• Journal of Periodontal and Implant Science
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• v.33 no.1
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• pp.91-102
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• 2003

Several effective treatment methods and materials have been developed for the treatment of furcation involvement. Currently, the combination of guided tissue regeneration (GTR) and bone grafts is the most commonly prescribed method of treating furcation involved defects. But because these cases often present with poor accessibility, placement of the membrane may be difficult and consequently, clinically impractical. In this study, the alveolar bone healing patterns of adult beagle dogs presenting with alveolar bone destruction treated by one of two methods - treatment using solely bone allografts (BBP(R)), or treatment using bone allografts (BBP(R)) stabilized by a fibrin adhesive - were comp ared. The effects of the fibrin adhesive on the initial stabilization of the newly formed bone, subsequent regeneration of bone, and the feasibility of the clinical application of the fibrin adhesive were analyzed. The results of the study were as follows: 1. Clinical signs of inflammation at the 4-8 week interval were not observed: but signs of mild inflammation were histologically observed at the 4-week interval. 2. Allografts stabilized by fibrin adhesive showed good bone formation, whereas defects treated with only the allograft material showed incomplete alveolar bone regeneration. 3. Allografts stabilized by fibrin adhesive showed a decrease in the amount old bone with a concurrent increase in the formation of new lamellar bone four weeks post-op, whereas defects treated with only the allograft material showed no new lamellar bone formation at the same interval. 4. In detects treated with only the allograft material, the defective area was filled with connective tissue 8-weeks post-op, whereas fibrin adhesive stabilized allografts showed viable connections between the original bone and the newly formed bone, in addition to neovascularization 8-weeks post-op. The results of this study show that concurrent use of fibrin adhesive materials can stabilize the allograft material and aid in new bone formation Although the stability of fibrin adhesives fall short of the results achievable by GTR membranes, in cases presenting with poor accessibility that contraindicate the use of membranes, fibrin adhesive materials provide a viable and effective alternative to graft stabilization and new bone formation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.499-507
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• 1994

The aim of this experiment is to compare the healing process of extraction sockets after immediate implant placement with those using autogenous bone grafts and guided tissue regeneration with Gore-Tex. The first lower premolars and the second premolars of six experimental dogs were extracted and Stryker fin type implants were placed into the extraction sockets immediately after extraction. In the control group, any graft materials were'not used and the dead space around implants was left in itself and covered with only periosteum. In the experimental group A, implants were covered with Gore tex without any bone grafts, and in the experimental group B, the dead space around implants was filled with the bone chips gained from drilling procedure. Each experimental dogs were sacrificed at the 1st, 2nd, 3rd, 6th, and 8th week and the specimens were observed by gross examination, radiological examination, and light microscopic examination. The following results were obtained. 1. Well healed soft tissue and no mobility of the implants were observed in control and two experimental groups. 2. In the radiogical examination, radiopacity around implants had been increased gradually. 3. In the microscopic examination, there were good healing process and active new bone formation in both in the experimental groups, Especially the more amount of new bone formation occurred in the experimental group B using bone chips. 4. Bone chip grafts and guided tissue regeneration (GTR) using Gore-Tex may be one of the successful methods in the immediate implantation.

• Journal of Periodontal and Implant Science
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• v.34 no.4
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• pp.711-722
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• 2004

The purpose of this study is to evaluate the regenerated bone histollogically using titanium reinforced ePTFE(TR-ePTFE) membrane and to investigate cell occlusiveness, wound stabilization and tissue integration of TR-ePTFE membrane. Adult male rabbits (mean BW 2kg) and TR9W (W.L.Gore&Associate.INC,USA) were used in this study. Intramarrow penetration defects were surgically created with round carbide bur(HP long #6) on calvaria of rabbits. TR-ePTFE membrane was applied to defect. Then guided bone regeneration was carried out using TR-ePTFE membrane and resorbable suture. At 2,4,8,12 weeks after the surgery, animals were sacrificed. Nondecalcified specimens were processed for histologic analysis. The result and conclusion of this study were as follows: 1. TR-ePTFE membrane had good ability of biocompatibility and cell occlusiveness. 2. space making for guided bone regenerayion was good at TR-ePTFE membrane. 3. Tissue integration was not good at TR-ePTFE membrane. So, wound stabilization was not good. 4. At 8 weeks, 12 weeks after GBR procedure, bone formation was seen. From the above results, TR-ePTFE membrane fixed tightiy on alveolar bone might be recommended for the early bone formation.

• Journal of Periodontal and Implant Science
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• v.33 no.1
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• pp.61-77
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• 2003

The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. Bone graft & guided tissue are being used for the regeneration of destroyed periodontium these days. Non-resorbable membranes were used for Guided tissue regeneration in early days, however more researches are focused on resorbable membranes these days. The aim of this study is to evaluate the osteogenesis of paradioxanone membrane on the calvarial critical size defect in Sprague Dawley rats. An 8 mm diameter surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into three groups: Untreated control group, Biomesh(R) group and paradioxanone group. The animals were sacrificed at 4, 8 and 12 weeks after surgical procedure. The specimens were examined by histologic, histomorphometric analyses. The results are as follows: 1. In histological view on Biomesh(R), no visible signs of resorption was observed at 4 weeks but progressive resorption was observed at 8 weeks through 12 weeks. Paradioxanone membrane expanded at 4 weeks, and rapid resorption was observed at 8 weeks. In both the membranes, inflammatory cells were observed around them. Inflammatory cells decreased with time but were still present at 12 weeks. More inflammatory cells were observed in paradioxanone membranes than in Biomesh(R) membrane. 2. The area of newly formed bone in the defects were 0.001${\pm}$0.001, 0.006${\pm}$0.005, 0.002${\pm}$0.003 at the 4 weeks, 0.021${\pm}$0.020, 0.133${\pm}$0.073, 0.118${\pm}$0.070 at the 8 weeks and 0.163${\pm}$0.067, 0.500${\pm}$0.197, 0.487${\pm}$0.214 at the 12 weeks in the control group, Biomesh(R) group and experimental group respectively. Compared to the control group, Biomesh(R) group displayed significant differences at 4,8, and 12 weeks and the paradioxanone group at 8 and 12 weeks.(P<0.05)

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.3
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• pp.240-248
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• 1999

To investigate the expression pattern of noncollagenous bone matrix proteins such as osteonectin(OSN), osteopontin(OPN) and osteocalcin(OSC) mRNA during bony healing procedure induced by guided bone regeneration method, we made artificial defects on bilateral femur of rats. Then induced bony healing by application of a nonabsorbable PTFE membrane in experimental sites and without its application in control sites for 3 weeks. The mRNA expression pattern at specimens obtained at 1, 2 and 3 weeks after operation was detected by in situ hybridization method using its antisense mRNA probes. The experimental sites revealed more rapid and favorable bony healing than control sites and new bone formation was limited within defected area by inhibitory activity of bone marrow cells. In experimental sites, the OSN and OSC mRNA were expressed strongly on osteoblasts of regenerating cortical bone at 1st week and on osteoblasts lining the trabecular bone in marrow space at 3rd week, whereas, in control sites, their expression were noted on osteoblasts lining the reactively formed sponge bones at 2nd and 3rd week. In addition, the OPN mRNA was expressed on osteoblasts and osteoclasts at sites of remodeling and osteocytes of remained trabecular bone of defected area in experimental sites and on macrophages at 1st week and osteoclasts at sites of remolding at 2nd and 3rd week in control sites. The above findings suggest that the more rapid and favorable bony healing might be induced by blocking of invading fibrous connective tissue into bony defects. And the earlier expression of OSN and OSC mRNA on osteoblasts of experimental sites suggest that the formation and resorption of regenerating bone was more rapidly progressed in confined spaces made by applicate membranes.

• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.1-17
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• 1997

Tetracycline is known to be effective in eliminating periodontopathogens and have collagenolytic activity. This study was performed to observe the desorption kinetics and structural changes of tetracycline-treated barrier membranes for guided tissue regeneration. Four kinds of barrier membranes were tested : $Tefgen^{(R)}$(American Custom Medical, USA) and $Gore-Tex^{(R)}$(W.L. Gore & Associates Inc., USA) as nonresorbable membranes ; Resolut(polyglycolide & polylactide copolymer, W.L. Gore & Associates Inc., USA) and $Biomend^{(R)}$(collagen, Collatec Co., USA) as resorbable membranes. The membranes were cut into discs(diameter : 4mm) and were immersed in 5% tridodecylmethylammonium chloride(TIMAC) ethanol and air-dried. The membrane discs were absorbed with $100{\mu}g/ml tetracycline solution(pH8) for one minute and dried. For desorption kinetics, TC treated discs were immersed in phosphate buffered saline solution (PBS, pH 7.4). PBS was exchanged daily and TC concentration was measured by absorbance at 276nm on UV spectrophotometer. To measure remaining antibacterial activity, discs of 1 day to 4 weeks after desorption were placed on Mueller Hinton agar containing Bacillus cereus and incubated aerobically in $37^{\circ}C$ for twelve hours and the inhibition diameters were measured. To observe the structural change of membranes after TIMAC treatment or immersion in PBS, the membrane discs were examined under SEM. The results were as follows : 1. Total amounts of TC absorbed into membrane discs($0.7536mm^2$) were $2000{\mu}g$, $1800{\mu}g$, $2625{\mu}g$ and $2499{\mu}g$ for $Tefgen^{(R)}$, $Gore-Tex^{(R)}$, $Biomend^{(R)}$ and $Resolut^{(R)}$. 2. The concentration of TC released from barrier membrane discs was maintained over $4{\mu}g/ml$ until the fifth day in nonresorbable membranes and $Resolut^{(R)}$, but until the fourth day in $Biomend^{(R)}$, Until the ninth day in nonresorbable membranes and until the seventh day in resorbable membranes, the TC concentration was maintained over $1{mu}g/ml$. 3. The four membrane discs in the first day showed similar size of inhibition zone. One to four weeks later, the inhibition zone was much smaller in resorbable membrane discs than nonresorbable membrane discs. 4. Any structural change due to treatment of TIMAC was not observed on the nonresorbable membranes. $Resolut^{(R)}$ did not show any structural change except fibrillar loosening during immersion period, but Biomend showed destruction of membrane structure from the first week of immersion. This study indicates that tetracycline treated barrier membranes lead to the sustained release of tetracycline for over 7 days. This slow release pattern of tetracycline may contribute to the favorable clinical outcome of guided tissue regeneration.

• Journal of Korean Dental Science
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• v.17 no.2
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• pp.53-63
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• 2024

Purpose: To investigate the effects of simultaneous soft and hard tissue augmentation and the addition of polydeoxyribonucleotide (PDRN) on regenerative outcomes. Materials and Methods: In five mongrel dogs, chronic ridge defects were established in both mandibles. Six implants were placed in the mandible, producing buccal dehiscence defects. The implants were randomly allocated to one of the following groups: 1) control: no treatment; 2) GBR: guided bone regeneration (GBR) only; 3) GBR/PDRN: GBR+PDRN application to bone substitute particles; 4) GBR/CTG: GBR+connective tissue grafting (CTG); 5) GBR/VCMX: GBR+soft tissue augmentation using volume stable collagen matrix (VCMX); and 6) group GBR/VCMX/PDRN: GBR+VCMX soaked with PDRN. The healing abutments were connected to the implants to provide additional room for tissue regeneration. Submerged healing was achieved. The animals were euthanized after four months. Histological and histomorphometric analyses were then performed. Results: Healing abutments were gradually exposed during the healing period. Histologically, minimal new bone formation was observed in the dehiscence defects. No specific differences were found between the groups regarding collagen fiber orientation and density in the augmented area. No traces of CTG or VCMX were detected. Histomorphometrically, the mean tissue thickness was greater in the control group than in the other groups above the implant shoulder (IS). Below the IS level, the CTG and PDRN groups exhibited more favorable tissue thickness than the other groups. Conclusion: Failure of submerged healing after tissue augmentation deteriorated the tissue contour. PDRN appears to have a positive effect on soft tissues.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2003.11a
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• pp.80-80
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• 2003

Insulin-dependent or Type 1 diabetes mellitus (IDDM) has been associated with an increased severity of periodontal disease. Since periodontal ligament (PDL) cells play a significant role in maintenance and regeneration of mineralized tissue, the success of procedures, such as guided tissue regeneration, is directly related to the ability of these cells to augment mineralized tissue. In this study, we investigated the time- and dose-dependent effect of high glucose on the proliferation and collagen synthesis of human periodontal ligament (PDL) cells. PDL cells were treated with high glucose (22mM, 33mM, 44mM) for 1 or 2 days. High glucose significantly inhibited proliferation of PDL cells as a time- and dose-dependent manner as evidenced by MTT assay. PDL cells were cultured in high glucose media (22mM, 33mM, 44mM) for 24 h. The ratio of collagen content to total protein was evaluated, and the gene expression of type I collagen was assessed by RT - PCR. The high concentration of glucose inhibited collagen synthesis, a marker of bone formation activity. This study indicated high glucose concentration could alter the metabolism of periodontal ligament cell, leading to alveolar bone destruction.

• Journal of Periodontal and Implant Science
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• v.50 no.6
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• pp.406-417
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• 2020

Purpose: This study investigated whether the placement of ribose cross-linked collagen (RCLC) membranes without primary soft tissue closure predictably resulted in sufficient alveolar ridge preservation in contained and non-contained extraction sockets. Methods: Membranes were positioned across extraction sockets, undermining full-thickness flaps, and the gingival margins were fixed by double-interrupted sutures without crossed horizontal mattress sutures for 1 week. In non-contained sockets, a bone substitute was used to support the membrane within the bony envelope. Radiographs and clinical images obtained 4 months later were analyzed by ImageJ software using non-parametric tests. Results: In 18 patients, 20 extraction sockets healed uneventfully and all sites received standard-diameter implants (4.1, 4.8, or 5.0 mm) without additional bone augmentation. Soft tissues and the muco-gingival border were well maintained. A retrospective analysis of X-rays and clinical photographs showed non-significant shrinkage in the vertical and horizontal dimensions (P=0.575 and P=0.444, respectively). The new bone contained vital bone cells embedded in mineralized tissues. Conclusions: Within the limitations of this pilot study, open healing of RCLC membranes may result in sufficient bone volume for implant placement without additional bone augmentation in contained and non-contained extraction sockets.

• Journal of Periodontal and Implant Science
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• v.51 no.3
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• pp.189-198
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• 2021

Purpose: This study was conducted to determine how the distance of the near insertion points in a vertical mattress suture from the wound margin influences the pattern of primary closure in an in vitro experimental model. Methods: Pairs of 180 porcine gingival and alveolar mucosa samples were harvested from 90 pig jaws and fixed to a specially designed model. A vertical mattress suture was performed with the near insertion point at 3 different distances from the wound margin (1-, 3-, and 5-mm) on both the gingival and mucosal samples (6 groups; n=30 for each group). The margin discrepancy and the presence of epithelium between the wound margins were measured on histologic slides. Results: The margin discrepancy decreased significantly as the near insertion point became closer to the wound margin both in mucosal tissue (0.241±0.169 mm, 0.945±0.497 mm, and 1.306±0.773 mm for the 1-, 3-, and 5-mm groups, respectively) and in gingival tissue (0.373±0.304 mm, 0.698±0.431 mm, and 0.713±0.691 mm, respectively). The frequency of complications of wound margin adaptation reduced as the distance of the near insertion point from the wound margin decreased both in the mucosal and gingival tissues. Conclusions: Placing the near insertion point close to the wound margin enhances the precision of wound margin approximation/adaptation using a vertical mattress suture.