• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.535-563
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• 1993

New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration alre basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet-derived growth factor (PDGF) is one of polypeptide growth factor. PDGF have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purposes of this study is to evaluate the possibility of using the PDGF as a regeneration promoting agent for furcation involvement defect. Eight adult mongrel dogs were used in this experiment. The dogs were anesthetized with Pentobarbital Sodium (25-30 mg/kg of body weight, Tokyo chemical Co., Japan) and conventional periodontal prophylaxis were performed with ultrasonic scaler. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree III furcation defect was made on mandibular second(P2) and fourth(P4) premolar. For the basic treatment of root surface, fully saturated citric acid was applied on the exposed root surface for 3 minutes. On the right P4 20ug of human recombinant PDGF-BB dissolved in acetic acid was applied with polypropylene autopipette. On the left P2 and right P2 PDGF-BB was applied after insertion of ${\beta}-Tricalcium$ phosphate(TCP) and collagen (Collatape) respectively. Left mandibular P4 was used as control. Systemic antibiotics (Penicillin-G benzathine and penicillin-G procaine, 1 ml per 10-25 1bs body weight) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operated sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 2, 4, 8, 12 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. At 2 weeks after surgery, therer were rapid osteogenesis phenomenon on the defected area of the PDGF only treated group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. New cementum fromation was observed from 2 weeks after surgery, and the thickness was increased until 8 weeks with typical Sharpey’s fibers reembedded into new bone and cementum. In both PDGF-BB with TCP group and PDGF-BB with Collagen group, regeneration process including new bone and new cementum formation and the group especially in the early weeks. It might be thought that the migration of actively proliferating cells was prohibited by the graft materials. In conclusion, platelet-derived growth factor can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

• The korean journal of orthodontics
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• v.31 no.3 s.86
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• pp.369-379
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• 2001

The aim of this study was to investigate the periodontal response according to the timing of orthodontic force application after bone graft into the angular bony defect. Nine dogs were divided into three groups, 2, 4, and 6 weeks, according to the timing of orthodontic force application after bone graft. Periodontal angular bony defects were created surgically at the distal aspect of both maxillary third incisors. Two weeks later, flap operation was performed to eliminate inflammation and reference notch was made on the root surface at the level of the bottom of each defect. Demineralized freeze-dried bone was implanted on the left side whereas only debridement was done on the other side. Experimental tooth movement was executed during 8 weeks on both graft and non-graft sides. After 2 weeks of retention period, animals were sacrificed for histologic specimens. The results were obtained as follows 1 New bone formation was more pronounced in the graft side than in the non-grad side in all experimental animals. 2. In the 6-week group, new bone and cementum formation was observed in more than half from the notch to the cemento-enamel junction, and the zone of connective tissue attachment was found without apical migration of junctional epithelium. 3. In the 4-week group, the amount of new bone formation was smaller than in the 6-week group whereas the overall remodeling pattern was similar. 4. New bone formation was confined to around the notch and the junctional epithelium migrated apically to the level of the notch with no connective tissue attachment and cementum formation in the 2-week group. The results of the present study suggest that periodontal response may be influenced by the timing of orthodontic force application after bone graft into angular bony defect.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.3
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• pp.301-305
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• 2012

The odontoma is a hamartoma of odontogenic origin and consists of enamel, dentin, cementum and pulp tissue. Two types of odonotma are histologically recognized: complex and compound. Odontoma may be the cause of noneruptoin or impaction of teeth, formation of cyst and resorption of adjacent bone. The recommended treatment for an odontoma is conservative surgical excision. No propensity for recurrence has been noted. Peripheral odontoma is relatively rare lesion and shows the histological characteristics of an intraosseous odontoma. This report described a 3-year-old Korean girl with a firm gingival mass in the posterior mandibular area, which had been gradually enlarging over 18months. Radiographic examination showed a radiopaque mass but no evidence of underlying intraosseous lesion. Excisional biopsy was performed for the mass removal and histopathological examination. The result of histopathological study was identified as hamartous supernumerary tooth germ. Based on the clinical presentation, radiographic and histopathologic findings, we concluded that the final diagnosis was peripheral odontoma. For three years after surgery, there is no clinical sign of recurrence.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.490-497
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• 2007

Odontoma is defined as a benign odontogenic tumor containing enamel, dentin as well as cementum and constitued 22% of all odontogenic tumors. Although the lesions are commonly asymptomatic, they may be discovered routine radiographic examination. Odontomas often cause disturbances in the eruption of teeth such as, impaction or delayed eruption, retention of primary teeth, or abnomalities in the position of the teeth such as tipping or displacement of adjacent teeth. Radiologically, odontomas manifest as a dense radiopaque lesion surrounded by a thin radiotransparent halo. However, in some cases, radiopacity was not quite clear and images of the teeth shadowed very tiny odontomas. And at early development stages of odontoma, calcification remains immature and is difficult to diagnose on radiographs. This suggests that when delayed eruption of the teeth is found, periapical radiographs should be taken to clarify whether any small area of radiopaque material exists. This case report shows tiny odontomas involving an impacted tooth and crowding and we remove the tiny odontoma surgically.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.4.1-4.10
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• 2019

Background: The mandibular third molar (M3) is typically the last permanent tooth to erupt because of insufficient space and thick soft tissues covering its surface. Problems such as alveolar bone loss, development of a periodontal pocket, exposure of cementum, gingival recession, and dental caries can be found in the adjacent second molars (M2) following M3 extraction. The specific aims of the study were to assess the amount and rate of bone regeneration on the distal surface of M2 and to evaluate the aspects of bone regeneration in terms of varying degree of impaction. Methods: Four series of panoramic radiographic images were obtained from the selected cases, including images from the first visit, immediately after extraction, 6 weeks, and 6 months after extraction. ImageJ software^® (NIH, USA) was used to measure linear distance from the region of interest to the distal root of the adjacent M2. Radiographic infrabony defect (RID) values were calculated from the measured radiographic bone height and cementoenamel junction with distortion compensation. Repeated measures of analysis of variance and one-way analysis of variance were conducted to analyze the statistical significant difference between RID and time, and a Spearman correlation test was conducted to assess the relationship between Pederson's difficulty index (DI) and RID. Results: A large RID (> 6 mm) can be reduced gradually and consistently over time. More than half of the samples recovered nearly to their normal healthy condition (RID ≤ 3 mm) by the 6-month follow-up. DI affected the first 6 weeks of post-extraction period and only showed a significant positive correlation with respect to the difference between baseline and final RID. Conclusions: Additional treatments on M2 for a minimum of 6 months after an M3 extraction could be recommended. Although DI may affect bone regeneration during the early healing period, further study is required to elucidate any possible factors associated with the healing process. The DI does not cause any long-term adverse effects on bone regeneration after surgical extraction.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.967-987
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• 1996

The present study was to evaluate the healing patterns of guided tissue regeneration( GTR) using resorbable $Vicryl^{(R)}$(polyglactin 910) mesh and nonresorbable expanded polytetrafluoroethylene(ePTFE) membrane with or without bone grafting using autogeneous bone and demineralized freeze-dried bone allograft(DFDBA) in the grade II furcation defects. Mucoperiosteal flaps were reflected buccally in the mandibular 2nd, 3rd and 4th premolar areas and furcation defects were created surgically by removing $5{\times}6mm$ alveolar bone in 4 dogs. Root surfaces were thoroughly debrided of periodontal ligament and cementum, and notches were placed on root surface at the most apical bone level. In the right and left mandibular quadrant, each tooth was received $Vicryl^{(R)}$ mesh(ACE Surgical Supply Co., USA) only, $Vicryl^{(R)}$ mesh with DFDBA, $Vicryl^{(R)}$ mesh with autogeneous bone grafts, ePTFE membrane($Core-tex^{(R)}$ membrane, W.L. Gore & Associates Inc., USA) only, ePTFE membrane with DFDBA or ePTFE membrane with autogeneous bone grafts. For the fluorescent microscopic examination, fluorescent agents were injected at 2, 4 and 8 weeks after surgery. Four weeks after surgery, 2 dogs were sacrificed and ePTFE membranes were removed from remaining 2 dogs, which were sacrificed at 12 weeks after surgery. Undecalcified tissues were embedded in methylmethacrylate and $10{\mu}m$ thick sections were cut in a buccolingual direction. These sections were stained with hematoxylin-eosin stain and Masson's trichrome stain, and evaluated by descriptive histology and linear measurements. The results were as follows : 1) $Vicryl^{(R)}$ mesh group showed less connective tissue attachment than ePTFE membrane group. 2) The combination of GTR using $Vicryl^{(R)}$ mesh and osseous grafts resulted in new attachment and new bone formation more than GTR using $Vicryl^{(R)}$ mesh only. 3) GTR using ePTFE membrane, with or without osseous grafts, enhanced periodontal regeneration. 4) Root resorption and dentoalveolar ankylosis were observed in the areas treated with the combination of GTR and DFDBA. It was suggested that the effect of adjunctive bone grafting in GTR procedure depends on the materials and the physical properties of barrier membranes. $Vicryl^{(R)}$ mesh performed a barrier function and the use of adjunctive bone grafting may enhance the periodontal regeneration.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.3
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• pp.289-297
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• 2017

Local and general factors have been attributed to root resorption occurred by injuries such as trauma and dental caries that affect periodontal ligament or dental pulp tissue. Pathologic root resorption is different from physiologic root resorption in terms of resorption pattern such as micromorphology of resorption fossae and types of observed cells. Microscopic morphologies and histologic features of physiologic and pathologic root resorption surface of maxillary primary central incisors resulting from trauma and periapical inflammation were observed by scanning electron microscope and light microscope. The morphology of physiologic resorption lacunae was small and oval or circular shape with regularities. The morphology of pathologic resorption lacunae was large and polygonal shape with irregularities compared with the physiologic resorption lacunae. Multinucleated giant cells and mononuclear cells were closely attached to the physiologic and pathologic resorption lacunae, whereas several kinds of mesenchymal cells with numerous inflammatory cells were found in the areas adjacent to the pathologic resorption surface. Compensating cementum formation took place along some of the areas of physiologic and pathologic resorption area resulting from trauma, but could not be observed on pathologic resorption area resulting from periapical inflammation.

• Journal of Periodontal and Implant Science
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• v.47 no.6
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• pp.352-362
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• 2017

Purpose: Furcation involvement in the molars is difficult to treat, and has been recognized as a risk factor for tooth loss. Although periodontal regenerative therapies, including guided tissue regeneration and various types of bone grafts, have been applied to furcation defects, the effects of these treatments are limited, especially in large class III furcation defects. The purpose of this pilot study was to investigate the effect of reciprocal autologous root transplantation on periodontal wound healing and regeneration in class III furcation defects in dogs. Methods: Furcation defects (7 mm wide and 6 mm high) were surgically created after root separation of the unilateral third and fourth premolars in 4 dogs. Eight furcation defects were randomized to receive either reciprocal autologous root transplantation (test) or no further treatment (control). In the test group, the mesial and distal roots were transplanted into the distal and mesial extraction sockets, respectively. The animals were sacrificed 10 weeks after surgery for histologic evaluation. Results: The healing pattern in the control group was characterized by extensive collapse of the flap and limited periodontal regeneration. New bone formation in the test group ($3.56{\pm}0.57mm$) was significantly greater than in the control group ($0.62{\pm}0.21mm$). Dense collagen fibers inserting into the residual cementum on the transplanted root surfaces were observed in the test group. Slight ankylosis was observed in 2 of the 4 specimens in the test group on the mesiodistal sides where the root-planed surfaces faced the existing bone. Root resorption (RR) was detected in both the control and test groups. Conclusions: Within the limits of this study, it can be concluded that reciprocal autologous root transplantation was effective for bone regeneration in class III furcation defects in dogs. However, further studies are required to standardize the approach in order to prevent unwanted RR prior to clinical application.

• Restorative Dentistry and Endodontics
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• v.17 no.2
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• pp.307-330
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• 1992

The aim of this study was to investigate the physical properties of visible light curing Glass Ionomer cement for restorative esthetic filling. The control group was the autopolymerizing GC Fuji II Glass Ionomer cement (2.2: 1 P/L ratio) and the experimental groups were made by following procedure. To induce the polymerization by visible light, the powder of GC Fuji II GI cement and the liquid of Vitrabond for base & liner were mixed in an amalgam capsule with 2.5:1, 3.0:1, 3.5:1 P/L ratio (% wt/wt). After fabrication of specimens, compressive strength, fracture toughness ($K_{IC}$) Scanning Electron Microscope and X-ray Diffraction, water-leachable content, marginal leakage and surface roughness were studied. The results were as follows: 1. Only experimental No. 1 group (visible light curing) showed less compressive strength than control group 1 hour after curing. Strength was increased with aging in all groups, so the compressive strength of light curing groups was no less than that of autopolymerizing group after 3 weeks. 2. Experimental No.3 group (visible light curing) was inferior to No.2 group (visible light curing) in fracture resistance but light curing groups were more resistant to fracture than autopolymerizing group and showed ductile fracture pattern as compared with the brittle fracture pattern of autopolymerizing group. 3. From scanning electron microscopic image, various sized unreacted powder particles, surrounded by silica gel, were embedded in polysalt matrix. Light curing groups showed little crack and more dense unreacted particles than autopolymerizing group. 4. From X-ray diffraction analysis, GC Fuji II Glass Ionomer cement powder and all groups showed glassy appearance but light curing groups seemed to be more intensive in crystaline than autopolymerizing group. S. The most significant dissolution was shown in early setting period in all group. Light curing groups were dissolved less than autopolymerizing group. 6. Marginal leakage was not different significantly in case of cavity margin composed of same tooth structure (ex. only enamel margin, only dentin margin) but much more leakage was shown in dentin/cementum margin than enamel margin. In only case of only enamel margin, light curing groups were superior to autopolymerizing group. 7. All groups showed relatively smooth surface, which irregularity was less than $1{\mu}m$. Light curing groups were smoother than autopolymerizing group.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.4
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• pp.524-534
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• 2000

Deciduous teeth can be extracted for two reasons, one due to the physiologic resorption and the other by the inflammation at the apex after traumatic injury. Physiologic resorption may be different from pathologic resorption in timing and mechanism. Therefore we resumed the different features of physiologic and pathologic resorption root surfaces. Many previous studies showed micromorphology of resorbed surface of roots of deciduous teeth. But, few studies compared physiological and pathological root resorption surfaces. In this study, we carefully observed microscopic morphologies of those two different root surfaces by scanning electron microscope and histologic features by light microscope. The resultant differences between physiologic and pathologic resorption surfaces of deciduous teeth were as follows: 1. The morphology of pathologic resorption lacunae due to inflammation varied in size and shape with irregular boundaries compared with the physiologic areas from scanning electron microscope observations. 2. From light microscope observations, several large resorption fossae containing numerous resorption lacunae were found, whereas the resorption lacunae were irregular in shape with pathologic resorption surface. 3. Numerous multinucleated giant cells were closely attached to the physiologic resorption lacunae, whereas several kinds of mesenchymal cells with numerous inflammatory cells were found in the areas adjacent to the pathologic resorption surface. 4. Light microscope findings showed that compensating cementum formation took place along some of the areas of inflammatory dentinal resorption. In conclusion, several morphological differences were present between physiologic and pathologic root resorption surfaces of human deciduous teeth. The future studies should include cytochemistry to clarify the cellular roles in resorption process observations of pulpal surfaces of coronal and radicular dentin to and the changes that occur in each phase of human deciduous tooth resorption.