• Journal of Periodontal and Implant Science
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• 제38권3호
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• pp.551-556
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• 2008

Purpose: Cemental tear is an uncommon form of root fracture that can lead to rapid localized attachment loss. When it is exposed in the periodontal pocket, it should be removed to prevent accumulation of dental plaque and calculus. Material and Methods: 2 patients were diagnosed as a cemental tear and they were treated with conventional flap operation and subgingival curettage. Additional treatments such as bone graft or guided tissue regeneration were not performed. Result: Symptoms subsided after the treatment. Periodontal pocket has been reduced but no gain of clinical attachment was observed. Remnant of cemental fragment remained after curettage. However, periodontal pocket was stably maintained and there was no recurrence. Conclusion: Periodontal attachment loss associated with cemental tear can be successfully treated with conventional periodontal surgical and nonsurgical procedures.

• Journal of Periodontal and Implant Science
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• 제44권3호
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• pp.147-155
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• 2014

Purpose: In the anterior maxilla, hard and soft tissue augmentations are sometimes required to meet esthetic and functional demands. In such cases, primary soft tissue closure after bone grafting procedures is indispensable for a successful outcome. This report describes a simple method for soft tissue coverage of a guided bone regeneration (GBR) site using the double-rotated palatal subepithelial connective tissue graft (RPSCTG) technique for a maxillary anterior defect. Methods: We present a 60-year-old man with a defect in the anterior maxilla requiring hard and soft tissue augmentations. The bone graft materials were filled above the alveolar defect and a titanium-reinforced nonresorbable membrane was placed to cover the graft materials. We used the RPSCTG technique to achieve primary soft tissue closure over the graft materials and the barrier membrane. Additional soft tissue augmentation using a contralateral RPSCTG and membrane removal were simultaneously performed 7 weeks after the stage 1 surgery to establish more abundant soft tissue architecture. Results: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppuration were not observed in the donor or recipient sites after the stage 2 surgery. These procedures enhanced the alveolar ridge volume, increased the amount of keratinized tissue, and improved the esthetic profile for restorative treatment. Conclusions: The use of RPSCTG could assist the soft tissue closure of the GBR sites because it provides sufficient soft tissue thickness, an ample vascular supply, protection of anatomical structures, and patient comfort. The treatment outcome was acceptable, despite membrane exposure, and the RPSCTG allowed for vitalization and harmonization with the recipient tissue.

• Journal of Periodontal and Implant Science
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• 제38권3호
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• pp.429-436
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• 2008

Purpose: The goal of periodontal regenerative therapy is to replace bone, cementum, and periodontal ligament on a previously diseased root surface, which has suffered the loss of these supporting structures. To accomplish the regeneration, a number of surgical procedures have been advocated throughout the years. There seems to be a potential for some spontaneous periodontal tissue regeneration in the bottom of periodontal defect following open flap debridement alone. The aim of this study was to analyse the radiographic bone changes over 2-year after flap operation. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of infrabony defect(s). forty two sites of 33 patients aged 26 to 65 (mean age 45.5) were treated by flap operation with or without osseous surgery. Baseline and over 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, gender, defect depth, defect angle) using the paired t-test were examined. Result: We observed 0.74 mm of bone fill, 0.66 mm of crestal resorption, 1.40 mm of defect resolution, and 27% of percentage of defect resolution. Mandible, women, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. Conclusion: The results of this study suggest that the use of flap operation did enhance the outcome in terms of radiographically detectable bone fill. Both treatment resulted in some loss of crestal bone height.

• 구강회복응용과학지
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• 제39권4호
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• pp.276-284
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• 2023

발치 후 시간이 지남에 따라 치조골이 흡수되는 것은 자연스러운 현상이다. 치조골 소실과 상부 연조직의 감소는 추후 임플란트 식립 및 임플란트의 장기 생존 가능성에 어려움을 준다. 이번 증례보고는 치주질환에 이환된 발치와에 치조제 증강술과 연조직 대체제 중 이종 콜라겐 기질을 함께 이용하여 임플란트 식립 부위의 연조직과 경조직을 증가시키는 데 중점을 둔다. 각각의 증례에서 치조골의 너비가 6 mm, 8 mm, 4 mm로 증가하였고, 임플란트 주변으로 치간 유두의 재생과 각각 4 mm, 6 mm, 4 mm의 협측 각화치은을 보여준다. 증대된 치조골은 임플란트 수술을 용이하게 하며 치간 유두와 각화치은은 심미적인 보철이 가능하게 한다. 이 연구는 치주질환이 이환된 발치와를 가진 환자에게 치조제 증강술을 시행하고 연조직 대체제를 추가로 사용함으로써 임플란트 식립을 위한 보다 나은 환경을 제공하고 심미적이고 예지성 있는 임플란트 수술을 위한 긍정적인 효과를 보여준다.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.176-187
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• 1996

The ability of fibroblasts attached to teeth is paramount important in reestablishing the lost connective tissue attachment after periodontal therapy. The migration and proliferation of periodontal ligament cells are desired goal of periodontal regeneration therapy. PDGF is well known to regulate the cell activity of mesenchymal origin cell. Tobacco contains a complex mixture of substance including nicotine, various nitrosamines, trace elements, and variety of poorly characterized substances. Human gingival fibroblasts and periodontal ligament cells were cultured from extracted tooth for non-periodontal reason. Cultured human gingival fibroblasts and periodontal ligament cells in vitro were treated with PDGF, nicotine in time dependent manner. Cellular activities were determined by MTT assay. The purpose of this study was to determine the effects of Nicotine and PDGF, respectively and the effect of PDGF presence of nicotine on human gingival fibroblasts and periodontal ligament cells. The results were as follows : 1. In the cell activities of human gingival fibroblasts and periodontal ligament cells were similar or decreased to control value at 1st day. At 2nd day, cellular activities of both group were increased to control value. At 3rd day, cellular activities of both group were returned to the control value. 2. In the cell activities of PDGF on human gingival fibroblasts and periodontal ligament cells, cell activities significantly increase from control group on periodontal ligament cells compared to gingival fibroblast group at 3rd day. 3. In the cell activities of PDGF and nicotine combined application on human gingival fibroblasts and periodontal ligament cells, it seems likely that the nicotinic effect of gingival fibroblasts were higher than periodontal ligament cells and the PDGF effect of periodontal ligament cells were higher than gingival fibroblasts. This results suggested that PDGF might stimulate the selective growth on periodontal ligament cells.

• Journal of Periodontal and Implant Science
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• 제31권1호
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• pp.163-180
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• 2001

The aim of this study was to evaluate the effects of chitosan coating on the attachment, proliferation, functional and morphological change of periodontal ligament cells. Primary human periodontal ligament cells were cultured in dulbecco's modified Eagle's medium with 10% fetal bovine serum and 1% antibiotics. In experimental group, cells of 4th to 7th passage were inoculated in the multiwell plates coated with chitosan in concentration of 0.22, 0.2, and $2mg/m{\ell}$. Cell counting and MTT assay were done after 0.5, 1.5, 3, 6 and 24 hours of incubation to evaluate the cell attachment, and then after 2 and 7 days of culture to evaluate the cell proliferation. The alkaline phosphatase activity was measured after 4 and 7 days of culture and the ability to produce mineralized modules was evaluated after 21 days of culture. The results were as follows : 1. The morphology of periodontal ligament cells on the chitosan coating was round or spheric. Round cells were aggregated after 6 hours of culture. Aggregated cells on the chitosan coated surface showed nodule-like appearance after 24 hours of culture and not achieved confluency at 7 days. 2. During early period of culture, the attachment of periodontal ligament cells were inhibited by chitosan coating. Inhibition of cell attachment tended to increase with the concentration of chitosan. 3. At the chitosan concentration of 0.02 and $0.2mg/m{\ell}$, periodontal ligament cells were more rapidly proliferated at 7 days, compared to the control group. At the concentration of $2mg/m{\ell}$, the proliferation of periodontal ligament cells was inhibitied(p<0.01). 4. Alkaline phosphatase activity of periodontal ligament cells was increased in chitosan coated group, especially at the concentration of $0.02mg/m{\ell}$after 4 days of culture.5. Periodontal ligament cells produced mineralized nodules on chitosan coated wells without the addition of mineralized nodule forming materials (ascorbic acid, ${\beta}-glycerophosphat$, dexamethasone). With the addition of mineralized nodule forming materials, periodontal ligament cells produced more mineralized nodules at the concentration of $0.02mg/m{\ell}$, compared to the control. In summary, the attachment, proliferation, cell activity, and alkaline phosphatase activity of periodontal ligament cells depended on the concentration of coated chitosan. Chitosan stimulated mineralized nodule formation by periodontal ligament cells. At the appropriate concentration($0.02mg/m{\ell}$), chitosan could increase alkaline phosphatase activity and stimulate the formation of mineralized nodule by periodontal ligament cells. These results suggest that chitosan can be used as an adjunct for bone graft material, and the matrix of tissue engineering for periodontal regeneration, especially bone regeneration.

• Journal of Periodontal and Implant Science
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• 제36권4호
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• pp.809-816
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• 2006

Periodontal disease accompany the inflammation around periodontal tissue and generally periodontal destruction is followed, This destruction often makes the molar teeth have furcation defect. And to treat molar furcation involvement, resective surgery such as root resection and ostectomy and regenerative procedure such as guided tissue regeneration were introduced. Also implant can be considered as one of the good treatment methods, Among these treatment alternatives, root resection can be considered as a good procedure in the point of saving one's natural teeth or amount of cost. Therefore the purpose of this article is to evaluate root-resected teeth which were done at least 2 years ago. 70 root-resected teeth in 58 patient who visited Kyungpook National University Hospital were included in this study. They were evaluated by two clinical method. One is subjective evaluation and another is objective evaluation. To evaluate subjective outcome, 58 patients answered to the questionnaire if they experienced tooth extraction, bleeding, swelling, pain, mobility and chewing problem. To evaluate objective outcome, 28 teeth was evaluated according to Langer's criteria. The subjective result showed 82% of success rate and 18% of failure rate. 13 of 70 teeth showed discomfort and were considered as failure, which include chewing problem (39%) and pain (23%). The objective outcome showed that 4 failure (14% failure rate) which were 2 cases of bone loss by periodontal problem, one endodontic problem and one untreatable caries. By these limited results, some of clinical consideration in root resective procedure can be suggested. Periodontal support and less occlusal loading on resected tooth should be evaluated before the procedure, moreover, good oral hygiene is essential. When these factors are considered carefully, the root resection may produce predictive outcomes in the treatment of furcational involvement.

• Journal of Periodontal and Implant Science
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• 제34권4호
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• pp.711-722
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• 2004

The purpose of this study is to evaluate the regenerated bone histollogically using titanium reinforced ePTFE(TR-ePTFE) membrane and to investigate cell occlusiveness, wound stabilization and tissue integration of TR-ePTFE membrane. Adult male rabbits (mean BW 2kg) and TR9W (W.L.Gore&Associate.INC,USA) were used in this study. Intramarrow penetration defects were surgically created with round carbide bur(HP long #6) on calvaria of rabbits. TR-ePTFE membrane was applied to defect. Then guided bone regeneration was carried out using TR-ePTFE membrane and resorbable suture. At 2,4,8,12 weeks after the surgery, animals were sacrificed. Nondecalcified specimens were processed for histologic analysis. The result and conclusion of this study were as follows: 1. TR-ePTFE membrane had good ability of biocompatibility and cell occlusiveness. 2. space making for guided bone regenerayion was good at TR-ePTFE membrane. 3. Tissue integration was not good at TR-ePTFE membrane. So, wound stabilization was not good. 4. At 8 weeks, 12 weeks after GBR procedure, bone formation was seen. From the above results, TR-ePTFE membrane fixed tightiy on alveolar bone might be recommended for the early bone formation.

• Journal of Periodontal and Implant Science
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• 제29권1호
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• pp.65-80
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• 1999

The purpose of this study was to evaluate the effects of periodontal curet and various rotating instruments on the root surfaces. Thirty-five extracted teeth with advanced periodontal disease were used. They was root planed with periodontal curet, periodontal Perio-Clean bur, periodontal Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur. To find dentinal tubule orifices on the root surface, tetracycline HCI solution was applied to the one tooth of treated each group. Then, root surfaces were investigated using scanning electron microscope. Amount of loss of cementum was evaluated by loss of tooth substance index. The results were as follows. 1. Groups treated with periodontal curet and Perio-Clean bur showed irregular surface and concavities. Concavities seemed to be lacunae of cementocyte. Other groups treated with Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur showed partially opened dentinal tubule orifice. 2. Groups treated with periodontal curet and Perio-Clean bur and tetracycline HCl showed irregular surface. No dentinal tubule orifice was seen. Other groups treated with Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur and tetracycline HCl showed dentinal tubule orifice with various shape and size. 3. Loss of tooth substance indices were compared between groups. There was no statistically difference between periodontal curet and Perio-Clean bur groups. There were statistically differences between periodontal curet and Roto-Perio bur, ET bur, and diamond fissure bur groups. As a result of this study, groups treated with Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur showed more cementum removed than groups treated with periodontal curet and Perio-Clean bur. Therefore, in a conventional treatment for periodontal disease, it was recommended that periodontal curet or Perio-Clean bur should be used. In a treatment for regeneration of periodontal tissue, it was recommended that Roto-Perio bur, resin polishing ET bur, or resin polishing diamond fissure bur should be used

• 구강회복응용과학지
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• 제33권3호
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• pp.230-237
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• 2017

치간부 골내낭의 치주재생치료는 수술 후 발생할 수 있는 비심미성 때문에 치과의사에게 힘든 과제이다. 본 연구에서는 이러한 문제점을 해결하기 위해 치간부 골내낭의 bovine bone mineral과 enamel matrix derivative (EMD)를 이용한 재생 수술에 골막을 포함한 결합조직 이식을 동반한 임상증례를 소개하고자 한다. 임상적 및 방사선학적인 검사는 술 전과 수술 6개월 이후 시행하였다. 모든 임상 지표들이 개선되었고, 방사선학적 검사에서 골내낭이 감소함을 확인할 수 있었다. 또한, 부가적인 결합조직이식을 통해 치간부 연조직의 증대 및 형태 개선으로 인한 심미성이 증진되는 효과도 확인할 수 있었다.