• Journal of Periodontal and Implant Science
• /
• v.43 no.3
• /
• pp.136-140
• /
• 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.

• Journal of Periodontal and Implant Science
• /
• v.27 no.3
• /
• pp.459-468
• /
• 1997

Healing of periodontal tissues require the migration and proliferation of gingival fibroblasts and periodontal ligament cells. There is many evidences that the some agents like cytokines and polypeptide growth factors are mediate these cellular events in wound healing. Recently someone is interested in herbal drugs on periodontal tissue healing processes. The purpose of this study was to examine the effects of 4 herbal drugs, Carthami Flis, Moutan Redias Cortex, Scirpi Rhisoma, Seed of Carthamus tinctorius L. on human gingival fibroblasts and periodontal ligament cells. Periodontal ligament cells and gingival fibroblasts were primarily cultured from extracted premolar with non-periodontal diseases. The powder from extracted. herbal drugs were prepared with distilled water. Cells were cultured with DMEM at $37^{\circ}C$, 5% $CO_2$, 100% humidity incubator, and treated with each herbal drugs with proper concentration for 1, 2, and 3 days. The cell activity was determined by ELISA reader using MTT assay. There was the most significant elevation in $10^{-3}g/ml$ of almost herbal drugs on cellular activities. The result of this study demonstrated that Carthami Flis, Moutan Radicis Cortex, Scirpi Rhisoma, Seed of Carthamus tinctorius L. appears to have beneficial effect on healing process after periodontal treatment.

• Journal of Periodontal and Implant Science
• /
• v.32 no.1
• /
• pp.113-127
• /
• 2002

The purpose of this study is to evaluate histologically the tissue response and resorption of various nonresorbable and resorbable suture materials used for periodontal surgery, using a subcutaneous model on the dorsal surface of the rat. In this study, 10 Sprague-Dawley male rats (mean BW 150gm) were used and the commercially available materials included polyglactin 910, pain gut, nylon, e-PTFE. Animals were sacrificed at 3 days, 1, 2 and 4 weeks after implantation of various nonresorbable and resorbable suture materials. Specimens were prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows: 1. Resorption : The resorption of plain gut was showed at 1 week after implantation, was lost their structure and almost resorbed at 4 weeks. The resorption of polyglactin 910 was started at 2 weeks and slowly absorbed untill 4 weeks. 2. Tissue response : Plain gut showed persistent and severe inflammatory reactions from 3 days to 4 weeks. Polyglactin 910, e-PTFE and nylon showed mild inflammatory reactions. Suture material should be biocompatible and be able to be functioned until tissue tensile strength reaches maximum level. In this study, polyglactin 910, nylon and e-PTFE are considered to be proper suture materials for periodontal surgery.

• Journal of Periodontal and Implant Science
• /
• v.30 no.4
• /
• pp.803-814
• /
• 2000

Current acceptable methods of promoting periodontal regeneration are basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, biological mediators. Platelet Rich Plasma have been reported as a biological mediator which regulate activities of wound healing progress including cell proliferation, migration, and metabolism. The purpose of this study is to evaluate the possibility of using the Platelet Rich Plasma as a regeneration promoting agent for furcation involvement defect. 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 mandibular third(P3), forth(P4) and fifth(P5) premolar. 2 month later experimental group were PRP plus bovine bone and bovine bone only. After 4, 8 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. At 4 weeks after surgery, there were rapid osteogenesis phenomenon on the defected area of the Platelet Rich Plasma plus bovine bone group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 4 weeks after surgery. In conclusion, Platelet Rich Plasma can promote rapid osteogenesis during early stage of periodontal tissue regeneration.

• Journal of Periodontal and Implant Science
• /
• v.35 no.2
• /
• pp.511-524
• /
• 2005

The regeneration of lost periodontal tissue is a major goal of therapy. Periodontal ligament cell(PDL) is a specialized connective tissue that connects cementum and alveolar bone to maintain and support teeth in situ and preserve tissue homoeostasis. Bone morphogenetic proteins(BMPs) have shown much potential in the reconstruction of the periodontum by stimulate new bone and new cementum formation. Limitiations of BMP administration to periodontal lesions is high dose delivery, BMP transient biological activity, and low bioavailability of factors at the wound site. Gene delivery method can be alternative treatment strategy to deliver BMPs to periodontal tissue. The purpose of this study is to investigate efficiency of BMP-2 gene delivery with cell-based therapy using PDL cells. PDL cell were transduced with adenoviruses encoding either BMP-2 or Lac-Z gene. To evaluate osteogenic activity of expressed BMP-2 on PDL cells, we investigated secreted BMP-2, cellular activity, ALPase, produced mineralized nodules. To evaluate collagen scaffold as carrier for transduced cell delivery, we examined morphology and secreted BMP-2 of transducd PDL cells on it. BMP-2 transducd PDL cells produced higher levels of BMP-2, ALPase, mineralized nodules than non transduced cells. Cellular activity of transduced cells was showed similar activity to non transduced cells. Transduce cells attached on collagen scaffold secreted BMP-2 at 7day and was showed similar morphology to non transduced cells. These results demonstrated that transduced PDL cells produced biologically active BMP-2 and collagen scaffold could be carrier of transducd cells.

• Journal of Periodontal and Implant Science
• /
• v.27 no.1
• /
• pp.117-128
• /
• 1997

Using barrier membrane, guided bone regeneration(GBR) and guided tissue regeneration(GTR) of periodontal tissue are now widely studied and good results were reported. In bone regeneration, not all cases gained good results and in some cases using GTR, bone were less regenerated than that of control. The purpose of this study is to search for the method to improve the success rate of GBR and GTR by examination of the cause of the failure. For these study, rats and beagle dogs were used. In rat study, 5mm diameter round hole was made on parietal bone of the rat and 10mm diameter of bioresorbable membrane was placed on the bone defects and sutured. In 1 ,2, 4 weeks later, the rats were sacrificed and Masson-Trichrome staining was done and inspected under light microscope for guided bone regeneration. In dog study, $3{\times}4mm^2$ Grade III furcation defect was made at the 3rd and 1th premolar on mandible of 6 beagle dogs. The defects were covered by bioresorbable membrane extending 2-3mm from the defect margin. The membrane was sutured and buccal flap was covered the defect perfectly. In 2, 4. 8 weeks later. the animals were sacrificed and undecalcified specimens were made and stained by multiple staining method. In rats. there was much amount of new bone formation at 2 weeks. and in 4 weeks specimen, bony defect was perfectly dosed and plenty amount of new bone marrow was developed. In some cases, there were failures of guided bone regeneration. In beagle dogs, guided tissue regeneration was incomplete when the defect was collapsed by the membrane itself and when the rate of resorption was so rapid than expected. The cause of the failure in GBR and GTR procedure is that 1) the membrane was not tightly seal the bony defects. If the sealing was not perfect, fibrous connective tissue infiltrate into the defect and inhibit the new bone formation and regeneration. 2) the membrane was too tightly attached to the tissue and then there was no space to be regenerated. In conclusion, the requirements of the membrane for periodontal tissue and bone regeneration are the biocompatibility, degree of sealingness, malleability. space making and manipulation. In this animal study. space making for new bone and periodontal ligament, and sealing the space might be the most important point for successful accomplishment of GBR and GTR.

• Journal of Periodontal and Implant Science
• /
• v.32 no.2
• /
• pp.429-455
• /
• 2002

There are numerous kind of materials and techniques to regenerate the periodontal tissue which has been lost due to destructive periodontal disease, including bone graft material. Many bone graft materials have been reported and among these materials, synthetic material has been developed fin the long time because of its sufficient supply economically. Calcium sulfate which was evaluated as including much calcium, has been used in the clinical field. In the dental field calcium sulfate has been used as bone graft material and Kim reported that improved bone formation and more amount of new attachment after grafting calcium sulfate. but, because calcium sulfate has the problem that it generates the heat in setting period and resolves fast, we need to evaluate the effect of the improved calcium sulfate on periodontal tissue. The present study evaluates the effect of paste type calcium sulfate on the epithelial migration, alveolar bone regeneration, cementum formation and gingival connective tissue attachment in intrabony defect in dogs. Four millimeter deep and four millimeter wide 3-wall defects were surgically created in the mesial or distal aspects of premolars or molars. the test group received paste-type calcium sulfate with a flap procedure and the control group underwent flap procedure only. Histologic analysis after 8 weeks of healing revealed the following results : 1. The length of epithelial growth(the distance from CEJ to the apical end of JE) was 0.52${\pm}$0.26mm in the control and 0.56${\pm}$0.25mm in the test group. there was no statistically significant difference between the two groups. 2. The length of connective tissue adhesion was 1.74${\pm}$1.06mm in the control and 1.28${\pm}$0.57mm in the test group. there was no statistically significant difference between the two groups. 3. The length of new bone was 2.01${\pm}$0.95mm in the control and 2.62${\pm}$0.81mm in the test group. there was no statistically significant difference between the two groups. 4. The length of new cementum was 1.86${\pm}$0.80mm in the control and 2.77${\pm}$ 0.86mm in the test group. there was a statistically significant difference between the two groups.(P<0.01) These results suggest that the use of paste type calcium sulfate in 3-wall intrabony defects has significant effect on new cementum formation , but doesn't have any significant effect on the prevention of junctional epithelium migration and new bone formation. Finally, the paste type calcium sulfate that is used in this study is suggested to be the material that can have a significant effect on the periodontal healing, if its biocompatibility is improved.

• Carbon letters
• /
• v.13 no.3
• /
• pp.139-150
• /
• 2012

Poly-L-lactic acid (PLLA), PLLA/hydroxyapatite (HA), PLLA/multiwalled carbon nanotubes (MWNTs)/HA, PLLA/trifluoroethanol (TFE), PLLA/gelatin, and carbon nanofibers (CNFs)/${\beta}$-tricalcium phosphate (${\beta}$-TCP) composite membranes (scaffolds) were fabricated by electrospinning and their morphologies, and mechanical properties were characterized for use in bone tissue regeneration/guided tissue regeneration. MWNTs and HA nanoparticles were well distributed in the membranes and the degradation characteristics were improved. PLLA/MWNTs/HA membranes enhanced the adhesion and proliferation of periodontal ligament cells (PDLCs) by 30% and inhibited the adhesion of gingival epithelial cells by 30%. Osteoblast-like MG-63 cells on the randomly fiber oriented PLLA/TEF membrane showed irregular forms, while the cells exhibited shuttle-like shapes on the parallel fiber oriented membrane. Classical supersaturated simulated body fluids were modified by $CO_2$ bubbling and applied to promote the biomineralization of the PLLA/gelatin membrane; this resulted in predictions of bone bonding bioactivity of the substrates. The ${\beta}$-TCP membranes exhibit good biocompatibility, have an effect on PDLC growth comparable to that of pure CNF membrane, and can be applied as scaffolds for bone tissue regeneration.

• The korean journal of orthodontics
• /
• v.37 no.5
• /
• pp.351-363
• /
• 2007

The aim of this study was to evaluate pulp and periodontal changes following rapid tooth retraction by periodontal distraction after bone undermining surgery in young adult dogs. Methods: Alter extraction of second premolars, the interseptal bone mesial to the upper 3rd premolar was undermined. After activating the distraction appliance at 0.5 mm/day for six days, the dogs were sacrificed at 0, 1, 3, 5, 7, and 9 weeks during the consolidation period. Tissue changes of periodontium and pulp were evaluated radiologically, histologically, and immunohistochemically. Results: Digital subtraction radiography showed active bone formation in the stretched periodontal ligament from 0 - 4 weeks. Resorption of the alveolar bone, appearance of osteoclasts, and infiltration of inflammatory cells were observed just after the activation period at the pressure side, and distinctive bone formation was seen in the tension side of the periodontal ligament from 1 week. New bone formation was active at 1 - 3 weeks. The expression of calcitonin gene-related peptide in the experimental group was increased at the alveolar bone and pulp, and periodontal ligament at the pressure side from 0 - 1 week, and it decreased after 5 weeks to become similar to that of the control group. Conclusions: The results showed that rapid tooth movement using periodontal distraction can be new form of orthodontic tooth movement for accelerating normal bone formation.

• Journal of Periodontal and Implant Science
• /
• v.41 no.4
• /
• pp.176-184
• /
• 2011

Purpose: The final goal of regenerative periodontal therapy is to restore the structure and function of the periodontium destroyed or lost due to periodontitis. However, the role of periosteum in periodontal regeneration was relatively neglected while bone repair in the skeleton occurs as a result of a significant contribution from the periosteum. The aim of this study is to understand the histological characteristics of periosteum and compare the native periosteum with the repaired periosteum after elevating flap or after surgical intervention with flap elevation. Methods: Buccal and lingual mucoperiosteal flaps were reflected to surgically create critical-size, "box-type" (4 mm width, 5 mm depth), one-wall, intrabony defects at the distal aspect of the 2nd and the mesial aspect of the 4th mandibular premolars in the right and left jaw quadrants. Animals were sacrificed after 24 weeks. Results: The results from this study are as follows: 1) thickness of periosteum showed difference as follows (P<0.05): control group ($0.45{\pm}0.22$ mm)> flap-elevation group ($0.36{\pm}0.07$ mm)> defect formation group ($0.26{\pm}0.03$ mm), 2) thickness of gingival tissue showed difference as follows (P<0.05): defect formation group ($3.15{\pm}0.40$ mm)> flap-elevation group ($2.02{\pm}0.25$ mm) > control group ($1.88{\pm}0.27$ mm), 3) higher cellular activity was observed in defect formation group and flap-elevation groups than control group, 4) the number of blood vessles was higher in defect formation group than control group. Conclusions: In conclusion, prolonged operation with increased surgical trauma seems to decrease the thickness of repaired periosteum and increase the thickness of gingiva. More blood vessles and high cellular activity were observed in defect formation group.