1.Mucosal dehiscence coverage for dental implant using sprit pouch technique: a two-stage approach.
Toyohiko HIDAKA ; Daisuke UENO
Journal of Periodontal & Implant Science 2012;42(3):105-109
PURPOSE: Soft tissue recessions frequently cause esthetic disharmony and dissatisfaction. Compared with soft tissue coverage around a tooth, the coverage of an implant site is obviously unpredictable. Particularly in the cases of thin mucosa, a significant greater amount of recession takes place compared to thick mucosa. To overcome this problem, this case report demonstrates a two-step mucosal dehiscence coverage technique for an endosseous implant. METHODS: A 33-year-old female visited us with the chief complaint of dissatisfaction with the esthetics of an exposed implant in the maxillary left cental incisor region. A partial-thickness pouch was constructed around the dehiscence. A subepithelial connective tissue graft was positioned in the apical site of the implant and covered by a mucosal flap with normal tension. At 12 months after surgery, the recipient site was partially covered by keratinized mucosa. However, the buccal interdental papilla between implant on maxillary left central incisor region and adjacent lateral incisor was concave in shape. To resolve the mucosal recession after the first graft, a second graft was performed with the same technique. RESULTS: An esthetically satisfactory result was achieved and the marginal soft tissue level was stable 9 months after the second graft. CONCLUSIONS: The second graft was able to resolve the mucosal recession after first graft. This two-step approach has the potential to improve the certainty of esthetic results.
Adult
;
Connective Tissue
;
Dental Implants
;
Esthetics
;
Esthetics, Dental
;
Female
;
Gingiva
;
Humans
;
Hypogonadism
;
Incisor
;
Keratins
;
Mitochondrial Diseases
;
Mouth Mucosa
;
Mucous Membrane
;
Ophthalmoplegia
;
Oral Surgical Procedures
;
Tooth
;
Transplants
2.Heat or radiofrequency plasma glow discharge treatment of a titanium alloy stimulates osteoblast gene expression in the MC3T3 osteoprogenitor cell line.
Bruce E RAPUANO ; Kyle HACKSHAW ; Daniel E MACDONALD
Journal of Periodontal & Implant Science 2012;42(3):95-104
PURPOSE: The purpose of this study was to determine whether increasing the Ti6Al4V surface oxide negative charge through heat (600degrees C) or radiofrequency plasma glow discharge (RFGD) pretreatment, with or without a subsequent coating with fibronectin, stimulated osteoblast gene marker expression in the MC3T3 osteoprogenitor cell line. METHODS: Quantitative real-time polymerase chain reaction was used to measure changes over time in the mRNA levels for osteoblast gene markers, including alkaline phosphatase, bone sialoprotein, collagen type I (alpha1), osteocalcin, osteopontin and parathyroid hormone-related peptide (PTH-rP), and the osteoblast precursor genes Runx2 and osterix. RESULTS: Osteoprogenitors began to differentiate earlier on disks that were pretreated with heat or RFGD. The pretreatments increased gene marker expression in the absence of a fibronectin coating. However, pretreatments increased osteoblast gene expression for fibronectin-coated disks more than uncoated disks, suggesting a surface oxide-mediated specific enhancement of fibronectin's bioactivity. Heat pretreatment had greater effects on the mRNA expression of genes for PTH-rP, alkaline phosphatase and osteocalcin while RFGD pretreatment had greater effects on osteopontin and bone sialoprotein gene expression. CONCLUSIONS: The results suggest that heat and RFGD pretreatments of the Ti6Al4V surface oxide stimulated osteoblast differentiation through an enhancement of (a) coated fibronectin's bioactivity and (b) the bioactivities of other serum or matrix proteins. The quantitative differences in the effects of the two pretreatments on osteoblast gene marker expression may have arisen from the unique physico-chemical characteristics of each resultant oxide surface. Therefore, engineering the Ti6Al4V surface oxide to become more negatively charged can be used to accelerate osteoblast differentiation through fibronectin-dependent and independent mechanisms.
Alkaline Phosphatase
;
Alloys
;
Cell Differentiation
;
Cell Line
;
Collagen Type I
;
Dental Implants
;
Fees and Charges
;
Fibronectins
;
Gene Expression
;
Hot Temperature
;
Integrin alpha5beta1
;
Integrin-Binding Sialoprotein
;
Osteoblasts
;
Osteocalcin
;
Osteopontin
;
Parathyroid Hormone-Related Protein
;
Plasma
;
Proteins
;
Real-Time Polymerase Chain Reaction
;
RNA, Messenger
;
Titanium
3.Comparative evaluation of roughness of titanium surfaces treated by different hygiene instruments.
Otgonbayar UNURSAIKHAN ; Jung Seok LEE ; Jae Kook CHA ; Jung Chul PARK ; Ui Won JUNG ; Chang Sung KIM ; Kyoo Sung CHO ; Seong Ho CHOI
Journal of Periodontal & Implant Science 2012;42(3):88-94
PURPOSE: The use of appropriate instruments to clean surfaces with minimal change, is critical for the successful maintenance of a dental implant. However, there is no consensus about the type and methodology for such instruments. The aim of this study was to characterize changes in the roughness of titanium surfaces treated by various scaling instruments. METHODS: Thirty-seven identical disks (5 mm in diameter) were investigated in this study. The specimens were divided into eight groups according to the types of instrumentation and the angle of application. Ultrasonic scaling systems were applied on a titanium disk to simulate standard clinical conditions. The equipment included a piezoelectric ultrasonic scaler with a newly developed metallic tip (NS group), a piezoelectric ultrasonic scaler with a conventional tip (CS group), a piezoelectric root planer ultrasonic scaler with a conventional tip (PR group), and a plastic hand curette (PH group). In addition, the sites treated using piezoelectric ultrasonic scaler systems were divided two sub-groups: 15 and 45 degrees. The treated titanium surfaces were observed by scanning electron microscopy (SEM), and the average surface roughness (Ra) and mean roughness profile depth (Rz) were measured with a profilometer. RESULTS: SEM no significant changes in the titanium surfaces in the NS group, regardless of the angle of application. The PH group also showed no marked changes to the titanium surface, although some smoothening was observed. All CS and PR sites lost their original texture and showed irregular surfaces in SEM analysis. The profilometer analysis demonstrated that the roughness values (Ra and Rz) of the titanium surfaces increased in all, except the PH and NS groups, which showed roughness decreases relative to the untreated control group. The Ra value differed significantly between the NS and PR groups (P<0.05). CONCLUSIONS: The results of this study indicated that changes in or damage to titanium surfaces might be more affected by the hardness of the scaler tip than by the application method. Within the limitations of this study, the newly developed metallic scaler tip might be especially suitable for peri-implant surface decontamination, due to its limited effects on the titanium surface.
Consensus
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Decontamination
;
Dental Implants
;
Dental Instruments
;
Hand
;
Hardness
;
Hydrogen-Ion Concentration
;
Hygiene
;
Microscopy, Electron, Scanning
;
Peri-Implantitis
;
Periodontal Debridement
;
Plastics
;
Titanium
;
Ultrasonics
4.Surface characteristics of thermally treated titanium surfaces.
Yang Jin LEE ; De Zhe CUI ; Ha Ra JEON ; Hyun Ju CHUNG ; Yeong Joon PARK ; Ok Su KIM ; Young Joon KIM
Journal of Periodontal & Implant Science 2012;42(3):81-87
PURPOSE: The characteristics of oxidized titanium (Ti) surfaces varied according to treatment conditions such as duration time and temperature. Thermal oxidation can change Ti surface characteristics, which affect many cellular responses such as cell adhesion, proliferation, and differentiation. Thus, this study was conducted to evaluate the surface characteristics and cell response of thermally treated Ti surfaces. METHODS: The samples were divided into 4 groups. Control: machined smooth titanium (Ti-S) was untreated. Group I: Ti-S was treated in a furnace at 300degrees C for 30 minutes. Group II: Ti-S was treated at 500degrees C for 30 minutes. Group III: Ti-S was treated at 750degrees C for 30 minutes. A scanning electron microscope, atomic force microscope, and X-ray diffraction were used to assess surface characteristics and chemical composition. The water contact angle and surface energy were measured to assess physical properties. RESULTS: The titanium dioxide (TiO2) thickness increased as the treatment temperature increased. Additional peaks belonging to rutile TiO2 were only found in group III. The contact angle in group III was significantly lower than any of the other groups. The surface energy significantly increased as the treatment temperature increased, especially in group III. In the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, after 24 hours of incubation, the assessment of cell viability showed that the optical density of the control had a higher tendency than any other group, but there was no significant difference. However, the alkaline phosphatase activity increased as the temperature increased, especially in group III. CONCLUSIONS: Consequently, the surface characteristics and biocompatibility increased as the temperature increased. This indicates that surface modification by thermal treatment could be another useful method for medical and dental implants.
Alkaline Phosphatase
;
Cell Adhesion
;
Cell Survival
;
Dental Implants
;
Electrons
;
Phase Transition
;
Tetrazolium Salts
;
Thiazoles
;
Titanium
;
Transition Temperature
;
Water
;
Wettability
;
X-Ray Diffraction
5.Reply on "Reliability of two different presurgical preparation methods for implant dentistry based on panoramic radiography and cone-beam computed tomography in cadavers".
Journal of Periodontal & Implant Science 2012;42(4):145-145
No abstract available.
Cone-Beam Computed Tomography
;
Dentistry
;
Radiography, Panoramic
6.Commentary on "Reliability of two different presurgical preparation methods for implant dentistry based on panoramic radiography and cone-beam computed tomography in cadavers".
Journal of Periodontal & Implant Science 2012;42(4):144-144
No abstract available.
Cone-Beam Computed Tomography
;
Dentistry
;
Radiography, Panoramic
7.Novel analysis model for implant osseointegration using ectopic bone formation via the recombinant human bone morphogenetic protein-2/macroporous biphasic calcium phosphate block system in rats: a proof-of-concept study.
Jung Chul PARK ; Jong Bin LEE ; Guy DACULSI ; Sang Yeop OH ; Kyoo Sung CHO ; Gun Il IM ; Byung Soo KIM ; Chang Sung KIM
Journal of Periodontal & Implant Science 2012;42(4):136-143
PURPOSE: The osseointegration around titanium mini-implants installed in macroporous biphasic calcium phosphate (MBCP) blocks was evaluated after incubation with recombinant human bone morphogenetic protein-2 (rhBMP-2) in an ectopic subcutaneous rat model. METHODS: Mini-implants (phi1.8x12 mm) were installed in MBCP blocks (bMBCPs, 4x5x15 mm) loaded with rhBMP-2 at 0.1 mg/mL, and then implanted for 8 weeks into subcutaneous pockets of male Sprague-Dawley rats (n=10). A histomorphometric analysis was performed, and the bone-to-implant contact (BIC) and bone density were evaluated. RESULTS: Significant osteoinductive activity was induced in the rhBMP-2/bMBCP group. The percentage of BIC was 41.23+/-4.13% (mean+/-standard deviation), while bone density was 33.47+/-5.73%. In contrast, no bone formation was observed in the bMBCP only group. CONCLUSIONS: This model represents a more standardized tool for analyzing osseointegration and bone healing along the implant surface and in bMBCPs that excludes various healing factors derived from selected animals and defect models.
Animals
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Bone Density
;
Bone Morphogenetic Protein 2
;
Calcium
;
Dental Implants
;
Humans
;
Hydroxyapatites
;
Male
;
Nitrogen Mustard Compounds
;
Osseointegration
;
Osteogenesis
;
Rats
;
Rats, Sprague-Dawley
;
Recombinant Proteins
;
Titanium
;
Transforming Growth Factor beta
8.Clinical evaluation of a biphasic calcium phosphate grafting material in the treatment of human periodontal intrabony defects.
Min Jae LEE ; Byung Ock KIM ; Sang Joun YU
Journal of Periodontal & Implant Science 2012;42(4):127-135
PURPOSE: The aim of this study was to compare the clinical outcome of open flap debridement (OFD) with a biphasic calcium phosphate (BCP) graft to that of OFD without BCP graft for the treatment of intrabony periodontal defects (IBDs). METHODS: The study included 25 subjects that had at least one intrabony defect of 2- or 3-wall morphology and an intrabony component> or =4 mm as detected radiographically. Subjects were randomly assigned to treatment with (BCP group, n=14) or without BCP (OFD group, n=11). Clinical parameters were recorded at baseline and 6 months after surgery and included the plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), and gingival recession (REC). A stringent plaque control regimen was enforced for all of the patients during the 6-month observation period. RESULTS: In all of the treatment groups, significant PD reductions and CAL gains occurred during the study period (P<0.01). At 6 months, patients in the BCP group exhibited a mean PD reduction of 3.7+/-1.2 mm and a mean CAL gain of 3.0+/-1.1 mm compared to the baseline. Corresponding values for the patients treated with OFD were 2.5+/-0.8 mm and 1.4+/-1.0 mm, respectively. Compared to OFD group, the additional CAL gain was significantly greater in the patients in BCP group (P=0.028). The additional PD reduction was significant for the BCP group (P=0.048). The REC showed a significant increase in both groups, and the amount of recession was significantly smaller in the BCP group than OFD group (P=0.023). In radiographic evaluation, the height of the bone fill in the BCP group was significantly greater than OFD group. CONCLUSIONS: The clinical benefits of BCP found in this study indicate that BCP may be an appropriate alternative to conventional graft materials.
Alveolar Bone Loss
;
Bone Transplantation
;
Calcium
;
Calcium Phosphates
;
Chronic Periodontitis
;
Debridement
;
Gingival Recession
;
Humans
;
Hydroxyapatites
;
Periodontal Index
9.Improvement of osteogenic potential of biphasic calcium phosphate bone substitute coated with two concentrations of expressed recombinant human bone morphogenetic protein 2.
Hyunmin CHOI ; No Je PARK ; Otgonbold JAMIYANDORJ ; Kyung Hee CHOI ; Min Ho HONG ; Seunghan OH ; Young Bum PARK ; Sungtae KIM
Journal of Periodontal & Implant Science 2012;42(4):119-126
PURPOSE: The aim of this study was to determine whether biphasic calcium phosphate (BCP) bone substitute with two different concentrations of Escherichia coli-expressed recombinant human bone morphogenetic protein 2 (ErhBMP-2) enhances new bone formation in a standardized rabbit sinus model and to evaluate the concentration-dependent effect of ErhBMP-2. METHODS: Standardized, 6-mm diameter defects were made bilaterally on the maxillary sinus of 20 male New Zealand white rabbits. Following removal of the circular bony windows and reflection of the sinus membrane, BCP bone substitute without coating (control group) was applied into one defect and BCP bone substitute coated with ErhBMP-2 (experimental group) was applied into the other defect for each rabbit. The experimental group was divided into 2 subgroups according to the concentration of ErhBMP-2 (0.05 and 0.5 mg/mL). The animals were allowed to heal for either 4 or 8 weeks and sections of the augmented sinus and surrounding bone were analyzed by microcomputed tomography and histologically. RESULTS: Histologic analysis revealed signs of new bone formation in both the control and experimental groups with a statistically significant increase in bone formation in experimental group 1 (0.05 mg/mL ErhBMP-2 coating) after a 4-week healing period. However, no statistically significant difference was found between experimental group 1 and experimental group 2 (0.5 mg/mL ErhBMP-2 coating) in osteoinductive potential (P<0.05). CONCLUSIONS: ErhBMP-2 administered using a BCP matrix significantly enhanced osteoinductive potential in a standardized rabbit sinus model. A concentration-dependent response was not found in the present study.
Animals
;
Bone Morphogenetic Protein 2
;
Bone Morphogenetic Proteins
;
Bone Regeneration
;
Bone Substitutes
;
Calcium
;
Durapatite
;
Escherichia coli
;
Humans
;
Hydroxyapatites
;
Male
;
Maxillary Sinus
;
Membranes
;
Osteogenesis
;
Rabbits
;
X-Ray Microtomography
10.The biological effects of fibrin-binding synthetic oligopeptides derived from fibronectin on osteoblast-like cells.
Yun Jeong KIM ; Yoon Jeong PARK ; Yong Moo LEE ; In Chul RHYU ; Young KU
Journal of Periodontal & Implant Science 2012;42(4):113-118
PURPOSE: The aim of this study was to investigate the effects of synthetic fibronectin (FN) fragments, including fibrin binding sites from amino-terminal FN fragments containing type I repeats 1 to 5, on osteoblast-like cell activity. METHODS: Oligopeptides ranging from 9 to 20 amino acids, designated FF1, FF3, and FF5, were synthesized by a solid-phase peptide synthesizing system, and we investigated the effects of these peptides on cell attachment and extent of mineralization using confocal microscopy, 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays, and Alizarin red S staining. RESULTS: FF3 and FF5 peptides increased the number of attached human osteoblastic cells, and FF3 administration led to prominent cell spreading. Mineralization was increased in FF3 and FF5 compared to FF1 and the untreated control. CONCLUSIONS: Taken together, it can be concluded that the fibrin-binding oligopeptides FF3 and FF5 enhanced cell attachment and mineralization on osteoblast-like cells. These results indicate that FF3 and FF5 have the potential to increase osteoblast-like cell activity. Performing an in vivo study may provide further possibilities for surface modification of biomimetic peptides to enhance osteogenesis, thus improving the regeneration of destroyed alveolar bone.
Amino Acids
;
Anthraquinones
;
Binding Sites
;
Biomimetics
;
Fibrin
;
Fibronectins
;
Humans
;
Microscopy, Confocal
;
Oligopeptides
;
Osteoblasts
;
Osteogenesis
;
Peptides
;
Regeneration
;
Tetrazolium Salts
;
Thiazoles