• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권2호
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• pp.122-126
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• 2011

Introduction: In the lateral window approach for a maxillary sinus bone graft, there has been considerable controversy regarding the placement of a barrier membrane over the osteotomy site. In particular, when there is no damage to the Schneiderian membrane, clinicians should decide whether to use a barrier membrane or not, considering the benefits and costs. This study presents the clinical cases to demonstrate that only repositioning the detached window can lead to satisfactory bony healing of the grafted material without using a barrier membrane in the lateral approach for a maxillary sinus bone graft. Materials and Methods: Five consecutive patients were treated with the same surgical procedures. After performing the antrostomy on the lateral maxillary wall using a round carbide bur and diamond bur, the bony window was detached by a gentle levering action. After confirming no perforation of the Schneiderian membrane, the grafting procedure was carried out the detached window of the lateral maxillary wall was repositioned over the grafted material without using a barrier membrane. A gross examination was carried out at the postoperative 6 month re-entry, and the the preoperative and postoperative dental computed tomography (CT) at re-entry were compared. Results: All the procedures in the 5 patients went on to uneventful healing with no complications associated with the bone graft. Satisfactory bone regeneration without the interference of fibrous tissue on the gap between the repositioned window and lateral wall of the maxillary sinus was observed in the postoperative 6 month re-entry. The CT findings at re-entry revealed the, reconstruction of the external cortical plate including repositioned bony window. In addition, the loss of the discontinuity of the lateral maxillary wall was confirmed. Conclusion: This preliminary report showed that the detached window, which was just repositioned on the grafted material, could function as a barrier membrane in the lateral approach for a maxillary sinus bone graft. Therefore additional morphometric and histologic studies will be needed.

• 대한치과보철학회지
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• 제34권4호
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• pp.746-754
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• 1996

개교증, 절연부 파절, 변색등 심미적 요인으로 라미네이트를 설측연장시 연장길이에 따른 파절강도를 알아보기위해 발거된 60개의 상악 전치의 순면에 3개의 seating form을 형성하고sheet wax를 사용하여 가로 5mm $^*$세로 5mm $^*$두께 0.9mm의 block을 형성하고, 각 군에 따라 I군 : 0.5mm, II군 : 1mm, III군 : 2mm, IV군 : 0mm로 설측 연장 길이를 달리하여 block을 형성 이를 인상채득하여 내화모형을 제작하였다. 여기에 라미네이트용 도재를 2회에 걸쳐 축성 통법대로 소성 제작하였다. block에 맞추어 contouring하고, 내화매몰재를 제거 sandblast처리를 시행하였다. 그후 레진시멘트로 합착하였다. 절치간 각도를 127도로 특별히 제작된 holding device를 이용하여 인스트론 만능시험기에 시편을 거상하고, 분당 0.5mm cross head speed로 파절강도를 측정하여 다음과 같은 결과를 얻었다. 1. 각 군의 평균파절강도는 대조군인 설면으로 연장치 않은 IV군에서 86.95Mpa, 0.5mm 연장한 I군에서 44.98Mpa, 1.0mm연장한 II군에서 27.47Mpa, 2.0mm연장한 III군에서 19.61Mpa의 순으로 나타났다. 2. 모든 실험군 사이에는 통계적으로 유의성 있는 차이를 나타냈고(p<0.01), 이러한 실험 결과로 미루어 보아 라미네이트 디자인시, 설면으로 연장치 않거나, 절연부의 피개가 불가피한 경우에는 설면으로 0.5mm 연장하는 것이 파절 강도면에서 유리하다고 사료된다.

• Restorative Dentistry and Endodontics
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• 제31권5호
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• pp.337-343
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• 2006

본 연구에서는 색소 침투법을 이용한 5급 복합레진 수복물의 미세누출도와 주사전자 현미경을 이용한 변연적합도를 측정하고 두 방법 사이의 상관성을 평가하고자 하였다. 발거된 사람의 대구치 20개의 협면에 고속의 330번 버를 이용하여 5급 와동을 (백아법랑경계부를 중앙으로 가로 4 mm, 세로 3 mm, 깊이 1.5 mm) 형성하고, 평가시 참고점으로 사용하고자 1/2번 원형 버로 6개의 함몰부를 만들었다. 제조사의 지시에 따라 단일 단계의 올인원 접착제인 Xeno III로 치면을 처리한 다음, 미세혼합형 복합레진인 Esthet X로 단일 충전하였다. 시편을 식염수에 1일간 보관한 후 Sof-Lex 시스템으로 마무리 및 연마하였다. 이후 5도와 55도에서 1000회 열순환시킨 다음, 50%질산은 용액을 이용하여 침투시켰다. 실리콘 고무 인상재와 폴리우레탄 모형재로 수복물 주변의 레진 복제물을 제작하고 금도금한 다음 주사전자현미경으로 외부 및 내부 변연부의 변연적합도를 측정하였다. 또한 참고점을 기점으로 수복물을 3분한 다음, 미세누출도를 측정하였다. 내부 및 외부 변연적합도와 미세누출도 평가법 사이의 상관관계는 Spearman's rho test를 이용하여 다음과 같은 결과를 얻었다. 1. 미세누출도와 각각의 외부 및 내부 변연 적합도는 유의한 상관관계를 보였다 (p <0.01). 2.내부와 외부의 변연 적합도 사이에는 유의한 상관관계를 보이지 않았다.

• Restorative Dentistry and Endodontics
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• 제25권3호
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• pp.435-445
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• 2000

The purpose of this study was to compare the leakage of four different obturation techniques in conjunction with immediate apical barrier of ${\beta}$-tricalcium phosphate(TCP) in teeth with open apex. Eighty single-rooted human premolar teeth were prepared and sectioned horizontally, so maximum diameter in apex was 4mm. Apical defects that were similar to open apex, were created with #1/2 round bur and SF104R bur. The apical foramen were opened to a size 80 file extended 3mm beyond the apex. The teeth were placed into the oasis block soaked saline to simulate periapical tissue often associated with pulpless teeth and received apical barriers consisting of TCP followed by obturation using lateral condensation technique, vertical condensation technique, continuous wave technique and thermoplasticized gutta-percha injection technique. Two unobturated teeth served as positive and negative controls. Teeth were immersed in resorcinol-formaldehyde resin for S days at $4^{\circ}C$, and the resin was allowed to polymerize completely for 4 days at room temperature. Teeth were then sectioned horizontally at 1.5mm(level 1), 2.5mm(level 2) and 3.5mm(level 3) from the apex, and examined under a stereomicroscope at ${\times}40$ magnification. The photographs were taken at ${\times}40$ magnification of the filling in each level and scanned. The leakage length in tooth/resin interface was measured at each of the three levels. Each ratio of leakage was obtained by calculating the ratio of the leakage length of canal wall infiltrated with resin to the total length of the canal and was analyzed statistically(One-way ANOVA and Scheffe test). The result were as follows : 1. At the level 1, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), but there was statistically significant(p<0.05). 2. At the level 2, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), and the most leakage in the continuous wave technique group(group 3). There was statistically significant difference between the thermoplasticized gutta-percha injection technique group and the continuous wave technique group(p<0.05). 3. At the level 3, there was the least leakage in the thermoplasticized gutta-percha injection technique group(group 4), but there were no statistically significant differences between other groups(p>0.05). These results suggest that thermoplasticized gutta-percha injection technique which had 1mm apical gutta-percha matrix after the formation of TCP apical barrier, can demonstrate favorable apical sealing.

• Imaging Science in Dentistry
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• 제47권1호
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• pp.25-31
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• 2017

Purpose: The aim of this study was to compare the diagnostic accuracy of previously trained endodontists in the detection of artificially created periapical lesions using cone-beam computed tomography (CBCT) and digital periapical radiography (DPR). Materials and Methods: An ex vivo model using dry skulls was used, in which simulated apical lesions were created and then progressively enlarged using #1/2, #2, #4, and #6 round burs. A total of 11 teeth were included in the study, and 110 images were obtained with CBCT and with an intraoral digital periapical radiographic sensor (Instrumentarium dental, Tuusula, Finland) initially and after each bur was used. Specificity and sensitivity were calculated. All images were evaluated by 10 previously trained, certified endodontists. Agreement was calculated using the kappa coefficient. The accuracy of each method in detecting apical lesions was calculated using the chisquare test. Results: The kappa coefficient between examiners showed low agreement (range, 0.17-0.64). No statistical difference was found between CBCT and DPR in teeth without apical lesions (P=.15). The accuracy for CBCT was significantly higher than for DPR in all corresponding simulated lesions(P<.001). The correct diagnostic rate for CBCT ranged between 56.9% and 73.6%. The greatest difference between CBCT and DPR was seen in the maxillary teeth (CBCT, 71.4%; DPR, 28.6%; P<.01) and multi-rooted teeth (CBCT, 83.3%; DPR, 33.3%; P<.01). Conclusion: CBCT allowed higher accuracy than DPR in detecting simulated lesions for all simulated lesions tested. Endodontists need to be properly trained in interpreting CBCT scans to achieve higher diagnostic accuracy.

• Journal of Periodontal and Implant Science
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• 제30권3호
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• pp.553-569
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• 2000

Many natural medicines have been studied for their capacity and effects of antibacterial, anti-inflammatory and regenerative potential in periodontal tissues. Safflower seed has been traditionally used as a drug for treatment of bone fracture in oriental medicine. The purpose of the present study was to compare the effects of safflower seed extract and bone substitute on bone formation and regeneration in artificial defects in mongrel dogs. The bony defects were made with round bur at mandible and tibia. Extracts of safflower seed and bovine bone were placed directly at each defect for experimental group, and the defect of control group was sutured without any other treatment. Experimental animals were sacrificed at 8 weeks. And then histopathologic reading and histomorphometric study was done. There was not significant differences between control and experimental groups in osteoclastic activity and infiltration of inflammatory cells. However, new capillary proliferation, fibrosis and new bone formation were prominent in safflower seed extract group. The mandibular defects of safflower seed extract group were healed with dense connective and bony tissues, and endochondral bone formation was observed in tibial defect of safflower seed extract group only. New bone area of safflower seed extract group was more significantly increased than that of control and that of bone substitute group. These results indicate that direct local application of safflower seed extracts on bony defects seems to reduces the early inflammatory response and to promotes the bone regeneration.

• Journal of Periodontal and Implant Science
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• 제33권4호
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• pp.705-715
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• 2003

Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically compomer and Ketac Silver as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiostcal flap was elevated. Following decortication with 1/2 high speed round bur, furcation defect was made on maxillary premolar. 2 month later one premolar was filled with compomer and the other premolar was filled with Ketac Silver. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. Results were as follows. 1. Compomer & Ketac Silver restoration were encapsulated fine connective tissue. 2. In 4 weeks, compomer & Ketac Silver restoration slightly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, compomer & Ketac Silver restoration were less infiltrated iflammatory cell and encapsulated fine connective tissue. 4. Therefore, compomer & Ketac Silver filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances is possible clinical method and this technique is useful method for maxillary furcation involvement but it is thought that periodic maintenance should be needed

• 대한치과기공학회지
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• 제3권1호
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• pp.9-16
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• 1981

A comparative study was conducted to evaluate the relationship of investing medium to the amount of vertical occlusal changes and to the differences of surface smoothness during denture construction. Three groups of 20 dentures, 30 sets of upper and lower were fabricated of conventional heatcuring acrylic denture base resin, using silicone-gypsum molding techniques, with or without covering the occlusal surfaces of the teeth by artificial stone and all-gypsum molding techniques. The distance between the two reference points indented by 1/2 round bur on the upper and lower frontal surfaces of each articulator were measured and recorded before processing and again after processing and remounting of each denture on the articulator. The differences between the two recordings indicated the amount of vertical opening during denture processing. The difference of surface smoothness were investigated and determined by 3 observers continual comparing of the two randomly selected dentures with each other, which were seperately selected as pairs from the different two groups of 20. The results obtained were as follows: 1. During resin processing no statistically significant differences of the amount of vertical occlusal changes were detected between any of the two groups of two silicone-gypsum and one allgypsum molding techniques, although the amount of vertical opening was somewhat increased when silicone-gypsum molding technique was used. 2. Surface smoothness of the processed denture was makedly by increased when silicone-gypsum molding technique was used.

• Restorative Dentistry and Endodontics
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• 제21권1호
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• pp.35-53
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• 1996

The development and repair requires the formation of new tissues comprised of various extracellular matrix components. The present study investigated the formation and distribution of the major ECM components such as type I collagen, type III collagen, fibronection, bone sialoprotein, and osteonection during development and repair. For developing observation. Sprague-Dawley rats weighing $27{\pm}1gm$ were sacrificed. For repair observation, Sprague-Dawley rats weighing $110{\pm}5gm$ were used. The pulp perforation were prepared on mesial surface of the maxillary first molar by using 1/2round bur. At 5 days after perforation, rats were sacrificed by perfusion with 3 % paroformaldehyde. The maxillary first molar region were cut, demineralized, dehydrated and embedded in paraffin. Immunostaining the ECM components was achieved by the avidin-biotin complex method. The results as follows : 1. Bright immunoreaction for fibronectin was present in the basement membrane at the inner epithelial-mesenchymal interface, especially concentrated in the blood vessel walls, cell membrane of odontoblasts, and initial predentin. 2. Type I and III collagen was observed in the newly formed pulp tissue, predentin, and its intensity increased as more of these components during repair. 3. Strong immunostaining for bone sialoprotein and osteonectin was found in dentin while no or weaker staining was observed loose connective tissue of the pulp. 4. These results suggest that develpment and repair is achieved through a series of cell differentiation and attachment by the specific ECM components.

• Journal of Periodontal and Implant Science
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• 제34권4호
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• pp.711-722
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• 2004

The purpose of this study is to evaluate the regenerated bone histollogically using titanium reinforced ePTFE(TR-ePTFE) membrane and to investigate cell occlusiveness, wound stabilization and tissue integration of TR-ePTFE membrane. Adult male rabbits (mean BW 2kg) and TR9W (W.L.Gore&Associate.INC,USA) were used in this study. Intramarrow penetration defects were surgically created with round carbide bur(HP long #6) on calvaria of rabbits. TR-ePTFE membrane was applied to defect. Then guided bone regeneration was carried out using TR-ePTFE membrane and resorbable suture. At 2,4,8,12 weeks after the surgery, animals were sacrificed. Nondecalcified specimens were processed for histologic analysis. The result and conclusion of this study were as follows: 1. TR-ePTFE membrane had good ability of biocompatibility and cell occlusiveness. 2. space making for guided bone regenerayion was good at TR-ePTFE membrane. 3. Tissue integration was not good at TR-ePTFE membrane. So, wound stabilization was not good. 4. At 8 weeks, 12 weeks after GBR procedure, bone formation was seen. From the above results, TR-ePTFE membrane fixed tightiy on alveolar bone might be recommended for the early bone formation.