Purpose: In this study, we investigated the effect of silk scaffolds on one-wall periodontal intrabony defects. We conjugated nano-hydroxyapatite (nHA) onto a silk scaffold and then seeded periodontal ligament cells (PDLCs) or dental pulp cells (DPCs) onto the scaffold. Methods: Five dogs were used in this study. Bilateral 4 mm${\times}$2 mm (depth${\times}$mesiodistal width), one-wall intrabony periodontal defects were surgically created on the distal side of the mandibular second premolar and the mesial side of the mandibular fourth premolar. In each dog, four of the defects were separately and randomly assigned to the following groups: the PDLCcultured scaffold transplantation group (PDLC group), the DPC-cultured scaffold transplantation group (DPC group), the normal saline-soaked scaffold transplantation group, and the control group. The animals were euthanized following an 8-week healing interval for clinical, scanning electron microscopy (SEM), and histologic evaluations. Results: There was no sign of inflammation or other clinical signs of postoperative complications. The examination of cellseeded constructs by SEM provided visual confirmation of the favorable characteristics of nHA-coated silk scaffolds for tissue engineering. The scaffolds exhibited a firm connective porous structure in cross section, and after PDLCs and DPCs were seeded onto the scaffolds and cultured for 3 weeks, the attachment of well-spread cells and the formation of extracellular matrix (ECM) were observed. The histologic analysis revealed that a well-maintained grafted volume was present at all experimental sites for 8 weeks. Small amounts of inflammatory cells were seen within the scaffolds. The PDLC and DPC groups did not have remarkably different histologic appearances. Conclusions: These observations indicate that nHA-coated silk scaffolds can be considered to be potentially useful biomaterials for periodontal regeneration.
This study used FEM(Finite Element method) based on micro-CT images to see the effects of occlusal force distribution with varying bone density and structure. the mandibular premolar region from human cadaver, thickness of 10mm was imaged using micro-CT. the cross sectional images were taken every $10{\mu}m$. these were reconstructed and the longitudinal image at the mid point of mesiodistal of the speciman was obtained for the specimen for the FEM. The stress disribution produced by a vertical force at 100N and 100N horizontal were analyzed by MSC Nastran FEM Package. according to the result of this study the occlusal force distribution depends on the structure of cancellus bone and for further information on the occlusal force distribution on the tooth and the surrounding structure requires further studies on cancellus bone structure. CEJ of all model show the highest peak and region whice meet teeth and bone show second high peak. Original model and cortical bone add model show different stress distribution. Stress distribution changed according to bone structures and densities.
The prognosis of transplanted teeth is strongly related with periodontal healing. Several experimental studies showed that the application of enamel matrix derivatives on periodontitis-affected root surfaces resulted in periodontal regeneration. The purpose of this study was to determine the effect of enamel matrix derivatives on periodontitis-affected root surfaces prior to transplantation in dogs. Class III Furcation defects were surgically created on the left second, the third and the fourth premolar in the mandibles of nine mongrel dogs and experimental periodontitis was induced by placing small cotton pellets into defects for 3 weeks. Periodontitis-affected roots were treated by scaling and planing and the coronal portions were removed. Each root was extracted and implanted into recipient bed prepared in the contralateral premolar area. The transplanted roots were grouped according to the treatment modalities; Group I- roots treated with saline only, Group II- roots conditioned by neutral EDTA, and Group III- roots conditioned by neutral EDTA and enamel matrix derivatives ($EMDOGAIN^{(R)}$, BIORA Co., Sweden). The animals were sacrificed at 1 week, 3 weeks, and 10 weeks after transplantation and decalcified specimens were prepared for histologic examination. In Group I, healing was most frequently characterized by root resorption and ankylosis. In Group II, with root resorption and ankylosis in a few specimens, connective tissue attachment was partly seen on denuded root surface, but no cementum formation was seen. In Group III, there was regeneration by new cementum and periodontal ligament on denuded root surface, although slight root resorption and ankylosis were found in a few specimens. This result suggests that enamel matrix derivatives treatment on periodontitis-aggected root surface could reduce the frequency of root resorption and ankylosis and contribute to periodontal regeneration, and might be useful for autologous transplantation.
The present study investigates the effects of DFDB graft combined with Calcium sulfate membrane on the periodontal wound healing in dehiscence defects of dogs. Following the initiation of general anesthesia by I.V. administration of 30mg/kg of pentobarbital, first premolar was extracted and full-thickness flap was elevated from the second to the fourth premolar. The portion of premolars coronal to the alveolar crest was removed and mesial and distal roots separated to produce single rooted teeth. Exposed root canals were sealed with Caviton and covered completely with flaps sutured. Following the healing period of 12 weeks, the surgical sites were uncovered and $4{\times}4mm$ dehiscence defects were surgically created. Those defects with DFDB graft combined with Calcium sulfate membrane following root planing, were designated as test sites and those with flap surgery-only were designated as controls. 1. No foreign-body reaction or inflammation were observed in either groups. Calcium sulfate was completely resorbed in the test sites. 2. Significantly greater amounts of new cementum was observed in test sites compared with the controls. Significant amounts of functionally orientated collagens were observed in the test sites. 3. New bone formation was observed in significantly greater amounts in test sites. The results suggest that combined graft of DFDB and calcium sulfate is extremely biocompatible with a potential for new bone and cementum formation, and functional alignment of periodontal ligaments.
Statement of problem: The meaning of the beauty has a little different nature according to a time, culture, and nation. Purpose : This study was undertaken to estimate the geometric esthetic criteria for Korean woman by analysis of facial photograph in a smiling. Material and methods: The facial photographs of 678 Korean beautiful woman were collected from Miss Korea candidates(from 1971 to 2003 year). The dento-facial composition was measured and analyzed geometrically on computer monitor using $Adobe^{(R)}$$Photoshop^{(R)}$ 7.0. The statistical significance of the differences among the 4 decade groups was estimated by a $x^2$ test. Result : The Korean beautiful woman skewed the geometric characteristics such as the 'coincidence' (83.0%) between facial midline and dental midline, the 'normal' (96.9%) alignment and arrangement of upper anterior teeth. the 'average' (79.1%) position and 'upward' (53.4%) curvature of upper lip, the 'parallel' (85.7%) relationship between the lower lip and upper anterior incisal curvature, the 'touching' (49.9%) and 'not-touching' (44.8%) relationship between upper anterior incisor and towel lip, the 'first premolar' (54.1%) and 'second premolar' (38.9%) displayed in a smile, and the 'symmetry' (89.4%) of smile. There was statistical significance among the 4 decades in the respect of the upper lip curvature, the relationship between upper anterior incisor and lower lip, and the most posterior teeth displayed in a smile (p<0.05). Conclusion : The Korean beautiful woman showed similar results to the western esthetic criteria in the some respects and the tendency that the Korean woman had more active smiling recently.
Purpose: To evaluate the anteroposterior length and buccal angle of the anterior loop, and the size and location of the mental foramen using cone beam computed tomography (CBCT). Materials and Methods: 100 CBCT images from 87 adults (43 males and 44 females) ranging in age from 20 to 73 years (average 50 years) with edentulous ridge of the mandibular premolar region were obtained. Axial, sagittal, coronal images were reconstructed from Dental and Block Images of CBCT. The anteroposterior length, shape and buccal angle of the anterior loop, and the size and location of the mental foramen were calculated from reconstructed images of axial, sagittal and coronal CBCT. Results: The anteroposterior length and buccal angle of the mental canal was 4.0${\pm}$1.2mm, 37.8${\pm}$11.60$^{\circ}$respectively. The loop type with straight course was the most common shape of the mental canal. The location of the mental foramen below the apex of the lower second premolar (78%) was the most common. The maximum size of the mental foramen was 4.6${\pm}$1.0 mm in width and 3.0${\pm}$0.6 mm in height. The inner size of the mental canal was 2.6${\pm}$0.6 mm in width and 2.1 mm${\pm}$0.4 mm in height. Conclusion: CBCT is useful to evaluate the anterior loop and mental foramen of the mandibular canal. Safe guideline of 4 mm from the most anterior point of the mental foramen is recommended for implant and surgical treatment. (Korean J Oral Maxillofac Radiol 2009; 39: 81-7)
Statement of problem. In the partially edentulous patients, removable partial dentures have been working as a important treatment modality. Clasps, a kind of direct retainers, received some amount of stresses during the insertion and removal of partial denture on the abutment tooth. Purpose. The study is to investigate stresses of the different clasps. Material and methods. In order to investigate the degree of stresses, maxillary partial edentulism (Kennedy Class II modification I) was assumed and removable partial dentures were designed on it with three kinds of metallic materials; cobalt-chromium alloy, type IV gold alloy and commercially pure (c.p.) titanium. Aker's clasp was applied on the left second molar. RPA (mesial rest-proximal plate-Aker's) clasp was on the left first premolar and wrought wire clasp was on the right first premolar. Three dimensional, non-linear, dynamic finite element analysis method was run to solve this process. Results. 1. Cobalt-chromium alloy had the highest von Mises stress value and c.p. titanium had the lowest one irrespective of the types of clasps. 2. In the Aker's clasps, stress on the retentive tips was shown shortly after the appearance of stresses of the middle and minor connector areas. These time lag was much shorter in the RPA clasps than in the Aker's clasp. 3. In general. retentive tips of wrought wire clasps had much less amount of stress than other clasps. Conclusion. The amount of stress was the highest in the RPA clasp and the lowest in the wrought wire clasp, in general.
Bitewing and periapical radiographic techniques are used in clinical and epidemiological studies to assess crestal alveolar bone levels. The purpose of the present study investigated relationships between these techniques by assessing alveolar crest location at the same site. Bitewing and periapical radiographs were available from posterior quadrants of 120 subjects. The distance from cemento-enamel junction to the alveolar crest (CEJ -CR) was measured for each proximal surface from the distal of the cuspid to the distal of the second molar. Data were arranged according to the proximal surface examined, and bitewing and periapical measurements were compared using paired tests. The obtained results were as follows; 1. In maxilla, a significant t ratio with a P value of 0.05 or less was reached for 78% and in mandible reached for 39%. 2. Pearson correlations were calculated 32 surfaces (89%) had values below 0.70 and so, data obtained by these techniques can not be used interchangeably on an individual or group basis. 3. In situations where the periapical measure was greater than the bitewing, it ranged up to 20.7% greater with a mean 9.8%. Where the bitewing was greater than periapical, it ranged up to 51. 9% greater, with a mean 18.2%. 4. The percentage difference was greater in maxillary posterior areas than in mandibular molar, premolar areas. A lower prevalence of significant differences was attributed to relatively more simple root and favorable radiographic conditions in mandibular molar and premolar areas. 5. The anatomical limitations imposed on periapical radiographic technique, most often result in somewhat foreshortened radiographic images. This situation would tend to be accentuated by the anatomical restrictions of the hard palate. 6. Consequently, since the significant differences frequently exist between measurements obtained from bitewing and periapical techniques, it is important to define which technique is used.
Purpose: The non-carious cervical lesion(NCCL) is a loss of tooth structure at the neck of affected teeth that is unrelated to tooth caries. The reported prevalence of NCCL varies from 5% to 85%. Prevalence and severity of lesions have been found to increase with age. They are becoming more significant as people live longer and become more aware of the importance of oral health. The purposes of this study were first, to examine the periodontal conditions associated with NCCL, and second, to investigate the clinical effects of class V restorations of NCCL on periodontal tissues. Materials and methods: The sample size was 982 teeth of 50 subjects(25 male, mean age $52{\pm}7$) who were seen at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, clinical periodontal parameters were measured. After the initial examination, 24 patients who were absent from hypersensitivity were selected. The teeth with NCCL were randomly divided into the test and control groups. The teeth in the test group were restored with flowable resin; the control teeth were not restored. Six months later, the clinical examinations were repeated. The data were analyzed using the SPSS program. Results: The results were as follows: 1) NCCL occurred on 45.8% of examined teeth. The percentage of affected teeth was higher in maxillary and premolar teeth. 2) The shallow saucer type was the most common. 3) Teeth with NCCL had more gingival recession, lower attachment level, and higher incidences of bleeding on probing(BOP) and plaque than NCCL-free teeth. 4) Six months later, gingival recession, attachment level, the percentages of BOP and plaque in the test group were lower than in the control group(p<0.05). Conclusion: NCCLs were more found in maxillary teeth, especially in premolar teeth. The results suggest that the restoration of NCCL could affect some periodontal parameters favorably.
A fundamental principle in clasp selection for a specific abutment is the reduction of the transmission of excessive forces to the abutment tooth. Those forces include tilting, tipping, and stress on the abutment tooth. The flexibility of a clasp was believed to directly affect the reduction of such forces. Opinions have been expressed concerning the proper type of clasp to be used to prevent stress on periodontium. In order to evaluate and compare the various designs of a clasp system, it is necessary to measure these forces. This study compared the average measurements of forces required to dislodge three kinds of circumferential clasps having different amount of undercuts : the first with a round retentive arm, the second with a half round retentive arm, the third with a wrought wire retentive arm under tensile load. Three commonly used undercuts( 0.01, 0.02, 0.03 inch) were created on nine cast crowns, premolars and molars. The test was run six times for a same clasp. The means of tensile load required to dislodge each of the different clasps were compared statistically using the ANOVA test and multiple range test (Duncan test). The results were as follows. 1. The amount of tensile load of the wrought wire clasp was significantly different from the cast round or half round clasp (p<0.05). 2. The more amount of the undercut, the more tensile load was needed to dislodge the clasps. There were significant differences among them (p<0.05). 3. The molar showed higher tensile load than the premolar, and there was significant difference (p<0.05). 4. The means of tensile load according to clasp types showed significant differences at the molar between wrought wire clasp and cast clasp (p<0.05), but did not at the premolar.
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