• Journal of Periodontal and Implant Science
• /
• v.38 no.4
• /
• pp.589-594
• /
• 2008

Purpose: Osseointegration of implants in patients with pneumatized maxillary sinuses is difficult to achieve due to the deficiency of available bone in the posterior maxilla after loss of teeth. Maxillary sinus elevation is a method to overcome this problem. In this study, we evaluated the implant survival rate and the relationship between implant survival in patients with sinus elevation by the lateral approach. Materials and Methods: A total of 48 patients were consecutively treated with sinus elevation by the lateral approach between February 2003 & August 2006 at the dental hospital of Chonbuk National university. A total of 113 implants were placed. The mean healing period was 7.1 months and implants were placed after a mean period of 5.6 months. The mean observation period was 21.8 months. Results: Out of the 113 implants placed, fifteen failed, resulting in a survival rate of 86.7%, 18 cases of sinus membrane perforation were observed out of 65 sinuses treated. 33 implants were placed in a perforated site and 10 failed, representing a 60.7% implant survival. 80 implants were placed in a nonperforated site and 5 failed, representing a 92.6% implant survival. Conclusions: Implant placement with sinus elevation is an acceptable treatment for short term results. Sinus membrane perforation and postoperative complications, however, may have an effect on implant failure.

• Journal of Periodontal and Implant Science
• /
• v.38 no.4
• /
• pp.595-602
• /
• 2008

Purpose: Ti-6Al-4V alloy is widely used as an implant material because of its good biocompatibility and good mechanical property compared with commercial pure titanium. Otherwise, toxicity of aluminum and vanadium in vivo has been reported. Ti-8Ta-3Nb alloy is recently developed in the R&D Center for Ti and Special Alloys and it was reported that this alloy has high mechanical strength, no cytotoxicity and similar biocompatibility to commercial pure titanium, but many studies are needed for its clinical use. In these experiment, we carried out different surface treatment on each Ti-8Ta-3Nb alloy disks, then cultured cell on it and assessed biological response. Materials and Methods: cpTi, Ti-6Al-4V, Ti-8Ta-3Nb alloy disks were prepared and carried out sandblasting and acid etching (SLA) or alkali-heat treatment (AH) on the Ti-8Ta-3Nb alloy disks. We cultured primary rat calvarial cells on each surface and assessed early cell attachment and proliferation by scanning electron microscopy, cell proliferation, alkaline phosphatase activity. Result: The rates of cell proliferation on the cpTi, Ti-8Ta-3Nb AH disks were higher than others (p<0.05) and alkaline phosphatase activity was significantly enhanced on the Ti-STa-8Nb AH disks(p<0.05). Conclusion: Most favorable cell response was shown on the Ti-8Ta-3Nb AH surfaces. It is supposed that alkali-heat treatment of the Ti-8Ta-3Nb alloy could be induced earlier bone healing and osseointegration than smooth surface.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.31 no.4
• /
• pp.334-338
• /
• 2009

Supernumerary teeth are extra teeth or tooth-like structures which may have either erupted or unerupted in addition to the 20 deciduous teeth and the 32 permanent teeth. Clinicians sometimes confront unerupted supernumerary teeth where implants would be placed. Many clinicians consider immediate placement of implant into an extracted socket as an effective technique compared to the conventional method of waiting several months for bone healing, because of the advantages such as reduction of treatment period, preservation of alveolar bone and soft tissue, etc. We could hardly find the case of immediate placement of implant after extraction of impacted supernumerary teeth and permanent teeth together. Therefore we report the case of immediate implantation following extraction of impacted supernumerary teeth and poor periodontal conditioned permanent teeth.

• Journal of Periodontal and Implant Science
• /
• v.46 no.4
• /
• pp.244-253
• /
• 2016

Purpose: The aim of this study was to characterize the healing in the grafted calvarial defects of rats after adjunctive hyperbaric oxygen therapy. Methods: Twenty-eight male Sprague-Dawley rats (body weight, 250-300 g) were randomly divided into two treatment groups: with hyperbaric oxygen therapy (HBO; n=14) and without HBO (NHBO; n=14). Each group was further subdivided according to the bone substitute applied: biphasic calcium phosphate (BCP; n=7) and surface-modified BCP (mBCP; n=7). The mBCP comprised BCP coated with Escherichia-coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2) and epigallocatechin-3-gallate (EGCG). Two symmetrical circular defects (6-mm diameter) were created in the right and left parietal bones of each animal. One defect was assigned as a control defect and received no bone substitute, while the other defect was filled with either BCP or mBCP. The animals were allowed to heal for 4 weeks, during which those in the HBO group underwent 5 sessions of HBO. At 4 weeks, the animals were sacrificed, and the defects were harvested for histologic and histomorphometric analysis. Results: Well-maintained space was found in the grafted groups. Woven bone connected to and away from the defect margin was formed. More angiogenesis was found with HBO and EGCG/BMP-2 (P<0.05). None of the defects achieved complete defect closure. Increased new bone formation with HBO or EGCG/BMP-2 was evident in histologic evaluation, but it did not reach statistical significance in histometric analysis. A synergic effect between HBO and EGCG/BMP-2 was not found. Conclusions: Within the limitations of this study, the present findings indicate that adjunctive HBO and EGCG/BMP-2 could be beneficial for new bone formation in rat calvarial defects.

• Journal of Periodontal and Implant Science
• /
• v.44 no.1
• /
• pp.33-38
• /
• 2014

Purpose: Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts. Methods: Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the alveolar process with the indication of reconstruction procedures to allow rehabilitation with dental implants; and the absence of systemic disease, local infection, or inflammation. The patients were randomly divided into two groups based on whether they received a perforated (inner surface) or nonperforated graft. After a 6-month healing period, a biopsy was performed and osseointegrated implants were installed in the same procedure. Results: Fibrous connective tissue was evident at the interface in patients who received nonperforated grafts. However, full union between the graft and host bed was visible in those who had received a perforated graft. Conclusions: We found that cortical inner side perforations at donor sites increased the surface area and opened the medullary cavity. Our results indicate an increased rate of graft incorporation in patients who received such perforated grafts.

• Journal of Periodontal and Implant Science
• /
• v.34 no.4
• /
• pp.699-709
• /
• 2004

The present study was performed to evaluate histomorphological difference in various surface-treated implants in beagle. Implants($Implantium^{(R)}$, Dentium Co. Korea) with pure titanium machined surface, acid treated surface, and $Al_2O_3(50{\sim}100\;{\mu}m)$blasted with acid treated surface were used in this study. All mandibular premolars of $1.5{\sim}2$ year old male beagle dogs were extracted. At 3 months after extraction, the implants(${\Phi}$ 4mm, l 6mm) were installed. The beagle were sacrificed at 1, 3 months after installation and then tissues including implants were prepared for non-decalcified specimens. These specimens were analyzed comparatively under light microscope. The results of this study were as follow 1. Higher rate of osseointegration were showed in the $Al_2O_3(50{\sim}100\;{\mu}m)$blasted with acid-treated surface. 2. Increased osseointegration were showed in the $Al_2O_3(50{\sim}100\;{\mu}m)$blasted with acidtreated surface with time. 3. Higher maturation of integration were showed in the $Al_2O_3(50{\sim}100\;{\mu}m)$blasted with acid-treated surface. In conclusion, surface treatment of $Al_2O_3blasted$ with acid might be considered to shorten healing time and improve success rate as increasing contact of implant and bone.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.27 no.4
• /
• pp.449-454
• /
• 2011

Recently, jawbone osteonecrosis has been largely reported as a potential adverse effect of bisphosphonate (BP)administration. Currently available published incidence data for BRONJ are based on retrospective studies and estimates of cumulative incidence range from 0.8 to 12%. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60-70% of cases are preceded by a dental surgical procedure. The signs and symptoms that may occur before the appearance of clinical evident osteonecrosis include changes in the health of periodontal tissues, non-healing mucosal ulcers, loose teeth and unexplained soft-tissue infection. Tooth extraction as a precipitating event is a common observation. The significant benefits that bisphosphonates offer to patients clearly surpass the risk of potential side effects; however, any patient for whom prolonged bisphosphonate therapy is indicated, should be provided with preventive dental care in order to minimize the risk of developing this severe condition.

• Journal of Periodontal and Implant Science
• /
• v.26 no.4
• /
• pp.1003-1012
• /
• 1996

The induction of a phenotype with preoperties may have clinical significance in the acceleration of the wound-healing process. Wound contraction involves a specialized cell known as the myofibroblast. The myofibroblasts can be identified by their intense staining of actin bundles with anti-actin antibody. Tissue-specific actin distribution is correlated with the contractile activity of the myofibroblasts and smooth muscle etc. This study was performed to determine the expression of actin filaments in the cytoplasm of cultured human gingival fibroblsts after GaAs laser(BIOSAER, Korea) irradiation. Human gingival fibroblasts were cultured from explants of normal interdental gingival tissue. The third-generation fibroblasts were used for immunohistochemical study. The cultured fibroblasts were exposed $0.53joule/cm^2$(lmW, 7 mimutes) of energy density, and then observed by immunohistochemical method using, rabbit anti0gelsolin, hen smooth muscle polyclonal antibody(Chemicon international inc.), and biotinylated goat anti-rabbit IgG(Vectastain) 24-, 36-, 48-hour after laser irradiation Following results were obtained ; 1. In nonirradiated cultures, round shaped active fibroblasts with abundant cytoplasm and prominet nucleoli were observed. 2. In 24- and 36-hour cultures after laser irradiation, spindle shaped cells with long process were observed. The intensity of stain was seen in cytoplasm of these modified fibroblasts. 3. In 48-hoour cultures after laser irradiation, stained spindle shape cell were not observed. The results suggest that the effect of the galium-arsenide laser treatment on cultured gingival fibroblasts is the rapid development of cytoplasmic actin filaments.

• Journal of Periodontal and Implant Science
• /
• v.33 no.2
• /
• pp.139-147
• /
• 2003

The roots of teeth exposed by gingival recession, may be successfully covered by various type of gingival grafting procedures. Vascularization of the recipient site is an essential determinant of the grafts' survival during the first healing stages. It has been suggested that a procedure by which they stimulate the periosteum presurgically will induce the proliferation of neo-endothelium in the site to be operated. The purpose of this study is to evaluate the variations in the gingival blood flow during 4weeks after periosteal stimulation in patient scheduled to receive gingival grafts and to compare variations in the gingival blood flow between smoker and non-smoker. Laser Doppler Flowmetry(floLAB(R), Moor Instruments Ltd, England ; wave length = 780mm. Max. power =l.6mW) was used to measure the gingival blood flow. 112 sites of 68 male patients (32 smokers and 36 non-smoker), aged between 23 and 48 years (smoker : 24-44 years. mean=32.6, non-smoker : 23-48 years, mean=28.5) were monitored for the blood flow. Gingival blood flow measured at before periosteal stimulation, 1-, 2-, 3-, and 4-weeks after periosteal stimulation from 10 a.m. to 2 p.m. The difference of blood flow in each measuring time, each measuring site and between smokers and non-smokers were statistically analyzed by MANOVA. The results were as follows : (1) Blood flow stayed increased for 2 weeks, and then, it was a tendency to decrease(p<0.05). (2) There was no statistically significant difference of blood flow change between smokers and non-smokers. (3)The blood flow at middle site had lower than mesial and distal site during the measuring periods(p<0.05). The present study suggested that blood flow change following periosteal stimulation was significant difference, thus periosteal stimulation before gingival graft might induce favorable results in gingival recession patient.

• Journal of Periodontal and Implant Science
• /
• v.27 no.4
• /
• pp.723-737
• /
• 1997

본 연구의 목적은 조직유도재생술의 초기치유시에 구강양치액으로 사용되어지는 0.1% 클로르헥시딘과 0.2% 클로르헥시딘을 사용했을 경우, 양치액을 사용하지 않았을 경우의 세균감염 정도를 비교하는 것이다. 30명의 성인형 치주염에 이환되어진 사람을 대상으로 하였다. 초기치료(Scaling/Root planing/Oral hygiene instruction)를 시행한 후에 한 사람에 한 군데씩 선정하여 2급이나 3급의 치근이개부를 가지고 임상적으로 혹은 방사선학적으로 치간골내낭을 보이지 않는 치아에 통법에 따라 Gore-TexTM를 위치시켰다. 술후 5일간 항생제 (UnasynTM 375mg tablet p.o.tid)를 투여하고 차폐막을 제거할 때까지(4주 혹은 6주) 10명의 환자에게는 0.1% 클로르헥시딘을, 다른 10명의 환자에게는 0.2% 클로르헥시딘으로 구강양치를 하게 하고, 또 다른 10명의 환자에게는 구강양치액을 사용하지 않도록 하였다. 또 1주일에 한번씩 전문가구강위생술식을 실시하였다. 4주나 6주 후에 차폐막을 제거하고 주사전자현미경, 혐기성 세균배양을 이용하여 세균감염정도를 비교하였다. 1. 주사전자현미경으로 관찰시에 0.1% 클로르헥시딘을 사용했을 경우와 0.2% 클로르헥시딘을 사용했을 경우, 클로르헥시딘을 사용하지 않은 경우에 별 차이를 발견할 수 없었다. 2. 혐기성 세균배양시에 0.2% 클로르헥시딘을 사용했을 경우, 0.1%클로르헥시딘을 사용했을 경우보다 적은 수의 세균 수를 보였으나 통계적으로 유의할 만한 차이는 보이지 않았다. 클로르헥시딘을 사용하지 않은 경우에는 다른 두 경우에 비해 통계적으로 유의할 만한 차이를 보였다.(P<0.05) 3. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia를 인지한 경우에는 세 경우 모두 비슷한 비율로 발견되었다.