• Imaging Science in Dentistry
• /
• v.31 no.1
• /
• pp.35-42
• /
• 2001

Purpose: To evaluate the usefulness of fractal analysis for diagnosis of periodontitis. Materials and Methods : Each 30 cases of periapical films of male mandibular molar were selected in normal group and patient group which had complete furcation involvement. They were digitized at 300 dpi, 256 gray levels and saved with gif format. Rectangular ROIs (10×20 pixel) were selected at furcation, interdental crest, and interdental middle 1/3 area. Fractal dimensions were calculated three times at each area by mass radius method and were determined using a mean of three measurements. We compared fractal dimensions at furcation and interdental crest area of normal group with those of patient group. And then we compared ratio of fractal dimensions at furcation area, interdental crest area to interdental middle 1/3 area. Results: Fractal dimension at interdental crest area of normal group was 1.979±0.018 and that of patient group 1.971±0.012 (p>0.05). Fractal dimension at furcation area of normal group was 1.986±0.024 and that of patient group 1.974±0.015 (p<0.05). The ratio of fractal dimension at interdental crest area to interdental middle 1/3 of normal group was 1.003±0.015 and that of patient group 0.993±0.018 (p<0.05). The ratio of fractal dimension at furcation area to interdental middle 1/3 of normal group was 1.006±0.018 and that of patient group 0.994±0.018 (p<0.05). Conclusion : The ratio of fractal dimension at interdental crest and furcation area to interdental middle 1/3 area showed a statistically significant difference between normal and patient group. In conclusion, it is thought that fractal analysis might be useful for the diagnosis of periodontitis.

• Imaging Science in Dentistry
• /
• v.47 no.1
• /
• pp.17-24
• /
• 2017

Purpose: The purpose of this study was to assess the accuracy, sensitivity, and specificity of the diagnosis of incipient furcation involvement with periapical radiography (PR) and 2 cone-beam computed tomography (CBCT) imaging protocols, and to test metal artifact interference. Materials and Methods: Mandibular second molars in 10 macerated pig mandibles were divided into those that showed no furcation involvement and those with lesions in the furcation area. Exams using PR and 2 different CBCT imaging protocols were performed with and without a metallic post. Each image was analyzed twice by 2 observers who rated the absence or presence of furcation involvement according to a 5-point scale. Receiver operating characteristic (ROC) curves were used to evaluate the accuracy, sensitivity, and specificity of the observations. Results: The accuracy of the CBCT imaging protocols ranged from 67.5% to 82.5% in the images obtained with a metallic post and from 72.5% to 80% in those without a metallic post. The accuracy of PR ranged from 37.5% to 55% in the images with a metallic post and from 42.5% to 62.5% in those without a metallic post. The area under the ROC curve values for the CBCT imaging protocols ranged from 0.813 to 0.802, and for PR ranged from 0.503 to 0.448. Conclusion: Both CBCT imaging protocols showed higher accuracy, sensitivity, and specificity than PR in the detection of incipient furcation involvement. Based on these results, CBCT may be considered a reliable tool for detecting incipient furcation involvement following a clinical periodontal exam, even in the presence of a metallic post.

• Journal of Periodontal and Implant Science
• /
• v.25 no.2
• /
• pp.407-417
• /
• 1995

In order to evaluate the effect of platelet-derived growth factor(PDGF-BB) and guided tissue regeneration(GTR) technique on the regeneration of destructed periodontal tissue,intentional through-and-through furcation defects(4mm in height) were made on both mandibular 2nd and 4th premolars of 8 adult male dogs(30-40lb). Experimental group 1 was composed of the premolars that were treated by only topical application of PDGF-BB with 0.05M acetic acid without any barrier membrane. Experimental group 2 was composed of the premolars that were treated by GTR with expanded polytetrafluoroethylene membrane(ePTFE : Gore-tex periodontal material, USA). Experimental group 3 was composed of the premolars that were treated by GTR with ePTFE after topical application of PDGFBE. Control group was composed of the premolars that were treated by coronally positioned flap operation only without use of PDGF-BB and ePTFE membrane. All ePTFE membranes were carefully removed 4 weeks after regenerative surgery, and all experimental animals were sacrificed 8 weeks after regenerative surgery. The light microscopic findings were as follows ; (1) In experimental group 1, rapid new bone formation along the-root surface with multiple ankylosis and root resorption by multinucleated giant cells, and dense connective tissue in the central portion of the furcation defects were observed. (2) In experimental group 2, it was observed that the furcation defects were filled with newly formed bone, Sharpey's fibers were embedded into new cementum on root dentin of furcation fornix area, but the central portion and the area under furcation fornix were still filled with dense connective tissue. (3) In experimental group 3, the furcation defects were regenerated with newly formed dense bone and regular periodontal ligament with Sharpey's fibers embedded into newly formed cementum and bone underneath fornix area. (4) In control group, unoccupied space, apical migration of epithelium, dense infiltration of inflammatory cells in subepithelial connective tissue in relation to heavy plaque accumulation, and root resorption by inflammatory reaction were shown, but any new cementum formation on resorbed dentin surface could not be observed. The present study demonstrated that the combined therapy of PDGF-BB and GTR could enhance the regeneration of destructed periodontal tissue.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.33 no.3
• /
• pp.482-490
• /
• 2006

Deep caries in primary molars without early intervention frequently induce a pulpal disease and consequent abscess lesion in surrounding tissue. Especially in many furcation radiolucent lesions of primary molars, accessory canals in furcation areas of primary molars play an important role in theses pathological progress. Although the studies of these communication canals in furcation area of human permanent molar well documented, there has been little research showing their existence in primary molar. For the purpose of understanding the morphological characteristics of accessory canals at furcation areas of primary molars and examining its frequency and patency, 52 specimen teeth were observed under the scanning electro-microscope and tested with dye penetration under vacuum pressure, and obtained the results as follows : 1. In SEM study, the frequency of accessory foramina viewed from the external and internal furcation area was 60% and 35% respectively. Likewise the diameter of the accessory canals was within the range of $11{\sim}107{\mu}m$ and $12{\sim}62{\mu}m$ respectively. 2. The frequency of patent accessory canals evidenced by the dye penetrated under the vacuum suction at furca areas in primary molars was 50% among the 20 specimen teeth tested.

• Journal of Periodontal and Implant Science
• /
• v.27 no.1
• /
• pp.205-215
• /
• 1997

In periodontal regeneration treatment, access to the frucation area is very difficult. Thus complete removal of plaque, calculus and endotoxin is somewhat impossible. In this study, teeth that were extracted due to periodontal disease were used. The furcation area was treated with periodontal curette, ultrasonic scaler, roto bur and they observed using SEM. The result was follows 1. The group treatment with curette showed remaining plaque, the cementum existed in most of the surface and partial dentinal tubule orifice could be seen. 2. The group treatment with ultrasonic scaler showed less removalof plaque compared to curette and irregular surface could be seen. 3. The group treatment with roto bur showed cleaner surface and many dentinal tubule orifice could be seen compared to the curette and ultrasonic scaler groups. Thus when suing treatments such as bone grafting or guided tissue regeneration, it is considered that the furcation area should be treatment with Roto bur.

• Journal of Periodontal and Implant Science
• /
• v.35 no.1
• /
• pp.177-185
• /
• 2005

The purpose of the study was to investigate the influence of an endodontic infection on presence of furcation involvement in periodontally-involved mandibular molars. All first and second mandibualr molars in 45 patients were selected if at least one was root-filled or had a possible periapical radiolucency. The sample consisted of patients from a referral population at a periodotnal clinic which represented an adult population with a mean age of 47.5 years (range 31 to 63) For mandibular molars with periapical destruction at both roots, frequency of horizontal furcation depth ${\geqq}$ 3 mm was significantly more compared to teeth without periapical destruction. Mean periodontal probing depth was significantly greater at mandibular molars with periapical destruction. It is suggested that a root canal infection in periodontitis-involved molars may potentiate periodontitis progression by spreading of endodontic pathgens through patent accessory canals and dentinal tubules. In conclusion, an endodontic infection in mandibular molars was found to be associated with additional attachment loss in the furcation area, and may thus be considered to be one of several risk factors influencing the prognosis of molars in periodontitis-prone patients.

• Restorative Dentistry and Endodontics
• /
• v.19 no.1
• /
• pp.73-84
• /
• 1994

Using a model system that can compare the before and after of canal preparation in the same tooth, we measured the area of the cross section, and canal wall thickness of the distal portion of the mesial root of the mandibular molar, and compared the amount of reduction in the canal using hand flared preparation the Gates-Glidden drill flared preparation according to the changes in the MAF. The results were as follows. 1. After canal preparation, the canal wall thickness had no significant difference between the hand flared preparation and Gates-Glidden drill flared preparation. 2. The canal wall thickness, after canal preparation, there was no significant difference between the sizes of the MAF. 3. The area variation range of each cross section of root had no significant difference between MAF size and methods of canal preparation. 4. After canal preparation, the frequency of the canal wall thickness under 0.5mm showed 3.5mm below the furcation to be the most frequent with statistical significance(p<0.05). 2mm below the furcation and 5mm below the furcation followed but there was no statistical significance. 5. The danger zone of the mesial root of the mandibular molar seems to be around 3.5mm.

• Journal of Periodontal and Implant Science
• /
• v.26 no.4
• /
• pp.859-872
• /
• 1996

The purpose of this study was to evaluate the effect of low concentrative ${\beta}-APN$ on the periodontal ligament and relationship between lathyrintic bodies and osteoclast cells near the by alveolar bone. Mandibles including teeth and periodontiums of 24 Sprague-Dawley rat was used. ${\beta}-APN$ 0.2g/kg/day soluted in mineral water was administrated for 5 days before sacrifice in experimental group. 3 rats on each day was sacrificed on 1, 3, 7, 11 days after stop administration ${\beta}-APN$. Histologic examination and the activity of osteoclasts by tartrate resistant acid phosphatase was observed. The results were as follows : 1. In experimental group, the The small foci of lathyrintic bodies surrounded by palisading fibroblasts were seen obviously on 1, 3 days and decreased after 7 days. On 11 days, fibroblasts of periodontal ligament similar to control group. 2. The lathyrintic bodies were seen in the middle zone of periodontal ligament of pressured area like furcation area, alveolar crest, bone resorption area than tensioned area of apposition area. 3. In experimental group of 1, 3 days, lathyrintic bodies were much seen in the area that osteoclasts was much distributed area. After 7 days, experimental group was seen the control group. In conclusion, rathyrintic bodies were formed by low concentrative ${\beta}-APN$ chiefly on the pressured area like furcation area, alveolar crest, bone resorption area than tensioned area of apposition side in periodontal tissue and concerned with osteoclast cells.

• Journal of Periodontal and Implant Science
• /
• v.26 no.3
• /
• pp.735-751
• /
• 1996

An ultimate goal of periodontal therapy is to stop the disease process and to regenerate a functionally-oriented periodontium destroyed as a result of periodontal disease. The purpose of this study was to observe the effect of grafting granulation tissue obtained from extraction socket on the regeneration of horizontal furcation defect. Six dogs were used in this study. All mandibular first and third premolars were extracted. At 2, 3, and 5 days after extraction, tissues were obtained from extraction socket of 1 mongrel dog and examined by light microscope. Granulation tissue obtained at 5 days after extraction was chosen as the graft material. Five days later, horizontal furcation defects were created surgically at mandibular second and fourth premolars in the right and left side of the 5 beagle dogs. The entrance area of the artificially prepared "key hole" defects were about $3\;4mm^2$. By random selections, 2 exposed furcation defects were grafted with granulation tissue obtained from extraction socket as experimental group and 1 furcation defect was as control. The flaps were replaced to their original position and sutured with 4-0 chromic cat-gut. Three dogs were sacrificed 4 weeks and two dogs 8 weeks after surgery, and the prepared specimens were examined by light microscope. At 4 weeks, furcations were filled with epithelial lining and fibrous connective tissue infiltrated with chronic inflammatory cells. New bone formation was observed in all groups. Only experimental group showed new cementum formation. At 8 weeks, new cementum, functional arrangement of new PDL fiber, root resorption, and some ankylotic union of newly formed alveolar bone and root surface were observed in all groups. Experimental group showed that epithelial downgrowth was inhibited and new bone formation was more active compared to control. The success rate of the furcation defect healing was higher in experimental group than control. These results suggested that grafting of granulation tissue obtained from extraction socket which combined with reconstructive periodontal flap surgery may promote periodontal regeneration of horizontal furcation defect.

• Journal of Periodontal and Implant Science
• /
• v.23 no.3
• /
• pp.475-492
• /
• 1993

The effect of synthetic bone materials was assessed in the patients with pure periodontal class II and III furcation defects. The buccal aspects of the maxillary and mandilular first and second molars were surgically exposed, and synthetic bone materials were interposed between the gingival flap and the furcation defects in the experimental group. The control group were treated without the use of synthetic bone materials by same operator. Probing pocket depth, gingival recession, and loss of attachment, were measured by Michigan O-probe and tooth mobility was evaluated by an electronic mobility tester(Periotest(R), Siemens co. Germany) at preoperation and 3-, 6-, and 12-month postoperation. Standardized radiogrphs were taken at preoperation and 6-month and 12-month postoperation. The postoperative change of clinical parameters and the difference between experimental group and control group were statistically analyzed by Student, t-test. The results were as follows: 1. The probing pocket depth at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at preoperative examination in both experimental group and control group(P<0.005), but there was no significantly difference between experimental group and control group. 2. The amount of gingival recession at the 3-, 6-, and 12-month postoperative examination was increased, compared to that at the preoperative examination in both experimental and control group(P<0.005). In the case of the class III furcation involvement, the amount of gingival recession at the 3-, 6-, and 12-month postoperative examination was more significantly increased in control group than experimental group(P<0.05). 3. The amount of loss of attachment at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at the preoperative examination in both experimental and control group in the case of class II furcation involvement, and in experimental group only in the case of furcation III involvement(P<0.005). The amount of loss of attachment at, the 3-, 6-, and 12-month postoperative examination was more significantly decreased in experimental group than control group in the case of the class III furcation involvement(P<0.05), but in the case of class II furcation involvement there was no significant difference between experimental group and control group. 4. The tooth mobility at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at the preoperative examination in both experimental and control group(P<0.005), but there was no significant difference between experimental group and control group. 5. Radiopacity of furcation area was greatly increased in the experiment group, but there was no radiographic change in the control group.