• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.465-478
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• 2007

Various periodontal barrier membranes used in many clinical and experimental fields, and many recent studies of membranes have reported good results. To improve clinical results, selection of barrier membranes is an important factor. So, we need not only to evaluate various barrier mem-branes, but also to understand the property of barrier membranes appropriate to defect characteristics. For this purpose, this study reviewed available literature, evaluated comparable experimental models, and compared various barrier membranes. From above mentioned methods, the following conclusions are deduced. 1. In i-wall periodontal defect models, new bone formation showed a consistent result, almost 30% of the defect size. New cementum formations measured mostly 40% of the defect size, but showed more variations than new bone formations. This seems to be resulted form difference in experimental methods, so standardization in experimental methods is needed for future studies. 2. Application PLGA barrier membrane to periodontal defect demonstrated improved healing in new bone and new cementum. 3. There was a minimal periodontal regeneration with calcium sulfate barrier membrane only. But, there was better healing pattern in combination of calcium sulfate membrane with bone graft material, such as DFDBA, 4. There was no significant difference between the experimental group that used chitosan mem-brane only and the control group. But, in combination with bone graft material for space maintanence, periodontal regeneration was improved. Overall, Space maintenance is a critical factor for Guided tissue regeneration using barrier membranes. Also, a barrier membrane itself that has difficulty in maintaining space, achieved better result when used with graft material.

• The Journal of the Korean dental association
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• v.54 no.5
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• pp.365-373
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• 2016

Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

• Journal of Periodontal and Implant Science
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• v.31 no.4
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• pp.689-711
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• 2001

The purpose of this study was to compare clinical results of guided tissue regeneration(GTR) using either a nonresorbable ePTFE membrane or a resorbable membrane made from a synthetic copolymer of glycolide and lactide(PLGA) in the treatment of human class Ⅱ furcation defects. The ePTEE membranes were applied to 16 patients with maxillary molar buccal class Ⅱ furcation defects as Group I, PLGA membranes were applied to 15 patients with maxillary molar buccal class Ⅱ furcation defects as Group Ⅱ, ePTFE membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅲ and PLGA membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅳ and bone graft materials(DFDBA) were applied in all groups. Probing depth, gingival recession, clinical attachment level, tooth mobility and sulcus bleeding index(SBI) were measured at baseline, 3, 6 and 12months postoperatively. In addition, membrane exposure levels were measured at surgery, 1, 2 and 6weeks postoperatively and postoperative complications were evaluated. The results were as follows: In all groups, there were statistically significant differences in probing depth reduction, gain of clinical attachment and mobility reduction at values of 3, 6 and 12months postoperatively compared to values of baseline, whereas no significant differences in SBI except Group I and gingival recession(p<0.05). Membrane exposure levels were increased at 1, 2 and 6weeks postopratively compared to value of baseline in Group I(p<0.05). There were no statistically significant differences between ePTFE and PLGA membrane in probing depth, clinical attachment level and SBI. There were minimal gingival recession and membrane exposure in Group Ⅳ and pain and swelling were the most common postoperative complications in Group Ⅱ, Ⅲ(p<0.05). In conclusion, this study showed that both nonresorbable membrane and resorbable membrane were effective similarly in the treatment of class Ⅱ furcation defects, without statistical differences in clinical measurements.