• Journal of Periodontal and Implant Science
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• 제27권3호
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• pp.633-645
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• 1997

The recent trend of research and development on guided tissue regeneration focuses on the biodegradable membranes, which eliminate the need for subsequent surgical removal. They have demonstrated significant and equivalent clinical improvements to the ePTFE membranes. This study evaluate guided tissue regeneration wound healing in surgically induced intrabony periodontal defects following surgical treatment with a synthetic biodegradable membranes, made from a copolymer of glycolide and lactide, in 8 beagle dogs. After full thickeness flap reflection, exposed buccal bone of maxillary and mandibular canine and premolar was removed surgically mesiodistally and occlusoapically at $6mm{\times}6mm$ in size for preparation of periodontal defects. In experimental sites a customized barrier was formed and fitted to cover the defect. Flap was replaced slightly coronal to CEJ and sutured. Plaque control program was initiated and maintained until completion of the study. In 4, 8, 16 and 24 weeks after surgery, the animals were sacrificed and then undecalcified specimens were prepared for histologic evaluation. Histologic examination indicated significant periodontal regeneration characterized by new connective tissue attachment, cementum formation and bone formation. These membranes showed good biocompatibility throughout experiodontal period. The barriers had been completely resorbed with no apparent adverse effect on periodontal wound healing at 24 weeks. These results implicated that present synthetic biodegradable membrane facilitated guided tissue regeneration in periodontal defect.

• Journal of Periodontal and Implant Science
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• 제35권2호
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• pp.401-411
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• 2005

The aim of this study was to determine the minimal inhibitory concentration(MIC) of cefixime, which is a 3rd generation of cefalosporin, against 6 species of putative periodontopathogens; Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Prevotella nigrescens, Tannerella forsythia and Porphyromonas gingivalis. The efficacy of cefixime was examined by comparing it with that of several antibiotics(amoxicillin, $Augmentin^{(R)}$ ciprofloxacin, metronidazole, and tetracycline), which were used as the control. The MIC was measured using a microdilution method. The MIC of cefixime against the putative periodotopathogens, as a single use regimen, was relatively lower than that of the other antibiotics. The MIC of cefixime/metronidazole against P. intermedia ChDC KB14, P. nigrescens ChDC KB50, F. nucleatum ChDC PV-F37, F. nucleatum ChDC F130, and F. nucleatum ChDC F175, as a simultaneous regimen, was lower than that of the other antibiotics. The concentration of cefixime in the crevicular fluid of volunteers who received 250mg every 12 hours for 3 days was $9{\mu}g/ml$ after 9 hours. In conclusion, cefixime showed good antimicrobial activity in a single treatment or as a combined therapy with amoxicillin, $Augmentin^{(R)}$ or metronidazole against 6 periodontopathogens.

• Journal of Periodontal and Implant Science
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• 제38권3호
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• pp.521-528
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• 2008

Purpose: Tunneling is a periodontal surgical procedure that creates access for patient cleansing and maintenance within the furcal area of a molar tooth with severe furcation involvement. Up to date, there are few studies about a long term clinical and radiographic stability of tunneling. The purpose of this retrospective study is to evaluate the long term prognosis after tunnel preparation of molars with through and through furcation. Material and Methods: 25 teeth of 23 patients aged 36 to 70 (mean age 51.7) were treated surgically with tunnel preparation. These cases were followed for 2 to 13 years (mean 6.5years) after surgery. Patients were recalled for an evaluation which was based on a questionnaire, a clinical examination, and radiographic analysis. Clinical assessment included plaque index, caries registration, probing pocket depth, bleeding on probing, tooth mobility. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Result: 3 teeth(12%) had been extracted and 1 tooth(4%) hemisected. Root caries was detected in 3 teeth(12%). Thus 72% of the teeth were still caries tree and in function. Clinical parameters including PI, PD, BOP, mobility showed somewhat favourable results. Radiographic furcal bone loss showed no statistically significant difference compared to interproximal crestal bone loss ($3.59{\pm}1.69%$ vs $3.42{\pm}2.95%$) when root length was used as reference. There was no correlation between root trunk length and furcal bone loss. Conclusion: Over 2 years after tunneling procedure, teeth showed a clinically and radiographically stable condition, despite of slight root caries and alveolar bone loss within clinically acceptable range. The tunnel procedure may be considered as a viable periodontal treatment option for molar teeth with severe furcation involvement in individuals following a regular maintenance program.

• Journal of Periodontal and Implant Science
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• 제40권5호
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• pp.220-226
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• 2010

Purpose: This study was performed to evaluate the periodontal wound healing effect of particulate equine bone mineral on canine alveolar bone defects. Methods: Twelve adult male beagle dogs were used as study subjects. The mandibular second and fourth premolars were extracted prior to the experimental surgery, and the extraction sites were allowed to heal for 8 weeks. After periodontal probing, two-walled defects were created at the mesial and distal sides of the mandibular third premolars bilaterally, and the defects were filled with equine particulate bone with collagen membrane or bovine particulate bone with collagen membrane, or collagen membrane alone. The defects without any treatment served as negative controls. After probing depth measurement, animals were sacrificed at 10, 16, and 24 post-surgery weeks for micro-computed tomographic and histomorphometric analysis. Results: The equine particulate bone-inserted group showed significantly decreased values of probing depth and first bone contact compared to the negative control and collagen membrane alone groups at weeks 10, 16, and 24 (P<0.05). There were no significant differences in the new cementum length, newly-formed bone area, or newly-formed bone volume between equine particulate bone- and bovine particulate bone-inserted groups, both of which showed significantly increased values compared to the negative control and collagen membrane alone groups (P<0.05). Conclusions: Equine particulate bone showed significant differences in probing depth, first bone contact, new cementum length, newly formed bone area, and bone volume fraction values when compared to the negative control and collagen membrane alone groups. There were no significant differences between equine and bovine particulate bone substitutes in these parameters; therefore, we can conclude that equine particulate bone is equivalent to bovine bone for periodontal regeneration.

• Journal of Periodontal and Implant Science
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• 제39권1호
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• pp.1-8
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• 2009

Purpose: Bisphosphonates are drugs used to suppress osteoclastic activity and to treat osteoporosis, Paget's disease of bone and bone metastasis. The purpose of this report is to review the literatures on bisphosphonates use that could affect bone healing and cause osteonecrosis of the jaws. Materials and methods: Medline research was carried out to find relevant articles on bisphosphonates and osteonecrosis of the jaw. Results: Oral administration of bisphosphonates is reported to decrease the risk of adverse bone outcomes. On the contrary, IV bisphosphonates is known to significantly increase the risk. Prevention of the osteonecrosis of the jaw is primary concern before usage. If the adverse bone reaction takes place, proper management and treatments are required to alleviate pain of patients and prevent further progression of necrosis. Conclusion: Case reports of bisphosphonates induced osteonecrosis of the jaw are increasing. Dentists and physicians should be aware of the higher frequency of osteonecrosis of the jaw in patients receiving IV bisphosphonates and be prepared to prevent and cope with adverse bone reaction.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.849-857
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• 2007

Purpose: The purposes of this study were to compare and quantify the expressions of RANK and RANKL in the gingival tissues of non-periodontitis patient and patients with chronic periodontitis, in order to understand the contribution of these proteins to periodontal destruction. Material and methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was divided into two groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from non-periodontitis patients. Group 2 (n=8) is inflammed gingiva from patients with chronic periodontitis. Tissue samples were prepared and analyzed by Western blotting. The quantification of RANK and RANKL were performed using a densitometer and statistically analyzed by Student's t-Test. Results: The expression of RANK were similar in group 1 and 2. The difference between group 1 and 2 was not statistically significant. And the mean amount of RANKL was more increased in group 2 than group 1. The difference between group 1 and group 2 was statistically significant. Conclusion: The expression level RANK didn't show any significant difference between healthy tissue from non-periodontitis patients and inflamed tissue from chronic periodontitis, but the expression level of RANKL in inflammed tissue from chronic periodontitis showed significantly increased tendency compared to healthy gingiva from non-periodontitis patients. Therefore, characteristics of RANK and RANKL in progress of chronic periodontitis would be basis of further studies in diagnostic method and treatment index of the disease.

• Journal of Periodontal and Implant Science
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• 제50권1호
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• pp.2-13
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• 2020

Purpose: Subepithelial connective tissue grafts (SCTGs) are commonly performed for the treatment of gingival recession due to their high predictability. This study evaluated and histologically compared connective tissue grafts in terms of the presence of epithelial remnants and composition of the tissue types that were present (epithelium, lamina propria, and submucosa). Methods: Ten patients underwent epithelium removal using 2 different techniques: the use of a blade (group B) and through abrasion (group A). Twenty samples were collected and each tissue type was analyzed histologically in terms of its area, thickness, and proportion of the total area of the graft. Results: In 4 samples (40%) from group B (n=10) and 2 samples (20%) from group A (n=10), the presence of an epithelial remnant was observed, but the difference between the groups was not statistically significant (P>0.05). Likewise, no statistically significant differences were observed between the groups regarding the area, mean thickness, or proportion of the total area for any of the tissue types (P>0.05). Conclusions: Histologically, SCTGs did not show statistically significant differences in terms of their tissue composition depending on whether they were separated from the epithelial tissue by abrasion or by using a blade.

• Journal of Periodontal and Implant Science
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• 제35권3호
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• pp.719-730
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• 2005

The purpose of this study was to compare the effect of tetracycline HCL, Citric acid and PrefGel applied on the root surfaces that planed with periodontal curret with Roto bur. In this study, 20 extracted teeth with advanced periodontal disease were used. The teeth were root planing with periodontal curette and Roto bur. Following root planing, each agents was burnished on the prepared root surface for 3 minutes to find opened dentinal tubules. And then, each specimens were investigated using scanning electron microscope. Amount of remained cementum by loss of tooth substance index and the number of opened dentinal tubules were evaluated to each specimens The results were as follows. 1. Groups treated with periodontal curette were almost seemed no removed. Other groups treated with Roto bur showed partially opened dentinal tubule orifices. 2. Loss of tooth substance index were compared between groups. There was no statistically difference between periodontal curette groups. Between Roto bur groups was alike. But there were statistically differences between periodontal curette and Roto bur groups. 3. At comparing with various root conditioning agents, Tetracycline HCL group took statistically higher than Citric acid and PrefGel in opened dentinal tubules. On the other hand, there was no statistically difference between Citric acid group and PrefGel group. As a result of this study, groups treated with Roto bur showed more cementum removed than groups treated with periodontal curette. In a treatment for regeneration of periodontal tissue, it was regarded that Roto bur should be used and that Tetracycline HCL would be more effective as chemical root conditioning agent.

• 대한치과보철학회지
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• 제31권3호
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• pp.411-422
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• 1993

Osseointegrated dental implants are now an accepted part of the prosthetic treatment of fully and partially edentulous patients. Clinical studies have shown that osseointegrated dental implants may successfully be used as abutments for prosthetic rehabilitations, and that the supporting tissue can be kept in a stable and healthy clinical state for prolonged periods of time. The purpose of this study was to look for differences in the distribution in the bacterial morphotypes around natural teeth and osseointegrated dental implants. The subgingival plaque around natural teeth and implants was analysed by means of differential phase-contrast microscopy. In addition, clinical indices used to analyse natural teeth condition were used to compare the condition of natural teeth and implants. The results were as follows : 1. In implants of partially edentulous patients, the plaque index, sulcus bleeding index(P<0.05), pocket depth(P<0.01) were greater than natural teeth. 2. Gingival crevicular fluid volume was not significantly different between natural teeth and implants. 3. In implants of fully edentulous patients, the plaque index was greater than natural teeth(P<0.01) and implants of partially edentulous patients(P<0.05), but sulcus bleeding index was not significantly different. 4. In partially edentulous patient, coccoid cell proportion was greater in implants than natural teeth (P<0.05). 5. In implants of fully edentulous patients, coccid cell proportion was even greater than implants of partially edentulous patients(P<0.05) and natural teeth(P<0.01). 6. Among three groups, the proportions of non-motile rods, motile rods, spirochetes and others were not significantly different. 7. The proportion of motile bacteria was not significantly different among three group.

• Journal of Periodontal and Implant Science
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• 제31권2호
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• pp.299-315
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• 2001

Application of membranes for guided tissue regeneration(GTR) have been confined to the subgingival barrier functions; however, many studies have provided evidence that some drugs, including tetracycline, initially can promote the growth of periodontal ligament or alveolar bone in peridontal therapy. Osseous regeneration in periodontal defects is increased by local administration of tetracycline due to its anti-collagenolytic effect, which enhances bone-forming ability via osteoblast cell chemotaxis and reduced bone resorption. The aim of this study was to evaluate effects of tetracycline loaded poly-L-lactide(PLLA) barrier membranes for guided bone regenerative potential. Tetracycline was incorporated into the PLLA membrane with the ratio 10% to PLLA by weight. Ability to guided bone regeneration of the membranes were tested by measuring new bone in the tibial defects($7{\times}10{\times}5\;mm^3$) of the beagle dog for 4,5, and 6 weeks. In control, drug-unloaded PLLA membranes were used in same size of defect. In histologic finding of the defect area, a few inflammatory cells were observed in both groups. These membrane were not perforated by connective tissue and maintained their mechanical integrity for the barrier function for 4-6 weeks. New bone formation was greater in defects covered by tetracycline-loaded membrane than in defects covered by drug- unloaded membranes. In bone regeneration guiding potential test, tetracycline-loaded membrane was more effective than drug- unloaded membranes(p<0.05). These results suggest that tetracycline-loaded PLLA membranes potentially enhance guided bone regenerative efficacy and might be a useful barrier for GTR in periodontal treatment.