• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.7 no.1
• /
• pp.32-40
• /
• 1998

Alveolar ridge augmentation and preservation techniques designed to reconstruct deformed alveolar ridge now occupy a major role in esthetic dentistry. Previously, deformed alveolar ridges were filled with plastic materials(porcelain or resin) of prosthesis to restore ridge contours, which resulted in larger teeth and food impaction under the pontic base. So, prostheses of this type were unacceptable and really detectable when patients smiled. But nowadays, alveolar ridge augmentation procedures enable the dentists to provide patients with fixed prostheses that are esthetic. The development of guided tissue regeneration technique and materials also have made a major impact on extending the scope of therapeutic horizons in dentistry.

• The Journal of the Korean dental association
• /
• v.36 no.11 s.354
• /
• pp.794-799
• /
• 1998

Many references report that abnormal diastema except temporary diastema existing in mixed dentition period is caused by maxilary heavy labial frenum, malocclusion, progressive periodontal disease, and loss of posterior teeth. We can diagnose patient as diastema caused by periodontal disease, especially, in case of accompanying progressively destructed anterior maxillary alveolar bone defect, and interseptal bone defect. We report Multiple disciplinary approach for diastema associated with periodontal disease. Periodontal treatment(Guided Tissue -Regeneration, alveoloplasty, bone graft), or thodontic treatment (space closure, redistribution), and the final proshodontic restoration for retention were used.

• Journal of Periodontal and Implant Science
• /
• v.36 no.2
• /
• pp.515-529
• /
• 2006

Periodontal regeneration refers to the restoration of bone, cementum and periodontal ligament to their original levels before damage from periodontal disease process. Various surgical techniques to the promotion of periodontal regeneration have been used. Bone graft and guided tissue regeneration have used for the regeneration of furcation involvements which caused by periodontal disease. Fibrin adhesive is agents that have been shown to be effective in periodontal regeneration and biological carrier. Calcium sulfate which is one of the resorbable barrier materials has used for guided tissue regeneration. The purpose of this study was to compare the clinical effects between bone graft using fibrin adhesive and calcium sulfate barrier in the mandibular class II furcation involvement. For the study, twenty-six class II furcation involved teeth were surgically treated. 13 furcation defects(test group) were treated with bonegraft and fibrin adhesive and the others(control group) were treated with bone graft and calcium sulfate barrier. Pocket depth, clinical attachment level and gingival recession were measured at baseline, postoperative 3 and 6 months. The results of the study are as follows: 1. The change of pocket depth and clinical attachment level in both groups was decreased significantly at 3, 6 months than at baseline(p<0.05). 2. The change of gingival recession in both groups was increased significantly at 3, 6 months than at baseline(p<0.05). 3. The change of pocket depth and clinical attachment level in both groups was decreased at 3, 6 months, and the change of gingival recession in both groups was increased at 3, 6 months but there were no statistically or clinically significant differences with both groups. 4. The significant reduction of the pocket depth and clinical attachment level exhibited marked changes at 3 months in both groups. In conclusion, the results of this study suggest that there are no statistically or clinically significant differences between fibrin adhesive and calcium sulfate barrier in the treatment of class II furcations using xenograft.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.23 no.2
• /
• pp.145-155
• /
• 2007

The advent of osseointegration and advances in biomaterials and techniques have contributed to increased application of dental implants in the restoration of maxillary partial edentulous patients. Often, in these patients, soft and hard tissue defects result from a variety of causes, such as infection, trauma, and tooth loss. These create an anatomically less favorable foundation for ideal implant placement. Reconstruction of the atrophic maxillary alveolar bone through a variety of regenerative surgical procedures has become predictable; it may be necessary prior to implant placement or simultaneously at the time of implant surgery to provide a restoration with a good long-term prognosis. Regenerative procedures are used for horizontal and vertical ridge augmentation. Many different techniques exist for effective bone augmentation. The approach is largely dependent on the extent of the defect and specific procedures to be performed for the implant reconstruction. It is most appropriate to use an evidenced-based approach when a treatment plan is being developed for bone augmentation cases. The cases presented in this article clinically demonstrate the efficacy of using a autogenous block graft, guided bone regeneration, ridge split, immediated implant placement technique on the atrophic maxillary area.

• Journal of Periodontal and Implant Science
• /
• v.34 no.1
• /
• pp.149-162
• /
• 2004

This study was performed to evaluate the effect of freeze-dried bone graft on space-making capacity and bone formation in the procedure of guided bone regeneration with titanium reinforced ePTFE membrane. After decortication in the calvaria, GBR procedure was performed on 8 rabbits with titanium reinforced ePTFE membrane filled with human FDBA(Rocky Mountain Tissue Bank,Aurora Co., USA). Decortication was performed to induce the effect of bone forming factor from bone marrow. The animals were sacrificed at 2 weeks, 4 weeks, 8 weeks and 12 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis. πle results of this study were as follows: 1. Titanium reinforced-ePTFE membrane was biocompatable and capable of maintaining the space-making. 2. FDBA particle was surrounded with connective tissues but there was no evidence on new bone formation. 3. FDBA particle resorbed continuously but it remained until 12weeks after the surgery. Within the above results, TR-ePTFE membrane could be used effectively for Guided bone regeneration but It was assumed that FDBA does not appear to contribute to bone formation.

• Journal of Periodontal and Implant Science
• /
• v.40 no.5
• /
• pp.232-238
• /
• 2010

Purpose: To prolong the degradation time of collagen membranes, various cross-linking techniques have been developed. For cross-linking, chemicals such as formaldehyde and glutaraldehyde are added to collagen membranes, but these chemicals could adversely affect surrounding tissues. The aim of this study is to evaluate the ability of porous non-chemical cross-linking porcine-derived collagen nanofibrous membrane to enhance bone and associated tissue regeneration in one-wall intrabony defects in beagle dogs. Methods: The second and third mandibular premolars and the first molars of 2 adult beagles were extracted bilaterally and the extraction sites were allowed to heal for 10 weeks. One-wall intrabony defects were prepared bilaterally on the mesial and distal side of the fourth mandibular premolars. Among eight defects, four defects were not covered with membrane as controls and the other four defects were covered with membrane as the experimental group. The animals were sacrificed 10 weeks after surgery. Results: Wound healing was generally uneventful. For all parameters evaluating bone regeneration, the experimental group showed significantly superior results compared to the control. In new bone height (NBh), the experimental group exhibited a greater mean value than the control ($3.04{\pm}0.23\;mm/1.57{\pm}0.59$, P=0.003). Also, in new bone area (NBa) and new bone volume (NBv), the experimental group showed superior results compared to the control (NBa, $34.48{\pm}10.21%$ vs. $5.09{\pm}5.76%$, P=0.014; and NBv, $28.04{\pm}12.96$ vs. $1.55{\pm}0.57$, P=0.041). On the other hand, for parameters evaluating periodontal tissue regeneration, including junctional epithelium migration and new cementum height, there were no statistically significant differences between two groups. Conclusions: Within the limitations of this study, this collagen membrane enhanced bone regeneration at one-wall intrabony defects. On the other hand, no influence of this membrane on periodontal tissue regeneration could be ascertained in this study.

• Journal of Periodontal and Implant Science
• /
• v.35 no.3
• /
• pp.687-702
• /
• 2005

The purpose of this study is to examine the effect of non-resorbable membrane such as e-PTFE which was used with DFDB in bone regeneration on dehiscence defect in peri-implant area. Amomg the patients, who have recieved an implant surgery at the department of Periodontics in Dan Kook University Dental Hospital, 12 patients showed implant exposure due to the dehiscence defect and 15 implants of these 22 patients were the target of the treatment. Periodontists randomly applied $Gore-Tex^{(R)}$ to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 15 cases, 1 membrane exposure was observed and in this case, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area $9.25{\pm}4.84$ preoperatively and significantly increased to $11.48{\pm}7.52$ postoperatively(0.05). 4. The increase of bone surface area in non-resorbable membrane was $2.23{\pm}3.38$. 5. As a result of histopathological finding, DFDB surrounded by new bone formation and lamellate bone, resorption of DFDB and bone mineralization was found. Also, fibrosis of connective tissue beneath the membrane was found. This study shows that the surgical method using DFDB and non-resorbable membrane on dehiscence defect in peri-implant area is effective in bone regeneration.

• Journal of Periodontal and Implant Science
• /
• v.26 no.4
• /
• pp.967-987
• /
• 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
• /
• v.27 no.4
• /
• pp.767-783
• /
• 1997

Guided tissue regeneration, bone graft procedures, and application of growth factors have been used to regenerate lost periodontal tissues. Recently, enamel matrix derivative has been introduced into periodontal regeneration procedures in expectation of promoting new bone and cementum formation. The purpose' of this study was to evaluate the effect of enamel matrix derivative in 1-wall intrabony defects in beagle dogs. For this purpose, each dog was anesthesized using intravenous anesthesia and mandibular 1st, 3rd premolars were extracted. 2 months later, the 1-wall intrabony defects(mesio-distal width: 4mm, depth: 4mm) were created on the distal side of 2nd premolars and mesial side of 4th premolars. The control group was treated with debridement alone, and experimental group was treated with debridement and enamel matrix derivative application. The healing processes were histologically and histometrically observed after 8 weeks and the results were as follows : 1. The length of junctional epithelium was $0.94{\pm}0.80mm$ in the control group, $0.57{\pm}0.42mm$ in the experimental group, with no statistically significant difference between groups. 2. The connective tissue attachment was $1.36{\pm}0.98mm$ in the control group. $0.38{\pm}0.43mm$ in the experimental group, with statistically significant difference between groups(P<0.05). 3. The new cementum formation was $2.49{\pm}1.06mm$ in the control group, $3.59{\pm}0.74mm$ in the experimental group. with statistically significant difference between groups(P<0.05). 4. The new bone formation was $1.92{\pm}0.97mm$ in the control group, $2.32{\pm}0.59mm$ in the experimental group. with no statistically significant difference between groups. Within the limitation to this study protocol, enamel matrix derivative application in 1-wall intrabony defect enhanced new cementum formation. Although there was no statistically significant difference, enamel matrix derivative also seems to be effective in inhibition of apical migration of junctional epithelium and new bone formation.

• Journal of Korean Dental Science
• /
• v.11 no.2
• /
• pp.43-56
• /
• 2018

Purpose: The purpose of this study was to assess the adhesiveness and cytotoxicity of 3, 4-dihydroxyphenylalanine (DOPA), and to evaluate the role of collagen membrane with DOPA in the guided bone regeneration. Materials and Methods: Peel resistance and cell cytotoxicity test were performed. Four defect types in nine rabbit calvaria were randomly allocated: i) control, ii) membrane, iii) deproteinized porcine bone mineral (DPBM) covered by membrane with DOPA, and iv) DPBM covered by membrane with cyanoacrylate. Animals were sacrificed at 2 (n=4) and 8 weeks (n=5) for microcomputed tomography and histomorphometric analysis. DOPA showed low peel resistance but high cell viability. Result: Cyanoacrylate and DOPA groups showed significantly higher mineralized tissue volume (MTV) compared to control and membrane groups at 2 weeks (P<0.05). At 8 weeks, DOPA group showed the highest MTV. Significantly higher new bone area was found in DOPA group at 8 weeks (P<0.05). Bone formation increased from 2 to 8 weeks in DOPA group (P<0.05). Conclusion: DOPA showed high cell viability and in vivo study revealed predictable performance in bone regeneration.