• Journal of Periodontal and Implant Science
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• v.27 no.4
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• pp.723-737
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• 1997

본 연구의 목적은 조직유도재생술의 초기치유시에 구강양치액으로 사용되어지는 0.1% 클로르헥시딘과 0.2% 클로르헥시딘을 사용했을 경우, 양치액을 사용하지 않았을 경우의 세균감염 정도를 비교하는 것이다. 30명의 성인형 치주염에 이환되어진 사람을 대상으로 하였다. 초기치료(Scaling/Root planing/Oral hygiene instruction)를 시행한 후에 한 사람에 한 군데씩 선정하여 2급이나 3급의 치근이개부를 가지고 임상적으로 혹은 방사선학적으로 치간골내낭을 보이지 않는 치아에 통법에 따라 Gore-TexTM를 위치시켰다. 술후 5일간 항생제 (UnasynTM 375mg tablet p.o.tid)를 투여하고 차폐막을 제거할 때까지(4주 혹은 6주) 10명의 환자에게는 0.1% 클로르헥시딘을, 다른 10명의 환자에게는 0.2% 클로르헥시딘으로 구강양치를 하게 하고, 또 다른 10명의 환자에게는 구강양치액을 사용하지 않도록 하였다. 또 1주일에 한번씩 전문가구강위생술식을 실시하였다. 4주나 6주 후에 차폐막을 제거하고 주사전자현미경, 혐기성 세균배양을 이용하여 세균감염정도를 비교하였다. 1. 주사전자현미경으로 관찰시에 0.1% 클로르헥시딘을 사용했을 경우와 0.2% 클로르헥시딘을 사용했을 경우, 클로르헥시딘을 사용하지 않은 경우에 별 차이를 발견할 수 없었다. 2. 혐기성 세균배양시에 0.2% 클로르헥시딘을 사용했을 경우, 0.1%클로르헥시딘을 사용했을 경우보다 적은 수의 세균 수를 보였으나 통계적으로 유의할 만한 차이는 보이지 않았다. 클로르헥시딘을 사용하지 않은 경우에는 다른 두 경우에 비해 통계적으로 유의할 만한 차이를 보였다.(P<0.05) 3. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia를 인지한 경우에는 세 경우 모두 비슷한 비율로 발견되었다.

• Journal of Periodontal and Implant Science
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• v.31 no.4
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• pp.689-711
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• 2001

The purpose of this study was to compare clinical results of guided tissue regeneration(GTR) using either a nonresorbable ePTFE membrane or a resorbable membrane made from a synthetic copolymer of glycolide and lactide(PLGA) in the treatment of human class Ⅱ furcation defects. The ePTEE membranes were applied to 16 patients with maxillary molar buccal class Ⅱ furcation defects as Group I, PLGA membranes were applied to 15 patients with maxillary molar buccal class Ⅱ furcation defects as Group Ⅱ, ePTFE membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅲ and PLGA membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅳ and bone graft materials(DFDBA) were applied in all groups. Probing depth, gingival recession, clinical attachment level, tooth mobility and sulcus bleeding index(SBI) were measured at baseline, 3, 6 and 12months postoperatively. In addition, membrane exposure levels were measured at surgery, 1, 2 and 6weeks postoperatively and postoperative complications were evaluated. The results were as follows: In all groups, there were statistically significant differences in probing depth reduction, gain of clinical attachment and mobility reduction at values of 3, 6 and 12months postoperatively compared to values of baseline, whereas no significant differences in SBI except Group I and gingival recession(p<0.05). Membrane exposure levels were increased at 1, 2 and 6weeks postopratively compared to value of baseline in Group I(p<0.05). There were no statistically significant differences between ePTFE and PLGA membrane in probing depth, clinical attachment level and SBI. There were minimal gingival recession and membrane exposure in Group Ⅳ and pain and swelling were the most common postoperative complications in Group Ⅱ, Ⅲ(p<0.05). In conclusion, this study showed that both nonresorbable membrane and resorbable membrane were effective similarly in the treatment of class Ⅱ furcation defects, without statistical differences in clinical measurements.

• Journal of Periodontal and Implant Science
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• v.30 no.4
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• pp.821-836
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• 2000

The Peri-implantitis causes inflammation of periodontal tissue and bone loss. It contaminates surface of implants. Therefore, guided bone regeneration has been used for the treatment of this disease. For the reosseointegration of the exposed surface, various mechanical and chemical methods have been used for cleaning and detoxication of implant surface. Among these methods, air-powder abrasive and oversaturated citrate are known to be most effective. However, these treatments may deform implant surface. In this research, changes of surface roughness they were examined. 10 experimental machined titanium cylinder models were fabricated to be used for control groups. Each of them was air powder abraded for 1 minute and they were named group 1. And then, group 1 were burnished with cotton pellets soaked with citrate for 30 seconds(Group 2), 1 minute(Group 3), 3 minutes(Group 4), and 5 minutes(Group 5) burnishing were applied for grouping respectively. Each group were examined with SPM, and their surface roughness were measured and analyzed. 1. Surface roughness of titanium decreased when it was air-powder abraded for 1 minute. It was statistically significant. 2. When Air-powder abraded titanium were treated with citrate for 3 minutes, Their surface roughness was the lowest. Titanium treated for 1 minute was the second lowest and 30 seconds was the third and titanium burnished for 5 minutes was the highest. 3. Surface roughness of titanium which was treated with citrate was decreased till 3 minutes, which was statistically significant. There was no statistical significance from 30 seconds to 1 minute and from 1 minute to 3 minutes, and there was statistical significance from 30 seconds to 3 minutes. 4. Oxide layer was formed when titanium is exposed to air, and it was removed when air-powder abraded. It was made when treated with citrate. It is thought that citrate treatment is necessary after the air-powder abrasion, and 1 minute is clinically and qualitatively adequate for burnishing time of citrate.

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.877-889
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• 2005

This study was designed to compare the effects of treatment using chitosan membrane $(Nanogide-C^{(R)})$ resorbable barrier with control treated by polylactic acid/polylacticglycolic acid membrane(PLA/PLGA membrane, $Biomesh^{(R)}$). 44 furcation defecs from 44 patients with class 2 furcation degree were used for this study, 22 sites of them were treated by chitosan membrane as experimental group and 22 site were treated by PLA/PLGA membrane as control group. Clinical parameters including probing depth, gingival recession, attachment level and radiographic examination were evlauated at base line, 1 month, 2 month and 3 month. after surgery. Statistical test used to analyze these data included paired t-test, one way ANOVA. The results are as follows : 1. Probing depth was significanlly decreased in the two group and there were significant differences between groups(p<0.05). 2. Gingival recession was not significanlly increased in the two group and there were no significant differences between groups(p<0.05). 3. Loss of attachment was statistically decreased in the two group and there were no significant differences between groups(p<0.05). 4. Horizontal bone level was significanlly increased in the two group and there were significant differences between groups(p<0.05). On the basis of these results, chitoans resorbable membrane has similar potential to PLA/PLGA membrane in GTR for furcation defect.

• Journal of Periodontal and Implant Science
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• v.49 no.2
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• pp.90-104
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• 2019

Purpose: The aim of this study was to evaluate clinical and radiographic changes and the survival rate after periodontal surgery using deproteinized bovine bone mineral (DBBM) with 10% collagen or DBBM with a collagen membrane in endo-periodontal lesions. Methods: A total of 52 cases (41 patients) with at least 5 years of follow-up were included in this study. After scaling and root planing with or without endodontic treatment, periodontal regenerative procedures with DBBM with 10% collagen alone or DBBM with a collagen membrane were performed, yielding the DBBM + 10% collagen and DBBM + collagen membrane groups, respectively. Changes in clinical parameters including the plaque index, bleeding on probing, probing pocket depth, gingival recession, relative clinical attachment level, mobility, and radiographic bone gains were evaluated immediately before periodontal surgical procedures and at a 12-month follow-up. Results: At the 12-month follow-up after regenerative procedures, improvements in clinical parameters and radiographic bone gains were observed in both treatment groups. The DBBM + 10% collagen group showed greater probing pocket depth reduction ($4.52{\pm}1.06mm$) than the DBBM + collagen membrane group ($4.04{\pm}0.82mm$). However, there were no significant differences between the groups. Additionally, the radiographic bone gain in the DBBM + 10% collagen group ($5.15{\pm}1.54mm$) was comparable to that of the DBBM + collagen membrane group ($5.35{\pm}1.84mm$). The 5-year survival rate of the teeth with endo-periodontal lesions after periodontal regenerative procedures was 92.31%. Conclusions: This study showed that regenerative procedures using DBBM with 10% collagen alone improved the clinical attachment level and radiographic bone level in endo-periodontal lesions. Successful maintenance of the results after regenerative procedures in endo-periodontal lesions can be obtained by repeated oral hygiene education within strict supportive periodontal treatment.

• Journal of Periodontal and Implant Science
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• v.51 no.3
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• pp.179-188
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• 2021

Purpose: Due to the difficulty of the hygienic care and sanitary management of abutment teeth and subpontic areas associated with fixed dental prostheses (FDPs), intrabony defects occur and accelerate due to the accumulation of plaque and calculus. This study aimed to evaluate the efficacy of regenerative periodontal surgery for intrabony defects associated with FDPs. Methods: The study inclusion criteria were met by 60 patients who underwent regenerative treatment between 2016 and 2018, involving a total of 82 intrabony defects associated with FDPs. Periodontal osseous lesions were classified as 1-, 2-, and 3-wall intrabony defects and were treated with an enamel matrix derivative in combination with bone graft material. The changes in clinical (pocket probing depth [PPD] and clinical attachment level [CAL]) and radiographic (defect depth and width) outcomes were measured at baseline and at 6, 12, and 24 months. Results: Six months after regenerative treatment, a significant reduction was observed in the PPD of 1-wall (P<0.001), 2-wall (P<0.001), and 3-wall (P<0.001) defects, as well as a significant reduction in the CAL of 2-wall (P<0.001) and 3-wall (P<0.001) intrabony defects. However, there was a significant increase in the CAL of 1-wall intrabony defects (P=0.003). Radiographically, a significant reduction in the depth of the 3-wall (P<0.001) defects and a significant reduction in the width of 2-wall (P=0.008) and 3-wall (P<0.001) defects were observed. The depth decreased in 1-wall defects; however, this change was not statistically significant (P=0.066). Conclusions: Within the limitations of the current study, regenerative treatment of 2- and 3-wall intrabony defects associated with FDPs improved clinical and radiological outcomes. Additional prospective studies are necessary to confirm our findings and to assess long-term outcomes.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.382-394
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• 2022

The treatment of patients with severe periodontitis should be proceeded step-bystep through an accurate diagnosis of each patients' individual tooth and with a strategic treatment plan. Implant-supported fixed prosthetic restoration has the advantage of high patient satisfaction and stable vertical dimension compared to the removable partial denture. However, multiple teeth defect areas lacking hard tissue may be disadvantageous in aesthetic failure and longer treatment time. In addition, it takes a certain period of time to manufacture and install a conventional fixed prosthesis, and during this process, the provisional prosthesis must satisfy the mechanical, biological, and aesthetic requirements of teeth. The purpose of this article is to describe the fabrication of implant-supported fixed prosthesis through a step-by-step approach in a partially edentulous patient.

• Journal of Periodontal and Implant Science
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• v.42 no.6
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• pp.204-211
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• 2012

Purpose: This study was performed to establish an experimental rabbit model for single-stage maxillary sinus augmentation with simultaneous implant placement. Methods: Twelve mature New Zealand white rabbits were used for the experiments. The rabbit maxillary sinuses were divided into 3 groups according to sinus augmentation materials: blood clot (BC), autogenous bone (AB), and bovine-derived hydroxyapatite (BHA). Small titanium implants were simultaneously placed in the animals during the sinus augmentation procedure. The rabbits were sacrificed 4 and 8 weeks after surgery and were observed histologically. Histomorphometric analyses using image analysis software were also performed to evaluate the parameters related to bone regeneration and implant-bone integration. Results: The BC group showed an evident collapse of the sinus membrane and limited new bone formation around the original sinus floor at 4 and 8 weeks. In the AB group, the sinus membrane was well retained above the implant apex, and new bone formation was significant at both examination periods. The BHA group also showed retention of the elevated sinus membrane above the screw apex and evident new bone formation at both points in time. The total area of the mineral component (TMA) in the area of interest and the bone-to-implant contact did not show any significant differences among all the groups. In the AB group, the TMA had significantly decreased from 4 to 8 weeks. Conclusions: Within the limits of this study, the rabbit sinus model showed satisfactory results in the comparison of different grafting conditions in single-stage sinus floor elevation with simultaneous implant placement. We found that the rabbit model was useful for maxillary sinus augmentation with simultaneous implant placement.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.181-192
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• 2007

Periodontal surgery as part of the treatment of periodontal disease is mainly performed 1) to gain access to diseased areas for adequate cleaning; 2) to achieve pocket reduction or elimination; and 3) to restore the periodontal tissues lost through the disease; i.e., a new attachment formation of periodontal regeneration. To accomplish the latter, often referred to as the ultimate goal of periodontal therapy, a number of surgical procedures have been advocated throughout the years. Clinical studies have demonstrated that considerable gain of clinical attachment and bone can be achieved following guided tissue regeneration (GTR) therapy of intrabony defects. The aim of this study was to analyse the radiographic bone changes 2-year after GTR using a bone graft material and nonresorbable membrane. Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of intrabony defect(s), 33 sites of 30 patients aged 32 to 56 (mean age 45.6) were treated by GTR with a bone graft material and nonresorbable membrane. 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. We observed $2.86{\pm}1,87mm$ of bone fill, $065{\pm}0.79mm$ of crestal resorption, $3.49{\pm}2.11mm$ of defect resolution, and $44.42{\pm}19.51%$ of percentage of defect resolution. Mandible, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. But no difference was observed between xenograft and allograft. Outcome of GTR as a therapy of intrabony defect was better than other therapy, but herein, good oral hygiene maintenance as a anti-infective treatment and periodic recall check of patients are essential.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.241-257
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• 2000

Autogenous periosteal grafts are an attractive alternative to existing barrier membrane materials since they meet the reqiurements of an ideal material. But no histological data are available on the effectiveness of periosteal membranes in the treatment of periodontal defects. The purpose of this study was to evaluate effect of autogenous periosteal graft on periodontal regeneration histologically. Class II furcation defects were surgically created on the second, third and the fourth premolars bilaterally in the mandibules of six mongrel dogs. The experimental sites were divided into three groups according to the treatment modalities; control group - surgical debridement only; Group I- autogenous periosteal membrane placement after surgical debridement; Group II-autogenous periosteal membrane placement after surgical debridement and bone grafting. The animals were sacrificed at 2, 4 and 12 weeks after periodontal surgery and the decalcified and undecalcified specimens were prepared for histological and histometrical analysis. Clinically all treated groups healed without significant problems. Under light microscope, at 2 weeks, control group showed significant apical epithelial migration and bone remodelling only below the notch area. But for the group I, II with autogenous periosteal graft, less apical migration of epithelium appeared and large amount of osteoid tissue showed above the notch area. Grafted periosteal membrane was indiscernable at 4 weeks, so periosteal membrane might be organized to surrounding tissues. Histometrically, at 4 and 12 weeks, all the test and control groups didn't show significant change of epithelial zone but new attachment level tended to be gained in the test groups than control group. These results suggest that autogenous periosteal grafts should be a good alternative for guided tissue regeneration.