• Journal of Periodontal and Implant Science
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• v.46 no.1
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• pp.57-69
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• 2016

Purpose: The aim of this pilot study was to determine the osteoconductivity and dimensional stability of augmented sinuses using different ratios of biphasic calcium phosphate (BCP) in a rabbit sinus model. Methods: Each sinus of New Zealand white rabbits (2.5-3.5 kg) was assigned to one of two groups: BCP with a hydroxyapatite to ${\beta}$-tricalcium phosphate (HA:${\beta}$-TCP) ratio of 70:30 (group TCP30) and BCP with an HA:${\beta}$-TCP ratio of 30:70 (group TCP70). After preparing a window in the antral wall of a sinus, the Schneiderian membrane was elevated, and the applicable material was grafted. A fluorochrome calcein green was injected five days before euthanizing the animals at four months post-surgery. The specimens were analyzed histologically, histomorphometrically, and by using micro-computed tomography (micro-CT). Results: Micro-CT analysis revealed that the total augmented volume and the new bone volume did not differ significantly between the two groups whereas the resorption of materials was greater in the TCP70 group. The trabecular thickness, number, and separation also did not differ significantly between the two groups. Histomorphometrically, the areas of total augmentation, new bone, and residual material, as well as the ratio of new-bone-material contact did not differ significantly between the groups. Histologically, the residual particles were more scattered in the TCP70 group than in the TCP30 group. The fluorescence of the calcein green did not differ notably between the two groups. Conclusions: The osteoconductivity and dimensional stability of the two BCPs with different ratios tested in this study were comparable after four months of healing. Therefore, we conclude that both BCPs show promise as a bone substitute for sinus augmentation.

• Journal of Periodontal and Implant Science
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• v.53 no.6
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• pp.406-416
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• 2023

Purpose: No evidence exists regarding the advantages of periodontal regeneration treatment for furcation defects using soft block bone substitutes. Therefore, this randomized controlled trial aimed to assess the clinical and radiographic outcomes of regenerative therapy using porcine-derived soft block bone substitutes (DPBM-C, test group) compared with porcine-derived particulate bone substitutes (DPBM, control group) for the treatment of severe class II furcation defects in the mandibular molar regions. Methods: Thirty-five enrolled patients (test group, n=17; control group, n=18) were available for a 12-month follow-up assessment. Clinical (probing pocket depth [PPD] and clinical attachment level [CAL]) and radiographic (vertical furcation defect; VFD) parameters were evaluated at baseline and 6 and 12 months after regenerative treatment. Early postoperative discomfort (severity and duration of pain and swelling) and wound healing outcomes (dehiscence, suppuration, abscess formation, and swelling) were also assessed 2 weeks after surgery. Results: For both treatment modalities, significant improvements in PPD, CAL, and VFD were found in the test group (PPD reduction of 4.1±3.0 mm, CAL gain of 4.4±2.9 mm, and VFD reduction of 4.1±2.5 mm) and control group (PPD reduction of 2.7±2.0 mm, CAL gain of 2.0±2.8 mm, and VFD reduction of 2.4±2.5 mm) 12 months after the regenerative treatment of furcation defects (P<0.05). However, no statistically significant differences were found in any of the measured clinical and radiographic parameters, and no significant differences were observed in any early postoperative discomfort and wound healing outcomes between the 2 groups. Conclusions: Similar to DPBM, DPBM-C showed favorable clinical and radiographic outcomes for periodontal regeneration of severe class II furcation defects in a 12-month follow-up period.

• Journal of Periodontal and Implant Science
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• v.43 no.6
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• pp.315-322
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• 2013

Purpose: In this study, we investigated the effect of silk scaffolds on one-wall periodontal intrabony defects. We conjugated nano-hydroxyapatite (nHA) onto a silk scaffold and then seeded periodontal ligament cells (PDLCs) or dental pulp cells (DPCs) onto the scaffold. Methods: Five dogs were used in this study. Bilateral 4 mm${\times}$2 mm (depth${\times}$mesiodistal width), one-wall intrabony periodontal defects were surgically created on the distal side of the mandibular second premolar and the mesial side of the mandibular fourth premolar. In each dog, four of the defects were separately and randomly assigned to the following groups: the PDLCcultured scaffold transplantation group (PDLC group), the DPC-cultured scaffold transplantation group (DPC group), the normal saline-soaked scaffold transplantation group, and the control group. The animals were euthanized following an 8-week healing interval for clinical, scanning electron microscopy (SEM), and histologic evaluations. Results: There was no sign of inflammation or other clinical signs of postoperative complications. The examination of cellseeded constructs by SEM provided visual confirmation of the favorable characteristics of nHA-coated silk scaffolds for tissue engineering. The scaffolds exhibited a firm connective porous structure in cross section, and after PDLCs and DPCs were seeded onto the scaffolds and cultured for 3 weeks, the attachment of well-spread cells and the formation of extracellular matrix (ECM) were observed. The histologic analysis revealed that a well-maintained grafted volume was present at all experimental sites for 8 weeks. Small amounts of inflammatory cells were seen within the scaffolds. The PDLC and DPC groups did not have remarkably different histologic appearances. Conclusions: These observations indicate that nHA-coated silk scaffolds can be considered to be potentially useful biomaterials for periodontal regeneration.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.188-201
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• 1996

One of the initial events required for periodontal regeneration is the attachment, spreading and proliferation of fibroblasts at the healing sites. These have been reported that minocycline stimulates the attachment of gingival fibroblasts and periodontal ligament cells and $TGF-{\beta}1$ enhances the proliferation of periodontal ligament cells. The purpose of this study was to evaluate and confirm the effect of minocycline and $TGF-{\beta}1$ on human gingival fibroblasts and periodontal ligament cells. That gingival fibroblasts and periodontal ligament cells used in this study were obtained from the explants of healthy periodontal ligaments and gingival tissues of extracted 3rd molars or premolar teeth extracted from the patients with orthodontic treatment. The cells were cultured in ${\alpha}-MEM$(minimal essential medium) supplemented with antibiotics and FBS(fetal bovine serum) at $37^{\circ}C$ in a humidified atmosphere of 5% carbon dioxide-95% air. Cells were used between the 5th to 8th passage in this study. The attachment and activity of both cells were evaluated by MTT assay. The results were as follows: 1. Maximum gingival fibroblast attachment was seen at a $50{\mu}g/ml$ dose of minocycline, while maximum periodontal ligament cell attachment was seen at a $100{\mu}g/ml$, and exposure of both cells to minocycline above maximal attachment dose results in a decline from maximum attachment. 2. The activity values of both cells tested minocycline were below to the control activity values at all concentrations. 3. The attachment values of both cells tested $TGF-{\beta}1$ were below or similar to control attachment values. On the above the findings, minocycline stimulated the cell attachment of gingival fibroblasts and periodontal ligament cells and $TGF-{\beta}1$ enhances the cell activity of periodontal ligament cells.

• Journal of Periodontal and Implant Science
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• v.44 no.4
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• pp.178-183
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• 2014

Purpose: The aim of this study was to assess the possible paracrine effect of bone morphogeneticprotein-2 (BMP-2) at the experimental site on the adjacent control site for validating a rabbit calvarial defect model as a means of verifying the effect of BMP-2. Methods: Sixteen rabbits were divided into two groups (n=8 in each) according to whether or not BMP-2 would be used. Two circular defects (8 mm in diameter) were created side by side, 2 mm apart, in the calvarium of all of the rabbits. In each animal, one of the defects was grafted with either BMP-2-loaded carrier or carrier material alone. The control defects adjacent to these grafted defects, designated CB (the nongrafted defect adjacent BMP-2-loaded carrier-grafted defect) and CC (the nongrafted defect adjacent to carrier only-grafted defect), respectively, were the focus of this study, and were filled only with a blood clot in all of the animals. Histologic observation and histomorphometric analysis were performed at 2 and 8 weeks (n=4 animals per point in time) after surgery. Results: There was no noteworthy difference in the healing pattern, and no statistically significant differences in histomorphometric parameters such as the defect closure, new bone area, or total augmented area between the CC and CB groups. Conclusions: The results of this study suggest that rabbit calvarial defects separated by a distance of 2 mm are suitable for evaluating the effects of BMP-2 and the control defect can be regarded not to be affected by BMP-2 applied defect.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.127-138
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• 2004

Background: Crestal bone loss known as saucerization is a frequently observed phenomenon. Recent studies have shown that implants with micothreaded crest module reduced the force concentration in the crestal region thus resulting in no or reduced crestal bone loss. This study presents a clinical, histologic, and histometric evaluation of implants with microthreaded crest module and SLA surface. Methods: The implants were placed in the mandible of 5 beagle dogs weighing 10-15kg. Four premolars were bilaterally extracted 8 weeks prior to implant placement. Mucoperiosteal flap was elevated and drilling with increasing diameter was performed under saline irrigation. After countersinking 2 implants were placed in each side resulting in 4 implants per dog. Healing period of 8 weeks was allowed before sacrificing the animals. Histologic preparation was performed for histologic and histometric analysis. Bone to implant contact as well as percentage of bone area inside threads were measured. T-test was used for statistical analysis with pvalue p<0.05. Results: 1. Healing was uneventful without any cover screw exposure. New bone formation around the implants was observed without any inflammatory infiltration. 2. Bone to implant contact in the microthread and thread were 43.90 ${\pm}$ 20.30 %, and 53.19 ${\pm}$ 20.97 % respectively. The overall bone to implant contact was 48.54 ${\pm}$ 20.95 %. 3. Percentage of bone area inside threads were 54.43 ${\pm}$ 10.39 %, and 38.44 ${\pm}$ 16.44 % for the microthread and thread respectively. There was statistically significant difference(p<0.05). The overall percentage of bone area inside threads was 46.67 ${\pm}$ 15.68 %.

• Journal of Periodontal and Implant Science
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• v.25 no.3
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• pp.703-719
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• 1995

The purpose of this study was to observe the effects of the periodontal ligament on the healing and the formation of alveolar bone in the extraction socket, when this ligament had artificially remained in the socket during the tooth removal. Twenty rats aged 4 weeks were used and devided into the control groups (10) and the experimental groups (10) in this study. The maxillary right and left first molars were extracted in both groups. In the experimental groups the periodontal ligament was remained in the extraction sockets using 0.4% ${\beta}-aminopropionitrile$, and in the control the periodontal ligament was completely removed by curettage. At 1, 3, 5, 7 and 14 days after the tooth extraction, rats in both groups were serially sacrificed. And the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows ; 1. On 1 day, the periodontal ligament was only found in the extraction socket walls of the experimental groups, and there was not the distinguishable difference between the control and the experimental groups. 2. On 3 days, there were more collagen fibers and the appearance of higher cellular density in the experimental groups than in the control. And the cells and collagen of the periodontal ligament were so actively proliferated and synthesized that invaded into the connective tissue of the extraction sockets in the experimental groups. 3. In the experimental groups, the trabecular bone was formed on the basal and lateral bone surface on 5 days. However, there was not the new bone forming appearance in the control groups at this time. 4. On 7 days, the trabecular bone was formed in the control groups. 5. On 14 days, the extraction sockets were almost entirely filled with the bony trabeculae in both groups. But, compared to the control group, the experimental groups showed the prominent differences in the amount & the density of the new bone formed. In conclusion, it was suggested that the residual periodontal ligament tissue in the extraction socket will play a major role as the important cell source in the healing and the new bone formation of the extraction socket.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.89-112
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• 2002

The earliest reports of the use of electrical energy to directly stimulate bone healing seem to be in 1853 from England, the techniques involved the introduction of direct current into the non-united fracture site percutaneously via metallic needles, with subsequent healing of the defect. One endpoint of the periodontal therapy is to generate structure lost by periodontal diseases. Several procedural advances may support regeneration of attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical current which occurs in bone naturally, so that such bone may be particularly susceptible to electrical therapy. The purposes of this study were to observe the effects of electrical stimulation on the normal periodontium, to determine whether the electricity is the useful means for periodontal regeneration or not. Forty rats weighted about 100 gram were used and divided into 4 groups, the first group, there was no electrical stimulation with the connection of electrodes only. In the second group, there was stimulated by the 10 mA during 10 minutes per a day, in the third group was stimulated by the 25 mA , and the fourth by the 50 mA. At 3, 5, 10 and 15 days post-appliance , two rats in each group were serially sacrificed. and the maxillae and the mandible processed to paraffin, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was the distinct reversal line on the lingual alveolar crest, whereas a little changes in the labial alveolarcrest to the duration and amount of currents. 2. In 50 mA group, the cells were highly concentrated at the apex of anterior teeth, and was observed the necrotic tissue. In posterior root apex, the hypercementosis was appeared, and newly formed cementum layer has been increased continuously with the time. 3. The periodontal ligament fiber and Sharpey's fiber were arranged in order, and the bone trabeculae were increased as the experiment proceeded by, relatively the bone marrows were decreased. 4. In the pulp tissue, the blood vessels were increased with blood congestion in the experimetal specimens remarkably, and the dentinal tubules were obstructed . 5. The osteoblasts in alveolar bone proper had been showed highly activity, and also observed the formation of bone trabeculea. In the conclusion, it was suggested that the electrical stimulation has influence on the periodontium and the pulp tissue. However, there might be the injurious effects.

• Journal of Periodontal and Implant Science
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• v.37 no.4
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• pp.871-879
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• 2007

Purpose: The purpose of this study was to evaluate the bone regeneration of novel biodegradable amorphous calcium phosphate. Materials and Method: An 8-mm, calvarial, critical-size osteotomy defect was created in each of 20 male Sprague-Dawley rats(weight $250{\sim}300g$). The animals were divided into two groups of 10 animals each and allowed to heal for 2 weeks(10 rats). The first group was the control group and the other group was the experimental group which received the novel biodegradable calcium phosphate. Results: The healing of the calvarium in the control group was uneventful. The histologic results showed little bone formation in the control group. The experimental group which received the novel biodegradable calcium phosphate showed a normal wound healing. There were a lot of new bone formation around the biomaterial in 2 weeks. The bone formation increased in 8 weeks when compared to 2 weeks and there was a significant bone increase as well(P<0.01). The nobel biodegradable calcium phosphate showed statistical significance when compared to the control group (P<0.05). The novel biodegradable calcium phosphate in 8 weeks showed a significant increase in bone formation when compared to 2 weeks $(40.4{\pm}1.6)$(%). The biodegradable calcium phosphate which is made from mixing calcium phosphate glass(CPG), NaCO and NaOH solution, is biocompatible, osteoconductive and has a high potency of bone formation. Conclusion: We can conclude that the novel biodegradable calcium phosphate can be used as an efficient bone graft material for its biodegradability and osteoconductivity.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.283-302
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• 1994

Gingivectomy has been utilized as a therapeutic method to remove diseased periodontal pocket wall in order to aid in root planing. Although chemical agents and electrosurgery has been used in addition to the conventional method of using surgical blades, difficulties in controling the depth of chemical penetration and effectively regenerating the gingival tissue as well as the slow wound healing has been pointed out as shortcomings of these methods. This study was designed to assess the effect of Aloe vera on wound healing of gingivectomy sites created by $CO_2$ laser on palatal gingiva of maxillary molar region of white rats. Those sites treated by surgical blades were designated as control, by $CO_2$ laser as Experimental group I, by surgical blades in addition to topical application of Aloe vera as Experimental group II, and by $CO_2$ laser and Aloe vera application as Experimental group III. Animals were sacrificed at 2 days, 3 days, 1 week, 2 weeks and 3 weeks postoperatively, and the specimens were histologically analyzed. The results were as follows : 1. Resorption of blood clots were observed in the control at 3rd day, followed by the rest of the experimental groups at 1 week postoperatively. 2. Persistent inflammation was observed up to 1 week in the control and Experimental group II and III, and until the 2nd week in Experimental group I. 3. Granulation tissue was observed up to 1 week in the control, and 2 weeks in the rest of the groups. 4. Epithelization started on the 2nd day. The control showed the most rapid epithelization, and the process was completed by the 2nd week in all groups. 5. Experimental group II and III, which were treated with Aloe vera, showed similar healing patterns to the control and Experimental group I.