• Journal of The Korean Society of Integrative Medicine
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• v.2 no.2
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• pp.41-47
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• 2014

Purpose : The aim was to compare the implant success rate according to membrane type through a clinical case of patients, who used bio-resorbable membrane and non-resorbable membrane. Methods : A survey was conducted targeting patients with the use of bio-resorbable membrane and non-resorbable membrane who visited H dental clinic in Busan for implant surgery and bone graft for 1 year from May 2010 to May 2011. A chart was made and surveyed for 100 people with non-resorbable membrane and for 75 people with bio-resorbable membrane. Results were compared. Results : 1. As for the measurement value of Periotest M${(R)}$, the value of -8~0 was measured with 92% in case of surgery by using non-resorbable membrane. The value of +1~+9 was measured with 8.0%. In case of surgery by using bio-resorbable membrane, Peiotest M(R) was measured with 78.7% as for the value of -8~0 and 16(21.3%) as for the value of +1~+9. In light of this, a case of using non-resorbable membrane was indicated to be higher(p=0.021) in success rate than a case of using bio-resorbable membrane. 2. As a result of periodontal conditions, namely, bleeding(p=0.914), swelling(p=0.500), inflammation(p=0.074), pain(p=0.571), and itch appearance(p=0.475) according to membrane type, all were insignificant. Conclusions : A case of using non-resorbable membrane is considered to be likely to be more effective than using bio-resorbable membrane during GBR(Guided Bone Regeneration) with the use of membrane in implant surgery.

• Journal of Periodontal and Implant Science
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• v.28 no.3
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• pp.431-451
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• 1998

4 beagle dogs aged over one and half years and weighed 15 to 16 Kg were utilized in this study. Experimental dehiscent defects were made in the mandibular edentulous area after removal of lower premolar. e-PTFE membrane resorbable membrane, and PDGF-BB-loaded resorbable membrane were covered at the dehiscent defects around the dental implants respectively. Animal was sacrificed at 1, 2, 3 months respectively. Non-decalicifed specimens were made and mutiple-stained for light microscopic study. The results were as follows: 1. Dehiscent defects around the implant installed in the beagle dog were an excellent defect model for studying guided bone regeneration. 2. Fibroblasts penetrated into expanded-PTFE membrane was observed and inflammatory cell infiltration was also observed around the membrane. 3. Resorbable membrane was degradaded and resorbed at 1 month after application to the dehiscent defect. Though multinucleated giant cells were observed adjacent to the membrane, that had no reverse effect on the boe regeneration. 4. PDGF-BB-Ioaded resorbable membrane was same capability as the resorbable membrane and e-PTFE membrane in the guided bone regeneration. 5. PDGF-BB-Ioaded resorbable membrane-applied site was better than resorbable membrane-applied site in the speed and maturity of bone formation. Within the above results, it was suggested that PDGF-BB-Ioaded resorbable membrane might have same bone regeneration capacity as nonresorbable membrane in the dehisced implant of the beagle dog and potentiality to use in human subjects.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.323-335
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• 2000

The purpose of this study was to examine the frequency of dehiscence bone defect on peri-implant and to compare the difference between resorbable membrane and nonresorbable membrane in bone regeneration on peri-implant. Amomg the patients, 22 patientswho have recieved an implant surgery at the department of Periodontics in Dankook University Dental Hospital showed implant exposure due to the dehiscence defect and 27 implants of these 22 patients were the target of the treatment. $Gore-Tex^{(R)}$ and $Bio-mesh^{(R)}$ were applied to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 27 cases, 2 membrane exposures were observed and in these two cases, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area $9.25{\pm}4.84$ preoperatively and significantly increased to $11.48{\pm}7.52$ postoperatively.(P<0.05) 4. In resorbable membrane, bone surface area was $14.80{\pm}8.25$ preoperatively and meaningfully widened to $17.61{\pm}10.67$ postoperatively.(P<0.05) 5 . The increase of bone surface area in non-resorbable membrane was $2.23{\pm}3.38$ and the increase of bone surface area in resorbable membrane was $2.80{\pm}3.00$ ;therefore, there was no significant difference between these two membranes(P<0.05). This study implies that the surgical method using DFDB and membrane on peri-implant bone defect is effective in bone regeneration regardless the kind of the membrane, and a similar result was shown when a resorbable membrane was used.

• Journal of Periodontal and Implant Science
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• v.30 no.4
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• pp.757-779
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• 2000

The aim of our study is to achieve complete periodontal tissue regeneration by the application of BMP and resorbable membrane. Three beagle dogs aged over one and half years and weighed 14 to 16 kg were used in this study. Mandibular 1st, 2nd premolars were extracted bilaterally. Horizontal furcation defects were induced around 3rd, 4th premolars bilaterally. BMP-4 were applied in the right side with resorbable membranes and only resorbable membranes were applied in the left side respectively. Each animal was sacrificed at 2, 4, and 8weeks, after regenerative surgery. Specimens were prepared with Hematoxylin-Eosin stain and Goldner's modified Masson Trichrome stain for light microscopic evaluation. The results were as follows: 1. At 2 weeks after regenerative surgery, downgrowth of junctional epithelium was observed both in the membraneapplied site and BMP-4-and-membrane-applied site. 2. At 4 weeks after regenerative surgery, resorbable membranes were completely resolved, therefore would not prevent downgrowth of junctional epithelium. New bone formation, new cementum formation and Sharpey's fiber were observed in BMP-4-andmembrane-applied site. 3. At 8 weeks after regenerative surgery, downgrowth of junctional epithelium was observed in the membrane-applied site. But, new cementum formation was observed in the same site. The extensive regeneration of new bone, new cementum and remarkable formation of Shapey's fiber were showed in BMP-4-and-membrane-applied site. 4. Resorbable membranes were resolved via the cell-mediated processes. 5. Periodontal tissue regeneration were better achieved in the BMP-4-andmembrane-applied site than in the membrane-applied site. Within the above results, BMP-4 may have the strong capability to form the new bone and resorbable membrane may be able to prevent the bony ankylosis. However, resolution rate of resorbable membrane may not be enough to protect rapid epithelial downgrowth for ideal periodontal regeneration. In conclusion, I suggest BMP-4 may have the strong possibility to be utilized in the clinical periodontal treat-

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.475-488
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• 2002

The purpose of this study is to evaluate histologically the resorption and tissue response of various resorbable collagen membranes used for guided tissue regeneration and guided bone regeneration, 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 acellular dermal matrix allograft, porcine collagen membrane, freeze-dried bovine dura mater. Animals were sacrificed at 2,6 and 8 weeks after implantation of various resorbable collagen membranes. Specimens were prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows: 1. Resorption : Inner portion of porcine collagen membrane was resorbed a lot at 6 weeks, but its function was being kept for infiltration of another tissues were not observed. Freeze-dried bovine dura mater and acellular dermal allograft were rarely resorbed and kept their structure of outer portion for 8 weeks. 2. Inflammatory reactions : Inflammatory reaction was so mild and foreign body reaction didn't happen in all of resorbable collagen membranes, which showed their biocompatibility. 3. In all of resorbable collagen membranes, multinuclcated giant cells by foreign body reactions were not observed. Barrier membranes have to maintain their function for 4-6 weeks in guided tissue regeneration and at least 8 weeks in guided bone regeneration. According to present study, we can find all of the resorbable collagen membranes kept their function and structure for 8 weeks and were rarely resorbed. Foreign body reaction didn't happen and inflammatory reaction was so mild histologically. Therefore, all of collagen membranes used in this experiment were considered proper resorbable membranes for guided tissue regeneration and guided bone regeneration.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.71-76
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• 2009

Purpose: Many researches showed loss of alveolar bone in fresh extraction socket and even in case of immediate implant placement. The aim of this study was to evaluate the effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets. Materials and methods: Immediate implants were placed into artificially induced periapical lesion of mandibular premolars after complete debridement using buccal bone defect made by a 6mm trephine bur in 4 mongrel dogs. Before flap repositioning, a non-resorbable barrier membrane was placed on the buccal defect in the experimental group. No membrane was placed in the control group. In 12 weeks after placement, the dogs were sacrificed and undecalcified histologic specimens were prepared. The vertical distance from the smooth-rough surface interface(SRI) to gingiva, 1st bone contact and bone crest were measured in buccal and lingual side. The horizontal thicknesses of gingiva and bone at 0, 1, 2 and 3mm below SRI were measured. Results: The buccal bone was resorbed more than lingual bone in both groups and there was statistical significance(p<0.05). The distances from SRI to 1st bone contact were $2.45{\pm}2.35\;mm$ in experimental group and $4.49{\pm}3.10\;mm$ in control group. In all vertical level, lingual bone was thicker than buccal bone(p<0.05). Conclusion: Buccal bone was reduced more than lingual bone in immediate implant placement into periapically infected extraction sockets. Placement of non-resorbable barrier membrane reduced the buccal bone resorption. However there was no statistical significance.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.737-744
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• 2008

Purpose: In advanced case of periodontitis, surgical treatment without bone contouring may result in residual pockets inaccessible to proper cleaning during post-treatment maintenance. This problem can be avoided or reduced by applying guided tissue regeneration. Materials and Methods: All of 3 patients had deep periodontal pocket depth and bleeding on probing, and radiograph revealed osseous defect, so we planned guided tissue regeneration using resorbable membrane with or without xenograft. Result: 6 months later, periodontal pocket depth and bleeding on probing was improved and gingiva was stable. Conclusion: Guided tissue regeneration using resorbable membrane with or without xenograft in osseous defect is predictable.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.687-702
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• 2005

The purpose of this study is to examine the effect of non-resorbable membrane such as e-PTFE which was used with DFDB in bone regeneration on dehiscence defect in peri-implant area. Amomg the patients, who have recieved an implant surgery at the department of Periodontics in Dan Kook University Dental Hospital, 12 patients showed implant exposure due to the dehiscence defect and 15 implants of these 22 patients were the target of the treatment. Periodontists randomly applied $Gore-Tex^{(R)}$ to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 15 cases, 1 membrane exposure was observed and in this case, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area $9.25{\pm}4.84$ preoperatively and significantly increased to $11.48{\pm}7.52$ postoperatively(0.05). 4. The increase of bone surface area in non-resorbable membrane was $2.23{\pm}3.38$. 5. As a result of histopathological finding, DFDB surrounded by new bone formation and lamellate bone, resorption of DFDB and bone mineralization was found. Also, fibrosis of connective tissue beneath the membrane was found. This study shows that the surgical method using DFDB and non-resorbable membrane on dehiscence defect in peri-implant area is effective in bone regeneration.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.603-610
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• 2008

Purpose: The guided bone regeneration (GBR) technique is widely used in periradicular surgery. However, there is still some controversy regarding the effectiveness of GBR in promoting bone healing after periradicular surgery. The purpose of this study was to evaluate the resorbable membrane on the osteointegration of immediate implants in sites with periradicular lesion that had been removed by periradicular surgery. Materials and methods: Six roots of lower second premolars and 15 roots of lower third and fourth premolars of dogs were used as control and experimental teeth, respectively. Periradicular lesions were induced only in the experimental teeth. Twelve weeks later, the control and experimental teeth were extracted and implants were placed immediately. Periradicular lesions were removed with osteotomy, curettage and saline irrigation. Resorbable membranes were used in experimental group 1 but not in experimental group 2. After 12 week of healing period, the implants were clinically not mobile and showed no signs of infection. Data obtained by histomorphometric analysis were analyzed by Kruskal-Wallis test. Results: The control group showed a significantly higher bone to implant contact (BIC) ($74.14{\pm}16.18$) than experimental group 1 ($40.28{\pm}15.96$) and 2 ($48.70{\pm}17.75$)(p<0.05). However, there was no significant difference between experimental group 1 and 2. Conclusion: Although BIC in experimental groups were lower than in control group, immediate implant can be successfully placed at extraction socket with periradicular lesion and osseous defect. However, the use of resorbable membrane in bony defect created during periradicular surgery was questioned.

• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.19-43
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• 1997

The barrier membranes for GTR procedure could be affected bY bacterial contamination after exposure to oral environment. This study was done to evaluate whether the tetracycline impregnated barrier membranes could inhibit bacterial attachment and penetration into membranes. The resorbable membrane(polylactic and polyglycolide copolymer, $Resolute^{(R)}$, W.L Gore and Associates, Inc..USA) and the non-resorbable membrane(e-PTFE; Gore-TexTM, W.L. Gore & Associates, Inc.,USA) were cut into 4mm discs and trated with 5% tridodecylmethylammonium chloride solution in ethanol and dried in air. The membranes were immersed in tetracycline(TC) solution (100mg/ml, pH 8.0) and dried. To the maxillary canine-premolar region in six periodontally healthy volunteers, removable acrylic devices were inserted, on which 8 cylindrical chambers were glued with TC impregnated and non-impregnated discs, the membrane discs were examined for bacterial attachment and penetration, and structural changes under SEM and LM. From the 1st day to the 7th day, membranes showed bacterial plaque formation composed of cocci and rods. Thereafter, filamentous bacteria appeared and the plaque thickness increased. The TC impregnated e-PTFE membranes showed less bacterial attachment and delayed in bacterial plaque maturation than non-treated membranes. As for bacterial penetration, the TC impregnated e-PTFE membranes showed superficial invasion and infrequent presence of bacteria in unexposed inner surface at the 4th week. while the non-treated e-PTFE membranes showed deep bacterial invasion at the 2nd week and frequent presence of internal bacteria at the 4th week. The resorbable membranes started to be resorbed at the 2nd week and were perforated at the 4th week, regardless of TC treatment. In conclusion, bacterial plaque formation and penetration was efficiently delayed in TC impregnated e-PTFE membranes, whereas resorbable membranes were similar in bacterial invasion due to membrane degradation and perforation, regardless of TC treatment.