• Journal of Periodontal and Implant Science
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• 제31권4호
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• pp.713-726
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• 2001

Bisphosphonate가 백서 발치와의 치유과정에 미치는 영향에 대해 관찰하고자 생후 2개월 된 Sprague-Dawley계의 백서 18마리를 사용하여, 실험군과 대조군 모두 발치를 용이하게 하고 외상을 최소화 하기 위해 발치 전에 하루 ${\beta}-Aminoproprionitrile(APN)$ 0.2g/㎏을 5일간 투여한 후 발치하고, 감염방지를 위해 매일 1.5㎎/㎏ ampicillin을 3일 동안 근육주사 하였다. 실험군에서는 Biosphosphonate 1㎎/㎏을, 대조군에서는 vehicle(0.9%saline)을 1주에 3회씩 2주 동안 피하 주사하였으며, 각 군은 발치 후 1주, 2주, 4주 간격으로 3마리씩 희생시켜 H&E 염색에 의한 조직학적인 관찰, TRAP 염색에 의한 파골 세포의 활성, 경도 측정기에 의한 경도 측정을 통해 다음과 같은 결과를 얻었다. 1. 각 주간의 전반적인 치유양상은 시간이 경과함에 따라 실험군과 대조군 공히 유사한 치조골 회복 양상을 보였다. 2. 파골 세포의 활성은 1주, 4주 군에서는 실험군과 대조군에서 유사한 양상을 나타내었으나, 2주 군에서는 실험군에서 대조군에 비해 감소된 파골 세포 활성 양상을 관찰 할 수 있었다. 3. 경도측정에서는 모든 군에서 대조군에 비해 실험군에서 유의성 있는 증가 양상을 보였으며, 시간경과에 따른 경도의 차이에서는 1주군과 4주군 간에서 대조군에 비해 실험군에서 통계학적으로 유의성 있는 증가 양상을 보였다.(p<0.05) 이상의 연구를 통해 Bisphosphonate가 백서 발치와의 치유과정과 파골 세포의 활성에 영향을 미치며, 치유된 발치와의 경도를 증가시키는 것으로 나타났다.

• Journal of Periodontal and Implant Science
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• 제36권3호
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• pp.601-611
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• 2006

임프란트 식립을 필요로 하는 환자의 수평적 치조제 결손의 증대를 위해 골유도재생술과 병용한 bioactive glass (BG) $(Biogran^{(R)})$ 이식의 골재생 양상을 각기 다른 치유기간을 부여한 4명의 환자에서 평가하였다. 6, 8, 10, 18개월의 치유기간 후 임프란트 식립부위에서 조직절편을 채득하여 골재생을 조직계측학적으로 평가하였다. 임프란트 식립을 위한 surgical reentry시 모든 이식부위는 임상적으로 명확한 수평적 치조제 폭경의 증가를 관찰할 수 있었다. 하지만 조직학적 분석결과 BG는 불량한 골전도성을 나타내었다. 6, 8개월의 치유기간후, 이식부위에서 신생골이 거의 관찰되지 않았으며(2.5%이하), 이식부와 기존 골의 경계부위에서 BG particle에 대한 신생골 성장과 결합양상 또는 관찰할 수 없었다. 10개월의 치유기간후 기존 골조직으로부터 성장한 신생골의 BG particle과의 직접적인 접촉양상을 일부 관찰할 수 있었다. 이식부는 13.2%의 광물화된 신생골조직을 보였고, 대부분의 BG particle은 결체조직으로 둘러싸여 있었다. 18개월의 치유기간이 부여된 환자의 조직절편에서 신생골은 이식부의 10.7%를 차지하여 비교적 낮은 신생골 형성양을 나타내었고, 이식부에 존재하는 잔존BG particle은 대부분은 결체조직으로, 일부분에서 광물화된 골조직으로 둘러싸여 있었다. 6, 8, 10, 18개월에서 잔존 BG particle양은 전체 이식부 면적에 대해서 각기 22.3%, 26.5%, 30.7%, 18.7%로 나타났다. 본 증례보고는 비록 한정적인 4명의 환자에서의 조직계측학적 평가결과이지만, 수평적 치조제 결손의 증대를 위해 골유도재생술과 병용한 bioactive glass이식은 불량한 골전도성으로 인해 효과적인 골재생을 위한 이식재로서는 적절하지 않을 수 있음을 나타낸다.

• Journal of Periodontal and Implant Science
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• 제39권2호
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• pp.185-192
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• 2009

Purpose: The aim of this study was to examine the correlation of the subjective and the objective evaluation of edentulous ridge bone quality, and to evaluate the change of the dental implant stability in each bone density group for early healing period after implant installation. Methods: Sixty-seven implants(Osstem implant$^{(R)}$, Seoul, Korea) were included in this study. We evaluated the bone density by 2 methods. The one was the subjective method which was determined by practitioner s tactile sense, the other was the objective bone type was based on Hounsfield units. The implant stability in each bone type group was assessed by resonance frequency analyzer(Osstell mentor$^{(R)}$). Data were analyzed for the change of the implant stability, and they were compared to verify the difference of groups at the time of installation, 2, 6, 10, 14 weeks postoperatively. Spearman's correlation was used to demonstrate the correlation between the subjective and the objective evaluation of the bone density, and analysis of variance(ANOVA) was used to analyze the differences of implant stability at each time point. Results: There was no close relation between the subjective and the objective evaluation of the bone density(r=0.57). In the subjective groups, there was statistically significant difference between the type 1 and 3 at 10 weeks and between the type 2 and 3 at 14 weeks. In the objective groups, there was no statistically significant difference between the D 1, 2, 3, 4, and 5 group with regard to RFA from baseline to 14 weeks(P>0.1). Conclusions: The implant stability increased over time during the study, and it was improved with bone density proportionally after 2weeks postoperatively. It is recommended that the decision of bone density is base on Hounsfield unit for implant loading time.

• Journal of Periodontal and Implant Science
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• 제39권2호
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• pp.167-176
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• 2009

Purpose: The purpose of this study is to histologically and histomorphometrically evaluate the effect of PLGA on bone regeneration compared with bone graft material. Methods: The experimental study was conducted in 10 rabbits with 2 different healing periods of 2 and 4 weeks. Following surgical exposure of the calvarium, 4 circular bone defects with a diameter of 4.6mm were formed. Rabbits were divided into control group, test groups I, and II. 10 defects assigned to the test group Ⅰ were grafted with Nu-oss and other 10 defects assigned to the test group II were grafted with PLGA. The rest of the defects were in the negative control group. At 2nd and 4th week after surgery, 10 rabbits were sacrificed through intracardiac perfusion and then specimens were obtained. Histological analysis was performed following staining with trichorme and transversal sectioning of the calvarial bone. Results: A group which used PLGA showed tissue reactions characterized by severe inflammation, rather than distinctive new bone formation. Conclusions: The present experimental investigations have failed to prove any beneficial effects of PLGA. PLGA used in this study exhibited foreign body reactions and a less favorable pattern of new bone formation in comparison to control group. Conclusion: PLGA did not function as scaffold. Further investigations of many types of micro PLGA that could improve its potential in GBR procedures are needed.

• Journal of Periodontal and Implant Science
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• 제50권3호
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• pp.197-206
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• 2020

Purpose: The aim of this study was to determine the impact of different compressive forces on deproteinized bovine bone mineral (DBBM) particles covered by native bilayer collagen membrane (NBCM) during alveolar ridge preservation (ARP) in the molar area, and to identify any histomorphometric and clinical differences according to the compressive force applied. Methods: Sockets were filled with DBBM after tooth extraction, and different compressive forces (30 N and 5 N, respectively) were applied to the graft material in the test (30 N) and control (5 N) groups. The DBBM in both groups was covered with NBCM in a double-layered fashion. A crossed horizontal mattress suture (hidden X) was then made. A core biopsy was performed using a trephine bur without flap elevation at the implant placement site for histomorphometric evaluations after 4 months. The change of the marginal bone level was measured using radiography. Results: Twelve patients completed the study. The histomorphometric analysis demonstrated that the mean ratios of the areas of new bone, residual graft material, and soft tissue and the implant stability quotient did not differ significantly between the groups (P>0.05). However, the mean size of the residual graft material showed a significant intergroup difference (P<0.05). Conclusions: The application of 2 compressive forces (5 N, 30 N) on particulate DBBM grafts during open-healing ARP in the posterior area led to comparable new bone formation, implant feasibility and peri-implant bone level.

• Restorative Dentistry and Endodontics
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• 제41권4호
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• pp.316-321
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• 2016

Although it is challenging, the early diagnosis of a vertical root fracture (VRF) is crucial in order to ensure tooth preservation. The purpose of this clinical case report was to describe reparative surgery performed to treat a tooth affected by an incomplete VRF. A 26 year old male patient was suspected to have a VRF in a maxillary left central incisor, and an exploratory flap was performed in order to confirm the diagnosis. After detecting the fracture, the lesion was surgically treated, the fracture and the infected root-end were removed, and a platelet-rich plasma membrane was used to cover the defect in order to prevent bacterial migration. A 24 month clinical and radiological follow-up examination showed that the tooth was asymptomatic and that the healing process was in progress. The surgical approach described here may be considered an effective treatment for a combined endodontic-periodontal lesion originating from an incomplete VRF and a recurrent periapical lesion.

• Journal of Periodontal and Implant Science
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• 제35권4호
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• pp.1073-1079
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• 2005

1. Objective. The aim of this study was to investigate whether dental implant exposure to the maxillary sinus cavity increases the risk of maxillary sinus complications. 2. Study design. An implant was placed bilaterally in the maxillary sinus of eight adult female mongrel dogs in a way that it penetrated the bone and mucous membrane of the maxillary sinus floor to the extent of 2 mm, 4 mm, or 8 mm. The implants were left in place for six months. 3. Results. Radiographic and histologic examinations did not show any signs of pathologic findings in the maxillary sinus of the eight dogs. 4. Conclusion. This study indicates that implant protrusion into the maxillary sinus cavity is not related to the development of sinus complications.

• Journal of Periodontal and Implant Science
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• 제38권2호
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• pp.117-124
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• 2008

Purpose: The purpose of this study was to histomorphometrically evaluate the osteoconductivity of a new biphasic calcium phosphate ceramics with fully interconnected microporous structure. Material and Methods: Osseous defects created in the rabbit calvaria were filled with four different bone graft substitutes. Experimental sites were filled with a new fully interconnected microporous biphasic calcium phosphate with(BCP-2) or without(BCP-1) internal macropore of $4400\;{\mu}m$ in diameter. MBCP(Biomatlante, France) and Bio-Oss(Geistlich Pharma, Switzerland) were used as controls in this study. Histomorphometric evaluation was performed at 4 and 8 weeks after surgery. Result: In histologic evaluation, new bone formation and direct bony contact with the graft particles were observed in all four groups. At 4 weeks, BCP-1(15.5%) and BCP-2(15.5%) groups showed greater amount of newly formed mineralized bone area(NB%) compared to BO(11.4%) and MBCP(10.3%) groups. The amounts of NB% at 8 weeks were greater than those of 4 weeks in all four groups, but there was no statistically significant differences in NB% between the groups. Conclusion: These results indicate that new bone substitutes, BCP with interconnected microporous structure and with or without internal macroporous structures, have the osteoconductivity comparable to those of commercially available bone substitutes, MBCP and Bio-Oss.

• Journal of Periodontal and Implant Science
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• 제50권4호
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• pp.209-225
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• 2020

Purpose: Marginal bone loss (MBL) is an important clinical issue in implant therapy. One feature that has been cited as a contributing factor to this bone loss is peri-implant mucosal thickness. Therefore, in this report, we conducted a systematic review of the literature comparing bone remodeling around implants placed in areas with thick (≥2-mm) vs. thin (<2-mm) mucosa. Methods: A PICO question was defined. Manual and electronic searches were performed of the MEDLINE/PubMed and Cochrane Oral Health Group databases. The inclusion criteria were prospective studies that documented soft tissue thickness with direct intraoperative measurements and that included at least 1 year of follow-up. When possible, a meta-analysis was performed for both the overall and subgroup analyses. Results: Thirteen papers fulfilled the inclusion criteria. A meta-analysis of 7 randomized clinical trials was conducted. Significantly less bone loss was found around implants with thick mucosa than around those with thin mucosa (difference, -0.53 mm; P<0.0001). Subgroups were analyzed regarding the apico-coronal positioning, the use of platform-matched vs. platform-switched (PS) connections, and the use of cement-retained vs. screw-retained prostheses. In these analyses, thick mucosa was found to be associated with significantly less MBL than thin mucosa (P<0.0001). Among non-matching (PS) connections and screw-retained prostheses, bone levels were not affected by mucosal thickness. Conclusions: Soft tissue thickness was found to be correlated with MBL except in cases of PS connections used on implants with thin tissues and screw-retained prostheses. Mucosal thickness did not affect implant survival or the occurrence of biological or aesthetic complications.

• Journal of Periodontal and Implant Science
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• 제40권5호
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• pp.244-248
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• 2010

Purpose: The purpose of this study was to radiographically evaluate marginal bony changes in relation to different vertical positions of dental implants. Methods: Two hundred implants placed in 107 patients were examined. The implants were classified by the vertical positions of the fixture-abutment connection (microgap): 'bone level,' 'above bone level,' or 'below bone level.' Marginal bone levels were examined in the radiographs taken immediately after fixture insertion, immediately after second-stage surgery, 6 months after prosthesis insertion, and 1 year after prosthesis insertion. Radiographic evaluation was carried out by measuring the distance between the microgap and the most coronal bone-to-implant contact (BIC). Results: Immediately after fixture insertion, the distance between the microgap and most coronal BIC was $0.06{\pm}0.68\;mm$; at second surgery, $0.43{\pm}0.83\;mm$; 6 months after loading, $1.36{\pm}0.56\;mm$; and 1 year after loading, $1.53{\pm}0.51\;mm$ ($mean{\pm}SD$). All bony changes were statistically significant but the difference between the second surgery and the 6-month loading was greater than between other periods. In the 'below bone level' group, the marginal bony change between fixture insertion and 1 year after loading was about 2.25 mm, and in the 'bone level' group, 1.47 mm, and in 'above bone level' group, 0.89 mm. Therefore, the marginal bony change was smaller than other groups in the 'above bone level' group and larger than other groups in the 'below bone level' group. Conclusions: Our results demonstrated that marginal bony changes occur during the early phase of healing after implant placement. These changes are dependent on the vertical positions of implants.