PURPOSE: The aim of this case report is to present the successful clinical treatment of two cases of postoperative infection following maxillary sinus augmentation. METHODS: In the two cases of postoperative infection, immediate total removal of the grafted material from the sinus was conducted to stop the spread of the infection, after which a high dose of antibiotics was administrated. Re-augmentation procedures were then conducted after the infection subsided. RESULTS: No further complications occurred after sinus re-augmentation. The dental implants placed in the re-augmented sinus were clinically osseointegrated, and the implant-supported restorations in the two cases of postoperative infection have been functioning very well for over 2 years. CONCLUSIONS: In the case of infection of the grafted sinuses, it is necessary to completely remove the graft materials and then administer a high dose of antibiotics to treat the acute infection, after which sinus re-augmentation is suggested.
Anti-Bacterial Agents ; Dental Implants ; Maxillary Sinus ; Surgical Wound Infection ; Transplants

PURPOSE: Pink gingival esthetic especially on the anterior teeth has been an important success criterion in implant-supported restoration. Inter-implant papillae are a critical factor for implant esthetics, and various techniques for inter-implant papilla reconstruction have been introduced. The aim of this study is to suggest and evaluate a surgical technique for reconstructing inter-implant papillae. METHODS: A 28-year-old man had an implant placed on the #13 and #14 area. Four months after implant placement, a second stage surgery was planned for inter-implant papilla reconstruction. At the time of the abutment connection, I-type incisions were performed on the #13i & #14i area followed by full-thickness flap elevation and connection of a healing abutment on underlying fixtures without suture. RESULTS: Two weeks after the second stage implant surgery, soft tissue augmentation between the two implants was achieved. CONCLUSIONS: I-shaped incisions for papilla reconstruction performed during the second stage implant surgery were useful for inter-implant papilla reconstruction and showed a good esthetic result.
Adult ; Dental Implants ; Dental Papilla ; Esthetics ; Esthetics, Dental ; Humans ; Sutures ; Tooth

PURPOSE: The purpose of this study was to compare the bone regeneration effects of cortical, cancellous, and cortico-cancellous human bone substitutes on calvarial defects of rabbits. METHODS: Four 8-mm diameter calvarial defects were created in each of nine New Zealand white rabbits. Freeze-dried cortical bone, freeze-dried cortico-cancellous bone, and demineralized bone matrix with freeze-dried cancellous bone were inserted into the defects, while the non-grafted defect was regarded as the control. After 4, 8, and 12 weeks of healing, the experimental animals were euthanized for specimen preparation. Micro-computed tomography (micro-CT) was performed to calculate the percent bone volume. After histological evaluation, histomorphometric analysis was performed to quantify new bone formation. RESULTS: In micro-CT evaluation, freeze-dried cortico-cancellous human bone showed the highest percent bone volume value among the experimental groups at week 4. At week 8 and week 12, freeze-dried cortical human bone showed the highest percent bone volume value among the experimental groups. In histologic evaluation, at week 4, freeze-dried cortico-cancellous human bone showed more prominent osteoid tissue than any other group. New bone formation was increased in all of the experimental groups at week 8 and 12. Histomorphometric data showed that freeze-dried cortico-cancellous human bone showed a significantly higher new bone formation percentile value than any other experimental group at week 4. At week 8, freeze-dried cortical human bone showed the highest value, of which a significant difference existed between freeze-dried cortical human bone and demineralized bone matrix with freeze-dried cancellous human bone. At week 12, there were no significant differences among the experimental groups. CONCLUSIONS: Freeze-dried cortico-cancellous human bone showed swift new bone formation at the 4-week healing phase, whereas there was less difference in new bone formation among the experimental groups in the following healing phases.
Animals ; Bone Matrix ; Bone Regeneration ; Bone Substitutes ; Humans ; Osteogenesis ; Rabbits ; X-Ray Microtomography

PURPOSE: Among available biomaterials, bioceramics have drawn special interest due to their bioactivity and the possibility of tailoring their composition. The degradation rate and formulation of bioceramics can be altered to mimic the compositions of the mineral phase of bone. The aim of this study was to investigate the bone formation effect of amorphous calcium phosphate glass cement (CPGC) synthesized by a melting and quenching process. METHODS: In five male beagle dogs, 4 x 4 mm 1-wall intrabony defects were created bilaterally at the mesial or distal aspect of the mandibular second and fourth premolars. Each of the four defects was divided according to graft materials: CPGC with collagen membrane (CM), biphasic calcium phosphate (BCP) with CM, CM alone, or a surgical flap operation only. The dogs were sacrificed 8 weeks post-surgery, and block sections of the defects were collected for histologic and histometric analysis. RESULTS: There were significant differences in bone formation and cementum regeneration between the experimental and control groups. In particular, the CPGC and BCP groups showed greater bone formation than the CM and control groups. CONCLUSIONS: In conclusion, CPGC was replaced rapidly with an abundant volume of new bone; CPGC also contributed slightly to regeneration of the periodontal apparatus.
Animals ; Bicuspid ; Biocompatible Materials ; Bone Substitutes ; Calcium ; Calcium Phosphates ; Collagen ; Dental Cementum ; Dogs ; Freezing ; Glass ; Humans ; Hydrazines ; Hydroxyapatites ; Male ; Membranes ; Osteogenesis ; Regeneration ; Surgical Flaps ; Transplants

PURPOSE: In addition to regulating body weight, leptin is also recognized for its role in the regulation of immune function and inflammation. The purpose of this study was to investigate the effect of leptin on Prevotella (P.) intermedia lipopolysaccharide (LPS)-induced tumor necrosis factor (TNF)-alpha production in differentiated THP-1 cells, a human monocytic cell line. METHODS: LPS from P. intermedia ATCC 25611 was prepared by the standard hot phenol-water method. THP-1 cells were incubated in the medium supplemented with phorbol myristate acetate to induce differentiation into macrophage-like cells. The amount of TNF-alpha and interleukin-8 secreted into the culture medium was determined by enzyme-linked immunosorbent assay (ELISA). TNF-alpha and Ob-R mRNA expression levels were determined by semi-quantitative reverse transcription-polymerase chain reaction analysis. RESULTS: Leptin enhanced P. intermedia LPS-induced TNF-alpha production in a dose-dependent manner. Leptin modulated P. intermedia LPS-induced TNF-alpha expression predominantly at the transcriptional level. Effect of leptin on P. intermedia LPS-induced TNF-alpha production was not mediated by the leptin receptor. CONCLUSIONS: The ability of leptin to enhance P. intermedia LPS-induced TNF-alpha production may be important in the establishment of chronic lesion accompanied by osseous tissue destruction observed in inflammatory periodontal disease.
Body Weight ; Cell Line ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Interleukin-8 ; Leptin ; Macrophages ; Periodontal Diseases ; Phorbols ; Prevotella ; Prevotella intermedia ; Receptors, Leptin ; RNA, Messenger ; Tetradecanoylphorbol Acetate ; Tumor Necrosis Factor-alpha

PURPOSE: The aim of this study was to investigate whether vitrification in the cryopreservation of periodontal ligament (PDL) cells could be useful for tooth banking. METHODS: In step 1, primary cultured human PDL cells were cryopreserved in 100% conventional cryopreservation media and 100% vitrification media (ESF40 media) in different temperatures for 2 weeks. In step 2, a series of modified vitrification formulae named T1 (75% vitrification media + 25% F media), T2 (50% vitrification media + 50% F media) and T3 (25% vitrification media + 75% F media) were used to store PDL cells for 2 weeks and 4 weeks in liquid nitrogen. MTT assay was performed to examine the viability of PDL cells. RESULTS: Maximum cell viability was achieved in cells stored in 100% conventional cryopreservation media at -196degrees C (positive control group) in step 1. Compared to the positive control group, viability of the cells stored in 100% vitrification media was very low as 10% in all test conditions. In step 2, as the percentage of vitrification media decreased, the cell viability increased in cells stored for 2 weeks. In 4-week storage of cells in step 2, higher cell viability was observed in the T2 group than the other vitrification formulae while the positive control group had the highest viability. There was no statistically significant difference in the cell viability of 2-week and 4-week stored cells in the T2 group. CONCLUSIONS: These observations indicate 100% vitrification media is not successful in PDL cell cryopreservation. Conventional cryopreservation media is currently the most appropriate media type for this purpose while T2 media would be interesting to test for long-term storage of PDL cells.
Cell Survival ; Cryopreservation ; Humans ; Nitrogen ; Periodontal Ligament ; Tissue Banks ; Tooth ; Vitrification

PURPOSE: It has been reported that low-level semiconductor diode lasers could enhance the wound healing process. The periodontal ligament is crucial for maintaining the tooth and surrounding tissues in periodontal wound healing. While low-level semiconductor diode lasers have been used in low-level laser therapy, there have been few reports on their effects on periodontal ligament fibroblasts (PDLFs). We performed this study to investigate the biological effects of semiconductor diode lasers on human PDLFs. METHODS: Human PDLFs were cultured and irradiated with a gallium-aluminum-arsenate (GaAlAs) semiconductor diode laser of which the wavelength was 810 nm. The power output was fixed at 500 mW in the continuous wave mode with various energy fluencies, which were 1.97, 3.94, and 5.91 J/cm2. A culture of PDLFs without laser irradiation was regarded as a control. Then, cells were additionally incubated in 72 hours for MTS assay and an alkaline phosphatase (ALPase) activity test. At 48 hours post-laser irradiation, western blot analysis was performed to determine extracellular signal-regulated kinase (ERK) activity. ANOVA was used to assess the significance level of the differences among groups (P<0.05). RESULTS: At all energy fluencies of laser irradiation, PDLFs proliferation gradually increased for 72 hours without any significant differences compared with the control over the entire period taken together. However, an increment of cell proliferation significantly greater than in the control occurred between 24 and 48 hours at laser irradiation settings of 1.97 and 3.94 J/cm2 (P<0.05). The highest ALPase activity was found at 48 and 72 hours post-laser irradiation with 3.94 J/cm2 energy fluency (P<0.05). The phosphorylated ERK level was more prominent at 3.94 J/cm2 energy fluency than in the control. CONCLUSIONS: The present study demonstrated that the GaAlAs semiconductor diode laser promoted proliferation and differentiation of human PDLFs.
Alkaline Phosphatase ; Blotting, Western ; Cell Proliferation ; Extracellular Signal-Regulated MAP Kinases ; Fibroblasts ; Humans ; Low-Level Light Therapy ; Lasers, Semiconductor ; Periodontal Ligament ; Phosphotransferases ; Semiconductors ; Tooth ; Wound Healing

No abstract available.

PURPOSE: The purpose of this study was to evaluate the improvement of periodontal health of generalized aggressive periodontitis (GAgP) diagnosed patients treated with non-surgical periodontal therapy accompanying systemic antibiotics administration. METHODS: Two patients with GAgP were chosen for this study. Clinical indices were taken and a radiographic examination was performed at the baseline of the study and they were treated by periodontal therapy accompanying systemic antibiotics administration. Post-surgical visits were scheduled at regular intervals to check clinical and radiographic changes. RESULTS: Through non-surgical periodontal therapy accompanying systemic antibiotics administration, GAgP patients showed decreased probing pocket depth, sulcus bleeding index, and increased attachment level and clinical index when comparing the initial and six month follow up data. In the six month follow-up radiographic examination after non-surgical periodontal therapy, resolution of the bony defect was observed. CONCLUSIONS: Non-surgical therapy combined with systemic antibiotics administration in GAgP patients is suggested to be an effective approach to enhance the periodontal health.
Aggressive Periodontitis ; Anti-Bacterial Agents ; Follow-Up Studies ; Hemorrhage ; Humans ; Periodontitis

PURPOSE: The purpose of this study was to radiographically evaluate marginal bony changes in relation to different vertical positions of dental implants. METHODS: Two hundred implants placed in 107 patients were examined. The implants were classified by the vertical positions of the fixture-abutment connection (microgap): 'bone level,' 'above bone level,' or 'below bone level.' Marginal bone levels were examined in the radiographs taken immediately after fixture insertion, immediately after second-stage surgery, 6 months after prosthesis insertion, and 1 year after prosthesis insertion. Radiographic evaluation was carried out by measuring the distance between the microgap and the most coronal bone-to-implant contact (BIC). RESULTS: Immediately after fixture insertion, the distance between the microgap and most coronal BIC was 0.06 +/- 0.68 mm; at second surgery, 0.43 +/- 0.83 mm; 6 months after loading, 1.36 +/- 0.56 mm; and 1 year after loading, 1.53 +/- 0.51 mm (mean +/- SD). All bony changes were statistically significant but the difference between the second surgery and the 6-month loading was greater than between other periods. In the 'below bone level' group, the marginal bony change between fixture insertion and 1 year after loading was about 2.25 mm, and in the 'bone level' group, 1.47 mm, and in 'above bone level' group, 0.89 mm. Therefore, the marginal bony change was smaller than other groups in the 'above bone level' group and larger than other groups in the 'below bone level' group. CONCLUSIONS: Our results demonstrated that marginal bony changes occur during the early phase of healing after implant placement. These changes are dependent on the vertical positions of implants.
Alveolar Bone Loss ; Dental Implants ; Humans ; Nitrogen Mustard Compounds ; Prostheses and Implants