• Journal of Periodontal and Implant Science
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• v.46 no.5
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• pp.303-319
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• 2016

Purpose: The purpose of this animal study was to perform a 3-dimensional micro-computed tomography (micro-CT) analysis in order to investigate the influence of root surface distance to the alveolar bone and the periodontal ligament on periodontal wound healing after a guided tissue regeneration (GTR) procedure. Methods: Three adult Sus scrofa domesticus specimens were used. The study sample included 6 teeth, corresponding to 2 third mandibular incisors from each animal. After coronectomy, a circumferential bone defect was created in each tooth by means of calibrated piezoelectric inserts. The experimental defects had depths of 3 mm, 5 mm, 7 mm, 9 mm, and 11 mm, with a constant width of 2 mm. One tooth with no defect was used as a control. The defects were covered with a bioresorbable membrane and protected with a flap. After 6 months, the animals were euthanised and tissue blocks were harvested and preserved for micro-CT analysis. Results: New alveolar bone was consistently present in all experimental defects. Signs of root resorption were observed in all samples, with the extent of resorption directly correlated to the vertical extent of the defect; the medial third of the root was the most commonly affected area. Signs of ankylosis were recorded in the defects that were 3 mm and 7 mm in depth. Density and other indicators of bone quality decreased with increasing defect depth. Conclusions: After a GTR procedure, the periodontal ligament and the alveolar bone appeared to compete in periodontal wound healing. Moreover, the observed decrease in bone quality indicators suggests that intrabony defects beyond a critical size cannot be regenerated. This finding may be relevant for the clinical application of periodontal regeneration, since it implies that GTR has a dimensional limit.

• Journal of Periodontal and Implant Science
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• v.26 no.2
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• pp.334-349
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• 1996

Regeneration of the periodontal tissue destroyed by periodontal disease is one of the final goals of periodontal therapy. In the past few years, periodontists have used various alloplastic grafting materials in an attempt to regenerate bone lost from periodontal disease. These materials have used widely because they have shown to be nontoxic, biologically compatible with surrounding host tissue and chemically similar to bone. The purpose of this study was to investigate the effect of Porous Resorbable Calcium Carbonate and Porous Replamineform Hydroxyapatite on the regeneration of the alveolar bone and the healing of roots transplanted into the periodontally diseased extraction sockets of dogs. The experimental chronic periodontitis was induced by elastic ligatures on the 2nd and 3rd mandibular premolars of 2 adult dogs for 8weeks after surgically creating periodontal defect. The extracted root were split in half along the long-axis, and the extend of plaque exposure was marked on the root surfaces with burs. The roots were inserted in extraction sockets with Porous Resorbable Calcium Carbonate(PRCC) in left side and with Porous Replaminefrom Hydroxyapatite(PRH) in right side. The flaps were sutured to cover the sockets completely. The animals were sacrificed after 12 weeks of healing, and the specimens were examined histologically. The results were as follows: 1. No inflammatory reactions were observed in either groups. 2. Hoot resorption was observed in both groups while the general outline of the roots were maintained. 3. PRCC was almost completely resorbed and replaced with new bone, while R.H.A. was not resorbed & remained encased in newly-formed C-T and alveolar bone. 4. PRH was encapsulated with alveolar bone which has been deposited from apical & lateral area of the sockets, while the coronal portion of the sockets were filled with C-T. 5. In both groups, the resorbed portions of the roots were replaced with new bone. These results suggest that either PRCC or PRH may not interfere with bone formation or healing in extraction sockets, and in some degree, retard the root resorption. Because the roots maintained in anatomy, we think that graft materials prevent the root resorption.

• The korean journal of orthodontics
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• v.46 no.6
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• pp.379-385
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• 2016

Objective: Forced eruption has been proposed for the reconstruction of deficient bone and soft tissue. The aim of this study was to examine the changes in the alveolar ridge width and the vertical levels of the interproximal bone and papilla following forced eruption. Methods: Patients whose hopeless maxillary anterior teeth were expected to undergo severe bone resorption and soft tissue recession upon extraction were recruited. In addition, patients whose maxillary anterior teeth required forced eruption for restoration due to tooth fracture or dental caries were included. Before and after forced eruption, the interproximal bone height was measured by radiographic analysis, and changes in the alveolar ridge width and the interproximal papilla height were measured with an acrylic stent. Results: This prospective study demonstrated that the levels of the interproximal alveolar bone and papilla were significantly increased by 1.36 mm and 1.09 mm, respectively, in the vertical direction. However, the alveolar ridge width was significantly reduced by an average of 0.67 mm in the buccolingual direction. The changes in the level of the interproximal alveolar bone and papilla were positively correlated. Conclusions: Although the levels of the interproximal bone and papilla were significantly increased, the alveolar ridge width was significantly decreased following forced eruption. There was a modest positive and significant correlation between the changes in the height of the interproximal alveolar bone and the papilla. Based on our findings, modification of vertical forced eruption should be considered when augmentation of the alveolar ridge width is required.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.276-282
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• 2008

Objective: This is to report the efficacy of the sandwich technique for bone augmentation in a moderate atrophic posterior mandible through clinical and histological results in two cases. Subjects and Method: Two patients selected had moderate bone resorption in left lower edentulous area. Sandwich osteotomy using the piezosurgery was performed and the osteomized alveolar segments were elevated by 6mm in each two patients. The interpositional mineral allograft materials were inserted in the atrophic posterior mandibles. After four months healing period, bone biopsies in the grafted areas and placement of dental implants were performed. In both cases, panoramic views were taken preoperatively to measure the alveolar bone height for diagnosis, to monitor patient healing, and to evaluate bone healing and bone gain. Results: Sufficient vertical bone height was gained by using the sandwich technique and implants were placed successfully. In radiological evaluation, there was minimal resorption of bone height after the second operation and in histomorphometric evaluation, they showed favorable new bone formation without inflammation in the grafted areas. Conclusion: The sandwich technique can be an effective choice for augmenting vertical bone height in the atrophic mandible. More of cases and long term follow-up are needed to evaluate bone resorption and implant prognosis.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.1
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• pp.150-165
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• 1998

For the purpose of evaluating the effect of both direct retainer design and bony absorption degree around abutment of indirect retainer on the supporting tissue of abutment of indirect retainer, dislodging force was transmitted to unilateral distal extension RPD bases. Analysis of stress distributed within the supporting tissue around abutment of indirect retainer was carried out. Using three-dimensional photoelastic stress analysis method and the conclusion is a follows. 1. According to the extent of force which the direct retainer of the most distal abutment tooth, the amount of force transmitted to the abutment tooth of indirect retainer was small. 2. Of all the cases, Mandibular first premolar which was used abutment tooth of indirect retainer, buccal, mesial and distal sides represented compression stress and lingual side represented tensile stress. 3. The more bone resorption of abutment tooth of indirect retainer, the more distortion of buccal and distal side of abutment tooth was existed and the extent of compression stress which was existed and distal side to abutment tooth was large. 4. When the alveolar bone around the abutment with indircet retainer is normal. The amount of force transmitted on abutment with indirect retainer was small in the order of Akers clasp, RPA clasp, RPI clasp. 5. When the alveolar bone around the abutment with indirect retainer has been absorbed 20% and 30%, the amount of force transmitted on abutment with indirect retainer was small in the order of RPA calsp, RPI clasp, Akers clasp. 6. When denture is displaced, shape of the direct retainer reciprocating abutment affect much the function of indirect retainer.

• The korean journal of orthodontics
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• v.44 no.6
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• pp.320-329
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• 2014

Objective: To investigate the involvement of ephrinB2 in periodontal tissue remodeling in compression areas during orthodontic tooth movement and the effects of compressive force on EphB4 and ephrinB2 expression in osteoblasts and osteoclasts. Methods: A rat model of experimental tooth movement was established to examine the histological changes and the localization of ephrinB2 in compressed periodontal tissues during experimental tooth movement. RAW264.7 cells and ST2 cells, used as precursor cells of osteoclasts and osteoblasts, respectively, were subjected to compressive force in vitro. The gene expression of EphB4 and ephrinB2, as well as bone-associated factors including Runx2, Sp7, NFATc1, and calcitonin receptor, were examined by quantitative real-time polymerase chain reaction (PCR). Results: Histological examination of the compression areas of alveolar bone from experimental rats showed that osteoclastogenic activities were promoted while osteogenic activities were inhibited. Immunohistochemistry revealed that ephrinB2 was strongly expressed in osteoclasts in these areas. Quantitative real-time PCR showed that mRNA levels of NFATc1, calcitonin receptor, and ephrinB2 were increased significantly in compressed RAW264.7 cells, and the expression of ephrinB2, EphB4, Sp7, and Runx2 was decreased significantly in compressed ST2 cells. Conclusions: Our results indicate that compressive force can regulate EphB4 and ephrinB2 expression in osteoblasts and osteoclasts, which might contribute to alveolar bone resorption in compression areas during orthodontic tooth movement.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.2
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• pp.145-152
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• 2020

It is essential to record maxillomandibular relationship accurately for the harmony of esthetic and function in complete denture. Gothic arch tracing visually demonstrates the movement of the mandible, and is useful to establish accurate and reproducible centric relation. Proper retention and stability of complete denture in patients with severe alveolar bone resorption is difficult to attain. In such case, the closed mouth impression technique might be recommended. The denture border and impression are determined by patient's physiologic movement in the closed mouth impression technique. And, denture peripheral border is entirely closed with oral mucous membrane. This report presents satisfactory complete denture restoration using closed mouth impression technique and gothic arch tracing in patients with mandibular condyle fracture and severe absorption of mandibular alveolar ridge.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.152-159
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• 2016

Implant fixed prosthesis for the complete edentulous maxilla provides significant benefits in the aspects of functions and esthetics compared with the conventional denture. Implant supported fixed prosthesis are totally supported by implant, and thus stabilizes the prosthesis to the maximum degree as possible. Also, the improved retention and stability of fixed prosthesis enhance patients' psychological and psychosocial health. This clinical presentation describes a maxillary full arch implant-supported fixed prosthesis in complete maxillary edentulous patient who showed vertical and horizontal alveolar bone resorption in the anterior ridge. To rehabilitate the esthetics and proper lip support, the zirconia framework was fabricated and the pink porcelain was veneered to reproduce the natural gingival tissue. After 9 months of follow up, the restorations were maintained without complications and the patient was satisfied with the restoration both functionally and esthetically.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.5
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• pp.444-450
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• 2007

In general, labiolingual or buccolingual widths of residual alveolar bone are insufficient in edentulous area, because of alveolar resorption. Horizontal augmentation is bone graft procedure with a view to reinforcing horizontally insufficient bone quantity for installation of implants. The standard method is taking appropriate amount of block bone from intraoral or extraoral autogenous bone, and solid fixation with screws or mini-plate on labial or buccal side of residual alveolar bone. The purpose of this study is to discuss clinical usefulness of horizontal augmentation with autogenous block bone by observation and analysis of course of 41 implants installed to 12 patients by horizontal augmentation in Seoul National University Bundang Hospital from July, 2002 to December, 2005. The mean age of patients is 52.7, from 19 to 70, and the number of men and women is each 2 and 10. Block bone was taken from symphysis, body, ramus of mandible or iliac bone. And 6 types of implants were installed simultaneously or not, the diameters of implants are from 3.3 to 5.5mm, the lengths are from 8 to 15mm. The operator added artificial bone grafting material and optionally covered with membrane. The mean periods of observation after operation and final prosthetics were 28.6 and 17.0 months. As a result, 40 among 41 implants survived, the survival rate was 97.6%. Average 0.9mm crestal resorption was observed at final point of time by periapical view of each patients. Major complication related to the procedure was numbness in 7 patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.403-408
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• 2005

Ankylosis is defined as a fusion of cementum or dentine with alveolar bone. Due to the loss of the periodontal ligament on the ankylotic area, the tooth is incapable of continued eruption and hence is unable to follow the normal vertical development of the neighboring teeth and alveolar process. A 6-year-old female was referred to the Dept. of Pediatric Dentistry for ankylosis of primary molars and congenital missing of permanent premolars on both jaws. She had neither specific past medical history nor trauma and infection history in oral and maxillofacial region. Radiographic finding is that the maxillary primary molars were the early onset of ankylosis and had fast root resorption rate. However the mandibular primary molars were ankylosed later and being resorbed slower than maxillary primary molars. The object of treating this case is to maintain the proper alveolar bone growth and retention of deciduous molars. The point of managing this case is as follows: Proper treatment (observation, restoration, or extraction) should be established after thorough consideration of the time of onset, the root resorption rate, progression of infraocclusion and the development of alveolar bone support. We should consider the timing of extraction of the ankylosed teeth without problem of neighbouring alveolar bone growth and tilting of adjacent teeth in the view of growth spurt. Early diagnosis is important to avoid many of the complications with infraoccluded primary molars.