• Journal of Periodontal and Implant Science
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• 제24권1호
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• pp.51-63
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• 1994

There has been many attempts to develop a method that can regenerate periodontal tissues that were lost due to periodontal diseasd, but none of them was completely successful. This study was designed to investigate the healing and regeneration of periodontal tissue when bone substitutes such as porous replamineform hydroxyapatite and porous resorbable calcium carbonate were used in combination with oxidized cellulose membrane and collagen absorbable hemostat, compared to a control where only oxidized cellulose membrane or collagen absorbable hemostat were used. Chronic periodontitis was induced on mandibular premolars of and adult dog by placing orthodontic elastic ligatures for 10 weeks. After flap operation, the control group were received oxidized cellulose membrane (control- I )or collagen absorbable hemostat (control- II) only, while one experimental group was given either porous replamineform hydroxyapatite or porous resorbable calcium carbonate in addition to oxidized cellulose membrane (Experimental I-A, I-B), and another experimental group was treated by using either porous replamineform hydroxyapatite or porous resorbable calcium carbonate in addition to collagen absorbable hemostat. (Experimental II-A, II-B) After 56 weeks, healing was histologically analyzed with the following results. 1. Apical migration of junctional epithelium was observed only in areas coronal to the notch for both control and experimental group. 2. Inflammatory cell infiltration was not observed in any groups. 3. Oxidized cellulose membrane and collagen absorbable hemostat were completely resorbed. 4. Newly-formed cementum was observed up to the level where junctional epithelium was located, for both control and experimental groups. 5. Bone formation was limited of the middle portion of the notch in the control group, where as experimental groups showed bone formation up to the level of implant materials coronal to the notch. 6. Minute resorption of apically located portions of implanted materials was observed in experimental group I-B and II-B only.

• Journal of Periodontal and Implant Science
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• 제38권3호
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• pp.535-542
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• 2008

Purpose: The aim of this retrospective study is to evaluate survival rate of implant and bone formation, to analyze failure contribution factor. Material and Methods: A total of 52 consecutive patients(35 male, 17 female, mean age 49 years) with 104 osseous defects were treated during the period from October 2004 to June 2007 with a simultaneous or staged GBR approach using non-resorbable or resorbable membranes combined with autogenous bone grafts or xenograft(Bio-Oss, Bio-cera, BBP). Result: A total of 32(30,8%) of 104 GBR-treated sites failed the bone formation and a total of 5(5.6%) of 89 implants were removed. Early exposure of the membrane has significantly affected bone formation(p<0.05). Non-resorbable membrane showed more exposure of the membrane and low success rate of bone formation than resorbable membrane(p<0.05). There were no difference between success rate of bone formation and using autogenous bone or graft materials. There were no statistically significant difference between success rate of bone formation and smoking or using PRP. Mandible showed more success rate of bone formation than maxilla(p<0.05). Conclusion: Early exposure of the membrane, membrane type and maxilla/mandible type have influence on success rate of bone formation during GBR.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권5호
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• pp.297-303
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• 2023

A resorbable barrier membrane is commonly used for the repair of perforated sinus membranes during sinus lifting surgeries. However, repairing largescale perforations poses challenges for clinicians as the protection and isolation of graft material remain uncertain. With this technique, we aimed to prevent graft material loss and subsequent sinus-related complications using intra-sinus rigid fixation of the resorbable barrier membrane in cases with a large perforation of the sinus membrane.

• Journal of Periodontal and Implant Science
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• 제31권1호
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• pp.91-109
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• 2001

The purpose of this study is to evaluate histologically the resorption and tissue response of various resorbale membranes used for guided tissue regneration procedures, using a subcutaneous model on the dorsal surface of the rat. In this study, 12 Sprague-Dawley male rats(mean BW 150gm) were used and the commercially available materials included dense collagen membrane, freeze-dried bovine dura mater loos collagen membrane, PLA/PLGA membrane. Animals were sacrificed at 3, 6 and 8 weeks after implantation of various resorbable membranes. Specimens were prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows: 1. Resorption : Loose collagen membrane group was resorbed most rapidly. Dense collagen membrane group and freeze-dried bovine dura mater group were rarely resorbed. 2. Inflammatory reactions : PLA/PLGA membrane group showed persistent and severe inflammatory reactions for 3 to 8 weeks. Moderate inflammatory reactions and the ectopic formation of calcified material were observed in dense collagen membrane group. Freeze-dried bovine dura mater group and loose collagen membrane group showed mild inflammatory reactions 3. In PLA/PLGA membrane group, multinucleated giant cells by foreign body reactions were observed. In conclusion, the resorption of freeze-dried bovine dura mater didn't happen for 3-6weeks, which showed the best bio-compatibility. Therefore, freeze-dried bovine dura mater was considered proper resorbable membrane for guided tissue regeneration.

• Journal of Periodontal and Implant Science
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• 제31권4호
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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 the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권4호
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• pp.275-279
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• 2010

Introduction: Guided bone regeneration (GBR) is a common procedure for the treatment of bone defects and bone augmentation. The nonresorbable barriers are well-documented barriers for GBR because of their stability and malleability. However, few GBR studies have focused on the different types of non-resorbable barriers. Therefore, this study examined the clinical results of different non-resorbable barriers for GBR; expanded polytetrafluoroethylene (e-PTFE) (TR-Gore Tex, Flagstaff, AZ, USA), and high-density polytetrafluoroethylene (d-PTFE) (Cytoplast membrane, Oraltronics, Bremen, Germany). Materials and Methods: The analysis was performed on patients treated with GBR and implant placement from January 2007 to October 2007 in the department of the Seoul National University Bundang Hospital. The patients were divided into two groups based on the type of non-resorbable barrier used, and the amount of bone regeneration, marginal bone resorption after prosthetics, implant survival rate and surgical complication in both groups were evaluated. Results: The implants in both groups showed high survival rates, and the implant-supported prostheses functioned stably during the follow-up period. During the second surgery of the implant, all horizontal defects were filled with new bone, and there was no significant difference in the amount of vertical bone defect. Conclusion: In bone defect areas, GBR with non-resorbable barriers can produce favorable results with adequate postoperative management. There was no significant difference in bone regeneration between e-PTFE and d-PTFE.

• Journal of Periodontal and Implant Science
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• 제47권6호
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• pp.363-371
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• 2017

Purpose: The purpose of this study was to investigate the feasibility of regenerative therapy with a collagenated bone graft and resorbable membrane in intrabony defects, and to evaluate the effects of the novel extracellular matrix (ECM)-based membrane clinically and radiologically. Methods: Periodontal tissue regeneration procedure was performed using an ECM-based resorbable membrane in combination with a collagenated bovine bone graft in intrabony defects around the teeth and implants. A novel extracellular matrix membrane (NEM) and a widely-used membrane (WEM) were randomly applied to the test group and the control group, respectively. Cone-beam computed tomography images were obtained on the day of surgery and 6 months after the procedure. Alginate impressions were taken and plaster models were made 1 week and 6 months postoperatively. Results: The quantity of bone tissue, the dimensional changes of the surgically treated intrabony defects, and the changes in width and height below the grafted bone substitutes showed no significant difference between the test and control groups at the 6-month examination. Conclusions: The use of NEM for periodontal regeneration with a collagenated bovine bone graft showed similar clinical and radiologic results to those obtained using WEM.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권4호
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• pp.188-194
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• 2014

For large membrane perforations that develop during sinus-bone grafting, we performed repairs using a pedicled buccal fat pad and a resorbable collagen membrane simultaneously with the bone graft. This study included eight patients. Postoperative maxillary sinusitis developed in two patients, which we managed with incision and drainage, and antibiotics. Ultimately, six patients received 12 implants, three of which failed (75% success). Implant replacement was performed after the removal of the failed replacement, at which point the prosthetic treatment was considered complete. In all of the six cases that we were able to follow-up with, the sinus-bone graft was healing favorably. We observed that the sinus bone height decreased gradually with time. Based on these case series, we conclude that our procedure of repairing large sinus-membrane perforations with a pedicled buccal fat pad and a collagen membrane is a reliable technique.

• Journal of Periodontal and Implant Science
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• 제46권5호
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• pp.291-302
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• 2016

Purpose: The aim of the present study was to evaluate the effectiveness of using a mineralized bone cortical allograft (MBCA), with or without a resorbable collagenous membrane derived from bovine pericardium, on alveolar bone remodeling after immediate implant placement in a dog model. Methods: Six mongrel dogs were included. The test and control sites were randomly selected. Four biradicular premolars were extracted from the mandible. In control sites, implants without an allograft or membrane were placed immediately in the fresh extraction sockets. In the test sites, an MBCA was placed to fill the gap between the bone socket wall and implant, with or without a resorbable collagenous membrane. Specimens were collected after 1 and 3 months. The amount of residual particles and new bone quality were evaluated by histomorphometry. Results: Few residual graft particles were observed to be closely embedded in the new bone without any contact with the implant surface. The allograft combined with a resorbable collagen membrane limited the resorption of the buccal wall in height and width. The histological quality of the new bone was equivalent to that of the original bone. The MBCA improved the quality of new bone formation, with few residual particles observed at 3 months. Conclusions: The preliminary results of this animal study indicate a real benefit in obtaining new bone as well as in enhancing osseointegration due to the high resorbability of cortical allograft particles, in comparison to the results of xenografts or other biomaterials (mineralized or demineralized cancellous allografts) that have been presented in the literature. Furthermore, the use of an MBCA combined with a collagen membrane in extraction and immediate implant placement limited the extent of post-extraction resorption.

• Journal of Periodontal and Implant Science
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• 제30권2호
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• pp.305-324
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• 2000

This study compared the short-term(4 months) clinical results of regenerative therapy with bioabsorbable membranes($BioMesh^{(R)}$) and bone allograft for the treatment of periodontal(intrabony and furcation) defects in smokers and nonsmokers.(16 smokers) 32 subjects with 92 defects participated in the study(46 in smokers and 46 in non-smokers). This study also evaluated a bioresorbable barrier with and without decalcified freeze-dried bone allograft(DFDBA). The 92 periodontal defects were randomly treated with either the resorbable barrier alone or resorbable barrier in combination with DFDBA following thorough defect debridement and root preparation with tetracycline. Each patient received both types of treatment modalities. Clinical examinations(probing depth, gingival recession, clinical attachment level, plaque index and gingival index) were carried out immediately before and 4 months after surgery. Significant(p<0.001) gains in mean attachment level were observed for both smokers(2.93mm) and non-smokers(3.30mm) but there were not significant difference between two groups. Similarly, significant reductions in mean probing depthshowed for smokers(4.52mm) and non-smokers(4.26mm). However, when comparing gingival recession, smokers were found to exhibit significantly poorer treatment results(1.59mm vs 0.96mm, p<0.05). Using the split-mouth-design, no statistically significant difference between the two modalities could be detected with regard to pocket depth reduction, gingival recession, or attachment gain. These results illustrate that the attachment gain is better in the non-smoker and the best in the non-smoker with the combination therapy of resorbable barrier and DFDBA than with resorbable barrier alone but smoking had no significant effect on clinical treatment outcome, even though smokers show more significant gingival recession. In addition, both treatments, either resorbable barrier plus DFDBA or resorbable barrier alone, promoted significant resolution of periodontal defects but the addition of DFDBA with a bioabsorbable membrane appears to add no extra benefit to the only membrane treatment.