• Restorative Dentistry and Endodontics
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• v.39 no.2
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• pp.115-119
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• 2014

As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning.

• The Journal of the Korean dental association
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• v.48 no.9
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• pp.654-663
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• 2010

The success in periodontal-prosthetic therapy lies in patient satisfaction with subjective and customized treatment regimen that has been refined for individual needs. To fulfill these requirements, multiple predictors may have to be taken into consideration in the comprehensive treatment planning. Incorporation of complex factors that guarantee the evidence-based therapy would include, but not limited to, osseous morphology, biotype of gingival around abutment, bone morphology of interdental bone and those around furcation area, abutment or bridge mobility. The periodontal-restorative interface should be of mutually protective. Also strategic and esthetic value of abutment teeth to be restored should also be taken into consideration. Taken together, all these should work in concert to enhance the predictability and longevity of abutment teeth in periodontal-prosthetic therapy.

• Journal of Periodontal and Implant Science
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• v.53 no.3
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• pp.173-183
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• 2023

Purpose: Treatment for periodontitis has evolved over the years as new technologies have become available. Currently, lasers seem attractive as a treatment modality, but their effectiveness needs to be verified. The purpose of this project was to evaluate Laser Assisted New Attachment Procedure^® (LANAP^®) surgery as a single treatment modality. Methods: As part of a mandatory training program for periodontists and other dentists, 22 consecutive patients diagnosed with moderate to severe periodontitis (probing depth [PD] up to 11 mm) were treated with the LANAP^® surgical approach using a 1064-nm Nd:YAG laser as part of a multi-step protocol. Following single-session active therapy, they were entered into a maintenance program. Their clinical status was re-evaluated at 12-18 months following surgery. Results: All 22 patients completed the 12- to 18-month follow-up. PD, clinical attachment level, and furcation (FURC) showed substantial improvement. Recession was minimal (mean, 0.1 mm), while 93.5% of PD measurements were 3 mm or less at re-evaluation. Furthermore, 40% of grade 2 FURC closed clinically. Conclusions: Within the limits of this case series, LANAP^® was found to be an effective, minimally invasive, laser surgical therapy for moderate to advanced periodontitis.

• Journal of Periodontal and Implant Science
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• v.24 no.1
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• pp.1-14
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• 1994

Dental calculus which is calcifing and/or calcified dental plaque is divided into supragingival calculus and subgingival calculus according to the position of deposit to gingival margin. Subgingival calculus has more important clinical significance in diagnosis and treatment of periodontal disease than supragingival calculus. In order to investigate the deposition pattern of subgingival calculus on each root surface of different tooth type, extracted 192 teeth due to excessive destruction of periodontal tissue were divided according to tooth type and the deposition pattern of subgingival calculus was classified into linear type, veneer type, scattered type, and aggregated type according to the configuration and the extent of deposit. The difference of percentage between each deposition pattern was statistically analyzed by Chi-Square test. Following results were obtained : l. In maxillary incisors, linear type and aggregated type were predominant deposition pattern of subgingival calculus on labial(45.5%, 36.4%) and palatal(36.4%, 36.4%) root surface, aggreated type(72.7%) was on mesial surface, and aggregated type(54.5%) and scattered type(36.4%) was on distal suface. 2. In mandibular incisors, scattered type, linear type and aggregated type were predominant deposition pattern of subgingival calculus on labial(33.3%, 30.6%, 27.8%) and lingual(36.1%, 30.6%, 25.0%) root surface, aggregated type(33.3%), scattered type(27.8% ), and veneer type(27.8%) were on mesial surface, and aggregated type(38.9%) and scattered type(33.3%) on distal surface. 3. In maxillary peremolars, the predominant deposition patterns of subgingival calculus were linear type(28.6%) on buccal root suface, scattered type(35.7%) and linear type(28.6%) on palatal surface, scattered type(39.3%) on mesial surface, aggregated type(46.4%) on distal surface, and aggregated type(53.6%) on furcation area. 4. In mandibular premolars, scattered type was predominant deposition pattern of subgingival calculus on buccal(39.3%) and lingual(50.0%) root surface, scattered type(32.1%) and aggregated type(32.1% ) were on mesial surface, and aggregated type(42.9%) was on distal surface. 5. In maxillary molars, aggregated type(40.0%) and scattered type(32.5%) were predominat deposition pattern of subgingival calculus on buccal root surface, aggregated type was on distal(40.0%) and furcation area(50.0%), but there was no predominat pattern on palatal and mesial root surfaces. 6. In mandibular molars, aggregated type(39.5%) and scattered type(28.9%) were predominant deposition patterns of subgingival calculus on buccal root surface, aggregated type(36.8%) was on lingual surface, linear type(39.5%) and aggregated type(34.2%) were on furcation area, but there was no predominant pattern on mesial and distal root surfaces.

• Journal of Periodontal and Implant Science
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• v.38 no.1
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• pp.97-102
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• 2008

Purpose: Periodontal intrabony defects have great deal of importance since they contribute to the development of periodontal disease. Current treatment regimens for intrabony defects involve grafting of numerous bony materials, GTR using biocompatible barriers, and biomodification of root surface that will encourage the attachment of connective tissue. Xenograft using deproteinized bovine bone particles seems to be very convenient to adjust because it doesn't require any donor sites or imply the danger of cross infections. These particles are similar to human cancellous bone in structure and turned out to be effective in bone regeneration in vivo. We here represent the effectiveness of grafting deproteinized bovine bone particles in intrabony defect and furcation involvements that have various numbers of bony walls. Materials and methods: Open flap debridement was done to remove all root accretions and granulation tissue from the defects within persisting intrabony lesions demonstrating attachment loss of over 6mm even 3 months after nonsurgical periodontal therapy have been completed. Deproteinized bovine bone particles($BBP^{(R)}$, Oscotec, Seoul) was grafted in intrabony defects to encourage bone regeneration. Patients were instructed of mouthrinses with chlorohexidine-digluconate twice a day and to take antibiotics 2-3 times a day for 2 weeks. They were check-up regularly for oral hygiene performance and further development of disease. Probing depth, level of attachment and mobility were measured at baseline and 6 months after the surgery. The radiographic evidence of bone regenerations were also monitored at least for 6 months. Conclusion: In most cases, radio-opacities increased after 6 months. 2- and 3-wall defects showed greater improvements in pocket depth reduction when compared to 1-wall defects. Class I & II furcation involvements in mandibular molars demonstrated the similar results with acceptable pocket depth both horizontally and vertically comparable to other intrabony defects. Exact amount of bone gain could not be measured as the re-entry procedure has not been available. With in the limited data based on our clinical parameter to measure pocket depth reduction following $BBP^{(R)}$ grafts, it was comparable to the results observed following other regeneration techniques such as GTR.

• Journal of Periodontal and Implant Science
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• v.33 no.1
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• pp.91-102
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• 2003

Several effective treatment methods and materials have been developed for the treatment of furcation involvement. Currently, the combination of guided tissue regeneration (GTR) and bone grafts is the most commonly prescribed method of treating furcation involved defects. But because these cases often present with poor accessibility, placement of the membrane may be difficult and consequently, clinically impractical. In this study, the alveolar bone healing patterns of adult beagle dogs presenting with alveolar bone destruction treated by one of two methods - treatment using solely bone allografts (BBP(R)), or treatment using bone allografts (BBP(R)) stabilized by a fibrin adhesive - were comp ared. The effects of the fibrin adhesive on the initial stabilization of the newly formed bone, subsequent regeneration of bone, and the feasibility of the clinical application of the fibrin adhesive were analyzed. The results of the study were as follows: 1. Clinical signs of inflammation at the 4-8 week interval were not observed: but signs of mild inflammation were histologically observed at the 4-week interval. 2. Allografts stabilized by fibrin adhesive showed good bone formation, whereas defects treated with only the allograft material showed incomplete alveolar bone regeneration. 3. Allografts stabilized by fibrin adhesive showed a decrease in the amount old bone with a concurrent increase in the formation of new lamellar bone four weeks post-op, whereas defects treated with only the allograft material showed no new lamellar bone formation at the same interval. 4. In detects treated with only the allograft material, the defective area was filled with connective tissue 8-weeks post-op, whereas fibrin adhesive stabilized allografts showed viable connections between the original bone and the newly formed bone, in addition to neovascularization 8-weeks post-op. The results of this study show that concurrent use of fibrin adhesive materials can stabilize the allograft material and aid in new bone formation Although the stability of fibrin adhesives fall short of the results achievable by GTR membranes, in cases presenting with poor accessibility that contraindicate the use of membranes, fibrin adhesive materials provide a viable and effective alternative to graft stabilization and new bone formation.

• The Journal of the Korean dental association
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• v.50 no.9
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• pp.574-585
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• 2012

Purpose : This study was performed to evaluate the healing response around the root perforation restorative material. Materials and Methods : Four beagle dogs were used for experimental study. Endodontic treatment was performed at four maxillary premolars and artificial perforation was formed at furcation area of pulp chamber. Canal was filled with gutta percha cone and the perforation was sealed with MTA at group 1. At group 2, canal was filled and the perforation was sealed with dentin paste. Tooth paste was fabricated using extracted human teeth. Histologic examination of furcation area was performed 2, 4, 8 and 12 weeks after experiment. Results : New trabecular bone formation was observed around the MTA and tooth paste. Lamellar bone was observed as time is over. There were no inflammatory reaction in both groups. Conclusion : There is a possibility which endodontic filling material can be developed using extracted teeth.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.173-186
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• 2002

The purpose of this study was to evaluate effect of platelet rich plasma on the treatment of Grade II furcation involvement, with Demineralized Freeze-Dried Bone(Dembone(R)) and bioabsorable membrane(BioMesh(R)) in humans by digital subtraction radiography. 12 teeth(control group) were treated with Demineralized Freeze-Dried Bone(Dembone(R)) and bioabsorable membrane(BioMesh(R)), and 12 teeth(test group) were treated with Demineralized Freeze-Dried Bone(Dembone(R)), bioabsorable membrane(BioMesh(R)) and Platelet Rich Plasma. The change of bone density was assessed by digital subtraction radiography in this study. The change of mineral content by as much as 5%(vol) could be perceived in the subtracted images. The change of mineral content was assessed in the method that two radiographs are put into computer program to be overlapped and the previous image is subtracted by the later one. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-whitney Test using SPSS program (5% significance level). The results were as follows: 1. In test group, the radiopacity in 3 months after surgery were significantly increased than 1 month after surgery(p<0.05). However. there were no significant difference between 1 month after surgery and 3 months after surgery in control group(p>0.05). 2. In test and control group, the radiopacity in 6 months after surgery were significantly increased than 1 month after surgery(p<0.05) 3. In test and control group, the radiopacity in 6 months after surgery were significantly increased than 3 months after surgery(p<0.05). 4. There were no significant difference between test group and control group at 1 month, 3 months after surgery, but radiopacity in test group were significantly increased than control group at 6 months after surgery(p<0.05). In conclusion, Platelet Rich Plasma can enhance bone density.

• Imaging Science in Dentistry
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• v.37 no.2
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• pp.103-110
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• 2007

Purpose: To examine the danger zone of mesial root of mandibular first molar of patient without extraction using CBCT (cone-beam computed tomography) to avoid the risk of root perforation. Materials and Methods: 20 mandibular first molars without caries and restorations were collected, CT images were obtained by CBCT ($PSR9000N^{TM}$, Asahi Roentgen Co., Japan), reformed and analyzed by V-work 5.0 (CyberMed Inc., Korea), Distance between canal orifice and furcation was measured. In cross sectional images at 3, 4 and 5 mm below the canal orifice, distal wall thickness of mesiobuccal canal (MB-D), distal wall thickness of mesiolingual canal (ML-D), distal wall thickness of central part (C-D), mesial wall thickness of mesiobuccal canal (MB-M) and mesial wall thickness of mesiolingual canal (ML-M) were measured, Results: The mean distance between the canal orifice and the furcation of the roots is 2.40 mm, Distal wall is found to be thinner than mesial wall. Mean dentinal wall thickness of distal wall is about 1 mm, The wall thickness is thinner as the distance from the canal orifice is farther. But significant differences are not noted between 4 mm and 5 mm in MB-D and C-D, MB-D is thinner than ML-D although the differences is not significant. Conclusion: The present study confirmed the anatomical weakness of distal surface of the coronal part of the mesial roots of mandibular first molar by CBCT and provided an anatomical guide line of wall thickness during endodontic treatment.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.465-475
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• 2001

The purpose of this study was to evaluate effect of platelet rich plasma on the treatment of Grade II furcation involvement, with and without porous resorbable calcium carbonate($Biocoral^{(R)}$)in humans by digital subtraction radiography. 15 teeth(control group) were treated with porous resorbable calcium carbonate($Biocoral^{\(R)}$), and 15 teeth(test group) were treated with porous resorbable calcium carbonate($Biocoral^{(R)}$) and Platelet Rich Plasma. The change of bone density was assessed by digital subtraction radiography in this study. The change of mineral content by as much as 5%(vol) could be perceived in the subtracted images. The change of mineral content was assessed in the method that two radiographs are put into computer program to be overlapped and the previous image is subtracted by the later one. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-whitney Test using SPSS program(5% significance level). The results were as follows: 1. In test group, the radiolucency in 3 months after surgry were significantly increased than 1 month after surgery(p<0.05). 2. In test group, there were no significant difference between 1 month after surgery and 6 months after surgery(p>0.05). 3. In test group, the radiopacity in 6 months after surgery were significantly increased than 3 months after surgery(p<0.05). 4. In control group, the radiolucency in 3 months and 6 months after surgery were significantly increased than 1 month after surgery(p<0.05). 5. In control group, the radiopacity in 6 months after surgery were significantly increased than 3 months after surgery(p<0.05). 6. There were no significant difference between test group and control group at 1 month, 3 months after surgery, but radiopacity in test group were significantly increased than control group at 6 months after surgery(p<0.05). In conclusion, Platelet Rich Plasma can enhance bone density.