Periimplant bone change after alveolar ridge preservation: radiographic retrospective study / 대한치과보철학회지

Purpose@#The aim of this study is to evaluate bone change around the implant in patients who underwent alveolar ridge preservation for implantation in the posterior teeth using radiographic data measuring changes of mesial, distal crestal bone level according to post-implantation, post-final prosthesis delivery and follow-up periods. @*Materials and methods@#In total, 36 implants were placed in 32 patients. The mesial and distal crestal bone level of all the areas where alveolar ridge preservation was performed uses panoramic images taken post-implantation, post-final prosthesis delivery, and follow-up period each was measured and evaluated as a vertical value. The following factors were analyzed: associations between changes of crestal bone level and factors (e.g., age, sex, systemic diseases, dentist, implant location, tooth, bone type, membrane). The statistical analysis was performed using the mean, standard deviation and independent t-test, paired t-test (P < .05). @*Results@#Analysis of crestal bone level differences between periods shows statistically significant differences (P < .05). There was no statistically significant difference when the changes of crestal bone level between post-implantation, post-final prosthesis delivery and follow-up periods were correlated with each factors. @*Conclusion@#After alveolar ridge preservation, bone around the implant remained stable during the maintenance period without being affected by the patient and surgical factors, and alveolar ridge preservation is considered a clinically usable procedure.

Periimplant bone change after alveolar ridge preservation: radiographic retrospective study / 대한치과보철학회지

Purpose@#The aim of this study is to evaluate bone change around the implant in patients who underwent alveolar ridge preservation for implantation in the posterior teeth using radiographic data measuring changes of mesial, distal crestal bone level according to post-implantation, post-final prosthesis delivery and follow-up periods. @*Materials and methods@#In total, 36 implants were placed in 32 patients. The mesial and distal crestal bone level of all the areas where alveolar ridge preservation was performed uses panoramic images taken post-implantation, post-final prosthesis delivery, and follow-up period each was measured and evaluated as a vertical value. The following factors were analyzed: associations between changes of crestal bone level and factors (e.g., age, sex, systemic diseases, dentist, implant location, tooth, bone type, membrane). The statistical analysis was performed using the mean, standard deviation and independent t-test, paired t-test (P < .05). @*Results@#Analysis of crestal bone level differences between periods shows statistically significant differences (P < .05). There was no statistically significant difference when the changes of crestal bone level between post-implantation, post-final prosthesis delivery and follow-up periods were correlated with each factors. @*Conclusion@#After alveolar ridge preservation, bone around the implant remained stable during the maintenance period without being affected by the patient and surgical factors, and alveolar ridge preservation is considered a clinically usable procedure.

Correlation analysis of gingival recession after orthodontic treatment in the anterior region: an evaluation of soft and hard tissues

Purpose@#The aim of this study was to investigate and identify the main causes of periodontal tissue change associated with labial gingival recession by examining the anterior region of patients who underwent orthodontic treatment. @*Methods@#In total, 45 patients who had undergone orthodontic treatment from January 2010 to December 2015 were included. Before and after the orthodontic treatment, sectioned images from 3-dimensional digital model scanning and cone-beam computed tomography images in the same region were superimposed to measure periodontal parameters. The initial labial gingival thickness (IGT) and the initial labial alveolar bone thickness (IBT) were measured at 4 mm below the cementoenamel junction (CEJ), and the change of the labial gingival margin was defined as the change of the distance from the CEJ to the gingival margin. Additionally, the jaw, tooth position, tooth inclination, tooth rotation, and history of orthognathic surgery were investigated to determine the various factors that could have affected anterior periodontal tissue changes. @*Results@#The mean IGT and IBT were 0.77±0.29 mm and 0.77±0.32 mm, respectively. The mean gingival recession was 0.14±0.57 mm. Tooth inclination had a significant association with gingival recession, and as tooth inclination increased labially, gingival recession increased by approximately 0.2 mm per 1°. @*Conclusions@#In conclusion, the IGT, IBT, tooth position, tooth rotation, and history of orthognathic surgery did not affect labial gingival recession. However, tooth inclination showed a significant association with labial gingival recession of the anterior teeth after orthodontic treatment.

Prevalence and risk factors of peri-implantitis: A retrospective study / 대한치과보철학회지

PURPOSE: The study analyzed the prevalence of peri-implantitis and factors which may have affected the disease. MATERIALS AND METHODS: This study based on medical records and radiographs of 422 patients (853 implant cases) who visited Ewha Womans University Mokdong Hospital Dental Center from January 1, 2012 to December 31, 2016. Generalized estimation equations (GEE) was utilized to determine the statistical relationship between peri-implantitis and each element, and the cumulative prevalence of peri-implantitis during the observation period was obtained by using the Kaplan Meier Method. RESULTS: The prevalence rate of peri-implantitis at the patient level resulted in 7.3% (31 patients out of a total of 422 patients), and at the implant level 5.5% (47 implants out of a total of 853 implants). Sex, GBR, guided bone regeneration (GBR) and functional loading periods had statistical significance with the occurrence of peri-implantitis. Upon analysis of the cumulative prevalence of peri-implantitis in terms of implant follow-up period, the first case of peri-implantitis occurred at 9 months after the placement of an implant, and the prevalence of peri-implantitis showed a non-linear rise over time without a hint of a critical point. CONCLUSION: The prevalence of peri-implantitis at the patient level and the implant were 7.3% and 5.5%, respectively. Male, implant installed with GBR and longer Functional Loading Periods were related with the risk of peri-implantitis.

Evaluation of prognosis related to compliance with supportive periodontal treatment in patients with chronic periodontitis: a clinical retrospective study

PURPOSE: The purpose of this study was to evaluate the prognostic effect of patient compliance with supportive periodontal treatment (PC-SPT). Chronic periodontitis patients were classified based on their compliance level, and factors affecting PC-SPT and the prognosis of PC-SPT were investigated. METHODS: This study selected 206 patients who started SPT after receiving periodontal treatment between 2010 and 2012. Patients who continued SPT through February 2016 were included. The patients were classified according to whether they exhibited complete compliance (100% of visits), excellent compliance (≥70% of visits), incomplete compliance (<70% of visits), or non-compliance (only 2 visits). Patient characteristics that could affect PC-SPT, such as age, sex, distance of the clinic from their residence, implantation, and periodontal treatment, were investigated. The number of newly decayed and extracted teeth, alveolar bone level changes around the teeth and implants, and implant removal were examined to evaluate the prognosis of PC-SPT. RESULTS: Sex and the presence of an implant significantly affected PC-SPT. Additionally, the number of newly decayed and extracted teeth and changes in alveolar bone levels around the teeth and implants were significant prognostic factors related to PC-SPT. CONCLUSIONS: PC-SPT in chronic periodontitis patients will help maintain periodontal health and prevent further periodontal disease.

Maxillary anterior implant restoration with appropriate anterior guidance using T-Scan in a patient with full fixed prostheses / 대한치과보철학회지

In implant restorations, it is difficult for the patient to percept any symptoms. In addition, they are absent of shock absorbers, which can lead to mechanical failure if stress distribution is not considered. Since maxillary anterior multiple-implant restorations play a significant role in guiding the functional movement of the mandible by distributing lateral force, it is crucial to form appropriate occlusion. The use of the T-scan system is more advantageous in assessing ‘dynamic occlusion’, such as the change of occlusion over time, the amount of tooth contact during functional movement, and assessing the occlusion in the less-visible posterior teeth. The case is reported as it has satisfactory results in harmonious anterior guidance of a maxillary anterior multiple-implant restoration using T-scan analysis.

Effects of Block Bone Substitutes Loaded with Escherichia Coli-Produced Recombinant Human Bone Morphogenetic Protein-2 on Space Maintenance and Bone Formation in Rat Calvarial Onlay Model

We aimed to evaluate the effects of onlay-type grafted human freeze-dried corticocancellous bone block (FDBB) and deproteinized bovine bone with collagen (DBBC) loaded with Escherichia coli-produced recombinant human bone morphogenetic protein-2 (ErhBMP-2) on space maintenance and new bone formation in rat calvaria. Collagen sponge (CS), FDBB, or DBBC disks (8×4 mm) with ErhBMP-2 (2.5 µg) were implanted onto the calvaria of male Sprague-Dawley rats, whereas CS with buffer was implanted onto the calvaria as controls (n=20/carrier). Rats were killed at 2 or 8 weeks post-surgery for histologic and histomorphometric analyses; total augmented area, new bone area, and bone density were evaluated. At both time-points, all ErhBMP-2 groups showed significantly higher new bone area and bone density than the control group (p<0.05). ErhBMP-2/FDBB and ErhBMP-2/DBBC groups showed significantly higher total augmented area than ErhBMP-2/CS group (8 weeks), and ErhBMP-2/FDBB group showed significantly higher new bone area and bone density than ErhBMP-2/DBBC group (p<0.05). ErhBMP-2/CS group showed the highest bone density (p<0.05). Combining ErhBMP-2 with FDBB or DBBC could significantly improve onlay graft outcomes, by new bone formation and bone density increase. Moreover, onlay-grafted FDBB and DBBC with ErhBMP-2 could be an alternative to autogenous block onlay bone graft.

Radiographic study of the distribution of maxillary intraosseous vascular canal in Koreans / 대한악안면성형재건외과학회지

BACKGROUND: This study aimed to investigate the distribution and prevalence of intraosseous loop (anastomosis between posterior superior alveolar artery and infraorbital artery) in Koreans detected on computed tomography (CT) images taken prior to sinus augmentation surgery. METHODS: From the 177 patients who underwent sinus augmentation with lateral approach at Ewha Womans University Department of Implant Dentistry, 284 CT scans were evaluated. The canal height (CH), ridge height (RH), and canal height from the sinus floor (CHS) were measured on para-axial views at the first premolar, first molar, and second molar. The horizontal positions of the bony canals in the lateral wall were also classified. One-way analysis of variance (ANOVA) and t test were used to estimate the statistical differences (p < 0.05). RESULTS: The intraosseous loops were detected in 92 CT scans (32 %). The mean vertical height of the bony canals from the alveolar crest (CH) was 23.45 +/- 2.81, 15.92 +/- 2.65, and 16.61 +/- 2.92 mm at the second premolar, first molar, and second molar, respectively. In the horizontal positions of the bony canals, intraosseous type was the most predominant. The canal heights more than 15 mm and less than 17 mm were most prevalent (33.7 %) and those under 13 mm were 12.0 %. CONCLUSIONS: The radiographic findings in this study could be used to decide the lateral osteotomy line avoiding potential vascular complication. However, only one third of the canals could be detected in CT scans; a precaution should be taken for the possibility of severe bleeding during lateral osteotomy.

Histomorphometric Evaluation of Onlay Freeze-Dried Block Bone and Deproteinized Bovine Bone with Collagen in Rat

The aim of this study was to evaluate the effect of human freeze-dried bone block (FDBB) and deproteinized bovine bone with collagen (DBBC) on bone formation when applied as an onlay graft in rat calvariums. Thirty male Sprague-Dawley rats received collagen sponge (control), FDBB, or DBBC onlay grafts trimmed into 8-mm disks measuring 4-mm height. Each graft was secured onto the calvarium surface using horizontal mattress sutures. Rats in each group were killed at 2 (n=5) or 8 (n=5) weeks postoperatively for histologic and histomorphometric analysis. The total augmented area (mm²), new bone area (mm²), and bone density (%) were measured. The FDBB and DBBC groups showed significantly more new bone formation and bone density than the control group at 2 and 8 weeks. The increased new bone area was significantly greater in the FDBB group than in the DBBC group (p<0.05). The total augmented area was significantly higher in the FDBB and DBBC groups at 2 and 8 weeks than in the control group (p<0.05), and at 8 weeks, the area was significantly decreased in the DBBC group compared to that in the FDBB group and the area at 2 weeks (p<0.05). Within the limitations of the present study, we concluded that onlay FDBB and DBBC grafts caused new bone formation through an osteoconductive mechanism. In addition, compared to FDBB, DBBC had less capacity to form new bone and maintain the space.

Effects of enamel matrix derivatives on the proliferation and the release of growth factors of human periodontal ligament cells / 대한치과보철학회지

PURPOSE: Stimulating the proliferation and migration of periodontal ligament cells (PDLCs) has become the main goal of periodontal regeneration. To accomplish this goal, regeneration procedures have been developed, but results have not been predictable. Recently, tissue engineering using enamel matrix derivatives (EMDs) and growth factors has been applied to periodontal regeneration; however, the mechanism of EMDs is largely unknown. The aim of this study was to investigate the effects of EMDs on the proliferation and release of growth factors from PDLCs. MATERIALS AND METHODS: Human PDLCs were removed from individually extracted 3rd molars of healthy young adults, and cultured in the media containing EMDs (Emdogain, Biora, Malmo, Sweden) at concentration of 0, 12.5, 25, 50, 100, and 200 µg/mL each. Cell proliferation and ALP (alka-line phosphatase) activity were measured. The evaluation of growth factors released by PDLCs was also performed by one-way analysis of variance (ANOVA) and Bonferroni's multiple comparison test. RESULTS: Significantly increased proliferation and ALP activity were observed in PDLCs treated with over 25 µg/mL and 50 µg/mL EMDs, respectively. Additionally, treatment of PDLCs with 50 µg/mL resulted in significantly increased release of vascular endothelial growth factor (VEGF) and transforming growth factor (TGF)-β after 24 h and 48 h, respectively. CONCLUSION: EMDs enhance the proliferation and ALP activity of PDLCs, and promote the release of growth factors, including VEGF and TGF-β, from PDLCs. Therefore EMDs could be one of the effective methods for periodontal regeneration.

Effects of Slow Programmable Cryopreservation on Preserving Viability of the Cultured Periodontal Ligament Cells from Human Impacted Third Molar

PURPOSE: This study was conducted to determine cell viability and differentiation capability of human periodontal ligament (PDL) cells and to elucidate the effects of cryopreservation on the activity of human third molar PDL cells by comparing PDL cells with and without cryopreservation. MATERIALS AND METHODS: Human PDL fibroblasts obtained from immature third molars were cultured and divided into two groups. The experimental group was cryopreserved with a slow freezing rate of 0.5degrees C/min from 4degrees C to -35degrees C followed by plunging in liquid nitrogen at -196degrees C and cultured after fast thawing. The control group was cultured without cryopreservation. Cell viability, growth capacity and morphology were evaluated in both groups. Bivariate statistics were used to compare 2 groups and linear mixed model analysis was used to investigate the growth trends difference over time. RESULT: Cell viability and growth capacity were not significantly different between the 2 groups (P>0.05). Cultured cell of both groups showed fibroblast-like in appearance, and there were no significant differences in morphology between 2 groups. The mixed model analysis revealed no significant difference of growth capacity between 2 groups over time (beta=-0.0009; P=0.138). CONCLUSION: This study demonstrates that cryopreservation under control does not affect the biological properties of PDL cells, supporting the feasibility of autotransplantation of cryopreserved impacted third molars.

A prospective study of patient satisfaction after implant supported mandibular overdenture treatment in fully edentulous patients / 대한치과보철학회지

PURPOSE: The purpose of this prospective study was to compare the satisfaction levels of the patients worn implant supported mandibular overdentures and conventional complete dentures. MATERIALS AND METHODS: Full edentulous patients (n=40) who were planned to do implant supported mandibular overdentures, aged 51 to 82 years, were enrolled in this study. All subjects rated their satisfaction levels (mastication, pronunciation, esthetics, pain, and general satisfaction) of their original conventional dentures prior to treatment and their new overdentures 1 week and 12 weeks after the delivery on 10 cm visual analogue scales. Repeated-measures ANOVA was performed to compare the satisfaction level of each three period (P<.05). RESULTS: The mean satisfaction levels of the implant supported overdentures after 1 week and 12 weeks of delivery were significantly higher than those of the conventional complete dentures in all scoring parameters (P<.05). After 12 weeks of overdenture delivery, the increase of the satisfaction levels in mastication, pronunciation, and pain and the decrease in esthetics and general satisfaction were observed in comparison with those after 1 week of delivery, however, no significant difference was found between the satisfaction levels of 1 week and 12 weeks after delivery. CONCLUSION: An implant supported overdenture might be one of the effective ways to give more satisfaction to patients who were not gratified with a conventional denture and eventually to improve their quality of life.

Effects of adjunctive daily phototherapy on chronic periodontitis: a randomized single-blind controlled trial

PURPOSE: The purpose of this randomized single-blind controlled trial was to elucidate the clinical and antimicrobial effects of daily phototherapy (PT) as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis. METHODS: The study was conducted from December 2013 to May 2014 at Ewha Womans University Mokdong Hospital, Seoul, Korea. Forty-one patients with mild to moderate chronic periodontitis were randomly divided into two therapeutic groups in a 1:1 ratio: SRP+PT and SRP (control) groups. All participants underwent full-mouth SRP. PT was performed thrice a day for a month by using electric toothbrushes with embedded light-emitting diodes. Plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing were assessed before (baseline) and four weeks after (follow-up) the treatment. Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum, Parvimonas micra, Campylobacter rectus, Eikenella corrodens, Streptococcus mutans, and Streptococcus sobrinus levels were detected by a real-time polymerase chain reaction at the same points in time. RESULTS: The clinical parameters improved in both the groups. At the follow-up assessment, PPD was significantly decreased in the SRP+PT group (P=0.00). Further, PPD and CAL showed significantly greater changes in the SRP+PT group than in the SRP group (PPD, P=0.03; CAL, P=0.04). P. gingivalis and T. forsythia levels decreased in this group, but no significant intergroup differences were noted. CONCLUSIONS: Adjunctive PT seems to have clinical benefits, but evidence of its antimicrobial effects is not sufficient. Long-term studies are necessary to develop the most effective PT protocol and compare the effectiveness of PT with and without exogenous photosensitizers.

The effect of copper alloy scaler tip on the surface roughness of dental implant and restorative materials / 대한치과보철학회지

PURPOSE: This study is designed to investigate the various impacts of different types of scaler tips such as cooper alloy base tip and the others on the surface roughness of teeth and implant by the method which is currently in clinical use. MATERIALS AND METHODS: Four different types of disc shaped porcelain, titanium, zirconia, and Type III gold alloy dental materials sized 15 mm diameter, 1.5 mm thickness were used for the experiment. Plastic hand curette (Group PS), cooper alloy new tip (Group IS), and stainless steel tip (Group SS) were used as testing appliances. A total of 64 specimens were used for this study; Four specimens for each material and appliance group. Surface roughness was formed with 15 degree angle in ultrasonic scaler tip and with 45 degree angle in hand curette of instrument tip and the specimen surface with 5 mm long, one horizontal-reciprocating motion per second for 30 seconds by 40 g force. To survey the surface roughness of each specimen, a field emission scanning electron microscope, an atomic force microscope, and a surface profiler were used. (Ra, microm). RESULTS: According to SEM, most increased surface roughness was observed in SS group while IS groups had minimal roughness change. Measurement by atomic force microscope presented that the surface roughness of SS group was significantly greater than those of PS, IS and control groups in the type III gold alloy group (P<.05). IS group showed lesser surface roughness changes compared to SS group in porcelain and gold alloy group (P<.05). According to surface profiler, surface roughness of SS group showed greater than those of PS, IS and control groups and IS group showed lesser than those of SS group in all specimen groups. Type III gold alloy group had large changes on surface roughness than those of porcelain, titanium, zirconia (P<.05). CONCLUSION: The result of this study showed that newly developed copper alloy scaler tip can cause minimal roughness impacts on the surface of implant and dental materials; therefore this may be a useful alternative for prophylaxis of implant and restored teeth.

Anterior maxillary defect reconstruction with a staged bilateral rotated palatal graft

PURPOSE: In the anterior maxilla, hard and soft tissue augmentations are sometimes required to meet esthetic and functional demands. In such cases, primary soft tissue closure after bone grafting procedures is indispensable for a successful outcome. This report describes a simple method for soft tissue coverage of a guided bone regeneration (GBR) site using the double-rotated palatal subepithelial connective tissue graft (RPSCTG) technique for a maxillary anterior defect. METHODS: We present a 60-year-old man with a defect in the anterior maxilla requiring hard and soft tissue augmentations. The bone graft materials were filled above the alveolar defect and a titanium-reinforced nonresorbable membrane was placed to cover the graft materials. We used the RPSCTG technique to achieve primary soft tissue closure over the graft materials and the barrier membrane. Additional soft tissue augmentation using a contralateral RPSCTG and membrane removal were simultaneously performed 7 weeks after the stage 1 surgery to establish more abundant soft tissue architecture. RESULTS: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppuration were not observed in the donor or recipient sites after the stage 2 surgery. These procedures enhanced the alveolar ridge volume, increased the amount of keratinized tissue, and improved the esthetic profile for restorative treatment. CONCLUSIONS: The use of RPSCTG could assist the soft tissue closure of the GBR sites because it provides sufficient soft tissue thickness, an ample vascular supply, protection of anatomical structures, and patient comfort. The treatment outcome was acceptable, despite membrane exposure, and the RPSCTG allowed for vitalization and harmonization with the recipient tissue.

Non-submerged type implant stability analysis during initial healing period by resonance frequency analysis / 대한치주과학회지

PURPOSE: The purpose of the present study was to analyze the implant stability quotient(ISQ) values for Korean non-submerged type implant and determine the factors that affect implant stability. METHODS: A total of 49 Korean non-submerged type implants were installed in 24 patients, and their stability was measured by resonance frequency analysis(RFA) at the time of surgery, and 1, 2, 3, 4, 8, 12 weeks postoperatively. The data for implant site, age, sex, implant length and diameter, graft performing, bone type, and insertion torque were analyzed. RESULTS: The lowest mean stability measurement was at 3 weeks. There was significant difference between implant placement and 12 weeks. There was significant difference between implant placement and 12 weeks in diameters of 4.1 mm and 4.8 mm. Also, there were significant differences between diameters of 4.1 mm and 4.8 mm at implant placement and 12 weeks after surgery. This result suggests that the factor related to implant diameter may affect the level of implant stability. No statistically significant relationship was found between the resonance frequency analysis and the variables of maxilla/mandible, sex, anterior/posterior, implant length, age of patient, graft performing, bone type, insertion torque during initial healing period. CONCLUSIONS: These findings suggest that the factor related to implant diameter may affect the variance of implant stability, and ISQ value of implant was stable enough for proved stability level during initial healing period.

The effect of the freeze dried bone allograft and gel/putty type demineralized bone matrix on osseous regeneration in the rat calvarial defects / 대한치주과학회지

PURPOSE: This study was aimed to evaluate the effect of the Freeze Dried Bone Allograft and Demineralized Bone Matrix on osseous regeneration in the rat calvarial defects. METHODS: Eight mm critical-sized calvarial defects were created in the 80 male Sprague-Dawley rats. The animals were divided into 4 groups of 20 animals each. The defects were treated with Freeze Dried Bone Allograft(SureOss(TM)), Demineralized Bone Matrix(ExFuse(TM)Gel, ExFuse(TM)Putty), or were left untreated for sham-surgery control and were evaluated by histologic and histomorphometric parameters following a 2 and 8 week healing intervals. Statistical analysis was done between each groups and time intervals with ANOVA and paired t-test. RESULTS: Defect closure, New bone area, Augmented area in the SureOss(TM), ExFuse(TM) Gel, ExFuse(TM) Putty groups were significantly greater than in the sham-surgery control group at each healing interval(P<0.05). In the New bone area and Defect closure, there were no significant difference between experimental groups. Augmented area in the ExFuse(TM) Gel, ExFuse(TM) Putty groups were significantly greater than SureOss(TM) group at 2weeks(P<0.05), however there was no significant difference at 8 weeks. CONCLUSIONS: All of SureOss(TM), ExFuse(TM) Gel, ExFuse(TM) Putty groups showed significant new bone formation and augmentation in the calvarial defect model.

DNA microarray analysis of gene expression of MC3T3-E1 osteoblast cell cultured on anodized- or machined titanium surface / 대한치주과학회지

PURPOSE: The aim of this study was to evaluate adhesion and gene expression of the MC3T3-E1 cells cultured on machined titanium surface (MS) and anodized titanium surface (AS) using MTT test, Scanning electron micrograph and cDNA microarray. MATERIALS AND METHODS: The MTT test assay was used for examining the proliferation of MC3T3-E1 cells, osteoblast like cells from Rat calvaria, on MS and AS for 24 hours and 48 hours. Cell cultures were incubated for 24 hours to evaluate the influence of the substrate geometry on both surfaces using a Scanning Electron Micrograph (SEM). The cDNA microarray Agilent Rat 22K chip was used to monitor expressions of genes. RESULTS: After 24 hours of adhesion, the cell density on AS was higher than MS (p0.05). AS had the irregular, rough and porous surface texture. After 48 hours incubation of the MC3T3-E1 cells, connective tissue growth factor (CTGF) was up-regulated on AS than MS (more than 2 fold) and the insulin-like growth factor 1 receptor was down-regulated (more than 2 fold) on AS than MS. CONCLUSION: Microarray assay at 48 hours after culturing the cells on both surfaces revealed that osteoinductive molecules appeared more prominent on AS, whereas the adhesion molecules on the biomaterial were higher on MS than AS, which will affect the phenotype of the plated cells depending on the surface morphology.

Effect of maxillary sinus graft on the survival of endosseous implants: A 10-year retrospective study / 대한치주과학회지

PURPOSE: The aim of this study was to determine the survival rates of implants placed in grafted maxillary sinuses and compare the results obtained with graft materials, implant surfaces and timing of implant placement. MATERIALS AND METHODS: Between January 1996 and December 2005, 391 implants were placed in 161 patients who underwent sinus grafting treatment simultaneously or separately at Ewha Womans University Hospital. According to inclusion criteria, 272 implants were placed in 102 patients with 112 sinus grafts (30 females, 72 males), aged 26 to 88 years (mean age 49.0+/-9.7). The follow-up period ranged from 12 to 134 months (mean F/U 47+/-32). Survival rates were evaluated according to graft material, implant surface and timing of implant placement. The Kaplan-Meier procedure and the log rank (Mantel-Cox) test were used to estimate survival rates and test for equality of survival rates between different groups of patients. RESULTS: Ten-year cumulative survival rate for implants placed in the grafted sinuses was 90.1%. The survival rates for autogenous bone, combination and bone substitutes were 94.6%, 85.9% and 100%, respectively (p > 0.05). According to implant surface, survival rates were 84.8% in machined group and 97.5% in rough group (p 0.05). CONCLUSION: Ten-year cumulative survival rate for implants placed in the grafted sinuses was 90.1%. Rough-surfaced implants have a higher survival rate than machined-surfaced implants when placed in grafted sinuses (p < 0.05).

Free gingival graft for the increase of peri-implant attached keratinized mucosa decreased after guided bone regeneration / 대한치주과학회지

PURPOSE: During guided bone regeneration procedures for the augmentation of deficient alveolar ridge, primary closure of flap is necessary. For primary flap closure, flap is repositioned coronally and the zone of attached keratinized mucosa may decreased. The need for attached keratinized mucosa around dental implants is still controversial, but sufficient peri-implant attached keratinized mucosa would be beneficial for functional and esthetic aspects. This case report presents three cases that demonstrated free gingival graft for increasing the zone of peri-implant attached keratinized mucosa which was decreased after guided bone regeneration. MATERIALS AND METHODS: In first case, maxillary incisors were extracted and guided bone regeneration was performed simultaneously. Because the membrane was exposed at 3 weeks after operation, the membrane was removed and free gingival graft was performed for primary flap closure. Free gingival graft was performed again at implant placement for the increase of attached keratinized mucosa. In second case, guided bone regeneration was performed on lower right first molar area, and implant was placed with free gingival graft. In third case, lower right molar area showed insufficient attached keratinized mucosa after implant placement with guided bone regeneration. When abutments were connected, free gingival graft with apically positioned flap was performed. RESULT: In these three cases, the zone of attached keratinized mucosa around dental implants was decreased after guided bone regeneration. And the increase of peri-implant attached keratinized mucosa could be obtained effectively by free gingival graft. CONCLUSION: Free gingival graft could be a effective treatment method increasing the zone of attached keratinized mucosa which was decreased after guided bone regeneration procedures.