• Journal of Periodontal and Implant Science
• /
• v.30 no.4
• /
• pp.779-793
• /
• 2000

The ultimate goal of periodontal disease therapy is to promote the regeneration of lost periodontal tissue, there has been many attempts to develop a method to achieve this goal, but none of them was completely successful. This study was designed to compare the effects of treatment using resorbable barrier membrane($Biomesh^{?}$) in combination with autogenous bone graft material with control treated by only modified Widman flap. 22 infrabony defecs from 10 patients with chronic periodontitis were used for this study, 10 sites of them were treated with resorbable barrier membrane and autogenous bone graft material as experimental group and 12 site were treated by only modified Widman flap as control group. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded at 6-8 months later, and the significance of the changes was statistically analyzed. The results are as follows : 1. Probing depth of the two group was reduced with statistically significance(P<0.05), but this changes were not different between the two experiment, control group with statistically significance. 2. Gingival recession showed statistically significant increase in control group(P<0.05), but not in experimental group, and initial values of the two group were in statistically significant difference(P<0.05). 3. Bone probing depth showed statistically significant decrease in experimental group(P<0.05), but not in control group, and this changes were different between the two experiment, control group with statistically significance(P<0.05). 4. Loss of attachment showed statistically significant decrease in experimental group(P<0.05), but not in control group, and this changes were different between the two experiment, control group with statistically significance(P<0.05) On the basis of these results, treatment using resorbable barrier membrane in combination with autogenous bone graft material improve the probing depth, bone probing depth and loss of attachment in infrabony defects.

• 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 Periodontal and Implant Science
• /
• v.44 no.4
• /
• pp.194-200
• /
• 2014

Purpose: The purpose of this study was to assess and compare the clinical and radiographic outcomes of guided tissue regeneration therapy for human periodontal intrabony defects using two different collagen membranes: a porous nonchemical cross-linking collagen membrane (NC) and a bilayer collagen membrane (BC). Methods: Thirty subjects were randomly assigned and divided into the following 3 groups: a test group (NC+BM), in which a NC was used with xenograft bone mineral (BM), a positive control group (BC+BM), in which a BC was used with xenograft BM, and a negative control group (BM), in which only xenograft BM was used. The following clinical measurements were taken at baseline and 3 months after surgery: plaque index, gingival index, probing pocket depth, gingival recession, and clinical attachment level. Radiographic analysis was performed at baseline, 1 week and 3 months after surgery. Results: Membrane exposure was not observed in any cases. Significant probing depth reduction, attachment-level gain and bone fill were observed for both test and control groups compared to baseline at 3 months after surgery (P<0.05). However, there were no statistically significant differences in clinical improvement and radiographic bone fill between treatment protocols (P>0.05). Conclusions: Within the limitations of this study, the results suggest that both NC and BC were comparable in terms of clinical and radiographic outcomes for the treatment of periodontal intrabony defects in human subjects.

• Journal of Periodontal and Implant Science
• /
• v.24 no.1
• /
• pp.87-97
• /
• 1994

The ultimate goal of periodontal therapy is to fully reconstruct the periodontal attachment apparatus. Commonly used techniques for treatment of infrabony defects include a combination of root planing, curettage and root treatment. To prevent the apical migration of epithelial cells, the technique of guided tissue regeneration is used. The aim of this study is to compare the effects of root treatment with Citric acid & Tetracycline and Guided tissue regeneration in dogs. Experimental periodontitis was induced by the ligation of orthodontic elastic threads in the upper right and left premolars 3, 4 of five adult dogs for 6 weeks. 4 types of procedures were performed as follows; 1) Control graup : Mucoperiosteal flap 2) Experinental I : GTR used Gore-tex(R) membrane 3) Experinental II : Root treatment with citric acid (PHl) 4) Experinental III : Root treatment with tetracycline HCl (50mg/ml) There after, dogs were serially sacrificed at the 1, 2, 4, 5, 8 weeks, and the specimens were prepared, and stained with hematoxylin-eosin for the light microscopic evaluation. The results of this study were as follows; 1. Junctional epithelium reached to the notch through the furcation area in control group at 8 weeks. 2. In the aspects of the inflammatory cell infiltration, control group showed severe aggregation than experimental group I, II, III through the experimental period 3. New cementum was observed over the notch from 5 weeks in experimental group II 4. In the aspects of the amount of new bone formation, experimental group was better than control group, but there was not significant differences among the experimental group, I, II, III

• Restorative Dentistry and Endodontics
• /
• v.24 no.2
• /
• pp.286-298
• /
• 1999

The endodontic-periodontic combined lesions have been difficult to get correct diagnosis and predictable treatment. This study was to make the experimental endodontic-periodontic combined defects in dogs for the study of the periodontal regeneration and to evaluate the efficacy of the enamel matrix protein and e-PTFE membrane in the experimental endodontic-periodontic combined defects. 5 mongrel dogs were used. The pulp chambers were opened and the plaque was inserted into the chambers to induce the periapical lesions on the mandibular second, third and fourth premolars of the dogs. 1 month later, the root canal treatments were done with gutta perch a and ZOE sealer. On the day of surgery, the periapical defects were standardized by trephine bur. The buccal dehiscence defects were made by the dental bur and bone chisels. The apicoectomy with retrofilling was done. The prepared roots were randomly selected for test and control groups. In the experimental groups, the enamel matrix derivative and e-PTFE membrane were used. Nothing was placed on the control group. Fluroscent labelling was used to evaluate the bone formation. After 4 and 12 weeks, the dogs were sacrificed and undecalcified sections were prepared and stained with toluidine blue. Those histologic sections were examined by fluorescent microscopy and light microscopy. The results were as follows. 1. In the control group, new bone was formed in the periapical defects and scarcely in the buccal dehiscence defects. New cementum was not detected at 4 and 12 weeks. 2. In the experimental groups, new bone, new cementum and periodontal ligament were found in the periapical and buccal dehiscence defects. The relative amount and the quality of the new bone, new cementum and periodontal ligament tissue that had formed on the experimental groups were superior to those of the control group. 3. The current observation implicated that e-PTFE membrane and enamel matrix protein could be the effective tools for the guided tissue regeneration of the endo-perio combined defects.

• Journal of Periodontal and Implant Science
• /
• v.37 no.1
• /
• pp.53-64
• /
• 2007

The aim of this study was to examine the possibility of periodontal ligament regeneration when autotransplantation was used by the periodontal ligament fibroblasts cultured on the acellular dermal matrix in teeth without a periodontal ligament. One minipig was used in this study. The mandibular and maxillary permanent incisors were ex-tracted for the culture of the periodontal ligament cells. The roots of the unextracted teeth were classified into a positive control group, in which the normal periodontal ligament was preserved. The roots of the extracted teeth were divided into the following two groups: The negative control group, in which the periodontal ligament had been removed and the acellular dermal matrix was not applied; and an experimental group, in which the periodontal ligament had been removed and periodontal ligament fibroblast cultured on an acellular dermal matrix was applied. The prepared teeth were transplanted, and completely submerged using physical barrier membranes. The animal was sacrificed 4 weeks after the autotransplant. The transplanted teeth were examined histologically. In this study, the periodontal ligament was normal in the positive control group, and ankylosis was discovered on the denuded root surface in the negative control group. Periodontal ligament-like connective tissue was found adjacent to the denuded root and the new cementum-like layer of hard tissue was formed in the experimental group. These results suggest that the periodontal ligament fibroblasts cultured on the acellular dermal matrix may play a role in regenerating the periodontal ligament-like tissue with new cememtum-like tissue formation.

• Journal of Periodontal and Implant Science
• /
• v.48 no.5
• /
• pp.305-316
• /
• 2018

Purpose: The aim of the present study was to evaluate the biocompatibility and barrier function of mussel adhesive protein (MAP)-loaded collagen membranes in guided bone regeneration (GBR). Methods: Eight male New Zealand white rabbits were used. Four circular defects (diameter: 8 mm) were created in the calvarium of each animal. The defects were randomly assigned to 1) a negative control group, 2) a cyanoacrylate (CA)-loaded collagen membrane group (the CA group), 3) a MAP-loaded collagen membrane group (the MAP group), and 4) a group that received a polycaprolactone block with MAP-loaded collagen membrane (the MAP-PCL group). Specimens were harvested at 2 weeks (n=4) and 8 weeks (n=4) postoperatively for observational histology and histometric analysis. Results: In the histologic analysis, MAP was completely absorbed without any byproducts. In contrast, some of the CA adhesive remained, showing an inflammatory reaction, at 8 weeks. In the MAP-PCL group, the MAP-loaded collagen membranes served as a barrier membrane despite their fast degradation in GBR. No significant difference was found in the amount of new bone between the MAP-PCL and MAP groups ($1.82{\pm}0.86mm^2$ and $2.60{\pm}0.65mm^2$, respectively). Conclusions: The MAP-loaded collagen membrane functioned efficiently in this rabbit calvarial GBR model, with excellent biocompatibility. Further research is needed to assess clinical applications in defect types that are more challenging for GBR than those used in the current model.

• Journal of Periodontal and Implant Science
• /
• v.36 no.2
• /
• pp.427-434
• /
• 2006

The form of furcation influence both the pathogenesis of periodontal destruction and therapeutic results. The present study was performed to evaluate the effect of root trunk length on clinical outcomes of guided tissue regeneration. Total 30 mandibular first molars were evaluated in this study. Probing pocket depth, clinical attachment level, vertical defect depth and horizontal defect depth were measured at baseline and 6 month after GTR. Correlation coefficients between root trunk length and other clinical measurement were analyzed. The results of this study were as follows 1. The mean root trunk length in lower 1st molar was 2.15 mm. 2. Probing pocket depth, clinical attachment level, vertical defect depth and horizontal defect depth were significantly reduced at 6 month postoperatively compared to values of baseline 3. Correlation coefficient between root trunk length and vertical defect depth at baseline was 0.406 showing the positive correlation 4. Correlation coefficient between root trunk length and horizontal defect depth at baseline was -0.463 showing the negative correlation. 5. Correlation coefficient between root trunk length and decrease of horizontal defect depth after GTR was 0.654 showing the positive correlation. In conclusion, the root trunk length maybe effector for clinical outcome after guided tissue regeneration.

• 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.30 no.2
• /
• pp.277-287
• /
• 2000

For the regeneration of osseous defect on the furcation area, autogeneous bone graft has been primarily used. But it has the limitation of donor site, additive surgical operation etc. Recently anorganic xenogenic bone graft materials of removing all organic components are commonly used for the regeneration of periodontal defects. This study was the comparison of the effect on the regeneration with two types xenografts($Bio-oss^{(R)}$ and Ca-P thin coated Bovine bone powder) on the furcation involvement in Beagle dogs. After surgically induced chronic periodontitis in bifurcation area of premolar, $Bio-oss^{(R)}$ and Ca-P BBP were grafted on the osseous defects. Tissue blocks including defects with soft tissues were harvested following a four-& eight-week healing interval and prepared for histologic analysis. The results of this study were as follows: 1. $Bio-oss^{(R)}$ group: there were significant differences among the $Bio-oss^{?}$ group at 4weeks and 8weeks, but the control group had various appearances : new bone formation, resorption of graft materials by multinuclear giant cells, connective tissue cells intervention in the bone graft sites etc. 2. Ca-P BBP group: lots of new bone formation were observed but the arrangement of periodontal ligament was not completed at 4weeks. New bone were replaced mature bone and the periodontal ligaments showed the functional arrangement at 8weeks. 3. By reason of undergrowing the epithelium within the osseous defects, new bone formation was not happened in the upper area of bifurcation in $Bio-oss^{(R)}$ group. 4. In Ca-P BBP group, epithelial undergrowth was not seen and generally showed much more new bone formation. 5. Ca-P BBP group showed the osteocyte-like cells at the inner portion of the graft materials 6. Both groups were similar to resorptive appearances of graft materials, but Ca-P BBP group had the better effects of osteoconduction.