• Journal of Periodontal and Implant Science
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• v.47 no.4
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• pp.251-262
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• 2017

Purpose: The purpose of this study was to investigate the effects of implant tilting and the loading direction on the displacement and micromotion (relative displacement between the implant and bone) of immediately loaded implants by in vitro experiments and finite element analysis (FEA). Methods: Six artificial bone blocks were prepared. Six screw-type implants with a length of 10 mm and diameter of 4.3 mm were placed, with 3 positioned axially and 3 tilted. The tilted implants were $30^{\circ}$ distally inclined to the axial implants. Vertical and mesiodistal oblique ($45^{\circ}$ angle) loads of 200 N were applied to the top of the abutment, and the abutment displacement was recorded. Nonlinear finite element models simulating the in vitro experiment were constructed, and the abutment displacement and micromotion were calculated. The data on the abutment displacement from in vitro experiments and FEA were compared, and the validity of the finite element model was evaluated. Results: The abutment displacement was greater under oblique loading than under axial loading and greater for the tilted implants than for the axial implants. The in vitro and FEA results showed satisfactory consistency. The maximum micromotion was 2.8- to 4.1-fold higher under oblique loading than under vertical loading. The maximum micromotion values in the axial and tilted implants were very close under vertical loading. However, in the tilted implant model, the maximum micromotion was 38.7% less than in the axial implant model under oblique loading. The relationship between abutment displacement and micromotion varied according to the loading direction (vertical or oblique) as well as the implant insertion angle (axial or tilted). Conclusions: Tilted implants may have a lower maximum extent of micromotion than axial implants under mesiodistal oblique loading. The maximum micromotion values were strongly influenced by the loading direction. The maximum micromotion values did not reflect the abutment displacement values.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.2
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• pp.131-137
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• 2014

Purpose: This study examined the efficiency and wear of periodontal instrument sharpening using aluminum oxide stones with different levels of roughness. Materials and Methods: Thirty new No. 9-10 Gracey curets were used in this study. All curets had become dull after scaling and root planing. After similar blunting, the instruments were divided randomly into three groups (240, 600, 800 grit) containing 10 curets each. The stones were applied correctly to the lateral surface of each curet to maintain the $70-80^{\circ}$ angle. After resharpening, sharpness of the curets was examined by an optical microscope. After 20, 40, 60, and 80 strokes, the wear was measured at 1 mm and 2 mm from the tip of the cutting edge using a digital caliper. The data was analyzed statistically using analysis of variance (ANOVA) with repeated measures, 2-way ANOVA, and a Fisher's exact test. Results: The degree of sharpness increased significantly (P < 0.001) as the number of sharpening strokes grew for all stones. A comparison of the degree of sharpness on the same number of strokes showed that the 240 grit group significantly excelled the other groups on 5 and 10 strokes, respectively (P < 0.001). The mean wear showed no statistically significant difference among the groups (P > 0.05). Conclusion: The efficiency of Gracey curet resharpening was enhanced with more coarse stones, though we should consider the wear of the instrument during resharpening.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.3
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• pp.309-318
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• 2012

In advanced stages of periodontal disease, a lot of the periodontal tissue support are usually lost. The tissue destruction around some teeth is progressed to a level which requires either spontaneous exfoliation or extraction of several teeth due to their excessive mobility. In such cases, a comprehensive treatment plan encompassing the adequate periodontal and maintenance therapy, as well as perio-prosthetic treatment involving occlusal equilibration, is needed in order to restore health, function, and esthetics. Cross-arch fixed partial dentures(CAFPDs), one of the perio-prosthetic treatments, are used to stabilize the teeth with severely reduced periodontal tissue support. Unfortunately, however, a little is known about the occlusal scheme and biomechanical concept of CAFPDs. This paper will demonstrate summaries of the trauma from occlusion(TFO), Ante's law revisited, the treatment principles, the role of occlusion, and the long-term consequences for CAFPDs, and the possibility of CAFPDs through a case presentation.

• Journal of Periodontal and Implant Science
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• v.50 no.2
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• pp.106-120
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• 2020

Purpose: A new form of porous polyethylene, characterized by higher porosity and pore interconnectivity, was developed for use as a tissue-integrated implant. This study evaluated the effectiveness of porous polyethylene blocks used as an onlay bone graft in rabbit mandible in terms of tissue reaction, bone ingrowth, fibrovascularization, and graft-bone interfacial integrity. Methods: Twelve New Zealand white rabbits were randomized into 3 treatment groups according to the study period (4, 12, or 24 weeks). Cylindrical specimens measuring 5 mm in diameter and 4.5 mm in thickness were placed directly on the body of the mandible without bone bed decortication, fixed in place with a titanium screw, and covered with a collagen membrane. Histologic and histomorphometric analyses were done using hematoxylin and eosin-stained bone slices. Interfacial shear strength was tested to quantify graft-bone interfacial integrity. Results: The porous polyethylene graft was observed to integrate with the mandibular bone and exhibited tissue-bridge connections. At all postoperative time points, it was noted that the host tissues had grown deep into the pores of the porous polyethylene in the direction from the interface to the center of the graft. Both fibrovascular tissue and bone were found within the pores, but most bone ingrowth was observed at the graft-mandibular bone interface. Bone ingrowth depth and interfacial shear strength were in the range of 2.76-3.89 mm and 1.11-1.43 MPa, respectively. No significant differences among post-implantation time points were found for tissue ingrowth percentage and interfacial shear strength (P>0.05). Conclusions: Within the limits of the study, the present study revealed that the new porous polyethylene did not provoke any adverse systemic reactions. The material promoted fibrovascularization and displayed osteoconductive and osteogenic properties within and outside the contact interface. Stable interfacial integration between the graft and bone also took place.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.4
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• pp.327-336
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• 2007

Purpose This study was planned to compare and evaluate the stability of implant using $Osstell^{TM}$ and Osstell $Mentor^{TM}$. Material and methods Artificial bone and RBM(resorbable blasting media) surface blasted implants(Osstem US II, SS II implants - diameter: 4mm, length: 13mm) were used. To measure the stability of installed implants, $Osstell^{TM}$ and Osstell $Mentor^{TM}$ were used. In the first experiment, five implants were installed in D1(external type implants) and D3(internal type implants). In the second experiment, 4 internal type implants were divided in two groups and installed in D1 artificial bone with different depth. In the third experiment, two external implants were installed in D1 and D3 artificial bone each and two internal implants were installed in D1 and D3 artificial bone. In all groups, their stability were measured by $Osstell^{TM}$ and Osstell $Mentor^{TM}$. Results In all groups, $Osstell^{TM}$ and Osstell $Mentor^{TM}$ both showed reliable measurement values. The value difference between $Osstell^{TM}$ and Osstell $Mentor^{TM}$ was observed but the difference was small and clinically acceptable. Conclusion These results suggest that the use of Osstell $Mentor^{TM}$ has clinical relevance in the assessment of implant stability.

• Journal of Periodontal and Implant Science
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• v.43 no.4
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• pp.153-159
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• 2013

Purpose: The level of the implant above the marginal bone and flap design have an effect on the bone resorption during the healing period. The aim of this study is to detect the relationship between the level of the implant at the implant placement and the bone level at the healing period in the mesial and distal side of implants placed with flapless (FL) and full-thickness flap (FT) methods. Methods: Twenty-two nonsubmerged implants were placed with the FL and FT technique. Periapical radiographs were taken of the patient at implant placement, and at 6 and 12 weeks. By using computer software, bone level measurements were taken from the shoulder of the healing cap to the first bone implant contact in the mesial and distal side of the implant surface. Results: At 6 weeks, the correlation between the crestal bone level at the implant placement and crestal bone level of the FT mesially was significant (Pearson correlation coefficient=0.675, P<0.023). At 12 weeks, in the FT mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.297, P<0.346). At 6 weeks in the FT distally, the correlation was nonsignificant (Pearson correlation coefficient=0.512, P<0.107). At 12 weeks in the FT distally, the correlation was significant (Spearman correlation coefficient=0.730, P<0.011). At 6 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.083, P<0.809). At 12 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient= 0.062, P<0.856). At 6 weeks in the FL distally, the correlation was nonsignificant (Spearman correlation coefficient=0.197, P<0.562). At 12 weeks in the FL distally, the correlation was significant (Pearson correlation coefficient=0.692, P<0.018). Conclusions: A larger sample size is recommended to verify the conclusions in this preliminary study. The bone level during the healing period in the FT was more positively correlated with the implant level at implant placement than in the FL.

• Journal of Periodontal and Implant Science
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• v.37 no.1
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• pp.35-44
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• 2007

Periodontal ligament (PDL) is the connective tissue located between the tooth root and alveolar bone. In a previous study, PDLs22 was isolated as a PDL-specific gene by using subtractive hybrid-ization between cultured PDL fibroblasts and gingival fibroblasts. It was also suggested that PDLs22 plays important roles in the development, differentiation and maintenance of periodontal tissues. However, little is known about functional study of PDLs22 using recombinant protein in PDL fibroblast differentiation and periodontium formation. In this study, in order to produce the PDLs22 recombinat protein, PDLs22 expression vector were constructed and expressed its protein in various host cell and temperature conditions. The results were as follows: 1. PDLs22 protein was not strongly expressed In the induction system using pRSET-PDLs22 construct. 2. When the BL21(DE3) pLysS was used as a expression host, PDLS22 protein was strongly ex-pressed in the induction system using pHCEIIBNd-PDLs22 construct. 3. The PDLs22 protein was recognized at a molecular weight of 28 kDa in western blots. 4. Almost of the expressed PDLs22 protein was not soluble and observed like as inclusion body. 5. The protein solubility was not improved after modification of induction time and temperature during PDLs22 protein production. In this study, the system for the PDLs22 protein production was connstructed. However, the re-results suggest that further studies will be needed to produce the considerable amount of PDLs22 re-combinat protein, which can use for the periodontal regeneration.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.99-109
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• 2005

It has been focused on the importance of the host inflammatory response in periodontal pathogenesis and progression, treatment has been introduced to control the host response and the method, which diminishes production and activity of MMP by doxycycline, has been used in periodontal field. MMP is a proteolytic enzyme which plays a major role in tissue destruction and MMP-1 is secreted in the periodontally healthy tissue, while MMP-8, 9, 13, etc in the inflammatory state. Among these, MMP-13 has been discovered lately and reported to degrade primarily type II collagen. Periodontal ligament (PDL) cell plays a role in destruction of periodontal tissue. This study was to evaluate the effect of doxycycline and mefenamic acid, non-steroidal antiinflammatory drug on MMP-13 mRNA expression in the rat PDL cell. Doxycycline concentration of $1{\sim}100\;{\mu}g/ml$ was added rat PDL cell and cell activity was measured by MIT assay at day 1 and 3. MMP-13 gene expression was evaluated by RT-PCR after PDL cells were pre-treated for 1hour with doxycycline (50 ${\mu}g/ml$) alone or with mefenamic acid ($10^{-6}M$), then added $IL-1{\beta}$(1.0 ng/ml) and incubated for 16-18 hours. The results are as follows: 1. Cell activity decreased Significantly at 24 and 72 hours in 100 ${\mu}g/ml$ (p<0.05). 2. Level of MMP-13 mRNA was in 20.2% increase by $IL-1{\beta}$ and in pre-treating doxycycline group, expression of $IL-1{\beta}$ induced MMP-13 mRNA was inhibited by 31% than $IL-1{\beta}$ treated only. 3. Mefenamic acid did not inhibit on the expression of $IL-1{\beta}$ induced MMP-13 mRNA, while mefenamic acid in combination with doxycycline inhibited the expression by 41% compared to only $IL-1{\beta}$ stimulation. These results suggest that doxycycline synergistically inhibit the expression of $IL-1{\beta}$ induced MMP-13 mRNA in combination with mefenamic acid.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.4
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• pp.337-346
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• 2013

It is necessary to consider the median lingual foramen carefully to prevent the bleeding due to the damage of the sublingual artery for implant surgery. This study is to evaluate the frequency, location, diameter and the number of the Mandibular median lingual foramen regarding gender and age in the CBCT. Sixty two images of cone beam computed tomography (CBCT) whose visited the Chonnam National University Dental hospital from Sept. 2010 to Apr. 2011 were evaluated. Frequency, number, location and the diameter of Mandibular median lingual foramen shown in the CBCT image were evaluated. Sixty two patients (100%) had at least one median lingual foramen and fifty six patients (90.32%) had multiple foramens. Forty patients (66.13%) showed the median lingual foramen on the location between Mn. central incisors. The mean vertical position of the genial spine and the median lingual foramen was 24.21 mm and 14.52 mm, respectively. And the relative mean vertical dimension of median lingual foramen was 0.45. The mean diameter of the foramen was 0.93 mm. CBCT demonstrated the frequency, location, diameter and the number of median lingual foramen. It is necessary to take CBCT before implant placement to prevent the bleeding.

• Journal of Periodontal and Implant Science
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• v.28 no.1
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• pp.161-175
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• 1998

치주상태의 진단은 일반적으로 치주탐침과 같은 임상적 검사와 보조적으로 방사선 검사를 이용한다. 방사선학적인 검사가 치주조직의 파괴정도와 골 흡수를 진단하는데 유용하지만 실제적인 골 흡수를 정확하게 나타나는데는 한계가 있다고 하였다. 그리고 임상적 측정과 방사선 사진을 비교연구하여 이들간의 관계를 알아보고자 하는 노력이 있었다. 방사선이 임상에서 참고사항으로는 중요하지만 절대적 신뢰를 주는데는 문제가 있는 것으로 생각되어왔다. 방사선학적 측정과 임상지수 측정간의 상관관계에대하여 계속적인 연구를 통해 규명하는 것이 중요하다고 생각되어 저자는 연세대학교 치과 대학병원 치주과를 내원한환자중 연령 및 성별에 관계없이 전신질환이 없는 환자 130명을 대상으로 소구치의 원.근심부, 대구치의 원.중.근심부에서 치주낭의 깊이와 (P.D), 부착상실 (A.L)을 측정하였다. 방사선 사진상의 원.근심부에서 백악 법랑질 경계부에서 치조골능 상부까지의 치조골 수준 (Rx.B.L)을 측정하였고 이개부 부위에서는 이개부의 천정으로부터 나타나는 골 흡수의 방사선 투과상을 측정하였다. 이를 기초로 임상지수와 방사선학적 측정간에 상관관계를 연구하여 다음과 같은 결론을 얻었다. 1. 원·근심부의 P.D와 Rx.B.L을 비교 했을 때 상관관계는 모든 치아에서 높게 나타났다(r=0.897$\sim$r=0.725, p<0.01). 2. 원·근심부의 A.L와 Rx.B.L을 비교 했을 때 상관관계는 모든 치아에서 높게 나타났다 (r=0.915$\sim$r=0.732, p<0.01 ). 3. 대구치 769개가 실험 대상인었다. 상악 대구치중(356개) 40%가 이개부 병소를 나타냈고 (146개), 하악 대구치중(413개) 41%가 이개부 병소를 나타냈다(170개). 4. 대구치의 이개부 병소의 중앙부에서 측정한 P.D와 Rx.B.L을 비교 하였을 때 상관관계는 상악 제1대구치를 제외한 모든 치아에서 높게 나타 났다(r=0.811$\sim$r=0.435, p<0.01). 5. 대구치의 이개부 병소의 중앙부에서 측정한 A.L와 Rx.B.L을 비교 하였을 때 상관관계는 상악 제1대구치를 제외한 모든 치아에서 높게 나타 났다(r=0.906$\sim$r=0.479, p<0.01). 이상의 결과를 종합하여 볼 때 임상지수와 방사선학적 측정을 비교한 바, 이들의 상관관계는 모든 치아에서 밀접하게 나타났다. 따라서 방사선학적 측정은 임상지수와 더불어 치주질환의 진단과 치료계획에 크게 기여할 수 있을 것으로 사료된다.