• Journal of Periodontal and Implant Science
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• v.25 no.2
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• pp.418-437
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• 1995

The effect of the hydroxyapatite coatings on Titanium implants has been the subject of recent investigations. So far, the use of HA coating remains substantially controversial.This study was aimed to evaluate histologically the bone healing patterns around titanium plasm sprayed(TPS) amd HA-coated implant after implantation into the femur neck of ten adult dogs. After implantation, animals were sacrificed at the intervals of 2,4,6,8 and 12 weeks.The fluorescent dyes were injected on the postoperative 4th and 12th week into the animals supposed to be killed at the 12th week. The morphology and direction of new bone formation was similar in both TPS and HA-coated implants.There was a tendency toward more bone formation in the cortical bone area than in the cancellous bone area. Histologically,in the interface of the HA-coated implants, bone response and bone maturation was faster, compared to the TPS implants in the 2nd and 4th week. By fluorescent microscopy, new bone formation was active in the 4th week around both implants and was directed from the periosteum overlying cortical bone to the cancellous bone. These results suggest that the bone formation and maturation is faster during the early healing stage in the interface of the HA-coated implant and where the cortical bone quality is poor, HA coated implant is superior to the TPS implant in the early phase of new bone formation.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.15 no.1
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• pp.41-49
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• 1985

The purpose of this study was to evaluate the initial and postoperative radiographic features of the endodontic treated teeth. The author examined the radiographs which comprise 114 teeth with 155 canals of 64 persons. The following factors were considered; Age, sex, tooth location, number of root canals, postoperative periods, initial diagnosis, and radiographic findings, postoperative radiographic findings. The apical levels of the root fillings were 76.8% to apex, 19.0% underfilling, 3.9% overfilling. The following results were obtained. 1. Of the 93 teeth which revealed initial periapical rarefaction, 66 teeth (71.0%) had showed complete bone healing, 19 teeth (20.4%) decreased rarefaction, 6 teeth (6.5%) no change, 2 teeth (2.2%) increased rarefaction after 20.0 months mean healing time. 2. 21 teeth which had no initial periapical rarefaction showed no occurrence of new periapical rarefaction. 3. Of the 66 teeth completely healed, 53 teeth (80.3%) had showed reappearance of lamina dura, 64 teeth (97.0%) reappearance of periodontal ligament space after 23.4 months mean healing time.

• Journal of Periodontal and Implant Science
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• v.50 no.6
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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.

• Journal of Periodontal and Implant Science
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• v.47 no.2
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• pp.86-95
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• 2017

Purpose: The aim of this study was to determine the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded synthetic bone substitute on implants that were simultaneously placed with sinus augmentation in rabbits. Methods: In this study, a circular access window was prepared in the maxillary sinus of rabbits (n=5) for a bone graft around an implant (${\varnothing}3{\times}6mm$) that was simultaneously placed anterior to the window. Synthetic bone substitute loaded with rhBMP-2 was placed on one side of the sinus to form the experimental group, and saline-soaked synthetic bone substitute was placed on the other side of the sinus to form the control group. After 4 weeks, sections were obtained for analysis by micro-computed tomography and histology. Results: Volumetric analysis showed that the median amount of newly formed bone was significantly greater in the BMP group than in the control group ($51.6mm^3$ and $46.6mm^3$, respectively; P=0.019). In the histometric analysis, the osseointegration height was also significantly greater in the BMP group at the medial surface of the implant (5.2 mm and 4.3 mm, respectively; P=0.037). Conclusions: In conclusion, an implant simultaneously placed with sinus augmentation using rhBMP-2-loaded synthetic bone substitute can be successfully osseointegrated, even when only a limited bone height is available during the early stage of healing.

• Journal of Periodontal and Implant Science
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• v.29 no.2
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• pp.297-313
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• 1999

The ultimate goal of periodontal treatment is the regeneration of periodontal tissues which have been lost due to periodontal disease. Recently, many natural medicines have been studied for their potential of anti-bacterial, anti-inflammatory and regenerative effects in periodontal tissues. Safflower seeds have been traditionally used as a drug for treatment of fracture and blood stasis in oriental medicine. The objective of the present study is to examine the biologic effects of safflower seeds extract on bone formation and regeneration of rat calvarial defects. The calvarial defects were made with 8mm trephine bur and extract of safflower seeds were placed directly at these defects. 24 rats were divided into control and experimental groups, and each group was sacrificed at 1 week, 4 weeks and 8 weeks. To study a histopathology related to bone regeneration, Goldner's Masson Trichrome stain and histomorphologic measuring was done at each weeks. In the early phase of bone healing, less inflammatory infiltration and capillary proliferation was found in experimental group compared to control. Dense bony tissues and matured bone structures in defect areas were found in experimental groups. And area of new bone formation was significantly increased at 8 weeks in experimental group. These results indicate that direct local application of safflower seeds extract reduces the early inflammatory response and promotes the regeneration of new bone in calvarial defects of rats.

• Journal of Periodontal and Implant Science
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• v.43 no.1
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• pp.18-23
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• 2013

Purpose: The purpose of this study was to evaluate the osseointegration of calcium phosphate (CaP)-coated implants by ion beam assisted deposition with a lack of primary stability. Methods: A total of 20 CaP-coated implants were bilaterally placed in the mandible of five dogs. In the rotational implant group, the implants were inserted in oversized drilled sockets without mechanical engagement, while the conventional surgical protocol was followed in the control group. Each group was allowed to heal for 4 and 8 weeks. The bone-to-implant contact (BIC, %) was measured by a histometric analysis. Results: All of the implants were well-maintained and healing was uneventful. In the histologic observation, all of the implants tested were successfully osseointegrated with a high level of BIC at both observation intervals. There was no significant difference in BIC among any of the groups. Conclusions: Within the limitation of this study, successful osseointegration of CaP-coated implants could be achieved in unfavorable conditions without primary stability.

• Journal of Periodontal and Implant Science
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• v.45 no.4
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• pp.136-144
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• 2015

Purpose: The objective of this study was to comparatively assess the bone regenerative capacity of absorbable collagen sponge (ACS), biphasic calcium phosphate block (BCP) and collagenated biphasic calcium phosphate (CBCP) loaded with a low dose of recombinant human bone morphogenetic protein-2 (rhBMP-2). Methods: The CBCP was characterized by X-ray diffraction and scanning electron microscopy. In rabbit calvaria, four circular 8-mm-diameter defects were created and assigned to one of four groups: (1) blood-filled group (control), (2) rhBMP-2-soaked absorbable collagen sponge (0.05 mg/mL, 0.1 mL; CS group), (3) rhBMP-2-loaded BCP (BCP group), or (4) rhBMP-2-loaded CBCP (CBCP group). The animals were sacrificed either 2 weeks or 8 weeks postoperatively. Histological and histomorphometric analyses were performed. Results: The CBCP showed web-like collagen fibrils on and between particles. Greater dimensional stability was observed in the BCP and CBCP groups than in the control and the CS groups at 2 and 8 weeks. The new bone formation was significantly greater in the BCP and CBCP groups than in the control and CS groups at 2 weeks, but did not significantly differ among the four groups at 8 week. The CBCP group exhibited more new bone formation in the intergranular space and in the center of the defect compared to the BCP group at 2 weeks, but a similar histologic appearance was observed in both groups at 8 weeks. Conclusions: The dose of rhBMP-2 in the present study enhanced bone regeneration in the early healing period when loaded on BCP and CBCP in rabbit calvarial defects.

• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.179-189
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• 1997

Teeth mobility is an important part of a periodontal examination, because it represents a function of the persisting height of the alveolar bone and the width of the periodontal ligament. The purpose of this study was to evaluate clinical difference in teeth mobility after treatment with the modified Widman flap and the undisplaced flap in humans. Twenty males with moderate periodontal disease were selected. The severity of periodontal disease was evaluated with sulcular bleeding index, pocket depth and attachment level and tooth mobility was measured with Periotest(Siemens Co., Germany) at the initial examination, 1, 2, 4, 6, 8 and 12 weeks following the modified Widman flap and the undisplaced flap operation using the split-mouth technique. The relation of mobility to clinical parameters was statistically analyzed by multiple regression and the change of teeth mobility according to healing process by independent t-test using SPSS program. The results were as follows: 1. There was a strong relationship between the Periotest value(PTV) and attachment level. 2. The change of teeth mobility in both flap procedures was increased significantly at 1 week post-op. and was decreased to preoperative level at 4 weeks post-op, in modified Widman flap and at 6 weeks post-op. in undisplaced flap. 3. The change of teeth mobility in premolar teeth group in undisplaced flap compared to modified Widman flap was generally increased but these changes were not statistically significant. The changes of teeth mobility in molar teeth group in undisplaced flap was increased significantly at 2 weeks post-op.. 4. The change of teeth mobility following undisplaced flap was increased significantly compared to that of modified Widman flap at 2 weeks post-op.

• Journal of Periodontal and Implant Science
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• v.48 no.6
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• pp.395-404
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• 2018

Purpose: The purpose of this study was to propose a technique for periodontal biotype modification through thickening of the entire facial aspect using a volume-stable collagen matrix and autogenous subepithelial connective tissue graft (CTG) for the treatment of gingival recession. Methods: Four systemically healthy patients showing Miller class I or class II gingival recession in the mandibular incisor area were included in this study. Full-mouth scaling and root planing procedures were performed at least 4 weeks prior to periodontal plastic surgery. A split-thickness flap with a horizontal intrasulcular incision and 2 vertical incisions was used in cases 1-3, and the modified tunnel technique was used in case 4 for coronal advancement of the mucogingival complex. After the exposed root surfaces were debrided thoroughly, double-layered volume-stable collagen matrix was placed on the apical part of the recession and a subepithelial CTG harvested from the palatal area was placed on the coronal part. The amount of root coverage at 3 months postoperatively was evaluated in cases 1-3, and facio-lingual volumetric changes were analyzed in cases 1 and 2. Results: Healing was uneventful in all 4 cases and complete root coverage was shown in cases 1-3. In case 4, reduction of gingival recession was observed at 3 months after surgery. In cases 1 and 2, a comparison of stereolithographic files from the preoperative and postoperative time points demonstrated that the entire facio-lingual volume had increased. Conclusions: The surgical technique suggested herein, using a volume-stable collagen matrix and autogenous subepithelial CTG, may be an effective method for periodontal biotype modification through thickening of the entire facial aspect for the treatment of gingival recession.

• Journal of Periodontal and Implant Science
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• v.52 no.2
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• pp.127-140
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• 2022

Purpose: In dental avulsion, delayed replantation usually has an uncertain prognosis. After tooth replantation, complex inflammatory responses promote a return to periodontal tissue homeostasis. Various types of cytokines are produced in the inflammatory microenvironment, and these cytokines determine the periodontal tissue response. This study aimed to identify the gene expression profiles of replanted teeth and evaluate the functional differences between immediate and delayed replantation. Methods: Maxillary molars from Sprague-Dawley rats were extracted, exposed to a dry environment, and then replanted. The animals were divided into 2 groups according to the extra-oral time: immediate replantation (dry for 5 minutes) and delayed replantation (dry for 60 minutes). Either 3 or 7 days after replantation, the animals were sacrificed. Periodontal soft tissues were harvested for mRNA sequencing. Hallmark gene set enrichment analysis was performed to predict the function of gene-gene interactions. The normalized enrichment score (NES) was calculated to determine functional differences. Results: The hallmark gene sets enriched in delayed replantation at 3 days were oxidative phosphorylation (NES=2.82, Q<0.001) and tumor necrosis factor-alpha (TNF-α) signaling via the nuclear factor kappa light chain enhancer of activated B cells (NF-κB) pathway (NES=1.52, Q=0.034). At 7 days after delayed replantation, TNF-α signaling via the NF-κB pathway (NES=-1.82, Q=0.002), angiogenesis (NES=-1.66, Q=0.01), and the transforming growth factor-beta signaling pathway (NES=-1.46, Q=0.051) were negatively highlighted. Conclusions: Differentially expressed gene profiles were significantly different between immediate and delayed replantation. TNF-α signaling via the NF-κB pathway was marked during the healing process. However, the enrichment score of this pathway changed in a time-dependent manner between immediate and delayed replantation.