• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.53-58
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• 2009

Purpose: The resective treatment in mandibular Degree III furcation areas includes root resection and tunnel preparation. The purpose of this retrospective study is to evaluate which treatment procedure(root resection vs tunnel preparation) has more favorable prognosis in mandibular Degree III furcation involvement. Materials and methods: The subjects of this study were patients who were treated their mandibular posteriors with either root resection(22 teeth on 22 patients) or tunnel preparation(24 teeth on 22 patients) and have participated in periodic recall check program for at least 2 years. Failure rate, plaque index, bleeding on probing and probing pocket depth were measured and the results were compared and statistically analysed. Results: Failure rates of root resection and tunnel praparation were 13.6% and 16.7%, respectively, and showed no significant difference between two procedures. No significant differences were observed between two procedures with respect to plaque index, bleeding on probing and probing pocket depth. Conclusion: root resection and tunnel preparation are both effective procedures to treat mandibular posterior furcation involvement, if adequate treatment of choice is made and patient's cooperation is accompanied. However, tunnel preparation is more preservative procedure in mandibular posterior furcation involvement since root canal treatment and prosthetic restoration are needed additionally, in case of root resection.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.535-563
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• 1993

New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration alre basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet-derived growth factor (PDGF) is one of polypeptide growth factor. PDGF have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purposes of this study is to evaluate the possibility of using the PDGF as a regeneration promoting agent for furcation involvement defect. Eight adult mongrel dogs were used in this experiment. The dogs were anesthetized with Pentobarbital Sodium (25-30 mg/kg of body weight, Tokyo chemical Co., Japan) and conventional periodontal prophylaxis were performed with ultrasonic scaler. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree III furcation defect was made on mandibular second(P2) and fourth(P4) premolar. For the basic treatment of root surface, fully saturated citric acid was applied on the exposed root surface for 3 minutes. On the right P4 20ug of human recombinant PDGF-BB dissolved in acetic acid was applied with polypropylene autopipette. On the left P2 and right P2 PDGF-BB was applied after insertion of ${\beta}-Tricalcium$ phosphate(TCP) and collagen (Collatape) respectively. Left mandibular P4 was used as control. Systemic antibiotics (Penicillin-G benzathine and penicillin-G procaine, 1 ml per 10-25 1bs body weight) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operated sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 2, 4, 8, 12 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. At 2 weeks after surgery, therer were rapid osteogenesis phenomenon on the defected area of the PDGF only treated group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. New cementum fromation was observed from 2 weeks after surgery, and the thickness was increased until 8 weeks with typical Sharpey’s fibers reembedded into new bone and cementum. In both PDGF-BB with TCP group and PDGF-BB with Collagen group, regeneration process including new bone and new cementum formation and the group especially in the early weeks. It might be thought that the migration of actively proliferating cells was prohibited by the graft materials. In conclusion, platelet-derived growth factor can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.257-277
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• 2000

New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration are basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, and biological mediators. Platelet Rich Plasma has been reported as a biological mediator which regulates activities of wound healing progress including cell proliferation, migration, and metabolism. The purpose of this study is to evaluate the effects of using the Platelet Rich Plasma as a regeneration promoting agent for furcation involvement defect. Five adult beagle dogs were used in this experiment. The dogs were anesthetized with Ketamin HCl(0.1 ml/kg, IV)and Xylazine hydrochloride($Rompun^{(R)}$, Bayer, 0.1 ml/kg, IM) and conventional periodontal prophylaxis were performed with ultrasonic scaler and hand instruments. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree II furcation defect was made on mandibular third(P3), forth(P4) and fifth(P5) premolar, and stopping was inserted. After 4 weeks, stopping was removed, and bone graft was performed. Ca-P was grafted in P3(experimental group I), Combination of Ca-P and plasma rich platelet were grafted in P4(experimental group II), and P5 was remained at control group.Systemic antibiotics(gentamicin sulfate)and anlgesics(phenyl butazone) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operate sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 4, 8 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. At 4 weeks after surgery, there were rapid osteogenesis phenomenon on the defected area of the Platelet Rich Plasma plus Ca-P BBP group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. In conclusion, Platelet Rich Plasma can promote rapid osteogenesis during healing of periodontalregeneration.

• The korean journal of orthodontics
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• v.44 no.6
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• pp.320-329
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• 2014

Objective: To investigate the involvement of ephrinB2 in periodontal tissue remodeling in compression areas during orthodontic tooth movement and the effects of compressive force on EphB4 and ephrinB2 expression in osteoblasts and osteoclasts. Methods: A rat model of experimental tooth movement was established to examine the histological changes and the localization of ephrinB2 in compressed periodontal tissues during experimental tooth movement. RAW264.7 cells and ST2 cells, used as precursor cells of osteoclasts and osteoblasts, respectively, were subjected to compressive force in vitro. The gene expression of EphB4 and ephrinB2, as well as bone-associated factors including Runx2, Sp7, NFATc1, and calcitonin receptor, were examined by quantitative real-time polymerase chain reaction (PCR). Results: Histological examination of the compression areas of alveolar bone from experimental rats showed that osteoclastogenic activities were promoted while osteogenic activities were inhibited. Immunohistochemistry revealed that ephrinB2 was strongly expressed in osteoclasts in these areas. Quantitative real-time PCR showed that mRNA levels of NFATc1, calcitonin receptor, and ephrinB2 were increased significantly in compressed RAW264.7 cells, and the expression of ephrinB2, EphB4, Sp7, and Runx2 was decreased significantly in compressed ST2 cells. Conclusions: Our results indicate that compressive force can regulate EphB4 and ephrinB2 expression in osteoblasts and osteoclasts, which might contribute to alveolar bone resorption in compression areas during orthodontic tooth movement.

• International Journal of Oral Biology
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• v.41 no.4
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• pp.217-223
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• 2016

Porphyromonas gingivalis, a foremost periodontal pathogen, has been known to cause periodontal diseases. Epidemiologic evidences have indicated the involvement of P. gingivalis in the development of cardiovascular diseases. In this study, we show that the P. gingivalis lipopolysaccharide increases the mRNA expression and protein secretion of interleukin-6 in vascular smooth muscle cells. We demonstrate that P. gingivalis LPS activates the extracellular signal-regulated kinase 1/2 (ERK1/2), p38 mitogen-activated protein kinase (MAPK), and Akt, which mediate the IL-6 expression in vascular smooth muscle cells. Also, P. gingivalis LPS stimulates the vascular smooth muscle cell migration, which is a critical step for the progression of atherosclerosis. Moreover, neutralization of the IL-6 function inhibits the migration of vascular smooth muscle cells induced by P. gingivalis LPS. Taken together, these results indicate that P. gingivalis LPS promotes the expression of IL-6, which in turn increases the migration of vascular smooth muscle cells.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.80-88
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• 1996

The aim of the present investigation was to see the effect of combined use of PDGF BB and IGF -1 on the guided tissue regeneration(GTR) using barrier membrane in the treatment of human furcation involvement. Twelve patients with initially diagnosed as having moderate to advanced adult periodontitis with mandibular class II buccal furcation defects have been wer selected. Initial scaling and root planing has been performed and baseline data consisting of probing depths and attachment levels have been recorded prior to surgical procedures. The GTR procedures using either barrier membrane(control : ePTFE) alone or together with the application of PDGF - BB and IGF -l(experimental : ePTFE+PDGF/IGF) have been done under the routine guidelines. During the surgery, the distance from CEJ either to the bottom of the bone defects(CEJ - BD) or to the bone crest(CEJ-BC) were measured. Horizontal distance to the deepest area in the furcal defects were measured from the reference line connection the most prominent bony walls of the two buccal roots. 6 months following the GTR therapy, all the measurements were made repeatedly. The probing attachment gain of the experimental and the control grous were 2.14mm and l.07mm, respectively with no statically significnant difference. Amont of vertical bone fill in the experimental and the control groups were 2.43mm and 2.29mm, rexpectively. Amonut of horizontal bone fill were 2.86mm in the experimental group and 2.17mm in the control group, respectively. However, there were no significant differences in the amount of bone fill(both vertical and horizontal)between the two groups.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.173-186
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• 2002

The purpose of this study was to evaluate effect of platelet rich plasma on the treatment of Grade II furcation involvement, with Demineralized Freeze-Dried Bone(Dembone(R)) and bioabsorable membrane(BioMesh(R)) in humans by digital subtraction radiography. 12 teeth(control group) were treated with Demineralized Freeze-Dried Bone(Dembone(R)) and bioabsorable membrane(BioMesh(R)), and 12 teeth(test group) were treated with Demineralized Freeze-Dried Bone(Dembone(R)), bioabsorable membrane(BioMesh(R)) and Platelet Rich Plasma. The change of bone density was assessed by digital subtraction radiography in this study. The change of mineral content by as much as 5%(vol) could be perceived in the subtracted images. The change of mineral content was assessed in the method that two radiographs are put into computer program to be overlapped and the previous image is subtracted by the later one. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-whitney Test using SPSS program (5% significance level). The results were as follows: 1. In test group, the radiopacity in 3 months after surgery were significantly increased than 1 month after surgery(p<0.05). However. there were no significant difference between 1 month after surgery and 3 months after surgery in control group(p>0.05). 2. In test and control group, the radiopacity in 6 months after surgery were significantly increased than 1 month after surgery(p<0.05) 3. In test and control group, the radiopacity in 6 months after surgery were significantly increased than 3 months after surgery(p<0.05). 4. There were no significant difference between test group and control group at 1 month, 3 months after surgery, but radiopacity in test group were significantly increased than control group at 6 months after surgery(p<0.05). In conclusion, Platelet Rich Plasma can enhance bone density.

• 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.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.465-475
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• 2001

The purpose of this study was to evaluate effect of platelet rich plasma on the treatment of Grade II furcation involvement, with and without porous resorbable calcium carbonate($Biocoral^{(R)}$)in humans by digital subtraction radiography. 15 teeth(control group) were treated with porous resorbable calcium carbonate($Biocoral^{\(R)}$), and 15 teeth(test group) were treated with porous resorbable calcium carbonate($Biocoral^{(R)}$) and Platelet Rich Plasma. The change of bone density was assessed by digital subtraction radiography in this study. The change of mineral content by as much as 5%(vol) could be perceived in the subtracted images. The change of mineral content was assessed in the method that two radiographs are put into computer program to be overlapped and the previous image is subtracted by the later one. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-whitney Test using SPSS program(5% significance level). The results were as follows: 1. In test group, the radiolucency in 3 months after surgry were significantly increased than 1 month after surgery(p<0.05). 2. In test group, there were no significant difference between 1 month after surgery and 6 months after surgery(p>0.05). 3. In test group, the radiopacity in 6 months after surgery were significantly increased than 3 months after surgery(p<0.05). 4. In control group, the radiolucency in 3 months and 6 months after surgery were significantly increased than 1 month after surgery(p<0.05). 5. In control group, the radiopacity in 6 months after surgery were significantly increased than 3 months after surgery(p<0.05). 6. There were no significant difference between test group and control group at 1 month, 3 months after surgery, but radiopacity in test group were significantly increased than control group at 6 months after surgery(p<0.05). In conclusion, Platelet Rich Plasma can enhance bone density.

• Journal of Periodontal and Implant Science
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• v.39 no.3
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• pp.375-381
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• 2009

Purpose: Root resection can be a valuable procedure when the tooth in question has a high strategic value. The prognosis of root resection has been well documented in previous studies, but the results focused on the palatal root resection have not been discussed in depth. I represent here the short term effectiveness of palatal root resection of maxillary first molars. Methods: Palatal root resection was performed on maxillary first molars of three patients. All the palatal roots were floating state on the radiographic finding and showed full probing depth and purulent exudation at initial examination. Reduction of palatal cusp and occlusal table was performed concomitantly. Endodontic therapy was completed after root resection. Results: Compromised maxillary first molars were treated successfully by palatal root resection in 3 cases. The mobility of resected tooth was decreased a little bit. The probing pocket depth of remaining buccal roots was not increased compared to initial depth. All the patients satisfied with comfort and cost effective results and the fact they could save their natural teeth. Conclusions: Within the above results, palatal root resection is an effective procedure treating compromised maxillary first molar showing advanced palatal bone loss to root apex with or without pulp involvement when proper case selection is performed.