• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.229-242
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• 2000

The purpose of this study was to evaluate the effect of fibrin tissue adhesive and porous resorbable calcium carbonate on the periodontal regeneration of the class II furcation defect in dogs. Class II furcation defect was surgically created on the second, third, and fourth premolars bilaterally in the mandibles of six mongrel dogs. The experimental sites were divided into four groups according to the treatment modalities: Control-surgical debridement only; Group I-calcium carbonate grafting; Group II-application of fibrin adhesive only; Group III-application of fibrin adhesive after calcium carbonate grafting. The animals were sacrificed at the 2, 4, and 12 weeks after periodontal surgery and the decalcified specimens were prepared for histological and histometrical examination. The results are as follows : Clinically, there were no inflammatory response in all groups after 2, 4, 12 weeks. In the Control group, junctional epithelium was grown downward to the reference notch. In Group I, graft materials were exfoliated from the defect throughout the experimenta periods andnew bone was seen in the notch area at 4 and 12 week specimens. In Group II, fibrin adhesive was absorbed at 2 week specimens, and connective tissue attachment increased than that of control group. New cementum and new bone were seen above the notch area. In Group III, the graft material was maintained in the defect throughout the experimental period and inducing the amount of periodontal tissue regeneration was higher than other groups. These results suggest that the use of fibrin tissue adhesive in conjunction with porous resorbable calcium carbonate would improves the stability of graft material and inhibit the epithelial down growth and make it be a feasible method for periodontal regeneration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.337-349
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• 1999

The extracellular matrix(ECM) is a complex network of different combination of collagens, glycosaminoglycans, laminin, fibronectin, and many other glycoproteins including proteolytic enzymes. The composition and organization of the ECM contributes to the uniques physical or biomechanical properties of a tissue. Fibronectins(FN) are dimeric glycoproteins located on cell surfaces, in the matrix of connective tissue, and in blood. Fibronectins mediate cell attachment to collagen substratum and have been implicated in a variety of important biological processes, including embryogenesis and cell differentiation. The purpose of this study was to determine the effects of surgical induction of anterior disk displacement(ADD) on distribution of fibronectin in the rabbit temporomandibular joint(TMJ) tissues included the articular cartilage, disc, retrodiscal tissue, articular eminence using an immunohistochemical technique. The left TMJ was exposed surgically, and all discal attachments were severed except for the posterior attachment. The disk was then repositioned anteriorly and sutured to the zygomatic arch. The right TMJ served as a shamoperated control. Normal joints were used as a nonoperated control. Fourty-five rabbits were used for experiments in total. For fibronectin immunohistochemical study, eighteen rabbits (one normal group and 5 experimental groups, each group consists of 3 rabbits) were used. The experimental rabbits were sacrified after operation period of 2, 3, 4, 6 and 8 weeks on fibronectin. The obtained results were as follows ; 1. Fibronectin immunoreaction on all TMJ tissues(mandibular condyle, articular disc, retrodiscal tissue, articular eminence) in the normal rabbit was observed. Especially the reverse cell layer and proliferation zone of articular cartilage of condyle show strong positive reaction. 2. Depletion of fibronectin in the all TMJ tissues except hypertrophic zone of articular cartilage occurred at 2 weeks following induction of ADD. 3. The restoration of immunoreaction at 4 weeks was observed and a progressive increasing reaction at 6 weeks, 8 weeks also was found. Our study generally showed degenerative changes in TMJ tissues after ADD although TMJ tissues adapted or degenerated to abnormal loads and stress distribution according to the remodeling capacity of TMJ tissues.

• Journal of Periodontal and Implant Science
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• v.43 no.6
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• pp.315-322
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• 2013

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.

• Journal of Periodontal and Implant Science
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• v.38 no.1
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• pp.97-102
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• 2008

Purpose: Periodontal intrabony defects have great deal of importance since they contribute to the development of periodontal disease. Current treatment regimens for intrabony defects involve grafting of numerous bony materials, GTR using biocompatible barriers, and biomodification of root surface that will encourage the attachment of connective tissue. Xenograft using deproteinized bovine bone particles seems to be very convenient to adjust because it doesn't require any donor sites or imply the danger of cross infections. These particles are similar to human cancellous bone in structure and turned out to be effective in bone regeneration in vivo. We here represent the effectiveness of grafting deproteinized bovine bone particles in intrabony defect and furcation involvements that have various numbers of bony walls. Materials and methods: Open flap debridement was done to remove all root accretions and granulation tissue from the defects within persisting intrabony lesions demonstrating attachment loss of over 6mm even 3 months after nonsurgical periodontal therapy have been completed. Deproteinized bovine bone particles($BBP^{(R)}$, Oscotec, Seoul) was grafted in intrabony defects to encourage bone regeneration. Patients were instructed of mouthrinses with chlorohexidine-digluconate twice a day and to take antibiotics 2-3 times a day for 2 weeks. They were check-up regularly for oral hygiene performance and further development of disease. Probing depth, level of attachment and mobility were measured at baseline and 6 months after the surgery. The radiographic evidence of bone regenerations were also monitored at least for 6 months. Conclusion: In most cases, radio-opacities increased after 6 months. 2- and 3-wall defects showed greater improvements in pocket depth reduction when compared to 1-wall defects. Class I & II furcation involvements in mandibular molars demonstrated the similar results with acceptable pocket depth both horizontally and vertically comparable to other intrabony defects. Exact amount of bone gain could not be measured as the re-entry procedure has not been available. With in the limited data based on our clinical parameter to measure pocket depth reduction following $BBP^{(R)}$ grafts, it was comparable to the results observed following other regeneration techniques such as GTR.

• Journal of Periodontal and Implant Science
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• v.25 no.1
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• pp.24-34
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• 1995

The purpose of this study was to compare effects of demineralization of citric acid and tetracycline HCI on periodontally involved root surface. Twelve periodontally involved single rooted teeth were used. After scaling and root planing, root conditioning with citric acid and tetracycline HCI were carried and the teeth were processed scanning electron microscopic observation.The results were as follows: The scaled root surface was covered by much debris and calculus. The effect of demineralization of citric acid and tetracycline HCI was more reduced on scaling group than root planing group, because of hypermineralization of cementum surface and demineralization effect on root surface of tetracycline HCI showed tendency to reduction. The root planed group displayed more smooth root surface than scaling group, the surface was covered by smear layer, thus no exposure of dentinal tubule opening and collagen fiber, especially after root planing, citric acid and tetracycline HCl treated group showed exposure of dentinal tubule and collagen fiber, thus it was thought that new connective tissue attachment could be acquired.

• Journal of Periodontal and Implant Science
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• v.40 no.6
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• pp.257-264
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• 2010

Purpose: Connective tissue reattachment to periodontally damaged root surfaces is one of the most important goals of periodontal therapy. The aim of this study was to develop a root conditioning agent that can demineralize and detoxify the infected root surface. Methods: Dentin slices obtained from human teeth were treated with a novel root planing agent for 2 minutes and then washed with phosphate-buffered saline. Smear layer removal and type I collagen exposure were observed by scanning electron microscopy (SEM) and type I collagen immunostaining, respectively. Cell attachment and lipopolysaccharides (LPS) removal demonstrated the efficiency of the root conditioning agent. Results: SEM revealed that the smear layer was entirely removed and the dentinal tubules were opened by the experimental gel. Type I collagen was exposed on the surfaces of the dentin slices treated by the experimental gel, which were compared with dentin treated with other root planing agents. Dentin slices treated with the experimental gel showed the highest number of attached fibroblasts and flattened cell morphology. The agar diffusion assay demonstrated that the experimental gel also has effective antimicrobial activity. Escherichia coli LPS were effectively removed from well plates by the experimental gel. Conclusions: These results demonstrated that this experimental gel is a useful tool for root conditioning of infected root surfaces and can also be applied for detoxification of ailing implant surface threads.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.276-292
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• 1996

The purpose of this study was to evaluate whether removal of gingival epithelium with pulsed Nd :YAG laser could inhibit the downgrowth of junctional epithelium after alloplastic material grafting in periodontal bone defect. The periodontal bone defects were created surgically on the palatal aspect of the upper right and left molar teeth in 30 rats and filled with resorbable calcium carbonate($Biocoral\;450^{(R)}$: Inoteb, France). The control sites(right molar area) was sutured. The test side (left molar area) received controlled deepithelization of the oral and sulcular epithelium with pulsed Nd:YAG laser($Sunrise\;Maste^{(R)}$: Sunrise Technologies, U.S.A.) under the mode of 1.75W, 15Hz, 116mJ/pulse and was sutured. The control and test sites were evaluated clinically and histologically, at 1, 3, 7, 14, and 28 days postoperation. Clinically, the gingiva showed normal color and shape at the 5th day in the control site and at the 10th day in the test sites. Histologically, the junctional epithelium was formed at the 7th day in the control sites and at the 14th day in the test sites, and the long JE attachment were observed at the 28th day in both sites. The attachment of connective tissue to root surface was observed initially at the 7th day in the control sites and at the 14th day in the test sites, and completed at the 28th day in both sites. In summary, these results showed that the removal of oral epithelium using pulsed Nd:YAG Laser could not prevent epithelial downgrowth after alloplastic material implantation in rat periodontal bone defect.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.967-987
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• 1996

The present study was to evaluate the healing patterns of guided tissue regeneration( GTR) using resorbable $Vicryl^{(R)}$(polyglactin 910) mesh and nonresorbable expanded polytetrafluoroethylene(ePTFE) membrane with or without bone grafting using autogeneous bone and demineralized freeze-dried bone allograft(DFDBA) in the grade II furcation defects. Mucoperiosteal flaps were reflected buccally in the mandibular 2nd, 3rd and 4th premolar areas and furcation defects were created surgically by removing $5{\times}6mm$ alveolar bone in 4 dogs. Root surfaces were thoroughly debrided of periodontal ligament and cementum, and notches were placed on root surface at the most apical bone level. In the right and left mandibular quadrant, each tooth was received $Vicryl^{(R)}$ mesh(ACE Surgical Supply Co., USA) only, $Vicryl^{(R)}$ mesh with DFDBA, $Vicryl^{(R)}$ mesh with autogeneous bone grafts, ePTFE membrane($Core-tex^{(R)}$ membrane, W.L. Gore & Associates Inc., USA) only, ePTFE membrane with DFDBA or ePTFE membrane with autogeneous bone grafts. For the fluorescent microscopic examination, fluorescent agents were injected at 2, 4 and 8 weeks after surgery. Four weeks after surgery, 2 dogs were sacrificed and ePTFE membranes were removed from remaining 2 dogs, which were sacrificed at 12 weeks after surgery. Undecalcified tissues were embedded in methylmethacrylate and $10{\mu}m$ thick sections were cut in a buccolingual direction. These sections were stained with hematoxylin-eosin stain and Masson's trichrome stain, and evaluated by descriptive histology and linear measurements. The results were as follows : 1) $Vicryl^{(R)}$ mesh group showed less connective tissue attachment than ePTFE membrane group. 2) The combination of GTR using $Vicryl^{(R)}$ mesh and osseous grafts resulted in new attachment and new bone formation more than GTR using $Vicryl^{(R)}$ mesh only. 3) GTR using ePTFE membrane, with or without osseous grafts, enhanced periodontal regeneration. 4) Root resorption and dentoalveolar ankylosis were observed in the areas treated with the combination of GTR and DFDBA. It was suggested that the effect of adjunctive bone grafting in GTR procedure depends on the materials and the physical properties of barrier membranes. $Vicryl^{(R)}$ mesh performed a barrier function and the use of adjunctive bone grafting may enhance the periodontal regeneration.

• Journal of Periodontal and Implant Science
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• v.23 no.1
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• pp.37-47
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• 1993

The native connective tissue attachment of the periodontium is known to be a complex consisting of gingival fibroblasts, periodontal ligament cells, gingival epithelial cells, cementum, alveolar bone and extensive extracellular matrix (collagen, glycoprotein and proteoglycans). The purpose of this study was to evaluate the effects of natural extracts on DNA, collagen and protein synthesis and inhibition of cytokine production in the gingival and periodontal ligament fibroblasts and gingival epithelial cells. Healthy gingival tissue was obtained from orthodontic treatment patients, and gingival epithelial cells, gingival fibroblasts and periodontal ligament cells were isolated and cultured from the samples. After treated with Ginseng protein, Pluronic F-68, Scutellariae Radix, centella asiatica, PDGF, IGF, DNA synthesis, total protein and collagen synthesis, and cytokine production of gingival epithelial cell, gingival fibroblast and periodontal ligamentcells were measured. MTT method for DNA synthesis, Peterkofsky and Dingerman method for total protein and collagen synthesis, and IL-1 ELISA kit for cytokine production were used. The proliferation of epithelial cells was enhanced in Centella asiatica, Ginseng protein, Pluronic F-68 and Scutellariae Radix. The activities of PDL cells were increased in PDGF, IGF, and Pluronic F-68. Higher collagen synthesis was observed in Scutellariae Radix and total protein synthesis was increased in Scutellariae Radix and PDGF. The inhibitory effects on IL-1, IL-6, $TNF-{\alpha}$ were observed in all exrracts.

• Restorative Dentistry and Endodontics
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• v.21 no.1
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• pp.35-53
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• 1996

The development and repair requires the formation of new tissues comprised of various extracellular matrix components. The present study investigated the formation and distribution of the major ECM components such as type I collagen, type III collagen, fibronection, bone sialoprotein, and osteonection during development and repair. For developing observation. Sprague-Dawley rats weighing $27{\pm}1gm$ were sacrificed. For repair observation, Sprague-Dawley rats weighing $110{\pm}5gm$ were used. The pulp perforation were prepared on mesial surface of the maxillary first molar by using 1/2round bur. At 5 days after perforation, rats were sacrificed by perfusion with 3 % paroformaldehyde. The maxillary first molar region were cut, demineralized, dehydrated and embedded in paraffin. Immunostaining the ECM components was achieved by the avidin-biotin complex method. The results as follows : 1. Bright immunoreaction for fibronectin was present in the basement membrane at the inner epithelial-mesenchymal interface, especially concentrated in the blood vessel walls, cell membrane of odontoblasts, and initial predentin. 2. Type I and III collagen was observed in the newly formed pulp tissue, predentin, and its intensity increased as more of these components during repair. 3. Strong immunostaining for bone sialoprotein and osteonectin was found in dentin while no or weaker staining was observed loose connective tissue of the pulp. 4. These results suggest that develpment and repair is achieved through a series of cell differentiation and attachment by the specific ECM components.