• Journal of Periodontal and Implant Science
• /
• 제40권5호
• /
• pp.232-238
• /
• 2010

Purpose: To prolong the degradation time of collagen membranes, various cross-linking techniques have been developed. For cross-linking, chemicals such as formaldehyde and glutaraldehyde are added to collagen membranes, but these chemicals could adversely affect surrounding tissues. The aim of this study is to evaluate the ability of porous non-chemical cross-linking porcine-derived collagen nanofibrous membrane to enhance bone and associated tissue regeneration in one-wall intrabony defects in beagle dogs. Methods: The second and third mandibular premolars and the first molars of 2 adult beagles were extracted bilaterally and the extraction sites were allowed to heal for 10 weeks. One-wall intrabony defects were prepared bilaterally on the mesial and distal side of the fourth mandibular premolars. Among eight defects, four defects were not covered with membrane as controls and the other four defects were covered with membrane as the experimental group. The animals were sacrificed 10 weeks after surgery. Results: Wound healing was generally uneventful. For all parameters evaluating bone regeneration, the experimental group showed significantly superior results compared to the control. In new bone height (NBh), the experimental group exhibited a greater mean value than the control ($3.04{\pm}0.23\;mm/1.57{\pm}0.59$, P=0.003). Also, in new bone area (NBa) and new bone volume (NBv), the experimental group showed superior results compared to the control (NBa, $34.48{\pm}10.21%$ vs. $5.09{\pm}5.76%$, P=0.014; and NBv, $28.04{\pm}12.96$ vs. $1.55{\pm}0.57$, P=0.041). On the other hand, for parameters evaluating periodontal tissue regeneration, including junctional epithelium migration and new cementum height, there were no statistically significant differences between two groups. Conclusions: Within the limitations of this study, this collagen membrane enhanced bone regeneration at one-wall intrabony defects. On the other hand, no influence of this membrane on periodontal tissue regeneration could be ascertained in this study.

• Journal of Periodontal and Implant Science
• /
• 제26권2호
• /
• pp.356-364
• /
• 1996

The present study was done to evaluate the antibacterial effects of $Minoclin^R$ which was localally delivered on the $Gore-tex^R$ barrier membrane in the guided tissue regeneration(GTR) therapy for treatment of human furcal defects. Beneath the membranes. the antibiotics were applied for 1 week and then changed with new one. The $Minoclin^R$ was removed out one week later. 6 weeks after the GTR therapy. No systemic antibiotics were administered except for oral mouthrinses with chlorhexidines. 2 weeks and 6 weeks following the membrane therapy, the bacterial samples were examined for periodontopathic microorganisms. The results indicated that the locally delivered $Minoclin^R$ successfully inhibited the growth of periodontopathic organisms. This results might be further applied in the subgingival plaque control regimen in the GTR procedure, especialy in patients who is contraindicated for oral administration of systemic antibiotics

• Journal of Periodontal and Implant Science
• /
• 제38권2호
• /
• pp.253-262
• /
• 2008

Background: Incomplete flap coverage or early exposure over implants and/or barrier membranes have a negative effect on bone regeneration. In cases of using regenerative techniques, complete soft tissue coverage of the implant area is necessary to promote adequate conditions for guided bone regeneration. Primary socket closure may be difficult, when periosteal releasing incision is only used, due to the opening left by extracted tooth. Therefore, Soft tissue grafting techniques are used to achieve primary soft tissue closure. Materials and Methods: Soft tissue grafting techniques, with or without barrier membranes, were performed for primary closure in four cases of immediate placements. Three different methods were used (CTG, VIP-CT, Palatal advanced flap). Clinical results of the grafting were evaluated. Result: One case showed early exposure of cover-screw and, no other complications were noted. In the others, Primary closure was achieved by soft tissue grafting techniques. One of the cases, Graft showed partial necrosis, but there were no exposure over implants and/or barrier membranes. Conclusion: The use of grafting techniques, in immediate implant placement, can predictably obtain primary closure of extraction sockets, thereby providing predictable bone formation and improved implant results.

• Journal of Periodontal and Implant Science
• /
• 제50권5호
• /
• pp.327-339
• /
• 2020

Purpose: The purpose of this study was to examine the local tissue reactions associated with 3 different poly(lactic-co-glycolic acid) (PLGA) prototype membranes and to compare them to the reactions associated with commercially available resorbable membranes in rats. Methods: Seven different membranes-3 synthetic PLGA prototypes (T1, T2, and T3) and 4 commercially available membranes (a PLGA membrane, a poly[lactic acid] membrane, a native collagen membrane, and a cross-linked collagen membrane)-were randomly inserted into 6 unconnected subcutaneous pouches in the backs of 42 rats. The animals were sacrificed at 4, 13, and 26 weeks. Descriptive histologic and histomorphometric assessments were performed to evaluate membrane degradation, visibility, tissue integration, tissue ingrowth, neovascularization, encapsulation, and inflammation. Means and standard deviations were calculated. Results: The histological analysis revealed complete integration and tissue ingrowth of PLGA prototype T1 at 26 weeks. In contrast, the T2 and T3 prototypes displayed slight to moderate integration and tissue ingrowth regardless of time point. The degradation patterns of the 3 synthetic prototypes were similar at 4 and 13 weeks, but differed at 26 weeks. T1 showed marked degradation at 26 weeks, whereas T2 and T3 displayed moderate degradation. Inflammatory cells were present in all 3 prototype membranes at all time points, and these membranes did not meaningfully differ from commercially available membranes with regard to the extent of inflammatory cell infiltration. Conclusions: The 3 PLGA prototypes, particularly T1, induced favorable tissue integration, exhibited a similar degradation rate to native collagen membranes, and elicited a similar inflammatory response to commercially available non-cross-linked resorbable membranes. The intensity of inflammation associated with degradable dental membranes appears to relate to their degradation kinetics, irrespective of their material composition.

• Journal of Periodontal and Implant Science
• /
• 제43권3호
• /
• pp.136-140
• /
• 2013

Purpose: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Methods: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Results: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. Conclusions: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.

• Journal of Periodontal and Implant Science
• /
• 제35권1호
• /
• pp.235-250
• /
• 2005

The current interest in periodontal tissue regeneration has lead to research in bone graft, root surface treatments, guided-tissue regeneration, administration of growth factors, and the use of enamel matrix protein as possible means of regenerating lost periodontal tissue. Several studies have shown that a strong correlation between platelet-rich plasma and the stimulation of remodeling and remineralization of grafted bone exits, resulting in a possible increase of 15-30% in the density of bone trabeculae. The purpose of this study was to study the histopathological results and differences between the use of platelet-rich plasma and the use of enamel matrix $protein(Emdogain^?)$ about bone regeneration at the implant. Implant fixtures were inserted and graft materials placed into the left femur in the experimental group, while the only implant fixtures placed in the control group. In the first experimental group, platelet-rich plasma and xenograft were placed at the supracrestally placed implant site, and in the second experimental group, $Emdogain^{(R)}$ and xenograft placed at the supracrestally placed fixture site. The degree of bone regeneration adjacent to the implant fixture was observed and compared histopathologically at 2, 4, and 8 weeks after implant fixture insertion. The results of the experiment are as follows: 1. The rate of osseointegration to the fixture threads was found to be greater in the experimental group compared to in the control group. 2. The histopathological findings showed that the bone regeneration, the partial osseointegration existed at 4 weeks, and that osseointegration and bone density increaced in the experimental groups at 8 weeks. 3. The results showed that new bone formation and bone remodeling increased in the area near to the fixture in the first and second experimental groups at 8 weeks than at 4 weeks. The results showed that in the area distant from the fixture, new bone formation did not increase and bone remodeling decreased in the first experimental group at 4, 8 weeks, and that new bone formation increased in the second experimental group. 4. The histopathological findings showed that AZ deposition in the first experimental group was remarkable at 2, 8 weeks, and in the second experimental group at 2, 4, 8 weeks in the area distant from the fixture threads.

• Journal of Periodontal and Implant Science
• /
• 제37권3호
• /
• pp.465-478
• /
• 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
• /
• 제30권2호
• /
• pp.257-277
• /
• 2000

New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration are basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, and biological mediators. Platelet Rich Plasma has been reported as a biological mediator which regulates activities of wound healing progress including cell proliferation, migration, and metabolism. The purpose of this study is to evaluate the effects of using the Platelet Rich Plasma as a regeneration promoting agent for furcation involvement defect. Five adult beagle dogs were used in this experiment. The dogs were anesthetized with Ketamin HCl(0.1 ml/kg, IV)and Xylazine hydrochloride($Rompun^{(R)}$, Bayer, 0.1 ml/kg, IM) and conventional periodontal prophylaxis were performed with ultrasonic scaler and hand instruments. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree II furcation defect was made on mandibular third(P3), forth(P4) and fifth(P5) premolar, and stopping was inserted. After 4 weeks, stopping was removed, and bone graft was performed. Ca-P was grafted in P3(experimental group I), Combination of Ca-P and plasma rich platelet were grafted in P4(experimental group II), and P5 was remained at control group.Systemic antibiotics(gentamicin sulfate)and anlgesics(phenyl butazone) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operate sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 4, 8 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. At 4 weeks after surgery, there were rapid osteogenesis phenomenon on the defected area of the Platelet Rich Plasma plus Ca-P BBP group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. In conclusion, Platelet Rich Plasma can promote rapid osteogenesis during healing of periodontalregeneration.

• Journal of Periodontal and Implant Science
• /
• 제38권3호
• /
• pp.551-556
• /
• 2008

Purpose: Cemental tear is an uncommon form of root fracture that can lead to rapid localized attachment loss. When it is exposed in the periodontal pocket, it should be removed to prevent accumulation of dental plaque and calculus. Material and Methods: 2 patients were diagnosed as a cemental tear and they were treated with conventional flap operation and subgingival curettage. Additional treatments such as bone graft or guided tissue regeneration were not performed. Result: Symptoms subsided after the treatment. Periodontal pocket has been reduced but no gain of clinical attachment was observed. Remnant of cemental fragment remained after curettage. However, periodontal pocket was stably maintained and there was no recurrence. Conclusion: Periodontal attachment loss associated with cemental tear can be successfully treated with conventional periodontal surgical and nonsurgical procedures.

• The Journal of Advanced Prosthodontics
• /
• 제5권2호
• /
• pp.167-171
• /
• 2013

PURPOSE. The purpose of this case series was to evaluate the effect of guided bone regeneration using demineralized allogenic bone matrix with calcium sulfate. MATERIALS AND METHODS. Guided bone regeneration using Demineralized Allogenic Bone Matrix with Calcium Sulfate ($AlloMatrix^{TM}$, Wright. USA) was performed at the time of implant placement from February 2010 to April 2010. At the time of the second surgery, clinical evaluation of bone healing and histologic evaluation were performed. The study included 10 patients, and 23 implants were placed. The extent of bony defects around implants was determined by measuring the horizontal and vertical bone defects using a periodontal probe from the mesial, distal, buccal, and lingual sides and calculating the mean and standard deviation of these measurements. Wedge-shaped tissue samples were obtained from 3 patients and histologic examination was performed. RESULTS. In clinical evaluation, it was observed that horizontal bone defects were completely healed with new bones, and in the vertical bone defect area, 15.1% of the original defect area remained. In 3 patients, histological tests were performed, and 16.7-41.7% new bone formation was confirmed. Bone graft materials slowly underwent resorption over time. CONCLUSION. $AlloMatrix^{TM}$ is an allograft material that can be readily manipulated. It does not require the use of barrier membranes, and good bone regeneration can be achieved with time.