• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.123-131
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• 2007

Introduction: Distraction osteogenesis is widely used as for bone lengthening in patients with maxillofacial deformity and alveolar bone atrophy. One of the major problems in distraction osteogenesis is long consolidation period for 2-3 months, in which the devices have to be fixed on the bone to prevent relapse. It results in scar formation on the face, disturbance of mastication and speech. This study was performed to evaluate the stimulating effect of pulsed electromagnetic field on the early bone consolidation in distraction osteogenesis. Materials and methods: Total 10 rabbit were used (5 for control group, 5 for experimental group). A vertical osteotomy in the mandibular body was performed and the distraction device was fixed. After 5 days distraction was done 1mm per a day for 7 days. A pulsed electromagnetic field (38 Gauss, 60 Hz) was applied for 8 hours per day and it continued for 5 days immediately after distraction in the experimental group. Both groups were sacrificed after 2 weeks. Histological specimens with H&E and Masson Trichrome staining were made and histomorphometrically analysed with image analyser. Results: The device for distraction osteogenesis was displaced in one animal for each group, therefore, only four animals in both groups were evaluated. In both groups, a new bone formation was observed in the distracted area after 2 weeks. The bone formation was enhanced in the experimental groups ($31.76{\pm}8.68%$) compared with control group ($9.94{\pm}3.23%$), its difference was statistically significant (p<0.001). Conclusion: This study suggests that electrical stimulation with electromagnectic field may be effective in the early bone formation after distraction osteogenesis. Further studies with large number of animals are needed before clinical application.

• The Journal of the Korean dental association
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• v.45 no.9 s.460
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• pp.562-570
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• 2007

Many dentists and patients expect that implant function and esthetics will not change over time. However, even the most successful implant restorations with ideal position, vertical height, and occlusion can be aesthetically pleasing, but may hide a common problem. Many dentists noticed that there can be some circumferential bone loss around the neck of the implants. To circumvent this bone loss, a "platform switching" concept was introduced recently. The basic concept of platform switching is by moving the fixture-abutment interface further away from the crestal bone to minimize crestal bone loss. Since crestal bone loss is a multifactor problem, it is important to consider microgap formation and micromotion between the implant and abutment because platform switching does not solve the problem on its own. In this article, we reviewed studies concerning platform switching and discussed the clinical application and the problems that may occur with its use.

• The Journal of Korean Academy of Prosthodontics
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• v.23 no.1
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• pp.13-37
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• 1985

Biocompatibility of dense synthetic hydroxylapatite is well known and the direct bond with adjacent bone developed. The purpose of this study was to evaluate the potential of clinical application of tooth ash for preservation of alveolar ridge. For this purpose the author performed an experimental implantation of the particulate and root form of both pure dense hydroxylapatite and tooth ash in alveolar sockets immediately after extraction. The pure dense hydroxylapatite was particulate form and root form made by Calciteck Inc. The tooth ash was prepared by incineration at $950^{\circ}C$, and the syrindrical form of the tooth ash was sintered and trimmed to fit the size of the each extraction socket of 10 mongrel dogs. After sugery the clinical, roentgenographical, and histological observation was carried out. The results obtained were as follows; 1. Clinical observation disclosed no dehiscence and exfoliation due to tissue rejection. 2. Vertical resorption of alveolar bone occurred in all experimental sockets as well as the control sites on the roentgenograph. 3. Osteoclastic activity appeared at the inner surfaces of the crestal alveolar bone on the 1st week but disappeared on the 2nd week. 4. There were macrophages in the particulate form on the 1st and 2nd week after surgery but no macrophages appered in the root form. S. New bone formation was developed from the bony wall of experimental sockets and grew to bond with the implant materials. In particulate form the new bone formation did not occur in central zone independently. 6. Tooth ash implant sites were covered with the newly formed bony trabeculation from third week, but Calcitite particles were covered with soft tissue. 7. Generally the healing occurred more rapidly in control sites than in implant sites.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.567-577
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• 2006

Background Several bone grafting materials have been used in sinus augmentation procedures. Macroporous Biphasic Calcium Phosphate($MBCP^{TM}$) consists of the mixture of 60% HA and 40% ${\beta}-TCP$. Therefore, it can provide good scaffold for the new bone to grow owing to HA, in the other hand, it can have bioactivity for bone remodeling owing to ${\beta}-TCP$. The purpose of this study was to evaluate bone formation following maxillary sinus augmentation using $MBCP^{TM}$ by means of histologic analysis. Material and Method $MBCP^{TM}$ was placed as a primary bone substitute for maxillary sinus augmentation. Three patients were selected after evalaution of their medical dental examination. $MBCP^{TM}$ only, $MBCP^{TM}$ combined with Irradicated cancellous bone and $MBCP^{TM}$ combined with autogenous bone were used for each patient. After about eight months, bone biopsies were harvested for histologic evaluation and fixtures installed. Results Eight months after surgery we observed new vital bone surrounding $MBCP^{TM}$ particle and the amount of new bone was about 30% even though there were discrepancies between specimens. This case report documents that $MBCP^{TM}$ when used as a grafting material for sinus floor augmentation whether combined other bone graft material or not, may lead to the predictable results for dental implants on posterior maxillary area with insufficient vertical height for fixture installation.

• Journal of Periodontal and Implant Science
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• v.47 no.1
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• pp.51-63
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• 2017

Purpose: Following tooth extraction, alveolar ridge preservation (ARP) can maintain the dimensions of ridge height and width. Although previous studies have demonstrated the effects of ARP, few if any studies have investigated the compressive force applied during grafting. The aim of this study was to determine the effects of different compressive forces on the graft materials during ARP. Methods: After tooth extraction, sockets were filled with deproteinized bovine bone mineral with 10% porcine collagen and covered by a resorbable collagen membrane in a double-layered fashion. The graft materials were compressed using a force of 5 N in the test group (n=12) and a force of 30 N in the control group (n=12). A hidden X suture was performed to secure the graft without primary closure. Cone-beam computed tomography (CBCT) was performed immediately after grafting and 4 months later, just before implant surgery. Tissue samples were retrieved using a trephine bur from the grafted sites during implant surgery for histologic and histomorphometric evaluations. Periotest values (PTVs) were measured to assess the initial stability of the dental implants. Results: Four patients dropped out from the control group and 20 patients finished the study. Both groups healed without any complications. The CBCT measurements showed that the ridge volume was comparably preserved vertically and horizontally in both groups (P>0.05). Histomorphometric analysis demonstrated that the ratio of new bone formation was significantly greater in the test group (P<0.05). The PTVs showed no significant differences between the 2 groups (P>0.05). Conclusions: The application of a greater compressive force on biomaterials during ARP significantly enhanced new bone formation while preserving the horizontal and vertical dimensions of the alveolar ridge. Further studies are required to identity the optimal compressive force for ARP.

• Imaging Science in Dentistry
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• v.53 no.4
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• pp.303-312
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• 2023

Purpose: This study investigated the prevalence of developmental and acquired pathologic conditions associated with impacted third molars (3Ms) in a Southern Brazilian population and evaluated whether demographic and tooth characteristics were correlated with the presence of bone or tooth lesions. Materials and Methods: Panoramic radiographs were assessed for developmental (bone-related) or acquired (tooth-related) pathoses associated with impacted upper or lower 3Ms. Data on tooth positioning, tooth development, and patient demographics were collected. A trained, calibrated postgraduate student evaluated all images. Binary and multivariate logistic regression models were used to assess associations between outcomes and the demographic and radiographic variables. The threshold for statistical significance was set at 5% (P<0.05). Results: The sample comprised panoramic radiographs from 2054 patients, predominantly female (59.2%), with a mean age of 27.2±11.5 years. Overall, 4066 impacted 3Ms were evaluated, revealing 471 (11.6%) developmental and 710 (17.5%) acquired pathoses. Among the developmental pathoses, 460 (95.2%) were indicative of dentigerous cysts. Male sex, lower 3M location, vertical or distoangular positioning, and incomplete root formation were associated with an elevated likelihood of developmental pathology. Lower tooth position, complete root formation, and partial eruption were linked to an increased probability of an acquired pathology in the third or second molar. Conclusion: The prevalence of pathologic conditions associated with impacted 3Ms was low. Male sex, lower 3M placement, horizontal or distoangular positioning, and incomplete root formation were associated with developmental pathoses, while lower tooth position, complete root formation, and partial eruption were related to acquired pathoses.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.374-390
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• 1993

Regeneration of periodontal tissue after a loss of attachment due to disease or trauma repesents an important issue in dentistry, and various bone graft materials have been used to regenerated lost periodontal tissue and restore proper fuctions. Among those, allografts have been extensively researched and widely used clinically, since they are known to possess an excellent osteoinduction capability and result in proper topography of alveolar bone. Regeneration of periodontal tissue in supraalveolar defects may be technically difficult. However, a large amount of regeneration has been observed by complete tissue coverage of involved teeth. In this study, supraalveolar defects in adult dogs were treated with periodontal surgery, decalcified freez-dried bone allograft, complete tissue coverage was attained, and effects on repair and regeneration of alveolar bone, cementum and periodontal ligament were studied. Exposure of premolar furcation of adult dogs was attained by removing marginal alveolar bone down to 5mm from CEJ, and root surfaces were planed with curettes. On the left side, defects were treated without any allograft(Control Group). On the right side, a DFDB was used(Experimental Group). In all groups, flaps were coronally positioned and sutured, completely submerging the treated defects. At two weeks, the crown were exposed 2-3mm. Healing progresses were histologically observed after eight weeks and the results were as follows : 1. Distance from CEJ to AJE was : $2.82{\pm}0.66mm$ in the control group, $1.71{\pm}0.51mm$ in experimental group, with significant differences between groups.(P<0.01) 2. Periodontal repair was : $2.18{\pm}0.66mm$ in the control group, $3.29{\pm}0.51mm$ in experimental group, with significant differences between groups.(P<0.01) 3. Connective tissue repair was : $1.43{\pm}0.52mm$ in the control group, $0.76{\pm}0.47mm$ in experimental group, with significant differences between groups.(P<0.01) Orientation of connective tissue fibers in relation to root surfaces was : mostly parallel in the control group, vertical or parallel or irregular in experimental group. 4. The amount of cementum formation was : $1.66{\pm}0.58mm$ in the control group, $2.86{\pm}0.66mm$ in experimental group, with significant differences between groups. 5. The amount of alveolar bone formation was : $0.76{\pm}0.72mm$ in the control group, $2.53{\pm}0.56mm$ in experimental group, with significant differences between groups.(P<0.01)

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.27.1-27.7
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• 2015

The aim of this study was to evaluate the clinical relevance of autogenous fresh demineralized tooth (Auto-FDT) prepared at chairside immediately after extraction for socket preservation. Teeth were processed to graft materials in block, chip, or powder types immediately after extraction. Extraction sockets were filled with these materials and dental implants were installed immediately or after a delay. A panoramic radiograph and a conebeam CT were taken. In two cases, tissue samples were taken for histologic examination. Vertical and horizontal maintenance of alveolar sockets showed some variance depending on the Auto-FDT and barrier membrane types used. Radiographs showed good bony healing. Histologic sections showed that it guided good new bone formation and resorption pattern of the Auto-FDT. This case series shows that Auto-FDT prepared at chairside could be a good material for the preservation of extraction sockets. This study will suggest the possibility of recycling autogenous tooth after immediate extraction.

• Journal of Periodontal and Implant Science
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• v.53 no.6
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• pp.406-416
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• 2023

Purpose: No evidence exists regarding the advantages of periodontal regeneration treatment for furcation defects using soft block bone substitutes. Therefore, this randomized controlled trial aimed to assess the clinical and radiographic outcomes of regenerative therapy using porcine-derived soft block bone substitutes (DPBM-C, test group) compared with porcine-derived particulate bone substitutes (DPBM, control group) for the treatment of severe class II furcation defects in the mandibular molar regions. Methods: Thirty-five enrolled patients (test group, n=17; control group, n=18) were available for a 12-month follow-up assessment. Clinical (probing pocket depth [PPD] and clinical attachment level [CAL]) and radiographic (vertical furcation defect; VFD) parameters were evaluated at baseline and 6 and 12 months after regenerative treatment. Early postoperative discomfort (severity and duration of pain and swelling) and wound healing outcomes (dehiscence, suppuration, abscess formation, and swelling) were also assessed 2 weeks after surgery. Results: For both treatment modalities, significant improvements in PPD, CAL, and VFD were found in the test group (PPD reduction of 4.1±3.0 mm, CAL gain of 4.4±2.9 mm, and VFD reduction of 4.1±2.5 mm) and control group (PPD reduction of 2.7±2.0 mm, CAL gain of 2.0±2.8 mm, and VFD reduction of 2.4±2.5 mm) 12 months after the regenerative treatment of furcation defects (P<0.05). However, no statistically significant differences were found in any of the measured clinical and radiographic parameters, and no significant differences were observed in any early postoperative discomfort and wound healing outcomes between the 2 groups. Conclusions: Similar to DPBM, DPBM-C showed favorable clinical and radiographic outcomes for periodontal regeneration of severe class II furcation defects in a 12-month follow-up period.

• Journal of Yeungnam Medical Science
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• v.39 no.4
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• pp.322-331
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• 2022

Background: The combined use of biomaterials for regeneration may have great biological relevance. This study aimed to compare the regenerative potential of biphasic calcium phosphate (BCP) alone and with growth factor enamel matrix derivatives (EMDs) for the regeneration of intrabony defects at 1 year. Methods: This randomized controlled trial included 40 sites in 29 patients with stage II/III periodontitis and 2/3 wall intrabony defects that were treated with BCP alone (control group) or a combination of BCP and EMD (test group). BCP alloplastic bone grafts provide better bio-absorbability and accelerate bone formation. EMDs are commercially available amelogenins. Mean values and standard deviations were calculated for the following parameters: plaque index (PI), papillary bleeding index (PBI), vertical probing pocket depth (V-PPD), vertical clinical attachment level (V-CAL), and radiographic defect depth (RDD). Student paired and unpaired t-tests were used to compare the data from baseline to 12 months for each group and between the groups, respectively. The results were considered statistically significant at p<0.05. Results: At 12 months, the PI and PBI scores of the control and test groups were not significantly different (p>0.05). The mean V-PPD difference, V-CAL gain, and RDD difference were statistically significant in both groups at 12 months (p<0.001 for all parameters). Intergroup comparisons showed that the mean V-PPD reduction (2.13±1.35 mm), V-CAL gain (2.53±1.2 mm), and RDD fill (1.33±1.0 mm) were statistically significant between the groups at 12 months (p<0.001 for all parameters). Conclusion: BCP and EMDs combination is a promising modality for the regeneration of intrabony defects.