• 구강회복응용과학지
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• 제35권1호
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• pp.46-54
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• 2019

치수 질환 그리고 치주 질환이 복합적으로 발생하여 치근단 조직과 변연부 치주 조직이 개통되는 것을 치주-근관 복합병소라 일컫는다. 치주-근관 복합 병소의 치료를 위해서는 근관치료 및 치주 재생 처치 둘 다를 필요로 하며, 이는 치근단 및 변연부 조직 모두의 치유를 위함이다. 본 연구에서는 치주-근관 복합 병소를 나타내는 하악 전치부 치아에서 근관치료 이후 조직유도 재생술을 시행하였으며, 각각의 증례에서 심한 치조골 흡수를 보이는 치아들은 3년이 넘는 경과 관찰기간 동안 발치되지 않고 유지될 수 있었다. 따라서 하악 전치부에서 발생한 치주-근관 복합 병소의 근관치료 후 조직유도 재생술을 이용한 치료는 임상적으로 이점이 있는 것으로 고려된다.

• Journal of Periodontal and Implant Science
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• 제24권1호
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• pp.205-216
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• 1994

The goal of periodontal therapy is the regeneration of the periodontium lost by periodontal disease. The purpose of this study was to evaluate the regenerative potential of the autogenous bone graft and guided tissue regeneration in the treatment of periodontal bony defect in dogs. Experimental periodontitis were induced in the mandibular left 3rd premolar and right 3rd and 4th premolars of 5 dogs using orthodontic ligature wire. After 6 weeks, the ligature wire removed, surgical procedure were performed as follows. 1) control group : Flap operation(Mn.Lt 3rd premolar) 2) experimental group I : Flap operation + autogenous bone graft (Mn.Rt. 3rd premolar) 3) experimental group II : Flap operation + Gore-Tex membrane (Mn.Rt. 4th premoalr) Thereafter, dogs were sacrificed on the 1,2,4,8,16th week and the specimens were prepared and stained with hematoxyline-eosin stain for the light microscopic examination. The results of this study were as follows. 1. The apical migration of junctional epithelium was most remarkable in the flap operation and the experimental group II was less than the experimental group I. 2. In the formation of new alveolar bone, it was found in experimental group I,II and experimental group I is more than II. In the control group, few bone formation was found. 3. In the formation of new cementum, it was found in experimental group I,II and experimental group II is more than I. So, the periodontal therapy combined with autogenous and guided tissue regeneration will be produce the periodontal regeneration.

• Journal of Periodontal and Implant Science
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• 제27권4호
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• pp.767-783
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• 1997

Guided tissue regeneration, bone graft procedures, and application of growth factors have been used to regenerate lost periodontal tissues. Recently, enamel matrix derivative has been introduced into periodontal regeneration procedures in expectation of promoting new bone and cementum formation. The purpose' of this study was to evaluate the effect of enamel matrix derivative in 1-wall intrabony defects in beagle dogs. For this purpose, each dog was anesthesized using intravenous anesthesia and mandibular 1st, 3rd premolars were extracted. 2 months later, the 1-wall intrabony defects(mesio-distal width: 4mm, depth: 4mm) were created on the distal side of 2nd premolars and mesial side of 4th premolars. The control group was treated with debridement alone, and experimental group was treated with debridement and enamel matrix derivative application. The healing processes were histologically and histometrically observed after 8 weeks and the results were as follows : 1. The length of junctional epithelium was $0.94{\pm}0.80mm$ in the control group, $0.57{\pm}0.42mm$ in the experimental group, with no statistically significant difference between groups. 2. The connective tissue attachment was $1.36{\pm}0.98mm$ in the control group. $0.38{\pm}0.43mm$ in the experimental group, with statistically significant difference between groups(P<0.05). 3. The new cementum formation was $2.49{\pm}1.06mm$ in the control group, $3.59{\pm}0.74mm$ in the experimental group. with statistically significant difference between groups(P<0.05). 4. The new bone formation was $1.92{\pm}0.97mm$ in the control group, $2.32{\pm}0.59mm$ in the experimental group. with no statistically significant difference between groups. Within the limitation to this study protocol, enamel matrix derivative application in 1-wall intrabony defect enhanced new cementum formation. Although there was no statistically significant difference, enamel matrix derivative also seems to be effective in inhibition of apical migration of junctional epithelium and new bone formation.

• Journal of Periodontal and Implant Science
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• 제27권2호
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• pp.363-377
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• 1997

The main goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal diseases. Although conventional forms of periodontal therapy show sound clinical results, the healing results in long junctional epithelium. There have been numerous materials and surgical techniques developed for new attachment and bone regeneration. Bone grafts can be catagorized into: autografts, allografts, xenografts and bone substitutes. Synthetic bone substitute materials include hydroxyapatite, tricalcium phosphate, calcium carbonate, and Plaster of Paris. Calcium sulfate has found its use in dental practice for the last 30 years. Recent animal studies suggest that periodontal regeneration in 3 wall intrabony defect may be enhanced by the presence of calcium sulfate. And it is well known that 2 wall & 1 wall defect have less osteogenic potential, So we need to study the effect of calcium sulfate in 1 wall intrabony defect in dogs. The present study evaluates the effects of calcium sulfate on the epithelial migration, alveolar bone regeneration and cementum formation in intrabony defects of dogs. Four millimeter-deep one-wall intrabony defects were surgically created in the mesial aspect of anterior teeth and mesial & distal aspects of premolars. The test group received calcium sulfate grafts with a flap procedure. The control underwent flap procedure only. Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of junctional epithelium were: 2.52mm in the control, and 1.89mm in the test group. There was no statistical significance between the two groups. 2. Alveolar bone formation were: 0.61mm in the control, and 1.88mm in the test group. There was a statistically significant difference between the two groups (p<0.05). 3. Cementum formations were: l.lmm in the control, and 2.46mm in the test group. There was a statistically significant difference between the two groups (p<0.05). 4. The length of CT adhesion were: O.97mm in the control, and 0.17mm in the test group. There was no statistically significant differences between the two groups These results suggest that the use of calcium sulfate in intrabony defects has little effect on junctional epithelium migration, but has significant effects on new bone and new cementum formations.

• 한국결정성장학회지
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• 제33권3호
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• pp.104-109
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• 2023

Electrospinning was performed using an eco-friendly solvent composed of acetic acid, ethyl acetate and distilled water to investigate the effect of gelatin concentration on mechanical properties and cytotoxicity of absorbable poly(D,L-lactic acid) (PDLLA)/gelatin blend membrane. The tensile stress, strain at break, and WUC of the PDLLA/gelatin (97/3) scaffold at 26 wt% concentration were determined to be 3.9 ± 0.7 MPa, 37 ± 1.3 %, and 273 ± 33 %, respectively. FT-IR results revealed that PDLLA and gelatin were bound only by van der Waals interactions. The cell viability of PDLLA/gelatin membranes containing 0 %, 1 %, 2 %, 3 %, and 4 % gelatin were more than 100 %, which makes all membranes highly suitable as a barrier membrane for absorbable periodontal tissue regeneration due to their marketed physical properties and biocompatibility.

• International Journal of Stem Cells
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• 제16권1호
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• pp.93-107
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• 2023

Background and Objectives: Chronic periodontitis can lead to alveolar bone resorption and eventually tooth loss. Stem cells from exfoliated deciduous teeth (SHED) are appropriate bone regeneration seed cells. To track the survival, migration, and differentiation of the transplanted SHED, we used super paramagnetic iron oxide particles (SPIO) Molday ION Rhodamine-B (MIRB) to label and monitor the transplanted cells while repairing periodontal bone defects. Methods and Results: We determined an appropriate dose of MIRB for labeling SHED by examining the growth and osteogenic differentiation of labeled SHED. Finally, SHED was labeled with 25 ㎍ Fe/ml MIRB before being transplanted into rats. Magnetic resonance imaging was used to track SHED survival and migration in vivo due to a low-intensity signal artifact caused by MIRB. HE and immunohistochemical analyses revealed that both MIRB-labeled and unlabeled SHED could promote periodontal bone regeneration. The colocalization of hNUC and MIRB demonstrated that SHED transplanted into rats could survive in vivo. Furthermore, some MIRB-positive cells expressed the osteoblast and osteocyte markers OCN and DMP1, respectively. Enzyme-linked immunosorbent assay revealed that SHED could secrete protein factors, such as IGF-1, OCN, ALP, IL-4, VEGF, and bFGF, which promote bone regeneration. Immunofluorescence staining revealed that the transplanted SHED was surrounded by a large number of host-derived Runx2- and Col II-positive cells that played important roles in the bone healing process. Conclusions: SHED could promote periodontal bone regeneration in rats, and the survival of SHED could be tracked in vivo by labeling them with MIRB. SHED are likely to promote bone healing through both direct differentiation and paracrine mechanisms.

• Journal of Periodontal and Implant Science
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• 제36권1호
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• pp.27-37
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• 2006

Although the main purpose of periodontal treatment to regenerate is the complete regeneration of periodontal tissue due to periodontal disease, most of the treatment cannot meet such purpose because healing by long epithelial junction. Therefore, diverse materials of resorbable and non-resorbable have been used to regenerate the periodontal tissue. Due to high risk of exposure and necessity of secondary surgical procedure when using non-resorbable membrane, guided tissue regeneration using the resorbable membrane has gain popularity, recently. However, present resorbable membrane has the disadvantage of not having sufficient time to regenerate date to the difference of resorption rate according to surgical site. Meanwhile, other than the structure stability and facile manipulation, acellular dermal matrix has been reported to be a possible scaffold for cellular proliferation due to rapid revascularization and favorable physical properties for cellular attachment and proliferation. The purpose of this study is to estimate the influence of acellular dermal matrix on periodontal ligament, cementum and alveolar bone when acellular dermal matrix is implanted to 1-wall alveolar bone defect. 4 dogs of 12 to 16 month old irrelevant to sex , which below 15Kg of body weight, has been used in this study. ADM has been used for the material of guided tissue regeneration. The 3rd premolar of the lower jaw was extracted bilaterally and awaited for self-healing. subsequently buccal and lingual flap was elevated to form one wall intrabony defect with the depth and width of 4mm on the distal surface of 2nd premolar and the mesial surface of 4th premolar. After the removal of periodontal ligament by root planing. notch was formed on the basal position. Following the root surface treatment, while the control group had the flap sutured without any treatment on surgically induced intrabony defect. Following the root surface treatment, the flap of intrabony defect was sutured with the ADM inserted while the control group sutured without any insertion. The histologic specimen was observed after 4 and 8 weeks of treatment. The control group was partially regenerated by periodontal ligament, new cementum and new alveolar bone. the level of regeneration is not reached on the previous formed notch. but, experimental group was fully regenerated by functionally oriented periodontal ligament fiber. new cementum and new alveolar bone. In conclusion, we think that ADM seems to be used by scaffold for periodontal ligament cells and the matrix is expected to use on guided tissue regeneration.

• Journal of Periodontal and Implant Science
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• 제31권2호
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• pp.345-356
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• 2001

The purpose of the present study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) using resorbable polylactic/polyglycolic copolymer(PLA/PGA) membrane in mandibular class II furcation involvement and to compare it to the clinical efficacy of only flap operation. Both procedures were conducted in 5 patients with class II furcation involvements. After 6 months of follow up, the probing pocket depth, clincial attachment level, bone probing depth, and radiographic changes were compared, and the following results were obtained: 1. GTR using PLA/PGA demonstrated a statistically significant reduction in probing pocket depth and bone probing depth, and the control group demonstrated a statistically significant reduction in bone probing depth. 2. The comparison between the experimental and control group failed to demonstrate statistically significant difference in clinical improvement, but more reduction in probing pocket depth and bone probing depth were observed in the experimental group. The probing pocket depth and the bone probing depth were $2.2{\pm}1.6mm$ and $2.4{\pm}1.1mm$ respectively in the control group, while they were $2.4{\pm}1.3mm$ and $3.0{\pm}1.2mm$ respectively in the experimental group. 3. Radiographic change was not detectable for the both groups during the 6 months of follow up. 4. Sites with deeper probing pocket depth at baseline examination showed greater amount of clinical improvement in both groups. Other clinical factors didn't have any significant effect on the treatment results. It is concluded that though there are some limitations, PLA/PGA membrane is effective for the treatment of mandibular class II furcation involvement.

• Journal of Periodontal and Implant Science
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• 제30권2호
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• pp.229-242
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• 2000

The purpose of this study was to evaluate the effect of fibrin tissue adhesive and porous resorbable calcium carbonate on the periodontal regeneration of the class II furcation defect in dogs. Class II furcation defect was surgically created on the second, third, and fourth premolars bilaterally in the mandibles of six mongrel dogs. The experimental sites were divided into four groups according to the treatment modalities: Control-surgical debridement only; Group I-calcium carbonate grafting; Group II-application of fibrin adhesive only; Group III-application of fibrin adhesive after calcium carbonate grafting. The animals were sacrificed at the 2, 4, and 12 weeks after periodontal surgery and the decalcified specimens were prepared for histological and histometrical examination. The results are as follows : Clinically, there were no inflammatory response in all groups after 2, 4, 12 weeks. In the Control group, junctional epithelium was grown downward to the reference notch. In Group I, graft materials were exfoliated from the defect throughout the experimenta periods andnew bone was seen in the notch area at 4 and 12 week specimens. In Group II, fibrin adhesive was absorbed at 2 week specimens, and connective tissue attachment increased than that of control group. New cementum and new bone were seen above the notch area. In Group III, the graft material was maintained in the defect throughout the experimental period and inducing the amount of periodontal tissue regeneration was higher than other groups. These results suggest that the use of fibrin tissue adhesive in conjunction with porous resorbable calcium carbonate would improves the stability of graft material and inhibit the epithelial down growth and make it be a feasible method for periodontal regeneration.

• Journal of Periodontal and Implant Science
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• 제27권3호
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• pp.479-493
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• 1997

There are various treatment methods including barrier membranes in attaining periodontal regeneration and regaining the function of destructed periodontal tissues due to periodontal disease. Barrier membranes consist of non-Resorbable and resorbable types such as Dura mater and $Guidor^{(R)}$ used in the treatment of intrabony defects and classII furcation defects have been shown to be effectively increased the amount of new bone and cementum.In our study we used premolars with class III furcation defects created by removing the bone 4mm apically from CEJ in adult dogs and placed resorbable membrane Dura mater and $Guidor^{(R)}$ for the test group and flap operation was carried out for the control groups. The effect of membrane on junctional epithelium, alveloar bone, cementum, and gingival connective tisssue in the regeneration and healing potential of periodontal tissues was evaluated and healing results were evaluated histologically and histometrically 8 weeks following the surgical procedure. 1. In the clinical observation, there was no exposure of furcation defects in the control group, whereas slight membrane exposure was noted in the test group. 2. New bone was formed up to the level of the notch in the control group, whereas in the test group new bone formation was observed above the level of the notch. 3. New cementum was formed in both groups of the experiment. 4. The connective tissue observed between the new cementum and new bone in the test group were functionally orientated, compared to the irregular formation of connective tissues found in the control group. 5. Root resorption or ankylosis was not observed in any of the groups 6. The mean and median of the control group were 4.31% and 2.23% and for the Dura mater group were 27.85% and 15.57% respectively. There was no significant difference between Dura mater and the control group. 7. The mean and median of the control group were 4.31% and 2.23% and for the $Guidor^{(R)}$ group were 37.27% and 37.19% respectively. There was a significant difference in these two groups(P$Guidor^{(R)}$ were 37.27% and 37.19%. There was no significant difference between the two test groups. Thus, by using Dura mater and Guidor in classIII furcation defects, the predictable amount of periodontal ligament and alveolar bone regeneration may result.