer's criteria. The subjective result showed 82% of success rate and 18% of failure rate. 13 of 70 teeth showed discomfort and were considered as failure, which include chewing problem (39%) and pain (23%). The objective outcome showed that 4 failure (14% failure rate) which were 2 cases of bone loss by periodontal problem, one endodontic problem and one untreatable caries. By these limited results, some of clinical consideration in root resective procedure can be suggested. Periodontal support and less occlusal loading on resected tooth should be evaluated before the procedure, moreover, good oral hygiene is essential. When these factors are considered carefully, the root resection may produce predictive outcomes in the treatment of furcational involvement.

• 구강회복응용과학지
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• 제33권3호
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• pp.230-237
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• 2017

치간부 골내낭의 치주재생치료는 수술 후 발생할 수 있는 비심미성 때문에 치과의사에게 힘든 과제이다. 본 연구에서는 이러한 문제점을 해결하기 위해 치간부 골내낭의 bovine bone mineral과 enamel matrix derivative (EMD)를 이용한 재생 수술에 골막을 포함한 결합조직 이식을 동반한 임상증례를 소개하고자 한다. 임상적 및 방사선학적인 검사는 술 전과 수술 6개월 이후 시행하였다. 모든 임상 지표들이 개선되었고, 방사선학적 검사에서 골내낭이 감소함을 확인할 수 있었다. 또한, 부가적인 결합조직이식을 통해 치간부 연조직의 증대 및 형태 개선으로 인한 심미성이 증진되는 효과도 확인할 수 있었다.

• Journal of Periodontal and Implant Science
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• 제31권2호
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• pp.489-499
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• 2001

Bone graft and guided tissue regeneration have been used for the regeneration of periodontal tissue which is the ultimate goal of periodontal treatment. Recently, it was reported that some kind of growth factors were used for regeneration. Platelet rich plasma was researched that it could increase the density of bone and the rate of bone regeneration. For that, 25 patients which have pocket depth more than 5mm at any of 6 surfaces, of healthy patient without any systemic disease were treated. $Biogran^{?}$ Were grafted into 14 infrabony pockets as controls, and $Biogran^{(R)}$ with PRP were inserted into 31 infrabony pockets. And then, follwing evaluations were made at the end of 1, 3 and 6 months. 1. There was no statistical difference between control and experimental group in pocket depth, gingival recession, minimum probing attachment level and maximum probing attachment level at preoperation(p>0.05). 2. Decrease in probing pocket depth were reduced to 3.32mm for experimental group and 2.71mm for control group. The decrease was evident at the end of 1 month, they were 2.97mm and 2.29mm,and it was statistically difference(p<0.05). 3. Gingival recession was increased by 0.55mm in experimental group and 0.50mm in control group, it was evident at the end of 1 month. And it was statistically difference(p<0.05). 4. Minimum probing attachment level was increased by 0.35mm in experimental group and 0.36mm in control group, it was statistically difference(p<0.05). 5. Maximum probing attachment level was decreased by 3.19mm in experimental group and 2.93mm in control group, it was statistically difference(p<0.05). 6. There was no statistical difference between control and experimental group in pocket depth, gingival recession, minimum probing attachment level and maximum probing attachment level(p>0.05). There was statistical difference in decrease of pocket depth between pre-operation and 1 month after post-operation(p<0.05). In conclusion, bone graft using $Biogran^{?}$ and bone graft using $Biogran^{?}$ With platelet rich plasma were both effective in treatment of infrabony pocket, bone graft using $Biogran^{?}$ With platelet rich plasma was more effective in early soft tissue healing.

• Journal of Periodontal and Implant Science
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• 제47권6호
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• pp.352-362
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• 2017

Purpose: Furcation involvement in the molars is difficult to treat, and has been recognized as a risk factor for tooth loss. Although periodontal regenerative therapies, including guided tissue regeneration and various types of bone grafts, have been applied to furcation defects, the effects of these treatments are limited, especially in large class III furcation defects. The purpose of this pilot study was to investigate the effect of reciprocal autologous root transplantation on periodontal wound healing and regeneration in class III furcation defects in dogs. Methods: Furcation defects (7 mm wide and 6 mm high) were surgically created after root separation of the unilateral third and fourth premolars in 4 dogs. Eight furcation defects were randomized to receive either reciprocal autologous root transplantation (test) or no further treatment (control). In the test group, the mesial and distal roots were transplanted into the distal and mesial extraction sockets, respectively. The animals were sacrificed 10 weeks after surgery for histologic evaluation. Results: The healing pattern in the control group was characterized by extensive collapse of the flap and limited periodontal regeneration. New bone formation in the test group ($3.56{\pm}0.57mm$) was significantly greater than in the control group ($0.62{\pm}0.21mm$). Dense collagen fibers inserting into the residual cementum on the transplanted root surfaces were observed in the test group. Slight ankylosis was observed in 2 of the 4 specimens in the test group on the mesiodistal sides where the root-planed surfaces faced the existing bone. Root resorption (RR) was detected in both the control and test groups. Conclusions: Within the limits of this study, it can be concluded that reciprocal autologous root transplantation was effective for bone regeneration in class III furcation defects in dogs. However, further studies are required to standardize the approach in order to prevent unwanted RR prior to clinical application.