• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.141-151
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• 1999

To evaluate the effect of cetylpyridinium chloride in a powder form when used concomitantly with a commercial flouride containing tooth paste on inhibition of plaque formation, on gingivitis, and on irritation of oral mucosa, a double--blind, randomized parallel study was set up. Cetylpyridinium chloride was incorporated into a ligh brown colored powder with menthol added for scent. There were no diffemces between the active agent and the placebo which did not contain cetylpyridinium chloride in appearance, color, smell, taste, or dispenser. 98 healthy volunteers were assigned to one of two groups: brushing 3 times a day with flouride toothpaste and cetylpyridinium chloride powder, or brushing 3 times a day with flouride toothpaste and placebo. Before the test period, the subjects received through tooth cleaning and polishing. At basteline, GI, PI, BOP, and GCF of the Ramfjord teeth were measured in the experimental and placebo groups including 58 and 42 subjects repectively, After 4 weeks, GI, PI, BOP, GCF, compliance, irritation of the oral mucosa(redness, pus drainage, edema) and adverse reactions were measured. The PI, GI, and BOP of the experimental group recorded at baseline are 0.19${\pm}$0.19, 0.42${\pm}$0.31, and 0.08${\pm}$0.15. These scores showed significant decrease after 4 weeks of test period(0.11${\pm}$0.15, 0.22${\pm}$0.24, 0.02${\pm}$0.09 repectively at the end of the study) and inhibition of plaque accumulation and resolution of gingival inflammation could be observed. GCF shoed slight increase but this was not statistically different. Comparison of changes in measured scores of control and experimental groupshow GI, PI of the test indices have decreased. Test group showed significantly greater decrease in gingivitis and plaque accumulation after 4 weeks. GCF and BOP also showed greater decrease thant the control group but this difference was not statistically significant. At no time of the study period did any of the subjects show signs of irritation of the oral mucosa or adverse reactions. Following conclusions could be obtained from this study. The combined use of cetl powder and flouride toothpaste showed greater inhibition of plaque accumulation and greater decrease of gingivitis than use of flouride toothpaste with placebo agent.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.577-594
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• 1999

The major cause of periodontal disease is microorganism in the dental plaque. Gingival sulcular fluid, which is exudate released from the tissue near crevicular epithelium is related with inflammation. The purpose of this study was to evaluate the argon laser efficiency between the clinical index and onset of collagenase of gingival sulcular fluid. Material divided 16 patients into 4 groups. The first control was without treatmemt. The second was with just treatment of argon laser, The third was treated by scaling and root planning and the fourth was treated with both scailing and root planning and argon laser. The level of periocheck test, the index of bleeding, and the depth of periodontal pocket were evaluated from for 128 teeth of 64 anterior teeth and 64 posterior teeth. The results were as follows ; 1. In the score of periocheck test, root planing group(group 3) was significantly reduced more than the group without treatment(group 1) and the argon laser treatment(group 2) for results of 3 days and 7 days. But root planing plus argon laser treatment(group 4) in the 7days after experiment, was significantly reduced than no treatment(group 1) and root planing treatment(group 3)(P<0.05), in the 3 days after experiment, was significantly reduced than root planing(group3)(P<0.05). The score of periocheck test to the root planning group(group 3) were significantly reduced between days1, day3 and day7(P<0.05). Root planning plus argon laser group(group 4) were significantly reduced to 1 or 7days and 3 or 7days(P<0.05). The argon laser group(group 2) didn't show any changes. 2. In the case of sulcus bleeding index, the root planning group(group 3) and root planning plus argon laser group(group 4) were reduced more than without treatment group(group 1)(P<0.05) and sulcus bleeding index in the root planning group(group 3) were reduced more than the argon laser group(group 2)(P<0.05). 3. There wasn't any changes of pocket depth between the control and the experiment group as with experiment periods also.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.621-636
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• 1999

When mucoperiosteal flaps are positioned and sutured to desirable position, the wound contains several interface between tissues which differ fundamentally in composition & biological reaction. Thus the C-T surface of the flap will, on one hand, oppose another vascularized surface, and on the other, the avascular dental material for example, when root resoptions, fractured root, endodontic perforation, deep root carious lesions were filled with amalgam, glass ionomer, resin etc. Recently, a number of case report described the successful treatment of a subgingival root lesion with restorative material & free gingival graft, open flap surgery, but more objective research was needed . Most of study on restorative materials were concerned for cytotoxicity not for actual healing event on that materials and its influencing factors such as biocompatibility, surface wettability, surface topography . The aim of this in vitro study was to evaluate the effect of amalgam, resin modified glass ionomer, composite resin per se, and their surface roughness on the growth of human gingival fibroblast. The cells were obtained and placed on culture flask and incubated for 3 days with the prepared test materials. Then count the attached cell number with hemocytometer,(n=12) and 2 samples were examined with SEM about attachment cell morphology . Another 4 samples were evaluated on their surface roughness with Talysurf and average surface roughness value(Ra) were obtained. Statistical difference in attached cell number, roughness value were analyzed using ANOVA. The number of attached cell was as follows, for root dentin specimen 16.7${\pm}$4.41, resin modified glass ionomer 14.0${\pm}$4.15, resin 8.13${\pm}$3.63, amalgam 0.72${\pm}$3.33(${\times}10^3$). Between root dentin and resin-modified glass ionomer, no significant difference was observed, but resin, amalgam showed a significant less cell numbers than for root dentin, resin modified glass ionomer cement. SEM examination expressed many cell surface attachment apparatus in root dentin and resin modified glass ionomer specimens. For resin specimen, cell attachment was observed but exposed less appratus. The average surface roughness value are following results. Dentin specimen 0.6972${\pm}$ 0.104, resin modified glass ionomer 0.0822${\pm}$0.009, resin 0.0875${\pm}$0.005, amalgam 4.2145${\pm}$0.985(${\mu}m$). Between root dentin, resin-modified glass ionomer, and resin, no significant difference was observed, but amalgam showed a significant more rough surface than other groups. When evlauated the interrelationship between cell attachment and surface roughness, therefore, there was weak reverse correlation.(pearson correlation : - 0.593) These results suggest that resin modified glass ionomer have the favorable healing potential when used for subgingival restoration. And for relationship between cell attachment and surface characteristics, further investigations were needed.

• Journal of Periodontal and Implant Science
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• v.40 no.1
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• pp.3-10
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• 2010

Purpose: Periodontal regenerative therapies for defects created by severe periodontitis are mainly focused on bone regeneration. Although cementum regeneration needs to be better understood, it is believed to play an important role in periodontal regeneration. The first step toward a full understanding of cementum regeneration is to compare repaired cementum to pristine cementum. This study, which used histological techniques, was designed to focus on cementum regeneration and to compare pristine cementum to repaired cementum after surgical procedures with 8 and 24 week healing periods in a canine model. Methods: Buccal and lingual mucoperiosteal flaps of 10 beagle dogs were surgically reflected to create critical-sized defects. Intrabony one-wall defects, of which dimension is 4 mm width and 5 mm depth, were made at the distal aspect of mandibular second premolars and the mesial aspect of mandibular fourth premolars in the right and left jaw quadrants. Animals were sacrificed after 8 and 24 weeks post-surgery for histological specimen preparation and histometric analysis. Results: The repaired cementum was composed mostly of acellular cementum and cellular mixed fiber cementum and was thicker in the apical area than in the coronal area. The acellular cementum of the supracrestal area appeared to be amorphous. The newly formed cellular cementum was partially detached from the underlying circumpulpal dentin, which implied a weak attachment between new cementum and dentin, and this split was observed to a lesser extent in the 24 week group than in the 8 week group. The vertical height of the repaired cementum was greater in the 24 week group than in the 8 week group. Conclusions: Within the limitations of this study, we can conclude that repaired cementum after root planing was mainly acellular cementum and cementum tissue that matured to a shape similar to pristine cementum as the healing progressed from 8 to 24 weeks.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.489-496
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• 2007

The ultimate goal of periodontal treatment is to regenerate the lost periodontal apparatus. Many studies were performed in developing an ideal bone substitute. Anorganic bovine-derived xenograft is one of the bone substitute, which were studied and have been shown successful for decades. The aim of this study is to evaluate the effect anorganic bovine-derived xenograft. Total of 20 patients, with 10 patients receiving only modified widman flap, and the other 10 receiving anorganic bovine-derived xenograft and flap surgery, were included in the study. Clinical parameters were recorded before surgery and after 6 months. The results are as follows: 1. The test group treated with anorganic bovine-derived xenograft showed reduction in periodontal pocket depth and clinical attachment level with statistically significance(p<0.001) after 6 months. The control group treated with only modified Widman flap showed reduction only in periodontal pocket depth with statistically significance(p<0.001) after 6 months. 2. Although periodontal probing depth change during 6 months did not show any significant differences between the test group and the control group, clinical attachment level gain and re-cession change showed significant differences between the two groups(p<0.05). On the basis of these results, anorganic bovine-derived xenograft improves probing depth and clinical attachment level in periodontal intrabony defects. Anorganic bovine-derived xenograft could be a predictable bone substitute in clinical use.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.465-478
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• 2007

Various periodontal barrier membranes used in many clinical and experimental fields, and many recent studies of membranes have reported good results. To improve clinical results, selection of barrier membranes is an important factor. So, we need not only to evaluate various barrier mem-branes, but also to understand the property of barrier membranes appropriate to defect characteristics. For this purpose, this study reviewed available literature, evaluated comparable experimental models, and compared various barrier membranes. From above mentioned methods, the following conclusions are deduced. 1. In i-wall periodontal defect models, new bone formation showed a consistent result, almost 30% of the defect size. New cementum formations measured mostly 40% of the defect size, but showed more variations than new bone formations. This seems to be resulted form difference in experimental methods, so standardization in experimental methods is needed for future studies. 2. Application PLGA barrier membrane to periodontal defect demonstrated improved healing in new bone and new cementum. 3. There was a minimal periodontal regeneration with calcium sulfate barrier membrane only. But, there was better healing pattern in combination of calcium sulfate membrane with bone graft material, such as DFDBA, 4. There was no significant difference between the experimental group that used chitosan mem-brane only and the control group. But, in combination with bone graft material for space maintanence, periodontal regeneration was improved. Overall, Space maintenance is a critical factor for Guided tissue regeneration using barrier membranes. Also, a barrier membrane itself that has difficulty in maintaining space, achieved better result when used with graft material.

• Journal of Periodontal and Implant Science
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• v.29 no.2
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• pp.433-447
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• 1999

The objective of this study was to evaluate the effect a chewable tablet containing sodium flouride and lauroyl sodium sulfate on removing plaque and inhibiting gingival inflammation. A randomized parallel study was designed. 100 voluteers participated in the study. There were two test groups each with 30 subject. Test group A was instructed to brush once in the morning, and to use the tablet once in the afternoon and once in the evening. Test group B was instructed to use the tablet three times a day without brushing. There were two control groups each with 20 subjects. Control group A was instructed to brush once in the morning only. Control group B was instructed not to brush all. Two weeks before the test period, the subjects received through tooth cleaning and polishing. At baseline, GI, PI, BOP, and GCF of the Ramfjord teeth were measured in all groups. Bacteria culture was done with the plaque sampled from tooth with the deepest pocket. After 5 days, clinical indices were measured and the bacterial culture was repeated. Control group B was dropped from the study after this period. All the other groups remained and the indices and the culture was repeated after 2 weeks, and 3weeks. Also whether the oral mucosa showed signs of irritation was monitored throughout the test period. Test group A showed less PI, GI, BOP, probing depth, GCF than test group B or control group A. Especially, PI and the BOP was significantly less than that of the group that was instructed to brush once a day. This implies that the added use of this tablet aids in plaque removal in people who brush just once a day. Test group A showed increase of cocci, decrease of motile rods, and decrease of spirochetes after 14-21 days. And this was significantly different from the control group A. At no time of the test period did any of the subjects show signs of irritation of the oral mucosa or adverse reactions. Following conclusions could be obtained from this study. This chewable tablet for enhanced oral hygiene could be used as an adjunct to oral hygiene in people who do not brush adequately. The use of this tablet decreased the number of subgingival bacteria, and this could be effective in plaque removal and for prevention of gingival inflammation.

• Journal of Periodontal and Implant Science
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• v.30 no.3
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• pp.491-504
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• 2000

In clinical therapy, the current goal of dental implants is to enhance quantity and quality of osseointegration. Surface roughness and oxide structure are considered to influence the behavior of adherent cells. The purpose of this study is to evaluate the effect of different surface treatment on cellular response. The attachment and proliferation of osteoblast-like cell on sandblasted, sandblasted and etched, thermal oxidated surfaces have been compared. Sandblasting was done with $Al_2O_3$ particles(grain size of $50{\mu}m$), etching was processed with $NH_4OH$ : $H_2O_2$ : $H_2O(1:1:5)$ at $90^{\circ}C$ for 1 minute. Thermal oxidation was followed sandblasting and etching at $400^{\circ}C$, $600^{\circ}C$, $800^{\circ}C$ for 2 hours. Measurement of surface roughness after the different treatment did not show any differences of Ra value between terated surfaces. Cell attachment and proliferation were increased during experiment period, but no difference was observed. SEM evaluation revealed a similar pattern of osteoblast-like cells, well attached with dendritic extension and producing numerous matrix vesicles on cell surface. The results of this study showed that oxide layer alteration by thermal oxidation did not affect the attachment and proliferation of osteoblast-like cells. This suggests the possibility that the cellular responses are further influenced by surface roughness than titaniun oxide structure.

• Journal of Periodontal and Implant Science
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• v.26 no.3
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• pp.771-778
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• 1996

The assessment of alveolar bone changes on dental radiographs to indicate progression of periodontal diseases or healing response to therapy is routine procedure. However, the diagnostic accuracy in detecting small alveolar bone changes is very limited. Recently, guided bone regeneration therapy is popular, but the quantification of new bone is somewhat difficult with conventional evaluation method. To quantificate the amount of new bone, various evaluating methods have been introduced including histomorphometry, radiomorphometry, biochemical analysis, X-ray probe microanalysis, scanning electron microscope backscatter method. In this study, guided bone regeneration using resorbable membrane with & without PDGF-BB is quatificated through histomorphmetry to evaluate the efficacy of histomorphometric analysis. 4 beagle dogs and 8 Sprague-Dawley rats were selected as experimental animals. In beagle dog experiment, $4{\times}4mm$ Class II defects were created in maxillary both second premolars, and biodegradable membrane containing PDGF-BB(experimental group) were covered over one defect, and same membrane without PDGF-BB(control group) were covered over the other defect. At 2 weeks, 5 weeks after surgery, each beagle dogs were sacrificed, and the tissues were treated by undecalcified fixation. In Sprague-Dawley rat experiment, 5mm round defect were created in temporal bone, the same membranes were covered on the defects. At 1 week, 2 weeks after surgery, each rats were sacrificed, and undecalcified fixation were taken. After grinding tissue specimen, we analyse them histomorphometrically using image analysis system. In beagle dog 2 weeks specimens, new bone formation area were $0.03123mm^2$ in experimental group,and $0.03012mm^2$ in control group. At 5 weeks specimens, $0.15324mm^2$ in experimental group, and $0.09123mm^2$ in control group. In Sprague-Dawley rat specimens, new bone fomation area were $0.20448mm^2$ in 1 week experimental group, $0.03604mm^2$ in 1 week control group. At 2 weeks specimens, $0.46349mm^2$ in experimental group, $0.17741mm^2$ in control group. The results indicated that histomorphometric analysis of new bone formation using image analysis system is very effective quantification method to evaluate the efficacy of treatment modalities.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.340-356
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• 1994

The purpose of this study was to assess the clinical and microbiological effect of chlorhexidine rinse and supragingival plaque control following scaling and root planing on adult periodontal disease. 14 patients with adult periodontitis were selected for the study . They had not taken antibiotics for 6 months and history of dental treatment for 6 months before the study. Patients received a supragingival scaling and root planing under local anesthesia, plaque control group was subjected to professional plaque control 2 times for a period 2 week, chlorhexidine rinse group were subjected to twice daily 0.2% chlorhexidine rinse for a period 2 week. Clinical examination (plaque index, gingival index, probing pocket depth) and distribution of the bacteria morphology of subgingival plaque were monitored on baseline (0 week), 1 week, 2 week, 4 week and 6 week. The results were as follows : 1. Plaque index in chlorhexidine rinse group , plaque control group and control group was significantly reduced during all weeks (P<0.05). 2. Probing pocket depth was significantly reduced at 2, 4, 6 week (P<0.05) in chlorhexidine rinse group and control group, plaque control group was significantly reduced during all weeks (P<0.05). 3. Gingival index was significantly improved at 2, 4, 6 weeks(P<0.05) in chlorhexidine group and plaque control group, control group was significantly improved at 1, 2, 4 weeks (P<0.05). 4. Percentage of cocci was significantly increased at 1, 2, 4 and 6 weeks in chlorhexidine rinse group and control group, plaque control group was significantly increased at 2, 4 and 6 weeks(P<0.05). 5. Percentage of non-motile rods in all group were not significantly changed when compared with those of baseline (0 week) (P<0.05). 6. Percentage of motile rods was significantly reduced during all weeks (P<0.05) in chlorhexidine rinse group, plaque control group was significantly reduced at 2, 4, 6 weeks and 1, 2 and 4 weeks in control group. 7. Percentage of spirochetes was significantly reduced during all weeks (P<0.05), plaque control group was significantly reduced at 2, 4, 6 weeks and 1, 2, 4 weeks in control group. This results were suggested that clinical and microbiological effect of chlorhexidine rinse and supragingival plaque control following scaling and root planing on periodontal disease