• Journal of Periodontal and Implant Science
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• v.24 no.1
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• pp.87-97
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• 1994

The ultimate goal of periodontal therapy is to fully reconstruct the periodontal attachment apparatus. Commonly used techniques for treatment of infrabony defects include a combination of root planing, curettage and root treatment. To prevent the apical migration of epithelial cells, the technique of guided tissue regeneration is used. The aim of this study is to compare the effects of root treatment with Citric acid & Tetracycline and Guided tissue regeneration in dogs. Experimental periodontitis was induced by the ligation of orthodontic elastic threads in the upper right and left premolars 3, 4 of five adult dogs for 6 weeks. 4 types of procedures were performed as follows; 1) Control graup : Mucoperiosteal flap 2) Experinental I : GTR used Gore-tex(R) membrane 3) Experinental II : Root treatment with citric acid (PHl) 4) Experinental III : Root treatment with tetracycline HCl (50mg/ml) There after, dogs were serially sacrificed at the 1, 2, 4, 5, 8 weeks, and the specimens were prepared, and stained with hematoxylin-eosin for the light microscopic evaluation. The results of this study were as follows; 1. Junctional epithelium reached to the notch through the furcation area in control group at 8 weeks. 2. In the aspects of the inflammatory cell infiltration, control group showed severe aggregation than experimental group I, II, III through the experimental period 3. New cementum was observed over the notch from 5 weeks in experimental group II 4. In the aspects of the amount of new bone formation, experimental group was better than control group, but there was not significant differences among the experimental group, I, II, III

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.509-522
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• 2004

This study was performed to compare the clinical effectiveness of two regenerative techniques for class II furcation involvements in human: a combination of bone grafts with PRP vs. GTR with bone grafts. The e-PTFE group was treated with non-absorbable membrane and bone grafts, the PRP group was treated with PRP and bone grafts Pocket depth, clinical attachment level, and gingival recession were measured at baseline and postoperative 6 months. Vertical and horizontal furcation depth were measured by re-entry surgeries at 6 months post-treatment Both groups were statistically analyzed by Wilcoxon signed Ranks Test & Mann-whitney Test using SPSS program (5% significance level). The results were as follows: 1. The change of pocket depth, clinical attachment level, vertical furcation depth and horizontal furcation depth in both groups was decreased significantly at 6 months than at baseline. (p<0.05) 2. The change of gingival recession in both groups was increased significantly at 6 months than at baseline. (p<0.05) 3. The change of alveolar crest absorption in both groups was increased at 6 months than at baseline but there were no statistically significant differences. 4. The change of pocket depth, clinical attachment level, vertical furcation depth and horizontal furcation depth in both groups was increased significantly at 6 months, but there were no statistically or clinically significant differences with both groups. 5. The change of gingival recession and alveolar crest absorption in both groups was increased at 6 months, but there were no statistically or clinically significant differences with both groups. In conclusion, the use of bone graft with PRP or GTR technique improved clinical index of the soft and hard tissue in mandibular class II furcation involvement but there were no statistically or clinically significant differences between bone graft with PRP and GTR technique.

• Macromolecular Research
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• v.17 no.9
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• pp.682-687
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• 2009

Nanofibrous membranes of poly(D,L-lactic acid)/chitin blend were prepared by electro spinning for a barrier of guided tissue regeneration. A miscible solution was obtained by the blending chitin-salt complex into 1-methyl-2-pyrrolidone solution of poly(D,L-lactic acid). The properties of the blend were examined for nanofibrous fabrication. The viscosity of the blend solution was increased significantly due to chain entanglement despite the low ratio of chitin to poly(D,L-lactic acid). An interaction between two polymeric compositions was confirmed by Fourier transform infrared spectroscopy. X-ray diffraction detected an appreciably ordered microstructure in the nanofiber of the blend. A membrane of thinner nanofibers was fabricated by electro spinning the chitin blend. The permeability of the membranes was examined using bioactive model compounds.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.181-192
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• 2007

Periodontal surgery as part of the treatment of periodontal disease is mainly performed 1) to gain access to diseased areas for adequate cleaning; 2) to achieve pocket reduction or elimination; and 3) to restore the periodontal tissues lost through the disease; i.e., a new attachment formation of periodontal regeneration. To accomplish the latter, often referred to as the ultimate goal of periodontal therapy, a number of surgical procedures have been advocated throughout the years. Clinical studies have demonstrated that considerable gain of clinical attachment and bone can be achieved following guided tissue regeneration (GTR) therapy of intrabony defects. The aim of this study was to analyse the radiographic bone changes 2-year after GTR using a bone graft material and nonresorbable membrane. Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of intrabony defect(s), 33 sites of 30 patients aged 32 to 56 (mean age 45.6) were treated by GTR with a bone graft material and nonresorbable membrane. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. We observed $2.86{\pm}1,87mm$ of bone fill, $065{\pm}0.79mm$ of crestal resorption, $3.49{\pm}2.11mm$ of defect resolution, and $44.42{\pm}19.51%$ of percentage of defect resolution. Mandible, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. But no difference was observed between xenograft and allograft. Outcome of GTR as a therapy of intrabony defect was better than other therapy, but herein, good oral hygiene maintenance as a anti-infective treatment and periodic recall check of patients are essential.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.499-507
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• 1994

The aim of this experiment is to compare the healing process of extraction sockets after immediate implant placement with those using autogenous bone grafts and guided tissue regeneration with Gore-Tex. The first lower premolars and the second premolars of six experimental dogs were extracted and Stryker fin type implants were placed into the extraction sockets immediately after extraction. In the control group, any graft materials were'not used and the dead space around implants was left in itself and covered with only periosteum. In the experimental group A, implants were covered with Gore tex without any bone grafts, and in the experimental group B, the dead space around implants was filled with the bone chips gained from drilling procedure. Each experimental dogs were sacrificed at the 1st, 2nd, 3rd, 6th, and 8th week and the specimens were observed by gross examination, radiological examination, and light microscopic examination. The following results were obtained. 1. Well healed soft tissue and no mobility of the implants were observed in control and two experimental groups. 2. In the radiogical examination, radiopacity around implants had been increased gradually. 3. In the microscopic examination, there were good healing process and active new bone formation in both in the experimental groups, Especially the more amount of new bone formation occurred in the experimental group B using bone chips. 4. Bone chip grafts and guided tissue regeneration (GTR) using Gore-Tex may be one of the successful methods in the immediate implantation.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.539-553
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• 1999

The purpose of this 6-months study was to compare the clinical and radiographic outcomes following guided tissue regeneration treating human mandibular Class II furcation defects with a bioabsorbable BioMesh barrier(test treatment) or a nonabsorbable ePTFE barrier(control treatment). Fourteen defects in 14 patients(mean age 44 years) were treated with BioMesh barriers and ten defects in 10 patients(mean age 48 years) with ePTFE barriers. After initial therapy, a GTR procedure was done. Following flap elevation, root planing, and removal of granulation tissue, each device was adjusted to cover the furcation defect. The flaps were repositioned and sutured to complete coverage of the barriers. A second surgical procedure was performed at control sites after 4 to 6 weeks to remove the nonresorbable barrier. Radiographic and clinical examinations(plaque index, gingival index, tooth mobility, gingival margin position, pocket depth, clinical attachment level) were carried out under standardized conditions immediately before and 6 months after surgery. Furthermore, digital subtraction radiography was carried out. All areas healed uneventfully. Surgical treatment resulted in clinically and statistically equivalent changes when comparisons were made between test and control treatments. Changes in plaque index were 0.7 for test and 0.4 for control treatments; changes in gingival index were 0.9 and 0.5. In both group gingival margin position and pocket depth reduction was 1.0mm and 3.0mm; clinical attachment level gain was 1.9mm. There were no changes in tooth mobility and the bone in radiographic evaluation. No significant(p${\leq }$0.05) difference between the two membranes could be detected with regard to plaque index, gingival index, gingival margin position, pocket depth, and clinical attachment level. In conclusion, a bioabsorbable BioMesh membrane is effective in human mandibular Class II furcation defects and a longer period study is needed to fully evaluate the outcomes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.16.1-16.6
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• 2019

Background: Silk mats have been approved for clinical trials by the Korean Food and Drug Administration as membranes for guided tissue regeneration (GTR). In this study, silk mat application was compared to high-density polytetrafluoroethylene (dPTFE) membrane application or no membrane group. Methods: To compare the silk mat group to the dPTFE group or the no membrane group, a retrospective sample collection was conducted. Bony defects were measured at the time of extraction (T0) and then at 3 months (T1) and 6 months after extraction (T2) on a digital panoramic view. Bone gain (BG) was calculated by subtracting from the bony defect at T0 to the bony defect at each follow-up. Results: The BG at T2 was 2.44 ± 2.49 mm, 4.18 ± 1.80 mm, and 4.24 ± 2.05 mm in the no membrane group, silk mat group, and dPTFE group, respectively. Both membrane groups had significantly higher BG than BG in the no membrane group at T2 (P < 0.05). Conclusions: Both membrane groups showed higher BG than the no membrane group.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.3
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• pp.240-248
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• 1999

To investigate the expression pattern of noncollagenous bone matrix proteins such as osteonectin(OSN), osteopontin(OPN) and osteocalcin(OSC) mRNA during bony healing procedure induced by guided bone regeneration method, we made artificial defects on bilateral femur of rats. Then induced bony healing by application of a nonabsorbable PTFE membrane in experimental sites and without its application in control sites for 3 weeks. The mRNA expression pattern at specimens obtained at 1, 2 and 3 weeks after operation was detected by in situ hybridization method using its antisense mRNA probes. The experimental sites revealed more rapid and favorable bony healing than control sites and new bone formation was limited within defected area by inhibitory activity of bone marrow cells. In experimental sites, the OSN and OSC mRNA were expressed strongly on osteoblasts of regenerating cortical bone at 1st week and on osteoblasts lining the trabecular bone in marrow space at 3rd week, whereas, in control sites, their expression were noted on osteoblasts lining the reactively formed sponge bones at 2nd and 3rd week. In addition, the OPN mRNA was expressed on osteoblasts and osteoclasts at sites of remodeling and osteocytes of remained trabecular bone of defected area in experimental sites and on macrophages at 1st week and osteoclasts at sites of remolding at 2nd and 3rd week in control sites. The above findings suggest that the more rapid and favorable bony healing might be induced by blocking of invading fibrous connective tissue into bony defects. And the earlier expression of OSN and OSC mRNA on osteoblasts of experimental sites suggest that the formation and resorption of regenerating bone was more rapidly progressed in confined spaces made by applicate membranes.

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.877-889
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• 2005

This study was designed to compare the effects of treatment using chitosan membrane $(Nanogide-C^{(R)})$ resorbable barrier with control treated by polylactic acid/polylacticglycolic acid membrane(PLA/PLGA membrane, $Biomesh^{(R)}$). 44 furcation defecs from 44 patients with class 2 furcation degree were used for this study, 22 sites of them were treated by chitosan membrane as experimental group and 22 site were treated by PLA/PLGA membrane as control group. Clinical parameters including probing depth, gingival recession, attachment level and radiographic examination were evlauated at base line, 1 month, 2 month and 3 month. after surgery. Statistical test used to analyze these data included paired t-test, one way ANOVA. The results are as follows : 1. Probing depth was significanlly decreased in the two group and there were significant differences between groups(p<0.05). 2. Gingival recession was not significanlly increased in the two group and there were no significant differences between groups(p<0.05). 3. Loss of attachment was statistically decreased in the two group and there were no significant differences between groups(p<0.05). 4. Horizontal bone level was significanlly increased in the two group and there were significant differences between groups(p<0.05). On the basis of these results, chitoans resorbable membrane has similar potential to PLA/PLGA membrane in GTR for furcation defect.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.437-444
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• 2008

Purpose: A number of techniques and materials have been used for periodontal regeneration and bone graft procedures with guided tissue regeneration(GTR) have been suggested as alternatives to osseous surgery in the management of local infra-bony defects. However, the long-term stability and treatment outcome following bone graft procedure of infra-bony defects is poorly documented. The purpose of this study was to assess radiographic change in infra-bony defects over 2 years after bone graft procedures with various graft materials. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients showed clinical and radiographic evidence of infra-bony defect(s). 44 sites of 34 patients aged 31 to 69 (mean age 48.3) were treated by bone graft procedure with a bone graft material. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. Result: We observed $1.15{\pm}1.95\;mm$ of bone fill, $0.40{\pm}1.19\;mm$ of crestal resorption, $1.55{\pm}1.77\;mm$ of defect resolution, and $40{\pm}44%$ of percentage of defect resolution. Deeper initial defect depth, narrower initial defect angle showed significantly greater bone fill, defect resolution, and % of defect resolution. But no significant difference was observed in graft sites and graft materials. Conclusion: If good oral hygiene maintenance and periodic recall check of patients is assured, bone graft procedure using various graft materials is one of the appropriate treatment modality for regenerative therapy of infra-bony defects.