• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.581-591
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• 2004

Calcium carbonate(CC) is biocompatible and gradually absorb to be replaced by bone when implanted into bone tissue. Fibrin-fibronectin sealant system (FFSS) is a product of human-derived plasma. The effect is hemostasis, tissue fixation and adhesion, We expect synergic effects of this two materials in periodontal regeneration. When FFSS was grafted with bone graft in intrabony defects, could be eliminated exofolication of bone graft materials. This study evaluated above materials for periodontal regeneration of 6mm intrabony defects in 36 patients. lap surgery was carried in 14 defects of control group. experimental group 1 was 11 defects grafted with calcium carbonate, experimental group 2 was 11 defects which were grafted with calcium carbonate with FFSS. The clinical parameters evaluated included changes in attachment level, probing depth, gingival recession at 6 months. Postsurgery probing depth reduction was 3.1 ${\pm}$ 0.9mm in control, 3.8 ${\pm}$ 1.6mm in experimental group 1, 4.1 ${\pm}$ 1.1mm in experimental group 2. The result clinically and statistically improved compared to baseline(P<0.01), but the difference found among the groups were not statistically significant. Postsurgery clinical attachment level was 1.6 ${\pm}$ 1.2mm in control, 3.5 ${\pm}$ 2.0mm in experimental group 1, 3.3 ${\pm}$ 1.2mm in experimental group 2. All of the control and experimental groups resulted in a statistically significant reduction from baseline(P<0.01). The reduction of the experimental groups were statistically significant from control(P<0.05). But the change between experimental group 1 and experimental group 2 was not statistically significant. We conclude that mixture of CC and FFSS is effective to periodontal regeneration in intrabony defect.

• 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 Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.253-261
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• 2015

Chronic periodontitis involves subsequent loss of teeth, and if left untreated, can lead to adjacent teeth drifting and supraeruption of the rest dentition. Careful consideration has to be given when deciding extraction of remaining teeth in treatment of periodontally compromised dentitions. For tooth-supported fixed partial dentures or removable partial dentures, periodontally compromised teeth are extracted due to possible early failure from functional overload, but for implant restoration, the teeth could be used as supports for fixed partial dentures because implants can reduce overload on teeth. The remaining natural teeth can help clinicians restoring vertical dimension and normal occlusal plane in full mouth rehabilitation because it conserves patients' proprioceptive response. This clinical report describes treatment of a patient who has a few remaining teeth and supraeruption of the rest dentition from severe chronic periodontitis. Satisfactory clinical result was achieved with full mouth rehabilitation using a few teeth and implants.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.2
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• pp.175-182
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• 2013

The purpose of this study was to observe and analyze the initial marginal bone resorption changes according to the patterns of cover screw exposures during healing period followed by implants installation. Total 64 fixtures(TiUniteTM, NobelBiocare, Sweden) were installed in partially edentulous jaws of 28 patients, who were selected retrospectively and were shown at least one cover screw exposure. Cover screw exposures were defined at 1 month recall. According to the patterns of exposures, groups were categorized into group 1 (No exposure), group 2 (pin-point exposure), group 3 (less than 1/2 of cover screw), group 4 (more than 1/2 of cover screw), group 5 (total exposure). Periapical radiographs were taken in purpose of changes of marginal bone level between installation and 2 month recall. Healing abutments were secured on the exposure groups at 2 month recall. Results were as follows: 1. Marginal bone resorptions were identified whenever cover screws were exposed. 2. Group 2 and 3 were shown significantly increased bone loss more than other group (P <.05). 3. Group 4 and 5 were shown significantly increased bone loss more than group 1, however, less than other groups ( P <.05). Conclusionally, cover screw exposure may cause marginal bone resorptions, therefore, early connection of healing abutment is clinically helpful.

• Journal of Periodontal and Implant Science
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• v.28 no.3
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• pp.389-401
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• 1998

In this study, 21 patients diagnosed as adult periodontitis were divided into 4 groups. One quadrant with an average of 6mm deep pocket depth was chosen from each individual - Group A inserted tetra-cycline fiber after removing supragingival calculus while group RP had calculus removal and root planning alone. Group RP+A received combination of these treatments while group C received none. Plaque index, bleeding on probing, pocket depth, attachment level, and distribution of subgingival plaque were compared and evaluated among these groups at periods of first visit, 4th week and 8th week. The results were as follows ; 1. Plaque index and bleeding on probing improved after treatment and no significant difference was found between the groups. 2. When comparing the change in pocket depth between the groups, the use of tetracycline fiber showed significant reducton in pocket depth comparable to root planing. Combined therapy of tetracycline fiber and root planing showed synergistic effect in pocket depth reduction. 3. When comparing the change in attachment level between the groups, the use of tetracycline fiber showed significant increase in clinical attachment level comparable to root planing, but no synergistic effect was found in the combined therapy. 4. When comparing the change in the motile bacteria ratio between the groups, group RP and group RP+A showed significant decrease compared with control group. 5. There were no severe adverse effects from using tetracycline fiber, except for a few patient who experienced mild discomfort. In summary, the use of local adminstration of tetracycline fiber in adjunction to mechenical treatment can be effective for adult periodontitis.

• Journal of Periodontal and Implant Science
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• v.35 no.2
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• pp.413-426
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• 2005

수직 치근파절은 특이성을 나타내지 않기 때문에 치과의사가 정확한 진단을 하기 어렵다. 따라서 수직 치근파절의 임상적 특징, 진단적 증상을 파악하여 향후 근관치료된 치아나 치료되지 않은 치아에서 수직 치근파절의 유발인자와의 관련성 및 고찰을 통해 수직 치근파절의 예방 및 치료에 응용할 수 있을 것으로 생각된다. 연구대상은 조선대학교 부속치과병원 치주과에 내원한 환자 중 최근 2년간 144명의 환자에서 근관치료를 받았거나 받지 않았던 치아 중 임상적 및 방사선학적으로 수직 치근파절로 진단된 156개의 증례를 대상으로 하였다. 모든 불확실한 증례에서 수직 지근파절의 최종 진단은 외과적 탐지를 통해 이루어졌고, 금이 간 치아와 관련될 수 있는 치근파절의 증례의 경우는 제외되었다. 근관치료된 치아와 치료되지 않은 치아, 환자의 나이와 성별, 치아종류 및 파절된 치근부위, 자각증상의 유무를 기준으로 각각의 수치와 백분율로 분류하였다. 수직 치근파절의 증상과 증후별로 분류하였으며, 진단방법에 의한 분류, 치료방법에 따른 분류, 근관 치료 후 수직 치근파절이 발생한 기간에 따른 분류를 시행하고 통계분석을 하여 다음과 같은 결과를 얻었다. 1. 근관치료를 받지 않았던 치아의 수직 치근파절의 발생율은 58%였다. 2. 성별에 따른 발생률에 있어서 남성의 호발양상을 나타내었다. 3. 근관치료된 치아에 있어서 치료되지 않은 치아에 비해 호발연령이 낮았다. 4. 전치부의 수직 치근파절은 관찰되지 않았으며 특히, 강한 교합력을 필요로 히는 구치부에서의 높은 발생율을 나타냈다. 5. 수직 치근파절의 가장 주된 증상 및 증후는 깊은 치주낭 깊이였다. 6. 근관 치료 후 수직 치근파절이 발생한 기간은 평균 5.7년이었다. 7. 다수 증례에 있어서 3개 이하의 결손치를 가졌고, 자각증상이 나타났다. 이상의 결괴에서 한국인에 있어서 근관치료를 받지 않은 치아의 수직 치근파절은 드문 현상이 아님을 알 수 있었고 남성과 구치부에 있어서의 높은 발생율을 알 수 있었다. 그 이유로는 강한 교합력, 딱딱한 음식의 저작습관, 치조골 흡수에 따른 낮은 저항성, 골 유연성의 저하 등으로 여겨진다. 그러나, 수직 치근파절은 아직까지 정확한 진단을 내리기는 여전히 어려운 상태이며, 이를 위한 다양한 진단방법 및 더 나은 연구가 필수적이라 하겠다. 그리고, 향후 보다 많은 증례에 대한 분석, 치주질환에 이환되지 않은 경우의 분석, 치료 후 생존 기간에 대한 고찰 등도 필요하리라 사료된다.

• Journal of Periodontal and Implant Science
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• v.40 no.5
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• pp.227-231
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• 2010

Purpose: The healing process following tooth extraction apparently results in a pronounced resorption of the alveolar ridge. As a result, the width of alveolar ridge is reduced and severe alveolar bone resorption occurs. The purpose of this experiment is to clinically and histologically evaluate the results of using horse-derived bone mineral for socket preservation. Methods: The study comprised 4 patients who were scheduled for extraction as a consequence of severe chronic periodontitis or apical lesion. The extraction was followed by socket preservation using horse-derived bone minerals. Clinical parameters included buccal-palatal width, mid-buccal crest height, and mid-palatal crest height. A histologic examination was conducted. Results: The surgical sites healed uneventfully. The mean ridge width was $7.75{\pm}2.75\;mm$ at baseline and $7.00{\pm}2.45\;mm$ at 6 months. The ridge width exhibited no significant difference between baseline and 6 months. The mean buccal crest height at baseline was $7.5{\pm}5.20\;mm$, and at 6 months, $3.50{\pm}0.58\;mm$. The mean palatal crest height at baseline was $7.75{\pm}3.10\;mm$, and at 6 months, $5.00{\pm}0.82\;mm$. There were no significant differences between baseline and 6 months regarding buccal and palatal crest heights. The amount of newly formed bone was $9.88{\pm}2.90%$, the amount of graft particles was $42.62{\pm}6.57%$, and the amount of soft tissue was $47.50{\pm}9.28%$. Conclusions: Socket preservation using horse-derived bone mineral can effectively maintain ridge dimensions following tooth extraction and can promote new bone formation through osteoconductive activities.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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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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• v.31 no.2
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• pp.489-499
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• 2001

Bone graft and guided tissue regeneration have been used for the regeneration of periodontal tissue which is the ultimate goal of periodontal treatment. Recently, it was reported that some kind of growth factors were used for regeneration. Platelet rich plasma was researched that it could increase the density of bone and the rate of bone regeneration. For that, 25 patients which have pocket depth more than 5mm at any of 6 surfaces, of healthy patient without any systemic disease were treated. $Biogran^{?}$ Were grafted into 14 infrabony pockets as controls, and $Biogran^{(R)}$ with PRP were inserted into 31 infrabony pockets. And then, follwing evaluations were made at the end of 1, 3 and 6 months. 1. There was no statistical difference between control and experimental group in pocket depth, gingival recession, minimum probing attachment level and maximum probing attachment level at preoperation(p>0.05). 2. Decrease in probing pocket depth were reduced to 3.32mm for experimental group and 2.71mm for control group. The decrease was evident at the end of 1 month, they were 2.97mm and 2.29mm,and it was statistically difference(p<0.05). 3. Gingival recession was increased by 0.55mm in experimental group and 0.50mm in control group, it was evident at the end of 1 month. And it was statistically difference(p<0.05). 4. Minimum probing attachment level was increased by 0.35mm in experimental group and 0.36mm in control group, it was statistically difference(p<0.05). 5. Maximum probing attachment level was decreased by 3.19mm in experimental group and 2.93mm in control group, it was statistically difference(p<0.05). 6. There was no statistical difference between control and experimental group in pocket depth, gingival recession, minimum probing attachment level and maximum probing attachment level(p>0.05). There was statistical difference in decrease of pocket depth between pre-operation and 1 month after post-operation(p<0.05). In conclusion, bone graft using $Biogran^{?}$ and bone graft using $Biogran^{?}$ With platelet rich plasma were both effective in treatment of infrabony pocket, bone graft using $Biogran^{?}$ With platelet rich plasma was more effective in early soft tissue healing.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.93-98
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• 2007

Purpose: Many options are available for the incision and pocket selection in breast augmentation. Each method has its advantages and disadvantages. To leave an invisible operation scar and to achieve easier pocket dissection by the central location of the incision on the breast, we made a transareolar-perinipple incision. To overcome the disadvantages of the transareolar incision, originally advocated by Pitanguy in 1973, we modified the direction of incision line and dissection plane. Methods: To avoid the injury of 4th intercostal nerve responsible for nipple sensation, we made perinipple incision on the medial side of the nipple instead of trans-nipple incision and made the transareolar incision as 11-5 o'clock on the left side and 1-7 o'clock on the right side instead of 3-9 o'clock on both sides. To avoid the possible infection and breast feeding problem caused by the injury to the lactiferous duct, and the possible implant hernia caused by the incisions lying on a same plane of pocket dissection, we made a subcutaneous dissection just above the breast tissue medially down to the bottom of breast tissue and made a subglandular or subfascial pocket, which may avoid the injury of lactiferous duct and create different planes for skin incision and pocket dissection. Other advantages of the transareolar-perinipple incision include easier pocket dissection, less chance of hematoma, and as a result less postoperative pain because of the central location of the approach which allow finger dissection and meticulous bleeding control with direct vision, without any specialized instrument such as an endoscope or long mammary dissectors. As for pocket selection, we made dual pockets. We prefer subglandular or subfascial pocket. Also, we made a subpectoral pocket in the upper 1/4 of the pocket to add more volume on the upper part of the augmented breast, which can make aesthetically more desirable breasts in thin Asian women with small breasts. Possible disadvantages of our method are subclinical infection and scar widening, which could be overcome by meticulous operation techniques, antibiotic therapy, and intradermal tattooing. Results: From September, 2003 to August, 2005, 12 patients underwent breast augmentation using round smooth surface saline implants by our method. During the mean follow-up period of 13 months, there were no complications such as infection, hematoma, capsular contracture, and sensory change of nipple, and results were satisfactory. Conclusion: We suggest breast augmentation via transareolar-perinipple incision and dual pockets(subpectoral-subglandular or subfascial) as a valuable method in thin oriental women with small breasts.