• Journal of Periodontal and Implant Science
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• 제37권1호
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• pp.77-89
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• 2007

This study was performed to evaluate the effect of deproteinized bovine bone mineral soaked in inorganic polyphosphate on bone regeneration in the calvaria of rabbit in the procedure of guided bone regeneration with titanium reinforced expanded polytetrafluoroethylene(TR-ePTFE) membrane. The rabbits were divided into four groups. Control group used TR-ePTFE membrane filled with de-proteinized bovine bone mineral, experimental group I used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in 4% inorganic polyphosphate, experimental group II and III used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in 8% or 16% inorganic poly-phosphate respectively. After decortication in the calvaria, GBR procedure was performed on 8 rabbits with only TR-ePTFE membrane or titanium reinforced ePTFE membrane filled with deproteinized bovine bone mineral soaked in inorganic polyphosphate. The animals were sacrificed at 4 weeks, and 8 weeks af-ter the surgery. Non-decalcified specimens were processed for histologic analysis, and new bone for-mation was assessed by histomorphometric as well as statical analysis. 1. Both control group and experirrental group dermnstrated increasing of new bone formation until 8weeks. 2. At 8 weeks, experimental group I and group II showed the significant difference compared to control group in new bone formation. Especially experimental group II showed the most in-creasing of new bone formation. 3. The higher concentration of inorganic polyphosphate filled, the more volume of bone formation pro-moted, but experimental group III did not reveal significant difference compared to contol group. 4. Deproteinized bovine bone mineral did not resorbed at all until 8 weeks. These results suggest that inorganic polyphosphate has a promoting effect on bone regeneration. possibly by enhancing osteoconductivity of the carrier and by increasing osteoinductivity of the defected alveolar bone tissue, but not as we respect.

• Journal of Periodontal and Implant Science
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• 제38권3호
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• pp.437-444
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• 2008

Purpose: A number of techniques and materials have been used for periodontal regeneration and bone graft procedures with guided tissue regeneration(GTR) have been suggested as alternatives to osseous surgery in the management of local infra-bony defects. However, the long-term stability and treatment outcome following bone graft procedure of infra-bony defects is poorly documented. The purpose of this study was to assess radiographic change in infra-bony defects over 2 years after bone graft procedures with various graft materials. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients showed clinical and radiographic evidence of infra-bony defect(s). 44 sites of 34 patients aged 31 to 69 (mean age 48.3) were treated by bone graft procedure with a bone graft material. Baseline and 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, defect depth, defect angle, bone graft materials) using the paired t-test were examined. Result: We observed $1.15{\pm}1.95\;mm$ of bone fill, $0.40{\pm}1.19\;mm$ of crestal resorption, $1.55{\pm}1.77\;mm$ of defect resolution, and $40{\pm}44%$ of percentage of defect resolution. Deeper initial defect depth, narrower initial defect angle showed significantly greater bone fill, defect resolution, and % of defect resolution. But no significant difference was observed in graft sites and graft materials. Conclusion: If good oral hygiene maintenance and periodic recall check of patients is assured, bone graft procedure using various graft materials is one of the appropriate treatment modality for regenerative therapy of infra-bony defects.

• Journal of Periodontal and Implant Science
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• 제34권2호
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• pp.411-424
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• 2004

This study was performed to evaluate bone formation in the calvaria of rabbit by the concept of guided bone regeneration with titanium mesh membrane. Two different titanium meshes with varying number (353, 565) of pore were utilized in the study. Two surgical sites(T353, T565) were evaluated about whether or not the number of pore may have effect on the bone formation. The animal was sacrificed at 10days, 3 weeks, 6weeks, and 8 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis. 1. Titanium mesh was biocompatible and capable of maintaining the spacemaking. 2. At 3 weeks, 6 weeks, and 8 weeks after GBR procedure, bone formation was more in the T353 site than in the T565 site. 3. Soft tissue layer above the regenerated bone was better developed in the T565 site. 4. There was no difference between two membranes in bone maturity with time. Within the above results, titanium mesh with lesser pore in number might be recommended for the early bone formation.

• 대한치과의사협회지
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• 제34권10호통권329호
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• pp.742-751
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• 1996

본 연구의 목적은 관통된 뼈의 결손부위를 각기 다른 membrane(Gore-tex, Vicryl, Guidor)을 사용하여 보다 나은 골 재생을 얻을 수 있는 가를 평가하는 데 있다. 여섯 마리 흰 족제비의 12개 하악 소구치를 근관치료한 후, 치근단 절제술을 실시하여 $3mm\times5mm$ 크기의 관통된 뼈의 결손을 소구치의 근첨부에 형성하였다. 전부 12개의 결손부위가 형성되었고, 이를 3개의 군으로 나누었다. 대조군으로 결손부위를 membrane barrier없이 점막골막피판으로 덮었다. 다른 각 군은 결손부위를 각 Gore-Tex, Vicryl, Guidor membrane을 사용하여 설측과 협측 모두 덮었다. 각 군을 치유기간 6주와 12주로 두 아군으로 분리하였다. 방사선학적 소견으로 6주군에서 대조군은 $65\%$, Gore-Tex군은 $90\%$, Vicryl군은 $95\%$, Guidor군은 $65\%$의 결손부위의 치유를 보였다. 12주 군에서 대조군은 $80\%$, Gore-Tex군은 $95\%$, Vicryl군은 $95\%$, Guidor군은 $90\%$의 치유를 보였다. 조직학적 소견으로 대조군에서는 완전한 골 재생이 일어나지 않았으며, 결손부위로 결합조직이 자라들어온 것이 관찰되었다. Gore-Tex 6 주군에서는 대부분 fibrillar bone이 관찰되었고, 12 주군에서는 부분적으로 lamellar bone이 형성되었다. Vicryl군에서는 거의 완전한 골의 재생이 관찰되었다. 6주군에서는 재생된 뼈는 fibrillar bone이고 부분적으로 lamellar bone을 관찰되었고, 12주 군에서는 주로 lamellar bone으로 구성되었다. Guidor군에서는 제한적인 골 재생과 함께 심한 염증이 관찰되었다. 본 연구의 결과에서 조직재생유도술은 일반적으로 골 재생을 증진시킴을 볼 수 있었고, Vicryl membrane이 가장 뛰어난 골 재생유도 가능성을 보였다.

• Journal of Periodontal and Implant Science
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• 제43권3호
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• pp.136-140
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• 2013

Purpose: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Methods: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Results: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. Conclusions: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.27.1-27.7
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• 2015

The aim of this study was to evaluate the clinical relevance of autogenous fresh demineralized tooth (Auto-FDT) prepared at chairside immediately after extraction for socket preservation. Teeth were processed to graft materials in block, chip, or powder types immediately after extraction. Extraction sockets were filled with these materials and dental implants were installed immediately or after a delay. A panoramic radiograph and a conebeam CT were taken. In two cases, tissue samples were taken for histologic examination. Vertical and horizontal maintenance of alveolar sockets showed some variance depending on the Auto-FDT and barrier membrane types used. Radiographs showed good bony healing. Histologic sections showed that it guided good new bone formation and resorption pattern of the Auto-FDT. This case series shows that Auto-FDT prepared at chairside could be a good material for the preservation of extraction sockets. This study will suggest the possibility of recycling autogenous tooth after immediate extraction.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.627-629
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• 2013

The ReCell system (Avita Medical) is a cell culture product that allows the immediate processing of a small split-thickness skin biopsy to produce a complete population of cells including keratinocytes, melanocytes, Langerhans cells and fibroblasts. This series is the first to highlight the reconstructive applications of ReCell following ablative skin cancer surgery. The ReCell system was utilized for three patients following skin cancer excision. In two cases, the cells were applied to forehead flap donor sites following nasal reconstruction. In one case, the cells were applied to the calvarial periosteum following wide local excision of a melanoma scar. Assessment of the treated area was performed using the patient and observer scar assessment scale after 1 year. The Patient and Observer Scar Assessment Scale (POSAS) scores for the 2 patients treated with ReCell following forehead flap surgery were 22 and 32. The score for the patient that underwent wide local excision of a melanoma scar was 45. The absence of a donor site, accelerated healing and the satisfactory aesthetic appearance of the mature scars in this series suggest that ReCell may play a useful role in reconstruction following skin cancer excision.

• Journal of Periodontal and Implant Science
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• 제38권3호
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• pp.551-556
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• 2008

Purpose: Cemental tear is an uncommon form of root fracture that can lead to rapid localized attachment loss. When it is exposed in the periodontal pocket, it should be removed to prevent accumulation of dental plaque and calculus. Material and Methods: 2 patients were diagnosed as a cemental tear and they were treated with conventional flap operation and subgingival curettage. Additional treatments such as bone graft or guided tissue regeneration were not performed. Result: Symptoms subsided after the treatment. Periodontal pocket has been reduced but no gain of clinical attachment was observed. Remnant of cemental fragment remained after curettage. However, periodontal pocket was stably maintained and there was no recurrence. Conclusion: Periodontal attachment loss associated with cemental tear can be successfully treated with conventional periodontal surgical and nonsurgical procedures.

• Journal of Periodontal and Implant Science
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• 제38권2호
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• pp.237-246
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• 2008

Purpose: If bone grafts and guided tissue regeneration are effective individually in treating osseous defects, then the questionis, what would happen when they are combined. Bone grafts using Calcium Carbonate(Biocoral) and Guided Tissue Regeneration using Calcium Sulfate(CALMATRIX) will maximize their advantages and show the best clinical results in intrabony defects. This study was to compare the effects of a combination of CS and CC with control treated only with modified widman flap in a periodontal repair of intrabony defects. Materials and Methods: 30 patients with chronic periodontitis were used in this study. 10 patients were treated with a combination of CS and CC as the experimental group II and another 10 patients were treated with CC as the experimental group I, and the remaining 10 patients, the control group were treated only with modified widman flap. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded 6 months later. Results: The probing depth changes were $3.30{\pm}1.34\;mm$ in the control group, $4.2{\pm}1.55\;mm$ in the experimental group I(CC) and $5.00{\pm}1.33\;mm$ in the experimental group II(CS+CC). They all showed a significant decrease 6 months after surgery(p<0.01). There was a significant difference(p<0.05) between the control and experimental group. However there were no significant difference(p<0.05) between the experimental group I and II. The gingival recession changes w $-1.30{\pm}1.25\;mm$ in the control group, This is a significant difference(p<0.01). However, there was a $-0.50{\pm}0.53\;mm$ change in the experimental group I(CC) and $-0.60{\pm}0.97\;mm$ in the experimental group II(CS+CC). In addition, in terms of gingival recession, there was a no significance difference(p<0.05) among the groups. The clinical attachment level changes were $2.00{\pm}1.33\;mm$ in the control group, $3.60{\pm}1.58\;mm$ in the experimental group I(CC) and $4.40{\pm}1.17\;mm$ in the experimental group II(CS+CC). They all showed a significant decrease 6 months after surgery(p<0.01). There was a significant difference(p<0.05) between the control and experimental group. However there was a no significance difference(p<0.05) between the experimental group I and II. The bone probing depth changes were $0.60{\pm}0.52\;mm$ in the control group, $3.20{\pm}1.48\;mm$ in the experimental group I(CC) and $4.60{\pm}1.43\;mm$ in the experimental group II(CS+CC). All of them showed a significant decrease 6 months after surgery(p<0.01), there was a significance difference(p<0.05) among the groups. Conclusion: Treatment using a combination of CS and CC have a potential to improve periodontal parameters in intrabony defects and More efficient clinical results can be expected in intrabony defects less than 2 walls grafted with CS and CC.

• Journal of Periodontal and Implant Science
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• 제26권3호
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• pp.605-624
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• 1996

Various bonegraft materials and the technique of guided tissue regeneration have been used to regenerate lost periodontal tissue. Calcium sulfate has been known as a bone graft material because of good biocompatibility, rapid resorption and effective osteoinduction. It has been known that calcium sulfate works as a binder to stabilize the defect when it is used with synthetic graft materials. The effects on the regeneration of pericxiontal tissue were studied in dogs after grafting 3-wall intrabony defects with calcium carbonate and calcium sulfate and covering with calcium sulfate barrier. The 3-wall intrabony defectstdmm width, 4mm depth, 4mm length) were created in anterior area and treated with flap operation alone(contol group), with porous resorbable calcium carbonate graft alonetexperirnental group 1), with calcium sulfate graft alonetexperimental group 2) and with composite graft of 80% calcium carbonate and 20% calcium sulfate with calcium sulfate barriertexperimental group 3). Healing responses were histologically observed after 8 weeks and the results were as follows: 1. The alveolar bone formation was $0.59{\pm}0.19mm$ in the control group, $1.80{\pm}0.25mm$ in experimental group 1, $1.61{\pm}0.21mm$ in experimental group 2 and $1.94{\pm}0.11mm$ in experimental group 3 with statistically significant differences between control group and all experimental groups(P<0.05). There were statistically significant differences between experimental group 1 and group 2 (P<0.05). 2. The new cementum formation was $0.48{\pm}0.19mm$ in the control group. $1.72{\pm}0.26mm$ in experimental group 1, $1.43{\pm}0.17mm$ in experimental group 2, $1.89{\pm}0.15mm$ in experimental group 3 with statiscally significant differences between control group and all experimental groups (p<0.05). There were statistically significant differences between experimental group 1 and group 2, and between experimental group 2 and group 3(P<0.05). 3. The length of junctional epithelium was $1.61{\pm}0.20mm$ in the contol group, $0.95{\pm}0.06mm$ in experimental group 1, $1.34{\pm}0.16mm$ in experimental group 2, $1.08{\pm}0.11mm$ in experimental group 3 with statiscally significant differences between control group and experimental group 1. and btween control group and experimental group 3(p<0.05). There were statistically significant differences between experimental group 1 ,and group 2, and between experimental group 2 and group 3(P<0.05). 4. The connective tissue adhesion was $1.67{\pm}O.20mm$ in the control group, $1.33{\pm}0.24mm$ in experimental group 1. $1.23{\pm}0.16mm$ in experimental group 2, $1.08{\pm}0.14mm$ in experimental group 3 with statistically significant differences between control group and all experimental groups(p<0.05). There were nostatistically significant differences between all experimental groups. As a result, epithelial migration was not prevented when calcium sulfate was used alone, but new bone and cementum formation were enhanced. Epithelial migration was prevented and new bone and cementum formation were also enhanced when calcium carbonate was used alone and when both calcium carbonate and calcium sulfate were used.