• Journal of Periodontal and Implant Science
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• v.27 no.2
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• pp.347-361
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• 1997

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.

• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.249-262
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• 1997

The present study investigates the effects of calcium sulfate graft on the periodontal healing in intrabony periodontal defects of dogs. Following the general anesthesia with 30mg/kg pentobarbital injected intravenously, the first premolar was extracted and full-thickness periodontal flap was elevated from the second premolar to the fourth premolar. The portion of premolars coronal to the alveolar crest was removed and mesial and distal roots were separated. Exposed root canals were sealed with Caviton and covered completely with flaps sutured. Following the healing period of 12 weeks, the surgical sited were uncovered and $4{\times}4mm$ intrabony defects were surgically created. Those defects with calcium sulfate graft following the root planing was designated as the test sites and those with flap surgery-only were designated as control sites. The animals were sacrificed after 8 weeks and the healing was histologically analyzed. The results were as follows. 1. No foreign body reaction or inflammation were observed in either groups. Calcium sulfate was completely resorbed in the test sites. 2. New cementum was observed coronal to the notch in both groups. Connective tissue fibers were oriented parallel to the root surface in the controls. Connective tissues were formed in large amount in the sites. 3. Test sites showed marked amount of new bone formation while the control sites showed minimal bone gain. 4. Root resorption was observed in coronal portions of th control Sites. The results suggest that calcium sulfate is a biocompatible graft material with a potential for new bone and cementum formation.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.577-594
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• 1993

The ultimate goal of periodontal therapy is the regeneration of the periodontium that have been destroyed as a result of periodontal disease. This study were done in order to determine the healing status of periodontium under Polytetrafluoroethylene and millipore fillter combined with fibrin and the effect of the guided tissue regeneration procedures were performed as follows : 1) flap operation using PTFE membrane(control group) 2) flap operation using PTFE membrane which was fixed with fibrin(experimental group 1) 3) flap operation using millipore filter which was fixed with suture(experimental group II) 4) flap operation using millipore filter which was fixed with fibrin(experimental group II) After 1, 2, 4, 8, 12 weeks, dogs were sacrificed by perfusion technique and tissue block was excised including the tooth and prepared for light microscope with H-E & Masson’s trichrome staining. The result were as follows : In control and experimental group, there is no siginificant difference on epithelial cell down growth within 1st week, but more epithelial cell downgrowth in millipore or millipore combined with fibrin group. In this experiment, there were no significant difference in new cementum and alveolar bone formation whether PTFE membrane was fixed with suture or fibrin. In control and each experimental group, bone maturation appeared in 4 weeks, bone width increased bucco-lingually in control and experimental 1 group especially. Both control group and experimental group showed mild mew cementum formation on root surface and irregular arrangement of collagen fiber at 4 weeks, that showed obvious increased cementum formation at 8 weeks, and that was observed the functional arrangement of collagen fiber between new cementum and new alveolar bone at 12 weeks.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.261-270
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• 1994

The purpose of this study was to evaluate relationship of probing attachment levels, radiographic measurements and surgical measurements according to gingival inflammatory condition. Patients with incipient to moderate periodontitis were selected. Upper and lower premolar and molar teeth excluding third molars were measured. At first visit, gingival index and bleeding on probing were taken, and subjects were grouped into 4 categories as follows : Experimental group I : gingival index 1 and no bleeding on probing. Experimental group II : gingival index 2 and no bleeding on probing absent. Experimental group III : gingival index 1 and bleeding on probing present. Experimental group IV : gingival index 2 and bleeding on probing present. Probing attachment levels were measured with manual probe on mesial and distal surfaces from cementoenamel junctions to terminal ends of probe. Radiographic measurements were made to assess bone loss by measuring the distance from cementoenamel junction to the alveolar crest. After thorough scating, a flap was raised exposing the alveolar bone and surgical measurements were made from cementoenamel junction to alveolar bone. The results were as follows: 1. Differences between probing attachment level and radiographic measurements showed $1.01{\pm}0.73mm$ for experimental group I, $0.98{\pm}0.48mm$ for experimental group II, $0.59{\pm}0.66mm$ for experimental group III, $0.98{\pm}0.38mm$ for experimental group IV and with no significant difference between groups. 2. Differences between probing attachment level and surgical measurements showed $1.36{\pm}0.80mm$ for experimental group I, $1.47{\pm}0.54mm$ for experimental group II, $1.06{\pm}0.39mm$ for experimental group III, $1.41{\pm}0.40mm$ for experimental group IV and with no significant difference between groups. 3. Differences between surgical and radiographic measurements showed $0.36{\pm}0.48mm$ for experimental group I, $0.51{\pm}0.54mm$ for experimental group II, $0.57{\pm}0.72mm$ for experimental group III, $0.41{\pm}0.49mm$ for experimental group IV and with significant difference between experimental group I and experimental group II, III, IV(P<0.05).

• Journal of Periodontal and Implant Science
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• v.34 no.2
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• pp.281-292
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• 2004

Periodontal defects of the furcation are characterized by several inherent anatomic factors that can make successful periodontal therapy difficult and results unpredictable. The severity and rate of occurrence of periodontal disease are directly related to the location of the furcation relative to the cementa-enamel junction and anatomical form of the root by limiting the accessibility and effectiveness of the periodontal instrumentation. This study investigated the reliability and accuracy of panoramic radiograph diagnoses of the periodontal state of mandibular molars, particularly regarding the diagnosis of furcation area periodontal defects, treatment planning, and prognosis prediction. This study examined a total of 110 teeth belonging to 33 subjects (19 male, 14 female) presenting with incipient to moderate periodontitis 4-7mmpocket depth. The alveolar bone level, length and width of the root trunk, and root separation angle were measured using the panoramic radiograph and compared to the results taken directly by retracting a full-thickness flap. The results of the study are as follows: 1. Data regarding the alveolar bone level of the mandibular first molar showed that the directly taken surgical measurements resulted in $5.1{\pm}0.9mm$ that was slightly deeper than the corresponding panoramic measurement resulted in $4.8{\pm}0.8mm$, but these differences were statistically insignificant (p>0.05). 2. The data of the directly taken surgical measurement of the mandibular second molar $(5.1{\pm}1.1mm)$ was slightly deeper than the corresponding panoramic measurement $(4.7{\pm}1.2mm)$, but these differences were statistically insignificant (p>0.05). 3. The measured values of the length and width of the mandibular first molar root trunks were determined to be $4.1{\pm}0.6mm$ and $7.3{\pm}0.9mm$, respectively, while the values of the mandibular second molar root trunks were determined to be $4.6{\pm}1.3mm$ and $7.6{\pm}0.9mm$ respectively. The differences between these values were found to be statistically significant (p<0.01). 4. The measured values of the root separation angle showed that the mandibular first molars averaged $34.5{\pm}4.4^{\circ}$, while the mandibular second molars averaged $23.0{\pm}10.0^{\circ}$. The differences between these values were found to be statistically significant (p<0.01).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.263-268
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• 2013

Objectives: The interforminal region, between the mandibular foramen, is known as a relatively safe area that is free of anatomic structures, such as inferior alveolar nerve, submandibular fossa, and lingual side of the mandible is occasionally neglected for its low clinical importance. Even in the case of a severely constricted alveolus, perforation of the lingual cortical bone had been intended. However, anterior extension of the inferior alveolar canal, important anatomic structure, such as concavity of lingual bone, lingual foramina, and lingual canal, has recently been reported through various studies, and untypical bleeding by perforation of the lingual plate on implantation has also been reported. Therefore, in this study, we performed radiographic and statistical analysis on distribution and appearance frequencies of the lingual foramina that causes perforation of the mandibular lingual cortical bone to prevent complications, such as untypical bleeding, during surgical procedure. Materials and Methods: We measured the horizontal length from a midline of the mandible to the lingual foramina, as well as the horizontal length from the alveolar crest to the lingual foramina and from the lingual foramina to the mandibular border by multi-detector computed tomography of 187 patients, who visited Dankook University Dental Hospital for various reasons from January 1, 2008 to August 31, 2012. Results: From a total of 187 human mandibles, 110 (58.8%) mandibles had lingual foramina; 39 (20.9%) had bilateral lingual foramen; 34 (18.2%) had the only left lingual foramen; and 37 (19.8%) had the only right lingual foramen. Conclusion: When there is consistent bleeding during a surgical procedure, clinicians must consider damages on the branches of the sublingual artery, which penetrate the lingual foramina. Also, when there is a lingual foramina larger than 1 mm in diameter on a pre-implantation computed tomography, clinicians must beware of vessel damage. In order to prevent these complications and progress with a safe surgical procedure, a thorough radiographic examination before the surgery is indispensable. Further, clinicians should retract lingual flap definitely to confirm the shape of the lingual bone and existence of the lingual foramina.

• Journal of Periodontal and Implant Science
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• v.28 no.2
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• pp.249-264
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• 1998

The present study evaluates the effects of calcium sulfate and DFDB on alveolar bone regeneration and cementum formation and connective tissue adhesion in intrabony angulated 1 wall defects of dogs. Four millimeter-deep angulated one-wall intrabony defects were surgically created in the mesial & distal aspects of premolars and with flap operaion alone(control group), with calcium sulfate(experimental group 1), with composit graft of 50% calcium sulfate and 50% DFDB(experimental group 2), with DFDB alone(experimental group 3). Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of connective tissue adhesion was $1.05{\pm}0.48mm$ in the control, $1.30{\pm}0.67mm$ in the test group I, $0.97{\pm}0.22mm$ in the test group II and $0.93{\pm}0.15mm$ in the test group III. There was no statistical significance between control and all experimental groups. 2. Changes in alveolar bone level was $0.97{\pm}0.27mm$ in the control group, $1.45{\pm}0.42mm$ in the test group I, $2.00{\pm}0.33mm$ in the test group II, $1.88{\pm}0.34mm$ in the test group III. There was no statistically significant difference between control and experimental group I. There was a statistically significant difference between the control and experimental group II,III.(p<0.05). There was no statistically significant difference between all experimental group. 3. Cementum formation was $1.13{\pm}0.17mm$ in the control, $1.78{\pm}0.31mm$ in the test group I, $2.17{\pm}0.38mm$ in the test group II, $2.15{\pm}0.47mm$ in the test group III with statistically significant differences between control group and all experimental group(P<0.05). There was no statistically significant differences between all experimental group. These results suggest that the use of composit graft of 50% calcium sulfate and 50% DFDB and DFDB alone in angulated 1 wall intrabony defects has little effects on connective tissue adhesion, but has significant effects on new bone and new cementum formations.

• Journal of Periodontal and Implant Science
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• v.28 no.2
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• pp.219-237
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• 1998

Numerous bone graft materials have been used in Periodontics, in an attempt to reach the main goal of periodontal therapy, i.e. the regeneration of periodontal tissue lost due to destructive periodontal diseases. The present study investigates the effect of composite graft of DFDB and Calcium sulfate with and without Calcium sulfate barrier in Periodontal 1-wall intrabony defects in dogs. Following the initiation of general anesthesia by I.V. administration of 40mg/Kg of Pentobabital, second premolar was extracted and full thickness flap elevated. The crown portion of premolars was removed. Exposed root canals were sealed with Caviton and covered completely with flap. After the healing period of 8 weeks, the surgical sites were re-opened and 1-wall intrabony defects were created, and treated with flap operation alone(control group), with composit graft of 80% DFDB and 20% Calcium sulfate(Experimental group 1), with composite graft of DFDB and calcium sulfate with calcium sulfate membrane( Experimental group 2). Healing response was histologically observed after 8 weeks and the results were as follows : 1. New bone formation was 70 % in the control group, 93 % in the Experimental group I, 89 % in the Experimental group II. There was a no differences between Experimental groups. 2. New cementum formation was not significantly different between control and two Experimental groups. 3. The length of connective tissue adhesion was 30 % in the control, 7% in the Experimental group I and 11 % in the Experimental group II. 4. After 8weeks, calcium sulfate was completely resorbed, while DFDB particle remained. These results suggest that the use of composite graft of allogenic DFDB and Calcium sulfate with and without Calcium sulfate barrier in periodontal 1 wall intrabony defects have little effect on connective tissue adhesion, but has beneficial effect on new alveolar bone and new cementum formation, and prevent downgrowth of epithelium and connective tissue effectively.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.584-587
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• 2014

In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

• Journal of Periodontal and Implant Science
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• v.28 no.3
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• pp.409-418
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• 1998

The socket preservation technique is very effective in preventing alveolar ridge collapse after tooth extraction. Many technigues have been proposed for the primary closure of the flap and we tested a new graft design, "wing graft", which is a modification of free connective tissue graft in this case report. With this technique, primary closure was achieved without shallowing the vestibule. Additionally some vertical ridge augmentation effect could be observed and therefore good esthetic and functional results were obtained from this technique even in the case where severe bone loss and gingival recession was present. Finally we observed good healing appearance in the donor site after 2weeks. The results from this report suggest that this "wing graft" can be used successfully as an adjunctive procedure with socket preservation technique.