• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.1
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• pp.43-53
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• 2007

The purpose of this experimental study was to examine the effect of the decontamination of carbon dioxide ($CO_2$) laser in treatment of ligature-induced peri-implantitis in dogs. A total 24 implants with a sandblasted with large-grit and acid-etched (SLA) surface were inserted in six mongrel dogs. After a 3-month healing period, experimental peri-implantitis characterized by a bone loss of about 3mm was established by inducing with wires. And then wires were removed and plaque control was implemented. Surgical treatment involving flap procedure + debridement of implants surface with chlorhexidine and saline (group 1), flap procedure + GBR with absorbable collagen membrane (Bio-Gide) and mineralized bone graft (Bio-Oss) (group 2), and flap procedure + $CO_2$ laser application + GBR (group 3) was performed. The animals were killed 8 weeks and 16 weeks after treatment, respectively. A histomorphometric analysis confirmed statistically considerable new bone formation within the limit of the 5 most coronal threads in group 3 compared with group 1 at 16 weeks (P<0.05). And intragroup analysis showed considerable increase of new bone formation in group 3 at 16 weeks compared with 8 weeks (P<0.05). The present study demonstrates considerable new bone formation after treatment of experimental peri-implantitis with flap procedure, $CO_2$ laser application and GBR.

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.615-630
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• 2002

Various long-term studies have shown that titanium implants as abutments for different types of prostheses have become a predictable adjunct in the treatment of partially or fully edentulous patients. The continuous exposure of dental implants to the oral cavity with all its possible contaminants creates a problem. A lack of attachment, together with or caused by bacterial insult, may lead to peri-implantitis and eventual implant failure. Removal of plaque and calculus deposits from dental titanium implants with procedures and instruments originally made for cleaning natural teeth or roots may cause major alterations of the delicate titanium oxide layer. Therefore, the ultimate goal of a cleaning procedure should be to remove the contaminants and restore the elemental composition of the surface oxide without changing the surface topography and harming the surrounding tissues. Among many chemical and mechanical procedure, air-powder abrasive have been known to be most effective for cleaning and detoxification of implant surface. Most of published studies show that the dental laser may be useful in the treatment of pen-implantitis. $CO_2$ laser and Soft Diode laser were reported to kill bacteria of implant surface. The purpose of this study was to obtain clinical guide by application these laser to implant surface by means of Non-contact Surface profilometer and X-ray photoelectron spectroscopy(XPS) with respect to surface roughness and atomic composition. Experimental rough pure titanium cylinder models were fabricated. All of them was air-powder abraded for 1 minute and they were named control group. And then, the $CO_2$ laser treatment under dry, hydrogen peroxide and wet condition or the Soft Diode laser treatment under Toluidine blue O solution condition was performed on the each of the control models. The results were as follows: 1. Mean Surface roughness(Ra) of all experimental group was decreased than that of control group. But it wasn't statistically significant. 2. XPS analysis showed that in the all experimental group, titanium level were decreased, when compared with control group. 3. XPS analysis showed that the level of oxygen in the experimental group 1, 3($CO_2$ laser treatment under dry and wet condition) and 4(Soft Diode laser was used under toluidine blue O solution) were decreased, when compared with control group. 4. XPS analysis showed that the atomic composition of experimental group 2($CO_2$ laser treatment under hydrogen peroxide) was to be closest to that of control group than the other experimental group. From the result of this study, this may be concluded. Following air-powder abrasive treatment, the $CO_2$ laser in safe d-pulse mode and the Soft Diode laser used with photosensitizer would not change rough titanium surface roughness. Especially, $CO_2$ laser treatment under hydrogen peroxide gave the best results from elemental points of view, and can be used safely to treat peri-implantitis.

• Imaging Science in Dentistry
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• v.40 no.3
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• pp.123-129
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• 2010

Purpose : To evaluate the effect of surgical treatment of ligature-induced peri-implantitis in dogs using fractal analysis. Also, the capabilities of fractal analysis as bone analysis techniques were compared with those of histomorphometric analysis. Materials and Methods : A total of 24 implants were inserted in 6 dogs. After a 3-months, experimental periimplantitis characterized by a bone loss of about 3 mm was established by inducing with wires. Surgical treatment involving flap procedure, debridement of implants surface with chlorhexidine and saline (group 1), guided bone regeneration (GBR) with absorbable collagen membrane and mineralized bone graft (group 2), and $CO_2$ laser application with GBR (group 3) were performed. After animals were sacrificed in 8 and 16 weeks respectively, bone sections including implants were made. Fractal dimensions were calculated by box-counting method on the skeletonized images, made from each region of interest, including five screws at medial and distal aspects of implant, were selected. Results : Statistically significant differences in the fractal dimensions between the group 1($0.9340{\pm}0.0126$) and group 3($0.9783{\pm}0.0118$) at 16 weeks were found (P<0.05). The fractal dimension was statistically significant different between 8($0.9395{\pm}0.0283$) and 16 weeks in group 3 (P<0.05). These results were similar with the result of the evaluation of new bone formation in histomorphometric analysis. Conclusions : Treatment of experimental peri-implantitis by using $CO_2$ laser with GBR is more useful than other treatments in the formation of new bone and also the tendency of fractal dimension to increase relative to healing time may be a useful means of evaluating.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.451-463
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• 2001

Following the extensive use of implant, the incidence of peri-implantitis increases. Guided bone regeneration has been used for the optimal treatment of this disease. Because implant surface was contaminated with plaque and calculus, cleaning and detoxification were needed for the reosseointegration when guided bone regeneration was performed. Various mechanical and chemical methods have been used for cleaning and detoxification of implant surface, air-powder abrasive and oversaturated citrate were known to be most effective among these methods. However, these methods were incomplete because these could not thoroughly remove bacteria of implant surface, moreover deformed implant surface. Recent studies for detoxification of the implant surface using laser were going on, $CO_2$ laser and Soft Diode laser were known to be effective among these methods. The purpose of this study was to obtain clinical guide by application these laser to implant surface. 15 experimental machined pure titanium cylinder models were fabricated. The $CO_2$ laser treatment under dry, wet and hydrogen peroxide condition or the Soft Diode laser treatment under Toluidine blue O solution condition was performed on the each of models. Each groups were examined with SPM and SEM to know whether their surface was changed. The results were as follows : 1. Surface roughness and surface form weren't changed when $CO_2$ laser was usedunder dry condition(P>0.05). 2. Surface roughness and surface form weren't changed when $CO_2$ laser was used under wet condition(P>0.05). 3. Surface roughness and surface form weren't changed when $CO_2$ laser was used under hydrogen peroxide condition(P>0.05). 4. Surface roughness and surface form weren't changed when Soft Diode laser was used under toluidine blue O solution condition(P>0.05). From the result of this study, it may be concluded that the $CO_2$ laser having relatively safe pulse mode and the Soft Diode laser used with photosensitizer can be used safely to treat peri-implantitis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.6
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• pp.540-545
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• 2008

Since mid 20th century, dental treatments with laser have been introduced and improved a lot. Because early $CO_2$, Nd:YAG, diode, argon, and holmium lasers are used for dealing soft tissue, so it applied just limited field. But, in 1997 the lasers of erbium family that able to dealing soft and hard tissue also were introduced, laser application fields are enlarged. In today, the application fields reach on implantation treatment, so clinicians can use the laser to make holes for implantation, and flap elevation, even though treating peri-implantitis. So our class want to discover the optimal setting of Er:YAG laser when treating peri-implantitis. We observed the surface that initially treated by RBM and TPS passion and laser with varied options of exposure time and power with SEM image. For this we conclude the optimal setting range that does not alter the implant surface structure and report it.