• Journal of Periodontal and Implant Science
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• v.30 no.4
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• pp.793-803
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• 2000

Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically self-curing glass-ionomer cement and light-curing glass-ionomer cement as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. 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 maxillary third(P3), forth(P4) and fifth(P5) premolar. 2 month later experimental group were self-curing glassionomer cement and light-curing glassionomer cement. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. Results were as follows. 1. In all experiment group, there were not epithelial down growth and glass ionomer cement were encapsulated connective tissue. 2. In 4 weeks experiment I group slighly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, experiment groups I, II were encapsulated fine connective tissue. 4. Therefore glass-ionomer cement filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances were possible clinical methods and this technique is useful method for Maxillary furcation involvement.

• Journal of Periodontal and Implant Science
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• v.40 no.2
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• pp.61-68
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• 2010

Purpose: The present study was performed to clarify the relationship between periodontal disease severity and selected immunological parameters consisting of serum IgG titer against periodontopathogenic bacteria, the expression of the helper T-cell cytokine by gingival mononuclear cells, and patients' immunoreactivity to cross-reactive heat shock protein (HSP) epitope peptide from P. gingivalis HSP60. Methods: Twenty-five patients with moderate periodontitis had their gingival connective tissue harvested of gingival mononuclear cells during an open flap debridement procedure and peripheral blood was drawn by venipuncture to collect serum. The mean level of interproximal alveolar bone was calculated to be used as an index for periodontal disease severity for a given patient. Each of selected immunologic parameters was subject to statistical management to seek their correlations with the severity of periodontal disease. Results: A significant correlation could not be identified between serum IgG titers against specific bacteria (Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, and Streptococcus mutans) and the severity of periodontal disease. Expression of interleukin (IL)-10 by gingival mononuclear cells was statistically significant in the group of patients who had higher levels of alveolar bone height. However, a similar correlation could not be demonstrated in cases for IL-4 or interferon-$\gamma$. Patients' serum reactivity to cross-reactive epitope peptide showed a significant correlation with the amount of alveolar bone. Conclusions: It was concluded that expression of IL-10 by gingival mononuclear cells and patients' sero-reactivity to the cross-reactive HSP peptide of P. gingivalis HSP60 were significantly correlated with alveolar bone height.

• Journal of Periodontal and Implant Science
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• v.43 no.4
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• pp.177-182
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• 2013

Purpose: Diabetes and periodontal disease are two common diseases with high prevalence rates. Recent evidence has shown a bidirectional relationship between diabetes and periodontitis. The aim of this study was to investigate the effects of nonsurgical periodontal therapy on glycemic control in type 2 diabetes mellitus patients. Methods: Sixty subjects aged 35-45 years with blood sugar controlled by oral hypoglycaemic agents were randomly divided equally among 3 groups: group A (scaling, mouthwash, and brushing), group B (mouthwash and brushing), and group C (brushing only). Glycated haemoglobin (HbA1c), fasting blood sugar (FBS), probing pocket depth (PPD), gingival index (GI), plaque index (PI), and the relevant drug history were recorded at baseline and after 3 months of intervention. Comparison of the mean difference among the variables was performed by parametric and nonparametric tests, which were further evaluated using multiple regression analysis. Results: The mean differences between the PPD, FBS, HbA1c, GI, and PI in groups A and B were found to be statistically significant (P<0.001). Multiple regression analysis in group A showed that out of all the independent variables, GI and frequency of drug administration independently (b=0.3761 and b=0.598) showed a significantly greater impact on HbA1c ($R^2$=0.832, P<0.05). Conclusions: Nonsurgical periodontal therapy can effectively decrease HbA1c levels in type 2 diabetes mellitus patients on medication.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.5
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• pp.454-469
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• 2006

Today, there is considerable evidence to support a cause-effect relationship between microbial colonization and the pathogenesis of implant failures. The presence of bacteria on implant surfaces may result in an inflammation of the peri-implant mucosa, and, if left untreated, it may lead to a progressive destruction of alveolar bone supporting the implant, which has been named as peri-impantitis. Several maintenance regimens and treatment strategies for failing implants have been suggested. Recently, in addition to these conventional tools, the use of different laser systems has also been proposed for treatment of peri-implant infections. As lasers can perform excellent tissue ablation with high bactericidal and detoxification effects, they are expected to be one of the most promising new technical modalities for treatment of failing implants. It is introduced that Er,Cr:YSGG laser, operating at 2780nm, ablates tissue by a hydrokinetic process that prevents temperature rise. We studied the change of the titanium implant surface under scanning electron microscopy after using Er,Cr:YSGG laser at various energies, irradiation time. In this study, Er,Cr:YSGG laser irradiation of implant fixture showed different effects according to implant surface. Er,Cr:YSGG laser in TPS surface with RBM not alter the implant surface under power setting of 4 Watt(W) and irradiation time of 30sec. But in TPS surface with $Ca_3P$ coating alter above power setting of 2W and irradiation time of 10sec. TPS surface with RBM showed microfracture in 4W, 30sec and TPS surface with $Ca_3P$ coating showed destruction of fine crystalline structure, melting in excess of 2W, 10sec. We concluded that proper power setting, air, water of each implant surface must be investigated and implant surface must be irradiated under the damaged extent.

• Imaging Science in Dentistry
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• v.40 no.3
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• pp.123-129
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• 2010

Purpose : To evaluate the effect of surgical treatment of ligature-induced peri-implantitis in dogs using fractal analysis. Also, the capabilities of fractal analysis as bone analysis techniques were compared with those of histomorphometric analysis. Materials and Methods : A total of 24 implants were inserted in 6 dogs. After a 3-months, experimental periimplantitis characterized by a bone loss of about 3 mm was established by inducing with wires. Surgical treatment involving flap procedure, debridement of implants surface with chlorhexidine and saline (group 1), guided bone regeneration (GBR) with absorbable collagen membrane and mineralized bone graft (group 2), and $CO_2$ laser application with GBR (group 3) were performed. After animals were sacrificed in 8 and 16 weeks respectively, bone sections including implants were made. Fractal dimensions were calculated by box-counting method on the skeletonized images, made from each region of interest, including five screws at medial and distal aspects of implant, were selected. Results : Statistically significant differences in the fractal dimensions between the group 1($0.9340{\pm}0.0126$) and group 3($0.9783{\pm}0.0118$) at 16 weeks were found (P<0.05). The fractal dimension was statistically significant different between 8($0.9395{\pm}0.0283$) and 16 weeks in group 3 (P<0.05). These results were similar with the result of the evaluation of new bone formation in histomorphometric analysis. Conclusions : Treatment of experimental peri-implantitis by using $CO_2$ laser with GBR is more useful than other treatments in the formation of new bone and also the tendency of fractal dimension to increase relative to healing time may be a useful means of evaluating.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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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.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.71-76
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• 2009

Purpose: Many researches showed loss of alveolar bone in fresh extraction socket and even in case of immediate implant placement. The aim of this study was to evaluate the effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets. Materials and methods: Immediate implants were placed into artificially induced periapical lesion of mandibular premolars after complete debridement using buccal bone defect made by a 6mm trephine bur in 4 mongrel dogs. Before flap repositioning, a non-resorbable barrier membrane was placed on the buccal defect in the experimental group. No membrane was placed in the control group. In 12 weeks after placement, the dogs were sacrificed and undecalcified histologic specimens were prepared. The vertical distance from the smooth-rough surface interface(SRI) to gingiva, 1st bone contact and bone crest were measured in buccal and lingual side. The horizontal thicknesses of gingiva and bone at 0, 1, 2 and 3mm below SRI were measured. Results: The buccal bone was resorbed more than lingual bone in both groups and there was statistical significance(p<0.05). The distances from SRI to 1st bone contact were $2.45{\pm}2.35\;mm$ in experimental group and $4.49{\pm}3.10\;mm$ in control group. In all vertical level, lingual bone was thicker than buccal bone(p<0.05). Conclusion: Buccal bone was reduced more than lingual bone in immediate implant placement into periapically infected extraction sockets. Placement of non-resorbable barrier membrane reduced the buccal bone resorption. However there was no statistical significance.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.421-436
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• 2001

Transforming growth $factor-{\beta}(TGF-{\beta})$is a polypeptide biologic mediator considered to play a role in promoting bone formation in bony defect area. The purpose of this study was to examine the effect of $TGF-{\beta}$ to the periodontal regeneration of class III furcation defect in dogs. Classs III furcation defects were surgically created on the third and the fourth premolars bilaterally in the mandibles of eight mongrel dogs. Experimental periodontitis were induced by placing small cotton pellets into the created defects for 3 weeks. Experimental sites were divided into 4 groups according to the treatment modalities: Group I-Surgical debridement only; Group II-allogenic demineralized freeze dried bone grafting; Group III-allogenic demineralized freeze dried bone soaked in $TGF-{\beta}(4ng/10{\mu}l)$grafting; Group IV-allogenic demineralized freeze dried bone soaked in $TGF-{\beta}(20ng/10{\mu}l)$ grafting. The animals were sacrificed in the 8th week after periodontal surgery and the decalcified and undecalcified specimens were for histological and histometric examination. Although no significant differences was seen in the length of epitheial growth and connective attachment, group III showed the least apical migration among treatment groups. The amount of bone repair was significantly greater in group III, IV compared to group I and group II. New attachment formation was significantly greater in group III and group IV compared to group I and group II. These results suggest the allogenic demineralized freeze dried bone with $TGF-{\beta}$ in class III furcation defect has the potentiality of promoting alveolar bone formation and periodontal regeneration.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.655-662
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• 2011

Purpose: The anterolateral thigh flap is versatile flap for soft-tissue reconstruction for defects located at various sites of the body. This useful flap offers a thick and vascular fascia lata component with large amounts that can be soft tissue coverage for different reconstructive purposes. We present our clinical experience with the use of vascular fascia lata, combined with anterolateral thigh flap for various reconstructive goals. Methods: From April 2008 to February 2011, we transferred anterolateral thigh flaps with fascia lata component to reconstruct soft-tissue defects for different purposes in 11 patients. The fascia lata component of the flap was used for tendon gliding surface in hand/forearm reconstruction in 4 patients, for reconstruction medial and lateral patellar synovial membrane and retinaculum in 2 patients, for reconstruction of plantar aponeurosis in the foot in 2 patients, for reconstruction of fascial and peritoneal defect in the abdominal wall in 2 patient, and for dural defect reconstruction in the scalp in the remaining one. Results: Complete loss of the flap was not seen in all cases. Partial flap necrosis occurred in 2 patients. These complications were treated successfully with minimal surgical debridement and dressing. Infection occurred in 1 patient. In this case, intravenous antibiotics treatment was effective. Conclusion: Anterolateral thigh flap has thick vascular fascia with large amounts. This fascial component of the flap is useful for different reconstructive aims, such as for tendon, ligament, aponeurosis defects, abdominal wall or dura reconstruction. It should be considerated as an important advantage of the flap, together with other well-known advantages.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.552-554
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• 2011

Purpose: Though its general usage, traditional tie-over dressing using suture has a few drawbacks such as difficulty in re-fixation after its opening especially when hematoma or seroma has occurred. It is rather difficult to maintain a stable dressing on curvy parts of body like flank, buttocks and that leads to unsatisfactory results of the surgery. Authors recommend a quick and repeatedly doable method, tie-over dressing that incorporates the usage of hooks and rubber bands. Methods: Debridement was done at a recipient site to be able to do skin graft. A right size of skin graft was prepared and placed upon the defect site with suture. Enough number of hooks were attached using Blue nylon at the normal skin of the edge of grafted area. We Applied dressing with ointment and fluffy gauze then fixed the dressing by attaching a rubber band at the hook to give a certain amount of tension. One or two days after the surgery, we opened the tie-over dressing and repeated the tie-over dressing by reusing the hooks and rubber band. Results: The skin grafts were all successfully taken and by repeating tie-over dressing using hooks and rubber, we could take the advantage of shortened the dressing time and eliminate the inconvenience of the patient and the surgeon by using bandages and fixing tapes. Conclusion: The advantage of tie over dressing using hooks and rubber bsnds are its easy re-doability early detection of probable complications, preventability of reoccurence of hematoma and seroma. Therefore, authors report this as considering the tie-over dressing using hooks and rubber bands is recommendable.