• Title/Summary/Keyword: Flap Height

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A novel amnion-chorion allograft membrane combined with a coronally advanced flap: a minimally invasive surgical therapy to regenerate interdental papillary soft tissue recession - a six-month postoperative image analysis-based clinical trial

  • Pitale, Unnati;Pal, Pritish Chandra;Boyapati, Ramanarayana;Bali, Ashish;Varma, Manish;Khetarpal, Shaleen
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.6
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    • pp.438-444
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    • 2021
  • Objectives: Loss of the interdental papilla is multi-factorial and creates a multitude of problems. Autogenous connective tissue/biomaterial-based regeneration has been attempted for decades to reconstitute the black space created due to the loss of papilla. The aim of this present study was to regenerate papillary recession defects using an amnion-chorion membrane (ACM) allograft and to evaluate the clinical outcome up to six months postoperatively. Materials and Methods: Twenty patients with 25 Nordland and Tarnow's Class I/II interdental papillary recession defects were treated with ACM and coronal advancement of the gingivo-papillary unit via a semilunar incision on the labial aspect followed by a sulcular incision in the area of interest. A photographic image analysis was carried out using the GNU Image Manipulation software program from the baseline to three and six months postoperatively. The black triangle height (BTH) and the black triangle width (BTW) were calculated using the pixel size and were then converted into millimeters. The mean and standard deviation values were determined at baseline and then again at three and six months postoperatively. The probability values (P<0.05 and P≤0.01) were considered statistically significant and highly significant, respectively. An analysis of variance and post hoc Bonferroni test were carried out to compare the mean values. Results: Our evaluation of the BTH and BTW showed a statistically and highly significant difference from the baseline until both three and six months postoperatively (P=0.01). A post hoc Bonferroni test disclosed a statistically significant variance from the baseline until three and six months postoperatively (P<0.05) and a non-significant difference from three to six months after the procedure (P≥0.05). Conclusion: An ACM allograft in conjunction with a coronally advanced flap could be a suitable minimally invasive alternative for papillary regeneration.

Multicenter clinical study on the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique

  • Lee, Hyung-Ju;Moon, Jee-Won;Lee, Ju-Hyoung;Park, In-Sook;Kim, Nam-Ho;Sohn, Dong-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.2
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    • pp.85-89
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    • 2012
  • Objectives: This study was to evaluate the effect of vertical bone gain and success rate and analyze the failure cases using the hydrodynamic piezoelectric internal sinus elevation (HPISE) technique. Materials and Methods: Patients who had been operated in the three centers including Daegu Catholic University Medical Center were selected for this study. The mucoperiosteal flap was elevated, and the sinus floor was then broken by specially designed piezoelectric insert, with hydraulic pressure applied to the sinus membrane for even elevation. Afterward, implants were placed. Panoramic radiogram or computed tomogram was taken before and after surgery and at the second operation and prosthesis placement. Later, changes in vertical height were measured and compared. The survival rate was based on the criteria of Buser et al. and Cochran et al. Results: In this study, 8 implants failed out of a total of 169 implants, resulting a success rate of 95.3%. These failure cases were due to insufficient initial stability or sinus membrane perforation. The mean of radiographic vertical height change at prosthesis placement was 5.7 mm (0.5-10.5 mm). Conclusion: In this study, HPISE technique was found to be a predictable treatment for atrophic maxilla and an alternative technique to the lateral approach.

Identification of immunological parameters associated with the alveolar bone level in periodontal patients

  • Park, Chang-Seo;Lee, Ju-Yeon;Kim, Sung-Jo;Choi, Jeom-Il
    • Journal of Periodontal and Implant Science
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    • v.40 no.2
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    • pp.61-68
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    • 2010
  • Purpose: The present study was performed to clarify the relationship between periodontal disease severity and selected immunological parameters consisting of serum IgG titer against periodontopathogenic bacteria, the expression of the helper T-cell cytokine by gingival mononuclear cells, and patients' immunoreactivity to cross-reactive heat shock protein (HSP) epitope peptide from P. gingivalis HSP60. Methods: Twenty-five patients with moderate periodontitis had their gingival connective tissue harvested of gingival mononuclear cells during an open flap debridement procedure and peripheral blood was drawn by venipuncture to collect serum. The mean level of interproximal alveolar bone was calculated to be used as an index for periodontal disease severity for a given patient. Each of selected immunologic parameters was subject to statistical management to seek their correlations with the severity of periodontal disease. Results: A significant correlation could not be identified between serum IgG titers against specific bacteria (Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, and Streptococcus mutans) and the severity of periodontal disease. Expression of interleukin (IL)-10 by gingival mononuclear cells was statistically significant in the group of patients who had higher levels of alveolar bone height. However, a similar correlation could not be demonstrated in cases for IL-4 or interferon-$\gamma$. Patients' serum reactivity to cross-reactive epitope peptide showed a significant correlation with the amount of alveolar bone. Conclusions: It was concluded that expression of IL-10 by gingival mononuclear cells and patients' sero-reactivity to the cross-reactive HSP peptide of P. gingivalis HSP60 were significantly correlated with alveolar bone height.

Effect of polydeoxyribonucleotide with xenogeneic collagen matrix on gingival phenotype modification: a pilot preclinical study

  • Hyun-Chang Lim;Chang-Hoon Kim;Han-Kyu Lee;Gyewon Jeon;Yeek Herr;Jong-Hyuk Chung
    • Journal of Periodontal and Implant Science
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    • v.53 no.6
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    • pp.417-428
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    • 2023
  • Purpose: To investigate the effect of xenogeneic collagen matrix (XCM) with polydeoxyribonucleotide (PDRN) for gingival phenotype modification compared to autogenous connective tissue graft. Methods: Five mongrel dogs were used in this study. Box-type gingival defects were surgically created bilaterally on the maxillary canines 8 weeks before gingival augmentation. A coronally positioned flap was performed with either a subepithelial connective tissue graft (SCTG) or XCM with PDRN (2.0 mg/mL). The animals were sacrificed after 12 weeks. Intraoral scanning was performed for soft tissue analysis, and histologic and histomorphometric analyses were performed. Results: One animal exhibited wound dehiscence, leaving 4 for analysis. Superimposition of STL files revealed no significant difference in the amount of gingival thickness increase (ranging from 0.69±0.25 mm to 0.80±0.31 mm in group SCTG and from 0.48±0.25 mm to 0.85±0.44 mm in group PDRN; P>0.05). Histomorphometric analysis showed no significant differences between the groups in supracrestal gingival tissue height, keratinized tissue height, tissue thickness, and rete peg density (P>0.05). Conclusions: XCM soaked with PDRN yielded comparable gingival augmentation to SCTG.

A Study on Flight Characteristics and Flight Control Methodology for a Wing In Ground Effect Vehicle (지면효과익기의 비행특성 해석 및 비행제어 방식에 관한 연구)

  • Song, Yongkyu
    • Journal of Advanced Navigation Technology
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    • v.5 no.1
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    • pp.19-25
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    • 2001
  • In this study an analysis on flight characteristics and flight control methods for a wing in ground effect vehicle is made. In order to closely view its nonlinearity a few limit cycles are examined and related to the characteristics of the linearized systems. Several flight control methods are compared for the cruise mode with initial height error and command tracking mode of ascending, cruise, and descending. In comparison performance and the implementation aspects are examined. For the possible control inputs, combinations of elevator, thrust, and flap are considered and LQR-based output command tracking scheme is applied in the control system design.

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Experimental Study of the Thrust Vectoring Characteristics in a Two-Dimensional Convergent-Divergent Nozzle (2차원 축소확대노즐의 추력편향특성 실험연구)

  • Yu, Du Whan;Choi, Seong Man;Oh, Seong Hwan
    • Journal of the Korean Society of Propulsion Engineers
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    • v.17 no.2
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    • pp.84-93
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    • 2013
  • Stealthy, high maneuverability and super cruise abilities are required for the next generation fighter and unmanned aircraft. Thrust vector control technique currently come into use to meet these requirements. In this experimental study, axial and pitch thrust were measured and Schlieren visualization were carried out using the scaled two dimensional thrust vector nozzles under various pitch deflection angle, pitch flap length and height. From the study, we could get the supersonic flow characteristics and draw an optimum geometric configuration of the two dimensional thrust vector nozzle.

Retrospective case series analysis of vestibuloplasty with free gingival graft and titanium mesh around dental implant

  • Ku, Jeong-Kui;Leem, Dae Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.6
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    • pp.417-421
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    • 2020
  • Objectives: The purpose of this paper is to introduce an effective technique to easily obtain adequate amounts of keratinized gingiva and vestibular depth. Materials and Methods: Free gingiva (vertical height 10 mm) was harvested on the palatal mucosa and a partial thickness flap was elevated on the recipient site with same width as the free gingiva graft. After a conventional suture, a titanium mesh covered the graft and was fixed with miniscrews. Titanium mesh was removed 4.1±2.5 weeks after surgery. The amount of keratinized gingiva and vestibular depth was measured at the final follow-up. Results: Nine patients (males 4, females 5; 53.9±14.1 years) who underwent bone graft surgery before vestibuloplasty were included. No free gingival graft failure or complications were encountered in any of the patients. The relapse rate for vestibular depth (23.3%) was lower than that for keratinized gingiva (48.3%) after 34.4±14.4 months (P=0.010). Conclusion: Vestibuloplasty with a free gingival graft using titanium mesh could be achieved with an acceptable amount of keratinized gingiva and an appropriate vestibular depth around dental implant.

Effective Management of Multiple Non-carious Cervical Lesions with Gingival Recession and Dentin Hypersensitivity: Two Cases Report of Combined Restorative and Periodontal Approach

  • Hyunkyung Kim;Sungtae Kim;Young-Dan Cho
    • Journal of Korean Dental Science
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    • v.17 no.2
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    • pp.92-104
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    • 2024
  • Managing multiple non-carious cervical lesions (NCCLs) with gingival recession and dentin hypersensitivity can be challenging. Herein, we present two cases of successful treatment procedure for multiple NCCLs with gingival recession and dentin hypersensitivity using an envelope coronally advanced flap with CTG and composite resin restoration. Through the combined approach of restorative and periodontal procedure, both patients showed adequate extent of gingival coverage and esthetic outcome based on the Modified Root Coverage Esthetic Score (MRES) at 6 months postoperatively. Also, dentin hypersensitivity was reduced effectively during the follow up period. Although the pocket depth slightly increased in patient 1, possibly due to the amount of restoration located sub-gingivally, pocket depth remained within 3 mm. This suggest that re-establishing the clinical CEJ and performing partial restoration is advantageous for periodontal tissue and is expected to contribute to maintain gingival height in the long term. These case reports emphasize the efficacy of the combined approach for treating multiple NCCLs with gingival recession and dentin hypersensitivity, highlighting the importance of careful restoration planning for optimal clinical and aesthetic outcomes.

Simultaneous implant placement with sinus augmentation using a modified lateral approach in the pneumatized posterior maxilla: A Case Report (함기화된 상악 구치부에서 변형 측방 접근법을 이용한 상악동 거상술과 임플란트 동시식립에 대한 증례보고)

  • Sun, Yoo-Kyung;Cha, Jae-Kook;Lee, Jung-Seok;Jung, Ui-Won
    • The Journal of the Korean dental association
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    • v.56 no.3
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    • pp.142-150
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    • 2018
  • In the posterior maxillary area, due to resorption of the ridge after extraction and pneumatization of the maxillary sinus, the height of the alveolar ridge may not be sufficient for placement of implants. To solve this problem, sinus augmentation using both crestal and lateral approaches have been widely used. Jung et al. (2010) introduced the modified lateral approach technique, which is a simplified technique that combines the advantages of crestal and lateral approaches. The purpose of this case report is to report two cases in the posterior maxilla in which simultaneous implant placement with maxillary sinus augmentation has been performed using the modified lateral approach technique. In two female patients, 67 and 74 years old, respectively, simultaneous implant placement was performed using the modified lateral approach technique on the left maxillary second premolar and the first molar. In both patients, the residual bone height on the distal side of the maxillary second premolar was measured to be approximately 5 mm, and the residual bone height of the first molar was measured to be 2-3 mm. After flap elevation, osteotomy of the lateral window was performed in the form of a mesiodistally extended slot above the sinus floor and the Schneiderian membrane was elevated. Sequenced drilling was performed while protecting the membrane with a periosteal elevator. Bone graft and implant placement was performed after preparation of the implant site. Sufficient primary stability was achieved for each implant and sinus membrane was not perforated. After four and five months respectively, implant second surgery was performed. Clinically, the implants were observed to be stable. Implants and surrounding peri-implant mucosa were well maintained after prosthodontic treatment. In conclusion, the modified lateral approach could be a predictable and efficient technique for implant placement in the atrophied posterior maxilla.

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The effects of bioactive glass on the periodontal healing of 1-wall intrabony defects in dogs (성견 1면 골결손부에서 Bioactive Glass가 치주조직 치유에 미치는 영향)

  • Park, Weon-Yeong;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.28 no.1
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    • pp.145-160
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    • 1998
  • The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease, and numerous kinds of materials and techniques have been developed to achieve this goal. Bone grafts include autografts, allografts, xenografts and synthetic grafts. Among the synthetic grafts, bioactive glass has been used in dentistry for more than ten years and Fetner reported improved new bone formation and more amount of new attachment after grafting PerioGlas, a kind of bioactive glass, in 2-wall defects of monkeys in 1994. It Is well known that 1-wall defects have less osteogenic potential and more epithelial migration, so we need to study the erect of bioactive glass in 1-wall dejects in dogs. The present study evaluates the effect of bioactive glass on the epithelial migration, alveolar bone regeneration, cementum formation and gingival connective tissue attachment in intrabony detects of dogs. Four millimeter deep and four millimeter wide 1-wall defects were surgically cheated in the mesial aspects of premolars. The test group received bioactive glass with a flap procedure and the control underwent flap procedure only. Histologic analysis after 8 weeks of healing revealed the following results: 1. The height of gingival margin was 1.30{\pm}0.73mm$ above CEJ in the control and $1.40{\pm}0.78mm$ in the test group. There was no statistically significant difference between the two group. 2. The length of epithelial growth (the distance from CEJ to the apical end of JE) was $1.74{\pm}0.47mm$ in the control and $1.12{\pm}0.36mm$ in the test group. These was a statistically significant difference between the two groups (P<0.01). 3. The length of new cementum was $2.06{\pm}0.73mm$ in the control and $2.62{\pm}0.37mm$ in the test group. There was no statistically significant difference between the two groups. 4. The length of new bone was $1.83{\pm}0.74mm$ in the control and $2.39{\pm}0.59mm$ in the test group. There was no statistically significant difference between the two groups. These results suggest that the use of bioactive glass 1-wall intrabony defects has significant effect on the prevention of junctional epithelium migration, but doesn't have any significant effect on new bone and new cementum formation.

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