• The Journal of the Korean dental association
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• v.54 no.4
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• pp.296-305
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• 2016

Narrow zone of attached gingiva and shallow vestibule around the implants might contribute to difficulty of cleasing, periimplant mucositis caused by incomplete cleansing and further peri-implantitis. The aim of this case report is to present modification of soft tissue biotype around the implants by free gingival grafts according to timing of surgical intervention and shape of free gingiva. A 44 year-old male patient had a missing area on lower right second molar area with 1 to 2 mm of narrow attached gingiva zone and wanted to be treated by implant placement. In radiographic analysis, there was enough alveolar bone to install an implant, free gingiva from hard palate was grafted following implant placement using double layer flap. The width of attached gingival was increased to 4 to 5mm and well maintained during 5 months of follow up. A 69 year-old female patient also had a missing area on lower right first and second molar area with 1 to 2 mm narrow attached gingiva. Since she had systematically angina pectoris and dental phobia, minimal invasive free gingival graft after implants placement was planned. After 2 months of implant surgery, free gingival graft surgery was performed with healing abutments connection. The grafted gingiva was composed of two strip shaped free gingiva, and they were immobilized by periodontal pack. The width of attached gingival was increased to 4 to 5mm and well maintained during 10 months of follow up. With prosthesis delivery, the patients recovered ideal periodontal environment around implants and masticatory function. In conclusion, periodontal health and masticatory function could be achieved through implant placement and free gingival graft.

• Korean Journal of Cleft Lip And Palate
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• v.15 no.2
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• pp.89-96
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• 2012

Le Fort 1 osteotomy or maxillary advancement with distraction osteogenesis (DO) is main treatment strategy for cleft palate patients with maxillary hypoplasia. Maxillary DO allows greater maxillary advancement within physiological limit than Le Fort 1 osteotomy. Moreover, it is better for velopharyngeal function. However, there is a greater tendency for an increase in nasal sound when maxilla is advanced excessively. Therefore, the advancement of anterior maxillary segment using DO has been utilized. It offers advantages such as an increase in the length of the palate, a prevention of the change in palatopharyngeal depth, and a preservation of the velopharyngeal function. Moreover, it will obliterate the necessity of bone graft, and it prevents the occurrence of oronasal or oroantral fistula. Finally, it stimulates the regeneration of the soft and hard tissue of alveolus, and subsequently makes possible to place implant.

• Korean Journal of Plant Tissue Culture
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• v.25 no.5
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• pp.295-299
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• 1998

To detect the effects of gelling agent brands and concentration on rice anther culture, anthers of rice(O. sativa L. japonica, cv, Nagdongbyeo) were inoculated on N6-Y1 basic media supplemented with 0.4~1.6% Bacto agar(Difco, 04140-01), Agarose(Sigma, Type 1) and 0.2~0.8% Gelrite(Kelco, 143364) as gelling agents. On 0.4% Bacto agar and Agarose media, the frequency of callus formation which was significantly decreased in proportion to gelling agent's concentration was 39% and 55%, respectively. On 0.6% Gelrite media, the frequency of callus formation which was not statistically significant among the 0.2~0.8% concentration was 44%. Calli derived from the higher concentration of gelling agents showed embryogenic with slow growth, small, whitish and hard shape compare to that of the lower concentration. The frequency of green plant regeneration was high not only in calli derived from the higher concentration but also in plant regeneration medium with the higher concentration after callus transfer. Calli derived from the higher concentration was effective to maintain the frequency of green plant regeneration up to 60 days after anther inoculation. Introduction of 0.6~0.8% Geltite for callus formation, then transferred 1.6% Bacto agar and Agarose or 0.8% Gelrite for green plant regeneration was effective to increase anther culture efficiency.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.509-522
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• 2004

This study was performed to compare the clinical effectiveness of two regenerative techniques for class II furcation involvements in human: a combination of bone grafts with PRP vs. GTR with bone grafts. The e-PTFE group was treated with non-absorbable membrane and bone grafts, the PRP group was treated with PRP and bone grafts Pocket depth, clinical attachment level, and gingival recession were measured at baseline and postoperative 6 months. Vertical and horizontal furcation depth were measured by re-entry surgeries at 6 months post-treatment Both groups were statistically analyzed by Wilcoxon signed Ranks Test & Mann-whitney Test using SPSS program (5% significance level). The results were as follows: 1. The change of pocket depth, clinical attachment level, vertical furcation depth and horizontal furcation depth in both groups was decreased significantly at 6 months than at baseline. (p<0.05) 2. The change of gingival recession in both groups was increased significantly at 6 months than at baseline. (p<0.05) 3. The change of alveolar crest absorption in both groups was increased at 6 months than at baseline but there were no statistically significant differences. 4. The change of pocket depth, clinical attachment level, vertical furcation depth and horizontal furcation depth in both groups was increased significantly at 6 months, but there were no statistically or clinically significant differences with both groups. 5. The change of gingival recession and alveolar crest absorption in both groups was increased at 6 months, but there were no statistically or clinically significant differences with both groups. In conclusion, the use of bone graft with PRP or GTR technique improved clinical index of the soft and hard tissue in mandibular class II furcation involvement but there were no statistically or clinically significant differences between bone graft with PRP and GTR technique.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.37.1-37.7
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• 2018

Background: Fibrous dysplasia (FD) is characterized by the replacement of normal bone by abnormal fibro-osseous connective tissue and typically treated with surgical contouring of the dysplastic bone. When dysplastic lesions involve occlusion, not only is surgical debulking needed, orthognathic surgery for correction of dentofacial deformity is mandatory. However, the long-term stability of osteotomized, dysplastic bone segments is a major concern because of insufficient screw-to-bone engagement during surgery and the risk of FD lesion re-growth. Case presentation: This case report reviewed two patients with non-syndromic FD that presented with maxillary occlusal canting and facial asymmetry. Le Fort I osteotomy with recontouring of the dysplastic zygomaticomaxillary region had been performed. The stability of osseous segments were favorable. However, dysplastic, newly formed bone covered the previous plate fixation site and mild bony expansion was observed, which did not influence the facial profile. Including the current cases, 15 cases of orthognathic surgery for FD with dentition have been reported in the literature. Conclusion: The results showed that osteotomy did not appear to significantly reduce the long-term stability of the initial fixation insufficiency of the screw to the dysplastic bone. However, based on our results and those of the others, long-term follow-up and monitoring are needed, even in cases where the osteotomized segment shows stable results.

• Journal of Periodontal and Implant Science
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• v.33 no.1
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• pp.13-26
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• 2003

Periodontal regeneration therapy with bone-substituting materials has gained favorable clinical efficacy by enhancing osseous regeneration in periodontal bony defect. As bone-substituting materials, bone powder, calcium phosphate ceramic, modified forms of hydroxyapatite, and hard tissue replacement polymer have demonstrated their periodontal bony regenerative potency. Bone-substituting materials should fulfill several requirements such as biocompatibility, osteogenecity, malleability, biodegradability. The purpose of this study was to investigate biocompatibility, osteo-conduction capacity and biodegradability of $Na_2O$, $K_2O$ added calcium metaphosphate(CMP). Beta CMP was obtained by thermal treatment of anhydrous $Ca_2(H_2PO_4)_2$. $Na_2O$ and $K_2O$ were added to CMP. The change of weight of pure CMP, $Na_2O$-CMP, and $K_2O$-CMP in Tris-buffer solution and simulated body fluid for 30 days was measured. Twenty four Newzealand white rabbits were used in negative control, positive control(Bio-Oss), pure CMP group, 5% $Na_2$-CMP group, 10% $Na_2O$-CMP goup, and 5% $K_2O$-CMP group. In each group, graft materials were placed in right and left parietal bone defects(diameter 10mm) of rabbit. The animals were sacrificed at 3 months and 6 months after implantation of the graft materials. Degree of biodegradability of $K_2O$ or $Na_2O$ added CMP was greater than that of pure CMP in experimental condition. All experimental sites were healed with no clinical evidence of inflammatory response to all CMP implants. Histologic observations revealed that all CMP grafts were very biocompatible and osseous conductive, and that in $K_2O$-CMP or $Na_2O$-CMP implanted sites, there was biodegradable pattern, and that in site of new bone formation, there was no significant difference between all CMP group and DPBB(Bio-Oss) group. From this result, it was suggested that all experimental CMP group graft materials were able to use as an available bone substitution.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.4
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• pp.364-370
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• 2015

Fixed restoration using implants for patients with posterior partial edentulism is generalized technique. As patient demands increase, the functional and esthetic implant restoration to achieve similar results to lost natural teeth is becoming an important issue. It is inevitable to use customized CAD/CAM abutments rather than ready-made abutments for the creation of implant prosthesis which closely resembles natural teeth. Using CAD/CAM abutment made it possible to obtain natural emergency profiles for posterior implant prostheses, ensuring more comfortable, efficient management of oral hygiene. However, keratinized gingiva with sufficient width and height for a natural emergence profile is required to use a large diameter CAD/CAM abutment which ensures stability and esthetics of hard/soft tissue around the implants. In this case, for esthetical and functional implant zirconia prosthesis, soft tissue graft was performed and customized CAD/CAM abutments were used following ridge augmentation, sinus graft and implantation. Satisfactory results were obtained functionally and esthetically through periodic clinical evaluation, and I hereby report this case.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.113-122
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• 2007

Purpose: Platelet-rich plasma (PRP) is known to accelerate and/or enhance hard and soft tissue healing and regeneration. As such, PRP has been used in various clinical fields of surgery. Recently there have been several attempts to use PRP in the field of tissue engineering. However, some controversies still exist on exact mechanism and benefits of PRP. Therefore various animal experiments are necessary to reveal the effect of the PRP. However, even if animal experiment is performed, the efficacy of the experiment could not be validated due to absence of an animal PRP model. The purpose of this study is to establish rat PRP model by comparing several PRP fabricating methods, and to assay growth factor concentration in the PRP. Materials and methods: Rat blood samples were collected from nine SD rat (body weight: 600-800g). PRP was prepared using three different PRP fabricating methods according to previously reported literatures. (Method 1: 800 rpm, 15 minute, single centrifuge; Method 2: 1000 rpm, 10 minute, double centrifuge; Method 3: 3000 rpm, 4min and 2500 rpm, 8 min, double centrifuge). Platelet counts were evaluated in an automated machine before and after PRP fabrications. In terms of growth factor assay, prepared PRP were activated with 100 unit thrombin and 10% calcium chloride. Growth factor (PDGF-BB, VEGF) concentrations on incubation time were determined by sandwich-ELISA technique. Results: An average of 3ml (via infraorbital venous plexus) to 15ml (via celiac axis) the rat blood could be collected. By using Method 3 (3000 rpm, 4 min and 2500 rpm, 8 min, double centrifugation), around 1.5ml of PRP could be prepared. This method allowed us to concentrate platelet 3.77-fold on average. PDGF-BB concentration (mean, 1942.10 pg/ml after 1 hour incubation) and VEGF concentration (mean, 952.71 pg/ml after 1 hour incubation) in activated PRP were higher than those in untreated blood. Also PDGF-BB showed constant concentration during 4-hour incubation, while VEGF concentration was decreased after 1 hour. Conclusion: Total 11,000 g minute separation and condensation double centrifuge method can produce efficient platelet-rich plasma. Platelet-rich plasma activated with thrombin has showed higher concentrations of growth factors such as PDGF-BB and VEGF, compared to the control group. Platelet-rich plasma model in a rat model was confirmed in this study.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.637-646
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• 2007

Implants placed immediately after tooth extraction have been shown to be a successfully predictable treatment modality. Several clinical papers suggest that placing implants immediately after tooth extraction may provide some advantages: reduction of the number of surgical procedures or patient visits, preservation of the dimensions of alveolar ridge, and shortening of the interval between the removal of the tooth and the insertion of the implant supported restoration. In this case report, three patients received single immediate implant placements to replace a maxillary anterior tooth at the time of extraction. As the three cases were somewhat different, treatment protocols had to be modified as follows: Case 1. Immediate implant placement with healing abutment connection. Case 2. Immediate implant placement with immediate provisionalization. Case 3. Immediate implant placement with Guided Bone Regeneration(GBR). Every implant of these cases was placed in proper position buccolingually, mesiodistally and apicocoronally, The procedures following implantation such as immediate provisionalization and GBR were free of problem. Healing of each case was uneventful. In all cases, treatment outcomes were mostly satisfactory and the results maintained during follow-up periods. However, one case (Case 3) showed some papilla loss due to failure in delicate soft tissue handling during surgery. This papilla loss was compromised by prosthetic means. In conclusion, immediate implant placement in the fresh extraction socket can be a valid and successful option of treatment in aesthetic area. Moreover, this treatment protocol seems to maintain the preexisting architecture of soft and hard tissues in most cases.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.621-628
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• 2008

Purpose: Osteopontin is one of the major non-collagenous protein of hard tissue. Use of peptide domain of biologically active protein has some advantages. The objective of this experimental study is evaluation of periodontal regenerative potency of synthetic peptide gel which containing collagen binding domain of osteopontin in the degree III periodontal defect of beagle dogs. Material and Methods: Experimental degree III furcation defect was made in the mandibular third and fourth premolar of beagles. Regenerative material was applied during flap operation. 8 weeks after regenerative surgery, all animals were sacrificed and histomorphometric measurement was performed to calculate the linear percentage of the new cementum formation and the volume percentage of new bone formation. Result: The linear percent of new cementum formation was 41.6% at control group and 67.1% at test group and there was statistically significant difference. The volume percent of new bone formation was 52.1% at control group and 58.9% at test group. Conclusion: As the results of present experiment, synthetic peptide gel containing collagen binding domain of osteopontin significantly increase new bone and cementum formation in the degree III furcation defect of canine mandible.