Effect of Er:YAG laser combined with ethylenediamine tetra acetic acid on three-walled periodontal intrabony defects adjacent to implant sites / 华西口腔医学杂志

OBJECTIVES@#To investigate the clinical effect of Er:YAG laser combined with ethylenediamine tetra acetic acid (EDTA) on three-walled periodontal intrabony defects adjacent to implant sites.@*METHODS@#A total of 30 patients with three-walled periodontal intrabony defects adjacent to implant sites were treated with the combination therapy. Patients with three-walled intrabony defects were divided into two groups according to the depth of the intrabony pocket between the implant and natural teeth. Evaluation of wound healing was performed 10 days after the operation, and bone augmentation was evaluated 6 months after the operation.@*RESULTS@#Primary healing in group 1 was 92.31%, primary healing in group 2 was 82.35%. No significant difference was observed between the two groups (@*CONCLUSIONS@#The effect of bone augmentation with combination therapy was more ideal in group 2 than in group 1. Implant placement with combination therapy may be a viable technique to reconstruct three-walled intrabony defects due to the space maintenance provided by implants and bone grafts and the good root surface biocompatibility provided by the Er:YAG laser and EDTA.

Regeneración tisular guiada en paciente diabético: reporte de caso / Guided Tissue Regeneration in a Diabetic Patient: A Case Report

Se presenta el caso clínico del manejo de un defecto intraóseo de dos paredes con un procedimiento de regeneración tisular, guiada mediante el uso de una barrera de membrana reabsorbible de colágeno y aloinjerto óseo en una paciente de 56 años, diabética tipo 2 controlada, que acudió a la clínica de periodoncia de la Universidad Popular Autónoma del estado de Puebla en México. A 2 meses, el posoperatorio mostró una adecuada cicatrización de los tejidos, disminución de la profundidad al sondeo y una evidencia radiográfica de llenado del defecto y formación ósea a los 4 meses. A pesar de la relación bidireccional entre enfermedad periodontal y la diabetes tipo 2, queda demostrado que el tratamiento periodontal de un paciente diabético con buen control metabólico es muy similar a uno sin diabetes, que hace predecible el resultado de la terapia periodontal regenerativa con el uso de barrera de membrana reabsorbible y aloinjerto óseo.

A clinical case of the management of a two-wall intrabony defect with a guided tissue regeneration procedure by using a collagen resorbable barrier membrane and bone allograft in a 56 years old controlled diabetic patient who attended to the clinic periodontics of Popular Autonomous University of Puebla is presented. At 2 months, the postoperative period showed adequate scarring of the tissues, decreased depth of sounding and radiographic evidence of defect filling and bone formation at 4 months. Despite the bi-directional relationship between periodontal disease and type 2 diabetes, it was shown that the periodontal treatment of a diabetic patient with good metabolic control is very similar to one without diabetes, which makes the result of regenerative periodontal therapy predictable with the use of absorbable membrane barrier and bone allograft.

Eficacia del plasma rico en plaquetas y la fibrina rica en plaquetas en la regeneración periodontal: revisión sistemática / Efficacy of platelet rich plasma and platelet rich fibrin in periodontal regeneration: systematic review

La regeneración se define como la reproducción o reconstrucción de una parte perdida o lesionada del cuerpo de tal manera que la arquitectura y la función del tejido perdido o lesionado se restauren completamente. El objetivo de la terapia periodontal regenerativa es restaurar la estructura y la función del periodonto. Los efectos positivos del Plasma Rico en Plaquetas se atribuyen a las capacidades angiogénicas, mitogénicas y proliferativas de los factores de crecimiento, como el factor de crecimiento derivado de plaquetas, el factor de crecimiento transformante y el factor de crecimiento endotelial vascular. La fibrina rica en plaquetas, es una segunda generación de concentrado plaquetario que permite obtener membranas de fibrina enriquecidas con plaquetas y factores de crecimiento, después de comenzar con una recolección de sangre libre de anticoagulantes sin ninguna modificación artificial biomecánica. El objetivo de esta revisión es conocer la eficacia del plasma rico en plaquetas y de la fibrina rica en plaquetas en la regeneración periodontal de defectos intraóseos. Las implicaciones clínicas potenciales para este material autólogo son prometedoras. Se requieren ensayos clínicos controlados aleatorios más largos, más grandes, multicéntricos y controlados para determinar los efectos del PRP y PRF en la regeneración del hueso alveolar debido a la enfermedad periodontal

Regeneration is defined as the reproduction or reconstruction of a lost part or injury of the body in such a way that the architecture and function of the lost or injured tissue are comple-tely restored. The goal of regenerative periodontal therapy is to restore the structure and function of the periodontium. The positive effects of Platelet-rich plasma (PRP) are attributed to the angiogenic, mitogenic and proliferative capacities of growth factors such as platelet-derived growth factor, trans-forming growth factor and vascular endothelial growth factor. Platelet-rich fibrin (PRF) is a second generation platelet concentrate that allows fibrin membranes enriched with platelets and growth fac-tors to be obtained after starting an anticoagulant-free blood collection without any biomechanical artificial modification. The objective of this review is to know the efficacy of platelet-rich plasma and platelet-rich fibrin in the periodontal regeneration of intrabony defects. The clinical implications for this autologous material are promising. Further long term, larger, multicentred randomized controlled clinical trials are required to determine the effects of PRP and PRF on the regeneration of alveolar bone due to periodontal disease.

Comparative evaluation of platelet-rich fibrin and autogenous bone graft for the treatment of infrabony defects in chronic periodontitis: Clinical, radiological, and surgical reentry

Context: Both intraoral autogenous bone grafting (ABG) and platelet-rich fibrin (PRF) offer a useful treatment modality for periodontal regeneration of intrabony defects (IBDs). However, predictable regeneration in patients with severe attachment loss is a challenge to the practitioners. Aim: The aim of this study was to compare the clinical efficacy of PRF with ABG for the treatment of IBDs in chronic periodontitis. Settings and Design: This is a randomized controlled trial. Materials and Methods: Twenty chronic periodontitis patients with IBDs were randomly treated by PRF or ABG. Probing pocket depth (PPD), relative attachment level (RAL), surgical reentry bone fill, and radiographic bone fill (RBF) were recorded at baseline, 3, 6, and 9 months postsurgery, respectively. Statistical Analysis: Student's t-test was used for continuous variables. All means were expressed as mean ± standard deviation and proportions were expressed in percentage. The level of significance was set at P < 0.05. Results: Both PRF and ABG sites produced a significant improvement from baseline to 9 months for all the parameters. However, there was no significant difference between the two treatment modalities in the reduction of PPD and RAL gain at 9 months. In addition, ABG showed significantly greater RBF (30.34%) as compared to PRF (20.22%). Similar findings were supported by surgical reentry, where a surgical reentry of 65.31% at ABG sites and 43.64% at PRF sites was seen. Conclusion: Both ABG and PRF can be used predictably to reconstruct lost periodontal structures as indicated by PPD reduction and RAL gain. However, in terms of osseous defect fill, ABG yields more definitive outcome than PRF.

Prevalence And Distribution of Vertical Osseous Defects In Patients Being Treated For Chronic Periodontitis.

Background: The aim of the study was to determine the prevalence and distribution of vertical osseous defects in patients who underwent open flap debridement. Methods: A total of 83 subjects were examined for prevalence of vertical defects using direct observation during periodontal surgery. All patients required periodontal surgery in one or more segments. The diagnosis of periodontitis was made after clinical and radiographic examination. Periodontal surgery was performed on each patient and full thickness mucoperiosteal flaps were elevated to gain access to root and osseous structures. The vertical osseous defects were explored surgically using mouth mirror, explorer and a periodontal probe. Results: A total of 141 vertical osseous defects were detected in the 677 teeth assessed during surgical exposure. Of these 81 vertical defects were found in the maxilla and 60 vertical defects were found in the mandible. Craters accounted for almost 44% of the total defects. The posterior maxilla had the highest percentage of teeth with vertical defects (26.23%) while the mandibular anterior segment had the lowest percentage of vertical defects. Conclusion: The posterior maxilla had the highest percentage of vertical osseous defects which can be explained by the fact that greater thickness of supporting bone allows formation of a greater number of infrabony defects. Craters were found to be the most common defect.

BBP(R) graft for periodontal intrabony defects and molar furcation lesions: Case Report / 대한치주과학회지

PURPOSE: Periodontal intrabony defects have great deal of importance since they contribute to the development of periodontal disease. Current treatment regimens for intrabony defects involve grafting of numerous bony materials, GTR using biocompatible barriers, and biomodification of root surface that will encourage the attachment of connective tissue. Xenograft using deproteinized bovine bone particles seems to be very convenient to adjust because it doesn't require any donor sites or imply the danger of cross infections. These particles are similar to human cancellous bone in structure and turned out to be effective in bone regeneration in vivo. We here represent the effectiveness of grafting deproteinized bovine bone particles in intrabony defect and furcation involvements that have various numbers of bony walls. MATERIALS AND METHODS: Open flap debridement was done to remove all root accretions and granulation tissue from the defects within persisting intrabony lesions demonstrating attachment loss of over 6mm even 3 months after nonsurgical periodontal therapy have been completed. Deproteinized bovine bone particles(BBP(R), Oscotec, Seoul) was grafted in intrabony defects to encourage bone regeneration. Patients were instructed of mouthrinses with chlorohexidine-digluconate twice a day and to take antibiotics 2-3 times a day for 2 weeks. They were check-up regularly for oral hygiene performance and further development of disease. Probing depth, level of attachment and mobility were measured at baseline and 6 months after the surgery. The radiographic evidence of bone regenerations were also monitored at least for 6 months. CONCLUSION: In most cases, radio-opacities increased after 6 months. 2- and 3-wall defects showed greater improvements in pocket depth reduction when compared to 1-wall defects. Class I & II furcation involvements in mandibular molars demonstrated the similar results with acceptable pocket depth both horizontally and vertically comparable to other intrabony defects. Exact amount of bone gain could not be measured as the re-entry procedure has not been available. With in the limited data based on our clinical parameter to measure pocket depth reduction following BBP(R) grafts, it was comparable to the results observed following other regeneration techniques such as GTR.

Histologic evaluation of macroporous biphasic calcium phosphate(MBCP(R)) and flouorohydrxyapatite(Algipore(R)) in surgically created 1-wall periodontal intrabony defects of minipigs / 대한치주과학회지

Periodontal regenerative therapy and tissue engineering on defects destructed by severe periodontitis need maintaining of space, which provides the environment for cell migration, proliferation and differentiation. Application of bone grafts may offer this environment in periodontal defects. This study evaluated bone graft materials, MBCP(R) and Algipore(R), in surgically created 1-wall periodontal intrabony defects of minipigs by histological analysis. Critical sized(4mmX4mm), one wall periodontal intrabony defects were surgically produced at the proximal aspect of mandibular premolars in either right and left jaw quadrants in four minipigs. The control group was treated with debridement alone, and experimental group was treated with debridement and MBCP(R) and Algipore(R) application. The healing processes were histologically observed after 8 weeks and the results were as follows. 1. In the control group, limited new bone formation was observed. 2. In MBCP group, more new bone formation was observed compared to other groups. 3. Histologically, dispersed mixture of new bone, biomaterial particles and connective tissue were shown and osteoblasts, osteoclasts and new vessels were present in this area. 4. Defects with Algipore showed limited new bone formation and biomaterial particles capsulated by connective tissue. 5. Histologically, lots of osteoclasts were observed around the biomaterial but relatively small numbers of osteblasts were shown. Within the limitation to this study protocol, MBCP(R) application in 1-wall intrabony defect enhanced new bone formation rather than Algipore(R) application.

Periodontal Repair on Intrabony Defects treated with Anorganic Bovine-derived Xeonograft / 대한치주과학회지

The ultimate goal of periodontal treatment is to regenerate the lost periodontal apparatus. Many studies were performed in developing an ideal bone substitute. Anorganic bovine-derived xenograft is one of the bone substitues, which were studied and have been shown successful for decades. The aim of this study is to evaluate the effect anorganic bovine-derived xenograft. Total of 20 patients, with 10 patients receiving only modified widman flap, and the other 10 receiving anorganic bovine-derived xenograft and flap surgery, were included in the study. Clinical parameters were recorded before surgery and after 6 months. The results are as follows: 1. The test group treated with anorganic bovine-derived xenograft showed reduction in periodontal pocket depth and clinical attachment level with statistically significance(p<0.001) after 6 months. The control group treated with only modified Widman flap showed reduction only in periodontal pocket depth with statistically significance(p<0.001) after 6 months. 2. Although periodontal probing depth change during 6 months did not show any significant differences between the test group and the control group, clinical attachment level gain and recession change showed significant differences between the two groups(p<0.05). On the basis of these results, anorganic bovine-derived xenograft improves probing depth and clinical attachment level in periodontal intrabony defects. Anorganic bovine-derived xenograft could be a predictable bone substitute in clinical use.

The effects of Acellular dermal matrix on the healing of 1 wall intrabony defects in dogs / 대한치주과학회지

Although the main purpose of periodontal treatment to regenerate is the complete regeneration of periodontal tissue due to periodontal disease, most of the treatment cannot meet such purpose because healing by long epithelial junction. Therefore, diverse materials of resorbable and non-resorbable have been used to regenerate the periodontal tissue. Due to high risk of exposure and necessity of secondary surgical procedure when using non-resorbable membrane, guided tissue regeneration using the resorbable membrane has gain popularity, recently. However, present resorbable membrane has the disadvantage of not having sufficient time to regenerate date to the difference of resorption rate according to surgical site. Meanwhile, other than the structure stability and facile manipulation, acellular dermal matrix has been reported to be a possible scaffold for cellular proliferation due to rapid revascularization and favorable physical properties for cellular attachment and proliferation. The purpose of this study is to estimate the influence of acellular dermal matrix on periodontal ligament, cementum and alveolar bone when acellular dermal matrix is implanted to 1-wall alveolar bone defect. 4 dogs of 12 to 16 month old irrelevant to sex , which below 15Kg of body weight, has been used in this study. ADM has been used for the material of guided tissue regeneration. The 3rd premolar of the lower jaw was extracted bilaterally and awaited for self-healing. subsequently buccal and lingual flap was elevated to form one wall intrabony defect with the depth and width of 4mm on the distal surface of 2nd premolar and the mesial surface of 4th premolar. After the removal of periodontal ligament by root planing. notch was formed on the basal position. Following the root surface treatment, while the control group had the flap sutured without any treatment on surgically induced intrabony defect. Following the root surface treatment, the flap of intrabony defect was sutured with the ADM inserted while the control group sutured without any insertion. The histologic specimen was observed after 4 and 8 weeks of treatment. The control group was partially regenerated by periodontal ligament, new cementum and new alveolar bone. the level of regeneration is not reached on the previous formed notch. but, experimental group was fully regenerated by functionally oriented periodontal ligament fiber, new cementum and new alveolar bone. In conclusion, we think that ADM seems to be used by scaffold for periodontal ligament cells and the matrix is expected to use on guided tissue regeneration.

Clinical Long-term Assessment of Bioactive Glass Graft / 대한치주과학회지

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Recently, bioactive glass that has been utilized in plastic surgery is being investigated for application in dental practice. But, there has not been any long-term assessment of bioactive glass when used in periodontal intrabony defects. The present study evaluates the long-term effects of bioactive glass on the periodontal regeneration in intrabony defects of human and the effect of plaqu control on long term treatment results after dividing patients into those who underwent 3-month regular check-up and those who didn't under go regular check-up The clinical effect on 74sites from 17 infrabony pockets of 11 patients were analyzed 36months after treatment. 51 sites which underwent regular check up were classified as the Follow-up group(F/U group), and 23 sites which did not undergo regular check up were classified as Non Follow-up group(Non F/U group). After comparing the probing depth, attachment loss, bone probing depth before and 36months after treatment, the following results could be concluded. 1. The changes of probing pocket depth showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.79+/-0.68mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(0.61+/-0.54mm) (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after baseline and 36months after treatment in F/U group(1.44+/-0.74mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(1.18+/-1.54) (P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after baseline and 36 months after treatment in both F/U(1.35+/-0.28) and Non F/U group(0.78+/-0.55mm) (P<0.05). The results suggest that treatment of infrabony defects with bioactive glass resulted in significan reduction of attachment loss and bone probing depth 36months after the treatment. The use of bioactive glass in infrabony defects, combined with regular check-up and proper plaque control generally shows favorable clinical results. This measn that bioactive glass could be a useful bone substitute.

Clinical effects of combination anorganic bovine-derived hydroxyapatite matrix(ABM)/cell binding peptide (P-15) in periodontal intrabony defects / 대한치주과학회지

The ultimate goal of periodontal theraphy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Intensive research is underway to identity, purify, synthesize a variety biologic modulators that may enhance wound healing and regeneration of lost tissues in periodontal therapy. The present study evaluates the effects of ABM/P-15 on the periodontal regeneration in intrabony defects of human. We used thirty four 2-wall or 3-wall osseous defects in premolars and molars of chronic periodontitis patient that have more than 5mm pockets and more than 3mm in intrabony defect. 12 negative control group underwent flap procedure only, 11 positive control group received DFDBA graft with flap procedure, and 11 experimental group received ABM/P-15 graft with flap procedure. The changes of probing pocket depth, loss of attachment and bone probing depth following 6months after treatment revealed the following results: 1. The changes of probing pocket depth showed a statistically significant decrease between after scaling and 6months after treatment in negative control(2.0+/-0.9mm), positive control(3.0+/-0.9mm), and experimental group (3.4+/-1.5mm) (P<0.01). Significantly more reduction was seen in experimental group compared to negative control group (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after scaling and 6months after treatment in positive control(2.0+/-0.6mm), and experimental group (2.2+/-1.0mm) except negative control group(0.1+/-0.7mm) (P<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group (P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after scaling and 6months after treatment in positive control(2.7+/-1.0mm), and experimental group (3.4+/-1.3mm) except negative control(0.1+/-0.9mm) (P<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group (P<0.05). The results suggest that the use of ABM/P-15 in the treatment of periodontal intrabony defects can reduce loss of attachment and bone probing depth more than flap operation only. It suggests that ABM/P-15 may be an effective bone graft material for the regeneration of periodontal tissue in intrabony defects.

The Effects of Enamel Matrix Derivative and Calcium Sulfate Paste on the Healing of 1-Wall Intrabony Defects in Beagle Dogs / 대한치주과학회지

Recently, it was reported that enamel matrix derivative may be beneficial in periodontal regeneration procedures in expectation of promoting new bone and cementum formation. The aim of present study was to evaluate the effect of enamel matrix derivative(Emdogain?)and Caso4 sulfate paste in 1-wall intrabony defects in beagle dogs. Surgically created 1-wall intrabony defects were randomly assigned to receive root debridement alone or Emdogain(R) or Emdogain(R) and Caso4. Clinical defect size was 4 X 4mm. The control group was treated with root debridement alone,and Experimental group I was treated with enamel matrix derivative application, and Experimental group II was treated with enamel matrix derivative and Caso4 sulfate paste application,. The healing processes were histologically and histometrically observed after 8 weeks and the results were as follows : 1. The length of junctional epithelium was 0.41+/-0.01mm in the control group, 0.42+/-0.08mm in the experimental group I and 0.50+/-0.13mm in the experimental group II. 2. The connective tissue adhesion was 0.28+/-0.02 mm in the control group, 0.13+/-0.08mm in the experimental group I and 0.19+/-0.02 mm in the experimental group II. 3. The new cementum formation was 3.80+/-0.06 mm in the control group, 4.12+/-0.43mm in the experimental group I and 4.34+/-0.71mm in the experimental group II. 4. The new bone formation was 1.43+/-0.03mm in the control group, 1.53+/-0.47 mm in the experimental group I and 2.25+/-1.35mm in the experimental group II. Although there was limitation to present study, the use of enamel matrix derivative in the treatment of periodontal 1-wall intrabony defect enhanced new cementum and bone formation. Caso4 sulfate paste will be the candidate for carriers to deliver enamel matrix derivative, and so enhance the regenerative potency of enamel matrix derivative.

Periodontal repair in dogs: effect of the modified calcium sulfate paste on the 1-wall intrabony defects / 대한치주과학회지

The purpose of this study was to evaluate the effect of modified calcium sulfate paste on periodontal regeneration. 1-wall intrabony defect(mesio-distal width: 4mm, depth: 4mm) was surgically created on the distal side of P2 and mesial side of P4 in four dogs. The control group(GFS) was treated with conventional flap operation alone, and the experimental group(CS) observations were as follows. 1. The length of the junctional epithelium was 0.41+/-0.0lmm in the control groups, 0.47+/-0.0lmm in the experimental group. 2. The connective tissue attachment was 0.28+/-0.02mm(6.15+/-0.28%) in the control group, 0.18+/-0.0lmm(3.41+/-0.14%) in the experimental group. The control group showed more connective tissue attachment. 3. The new cementum formation was 3.80+/-0.06mm(84.80+/-0.33%) in the control group, 4.49+/-0.06mm(87.57+/-0.15%) in the experimental group. Both groups showed a lot of new cementum formation. 4. The new bone formation was 1.43+/-0.03mm(32.37%) in the control group, 2.04+/-0.09%nm(40.94%) in the experiment group. 5. The inflamatory cells were observed partially around resorbed calcium sulfate in the connective tissue of the experimental group. 6. Partially resorbed calcium sulfate were found within the connective tissue, around alveolar bone, and in the newly formed alveolar bone, On the basis of these results, newly formed calcium sulfate paste enhanced new bone formation and new cementum formation. The resorption rate of calcium sulfate seems to he controlled by the add-in compounds. Thus research about biocompatibility and adequate resorptionrate is required to develop a improved material.

The Effects of rhBMP-2/ACS on the Periodontal Healing of 1-Wall Intrabony Defects in Dogs / 대한치주과학회지

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue and repair of function. For more than a decade there have been many efforts to develop materials and bioactive molecule(such as growth factor and differentiation factors) to promote periodontal wound healing. Among the bioactive molecules, bone morphogenetic protein(BMP) was studied for periodontal wound healing. Since Urist demonstrated that demineralized bone matrix could induce the formation of cartilage and bone in ectopic site, many studies on BMP have been reported. Among those BMPs, it was reported that rhBMP-2 enhanced the healing of bone defects in animal studies and clinical studies. However, its efficacy in periodontal regeneration, especially 1-wall intrabony defects is still unknown. The purpose of this study was to examine the effect of rhBMP-2/ACS on the epithelial migration, gingival connective tissue adhesion, cementum formation, alveolar bone regeneration in intrabony defects of dogs. Four millimeter deep and four millimeter wide 1-wall defects were surgically created in the mesial aspects of the 3rd incisors. The test group received rhBMP-2/ACS with a flap procedure and the control underwent buffer/ACS with a flap procedure. Histologic analysis after 8 weeks of healing revealed the following results: 1. The length of epithelial growth(the distance from alveolar crest to the apical end of JE) was 0.9+/-1.5mm in the control group and 1.2+/-1.4mm in the test group. There was no statistically significant difference between the two groups. 2. The length of connective tissue adhesion was 2.4+/-1.3mm in the control group and 1.2+/-1.1mm in the test group. The control group showed significantly enhanced adhesion(P<0.05). 3. The length of new cementum was 0.9+/-1.0mm in the control group and 1.7+/-0.8mm in the test group. The test group showed significantly enhanced cementum regeneration(P<0.05). 4. The length of new bone height was 1.9+/-0.6mm in the control group and 2.4+/-0.9mm in the test group. There was no statistically significant difference between the two groups. 5. The new bone area was 4.7+/-1.7mm2 in the control group and 8.0+/- 2.0mm2 in the test group. The test group showed significantly enhanced bone formed area(P<0.05). 6. The new bone density was 73.0+/-8.6% in the control group and 66.6+/- 15.3% in the test group. There was no statistically significant difference between the two groups. These results suggest that the use of rhBMP-2 in 1-wall intrabony defects has significant effect on new cementum and new bone formation area, but doesn't have any significant effect on the prevention of junctional epithelium migration and new bone formation height.

The effects of bioactive glass on the periodontal healing of 1-wall intrabony defects in dogs / 대한치주과학회지

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease, and numerous kinds of materials and techniques have been developed to achieve this goal. Bone grafts include autografts, allografts, xenografts and synthetic grafts. Among the synthetic grafts, bioactive glass has been used in dentistry for more than ten years and Fetner reported improved new bone formation and more amount of new attachment after grafting PerioGlas , a kind of bioactive glass, in 2-wall defects of monkeys in 1994. It is well known that 1-wall defects have less osteogenic potential and more epithelial migration, so we need to study the effect of bioactive glass in 1-wall defects in dogs. The present study evaluates the effect of bioactive glass on the epithelial migration, alveolar bone regeneration, cementum formation and gingival connective tissue attachment in intrabony defects of dogs. Four millimeter deep and four millimeter wide 1-wall defects were surgically created in the mesial aspects of premolars. The test group received bioactive glass with a flap procedure and the control underwent flap procedure only. Histologic analysis after 8 weeks of healing revealed the following results: 1. The height of gingival margin was 1.30+/-0.73mm above CEJ in the control and 1.40+/-0.78mm in the test group. There was no statistically significant difference between the two groups. 2. The length of epithelial growth(the distance from CEJ to the apical end of JE) was 1.74+/-0.47mm in the control and 1.12+/-0.36mm in the test group. There was a statistically significant difference between the two groups(P<0.01) 3. The length of new cementum was 2.06+/-0.73mm in the control and 2.62+/-0.37mm in the test group. There was no statistically significant difference between the two groups. 4. The length of new bone was 1.83+/-0.74mm in the control and 2.39+/-0.59mm in the test group. There was no statistically significant difference between the two groups. These results suggest that the use of bioactive glass in 1-wall intrabony defects has significant effect on the prevention of junctional epithelium migration, but doesn't have any significant effect on new bone and new cementum formation.

The Effects of calcium sulfate on healing of 1-wall intrabony defects in dogs / 대한치주과학회지

The main goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal diseases. Although conventional forms of periodontal therapy show sound clinical results, the healing results in long junctional epithelium. There have been numerous materials and surgical techniques developed for new attachment and bone regeneration. Bone grafts can be catagorized into; autografts, allografts, xenografts and bone substitutes. Synthetic bone substitute materials include hydroxyapatite, tricalcium phosphate, calcium carbonate, and Plaster of Paris. Calcium sulfate has found its use in dental practice for the last 30 years. Recent animal studies suggest that periodontal regeneration in 3 wall intrabony defect may be enhanced by the presence of calcium sulfate. And it is well known that 2 wall & 1 wall defect have less osteogenic potential, So we need to study the effect of calcium sulfate in 1 wall intrabony defect in dogs. The present study evaluates the effects of calcium sulfate on the epithelial migration, alveolar bone regeneration and cementum formation in intrabony defects of dogs. Four millimeter-deep one-wall intrabony defects were surgically created in the mesial aspect of anterior teeth and mesial & distal aspects of premolars. The test group received calcium sulfate grafts with a flap procedure. The control underwent flap procedure only. Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of junctional epithelium were; 2.52mm in the control, and 1.89mm in the test group. There was no statistical significance between the two groups. 2. Alveolar bone formation were; 0.61mm in the control, and 1.88mm in the test group. There was a statistically significant difference between the two groups (p<0.05). 3. Cementum formations were; 1.1mm in the control, and 2.46mm in the test group. There was a statistically significant difference between the two groups (p<0.05). 4. The length of CT adhesion were; 0.97mm in the control, and 0.17mm in the test group. There was no statistically significant differences between the two groups These results suggest that the use of calcium sulfate in intrabony defects has little effect on junctional epithelium migration, but has significant effects on new bone and new cementum formations.

The effects of enamel matrix derivative on the healing of 1-wall intrabony defects in beagle dogs / 대한치주과학회지

Guided tissue regeneration, bone graft procedures, and application of growth factors have been used to regenerate lost periodontal tissues. Recently, enamel matrix derivative has been introduced into periodontal regeneration procedures in expectation of promoting new bone and cementum formation. The purpose of this study was to evaluate the effect of enamel matrix derivative in 1-wall intrabony defects in beagle dogs. For this purpose, each dog was anesthesized using intravenous anesthesia and mandibular 1st, 3rd premolars were extracted. 2 months later, the 1-wall intrabony defects(mesio-distal width; 4mm, depth; 4mm) were created on the distal side of 2nd premolars and mesial side of 4th premolars. The control group was treated with debridement alone,and experimental group was treated with debridement and enamel matrix derivative application. The healing processes were histologically and histometrically observed after 8 weeks and the results were as follows : 1. The length of junctional epithelium was 0.94+/-0.80mm in the control group, 0.57+/-0.42mm in the experimental group, with no statistically significant difference between groups. 2. The connective tissue attachment was 1.36+/-0.98mm in the control group, 0.38+/-0.43mm in the experimental group, with statistically significant difference between groups(P<0.05). 3. The new cementum formation was 2.49+/-1.06mm in the control group, 3.59+/-0.74mm in the experimental group, with statistically significant difference between groups(P<0.05). 4. The new bone formation was 1.92+/-0.97mm in the control group, 2.32+/-0.59mm in the experimental group, with no statistically significant difference between groups. Within the limitation to this study protocol, enamel matrix derivative application in 1-wall intrabony defect enhanced new cementum formation. Although there was no statistically significant difference, enamel matrix derivative also seems to be effective in inhibition of apical migration of junctional epithelium and new bone formation.