PURPOSE: The aim of the study was to evaluate the clinical outcome and complications of tension free vaginal tape (TVT) procedure for the surgical treatment of female stress urinary incontinence. MATERIALS AND METHODS: Between April 1999 and May 2000, 41 women with stress urinary incontinence underwent TVT procedure. Preoperative evaluation included questionnaires study, physical examination, one hour pad test and urodynamic study. Postoperative clinical outcome, patient's satisfaction and complications were checked after 3-months. RESULTS: The mean age of patients was 51.6 years (range 40-76) and mean hospital stay 2.1 days (range 1-10). The mean follow-up period was 9.9 months (range 3-15). Thirty six patients (87.8%) were cured, 2 patients (4.9%) were improved. Two of 3 patients with failed operation who developed postoperative urge incontinence had grade III cystocele. Five bladder perforations and 1 obturator nerve injury occurred. The abdominal leak point pressure (LPP) increased from 50.6cmH20 to 110.8cmH2O, detrusor pressure of maximal flow rate (Pdet.Qmax) increased from 15.8cmH2O to 28.6cmH2O and maximal flow rate (Qmax) decreased from 32.8ml/s to 22.5ml/s after operation. CONCLUSIONS: The TVT procedure is an effective and feasible surgical treatment for female stress urinary incontinence. However, in patients with grade III cystocele, postoperative urge incontinence may develop after the procedure. Since TVT procedure involves securing the mid-urethra, urinary obstruction may also occur, necessitating the need for continued follow-up as well as a careful comparison with other sling procedure.
Cystocele ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Obturator Nerve ; Physical Examination ; Surveys and Questionnaires ; Suburethral Slings* ; Urinary Bladder ; Urinary Incontinence ; Urinary Incontinence, Urge ; Urodynamics

The purpose of present study is to compare the effect of treatment using Guidor(R) as a barrier membrane in conjunction with platelet-derived growth factor and insulin like growth factors on experimental dehiscence defects. Following the resection of premolar crowns, roots were submerged. After 12 weeks of healing period, experimental dehiscence defects of 4mm in height and 4mm in width were surgically created on the mid-facial aspect of the lower premolar roots in each of 4 adult dogs. After root planning and demineralization of the root surface with citric acid, the control groups received 4% methylcellulose gel only, the test group I received 4% methylcellulose gel and were covered by Guidor(R) and the test group II were treated with PDGF and IGF and 4% methylcellulose gel with Guidor(R) coverage. Histological and histomorphometric analysis following 8 weeks of healing revealed the following results. 1. The new bone formation showed no statistically significant difference in all groups with 0.59+/-0.82mm(14.03+/-19.60%) for control, 0.70+/-0.39mm(16.30+/-9.01%) for group I, 0.87+/-0.76mm(18.74+/-16.03%) for group II. 2. The new cementum formation showed no statistically significant difference in all groups with 0.54+/-0.48mm(16.38+/-14.57%) for control, 0.95+/-0.38mm(23.43+/-9.30%) for group I, 1.01+/-0.75mm(22.10+/-16.11%) for gorup II. 3. The root resorption showed statistically significant differences betweenthe control group and all test groups(p<0.05) with 2.11+/-0.53mm(52.93+/-12.32%) for control, 0.63+/-0.27mm(15.32+/-7.05%) for group I, 0.89+/-0.33mm (19.26+/-7.11%) for group II. On the bases of these results, there were no statistically difference between treatment using resorbable membrane and resorbable membrane in conjunction with PDGF and IGF in the dehiscence defects, where it was difficult to maintain space. The use of membrane seemed to be more effective in the inhibition of root resorption.
Adult ; Animals ; Bicuspid ; Citric Acid ; Crowns ; Dental Cementum ; Dogs* ; Humans ; Membranes* ; Methylcellulose ; Osteogenesis ; Platelet-Derived Growth Factor* ; Root Resorption ; Somatomedins*

The present study evaluates the effects of calcium sulfate and DFDB on alveolar bone regeneration and cementum formation and connective tissue adhesion in intrabony angulated 1 wall defects of dogs. Four millimeter-deep angulated one-wall intrabony defects were surgically created in the mesial & distal aspects of premolars and with flap operaion alone(control group), with calcium sulfate(experimental group 1), with composit graft of 50% calcium sulfate and 50% DFDB(experimental group 2), with DFDB alone(experimental group 3). Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of connective tissue adhesion was 1.05+/-0.48mm in the control, 1.30+/-0.67mm in the test group I, 0.97+/-0.22mm in the test group II and 0.93+/-0.15mm in the test group III. There was no statistical significance between control and all experimental groups. 2. Changes in alveolar bone level was 0.97+/-0.27mm in the control group, 1.45+/-0.42mm in the test group I, 2.00+/-0.33mm in the test group II , 1.88+/-0.34mm in the test group III. There was no statistically significant difference between control and experimental group I. There was a statistically significant difference between the control and experimental group II,III.(p<0.05). There was no statistically significant difference between all experimental group. 3. Cementum formation was 1.13+/-0.17mm in the control, 1.78+/-0.31mm in the test group I, 2.17+/-0.38mm in the test group II, 2.15+/-0.47mm in the test group III with statistically significant differences between control group and all experimental group(P<0.05). There was no statistically significant differences between all experimental group. These results suggest that the use of composit graft of 50% calcium sulfate and 50% DFDB and DFDB alone in angulated 1 wall intrabony defects has little effects on connective tissue adhesion, but has significant effects on new bone and new cementum formations.
Animals ; Bicuspid ; Bone Regeneration ; Calcium Sulfate* ; Calcium* ; Connective Tissue ; Dental Cementum ; Dogs* ; Transplants*

Numerous bone graft materials have been used in Periodontics, in an attempt to reach the main goal of periodontal therapy, i.e. the regeneration of periodontal tissue lost due to destructive periodontal diseases. The present study investigates the effect of composite graft of DFDB and Calcium sulfate with and without Calcium sulfate barrier in Periodontal 1-wall intrabony defects in dogs. Following the initiation of general anesthesia by I.V. administration of 40mg/Kg of Pentobabital, second premolar was extracted and full thickness flap elevated. The crown portion of premolars was removed. Exposed root canals were sealed with Caviton and covered completely with flap. After the healing period of 8 weeks, the surgical sites were re-opened and 1-wall intrabony defects were created, and treated with flap operation alone(control group), with composit graft of 80% DFDB and 20% Calcium sulfate(Experimental group 1), with composite graft of DFDB and calcium sulfate with calcium sulfate membrane(Experimental group 2). Healing response was histologically observed after 8 weeks and the results were as follows: 1. New bone formation was 70 % in the control group, 93 % in the Experimental group I, 89 % in the Experimental group II. There was a no differences between Experimental groups. 2. New cementum formation was not significantly different between control and two Experimental groups. 3. The length of connective tissue adhesion was 30 % in the control, 7% in the Experimental group I and 11 % in the Experimental group II. 4. After 8weeks, calcium sulfate was completely resorbed, while DFDB particle remained. These results suggest that the use of composite graft of allogenic DFDB and Calcium sulfate with and without Calcium sulfate barrier in periodontal 1 wall intrabony defects have little effect on connective tissue adhesion, but has beneficial effect on new alveolar bone and new cementum formation, and prevent downgrowth of epithelium and connective tissue effectively.
Anesthesia, General ; Animals ; Bicuspid ; Calcium Sulfate* ; Calcium* ; Connective Tissue ; Crowns ; Dental Cementum ; Dental Pulp Cavity ; Dogs* ; Epithelium ; Osteogenesis ; Periodontal Diseases ; Periodontics ; Regeneration ; Transplants*

The aim of this study was to evaluate the clinical efficacy of mouthrinses prepared by sterilized water-generating device(Purister(R)) on the control of gingivitis and incipient periodontitis when it was used as a adjunctives to the mechanical plaque control. 40 healthy patients with gingivitis or incipient periodontitis were divided into two groups. Patients in the experimental group use mouthrinses prepared by sterilized water-generating device(Purister(R)) after tooth brushing while patients in the control group do only tooth brushing for plaque control. All patients received scaling and tooth brushing instruction. 1 week after scaling was set as baseline. Probing pocket depth, clinical attachment level, and bleeding on probing were scored at baseline, 4 weeks. Gingival index and plaque index were scored at baseline, 2 weeks, and 4 weeks. The results were as follows: 1. In the experimental group, gingival index, plaque index, probing pocket depth, and clinical attachment level showed statistically significant decrease, but in the control group, significant increase(p<0.05). 2. There was no significant difference between the experimental and the control group in bleeding on probing, but significant decrease in the experimental group and significant increase in the control group in a time-dependent manner(p<0.05). From these results, it can be concluded that regular use of mouthrinses prepared by sterilized water-generating device(Purister(R)) as adjunctives of mechanical plaque control, may be effective to prevent and treat gingivitis and incipient periodontitis.
Gingivitis ; Hemorrhage ; Humans ; Periodontal Diseases* ; Periodontal Index ; Periodontitis ; Tooth

The purpose of this study was to evaluate the adjunctive combined effect of demineralized freeze-dried bone allograft(DFDB) in guided bone regeneration on supra-alveolar peri-implant defect. Supra-alveolar perio-implant defects, 3mm in height, each including 4 IMZ titanium plasma-sprayed implants were surgically created in two mongrel dogs. Subsequently, the defects were treated with 1 of the following 3 modalities: Control) no membrane or graft application, Group1) DFDB application, Group2) guided bone regeneration using an expanded polytetrafluoroethylene membrane, Group3) guided bone regeneration using membrane and DFDB. After a healing period of 12-week, the animals were sacrificed, tissue blocks were harvested and prepared for histological analysis. Histologic examination were as follows; 1. New bone formation was minimal in Control and Group 1, but considerable new bone formation was observed in Group 2 and Group 3. 2. There was no osteointegration at the implant-bone interface in the high-polished area of Group2 and Group 3. 3. In fluorescent microscopic examination, remodeling of new bone was most active during week 4 and week 8. There was no significant difference in remodeling rate between group 2 and group 3. 4. DFDB particles were observed, invested in a connective tissue matrix. Osteoblast activity in the area was minimal. The results suggest that guided bone regeneration shows promising results in supra-alveolar peri-implant defects during the 12 week healing period although it has a limited potential in promoting alveolar bone regeneration in the high-polished area. There seems to be no significant adjunctive effect when DFDB is combined with GBR.
Allografts* ; Animals ; Bone Regeneration* ; Connective Tissue ; Dogs* ; Membranes ; Osteoblasts ; Osteogenesis ; Polytetrafluoroethylene ; Titanium ; Transplants

PURPOSE: We evaluated the early outcomes of Gortex patch sling operation in the management of women with intrinsic sphincter deficiency(ISD). MATERIALS AND METHODS: 20 women underwent Gortex patch sling operation to treat genuine stress urinary incontinence and all patients had ISD. Patients were interviewed by telephone for incontinence, self-catheterization, and voiding symptoms at a mean of 16.6 months(range 6-35) after surgery. RESULTS: The mean age of the patients was 54.2 years and mean parity was 2. Mean operation time was 55 minutes(range 45-90) and mean duration of postoperative catheterization was 7.0 days(range 5-12). Success rate(complete dry) was 90% and de novo urge incontinence occurred in 3(15%). CONCLUSIONS: Gortex patch sling operation is a safe, simple and effective procedure for the treatment of stress incontinence due to ISD. However, further follow-up of longterm results is needed.
Catheterization ; Catheters ; Female ; Follow-Up Studies ; Humans ; Parity ; Telephone ; Urinary Incontinence ; Urinary Incontinence, Urge

PURPOSE: Implant survival rates using a bone-added osteotome sinus floor elevation (BAOSFE) procedure with simultaneous placement of a non-submerged sand blasted with large grit and acid etched (SLA) implant are well documented at sites where native bone height is less than 5 mm. This study evaluated the clinical results of non-submerged SLA Straumann implants placed at the time of the BAOSFE procedure at sites where native bone height was less than 4 mm. Changes in graft height after the BAOSFE procedure were also assessed using radiographs for 5 years after the implant procedure. METHODS: The BAOSFE procedure was performed on 4 patients with atrophic posterior maxillas with simultaneous placement of 7 non-submerged SLA implants. At least 7 standardized radiographs were obtained from each patient as follows: before surgery, immediately after implant placement, 6 months after surgery, every year for the next 3 years, and after more than 5 years had passed. Clinical and radiographic examinations were performed at every visit. Radiographic changes in graft height were calculated with respect to the implant's known length and the original sinus height. RESULTS: All implants were stable functionally, as well as clinically and radiographically, during the follow-up. Most of the radiographic reduction in the grafted bone height occurred in the first 2 years; reduction after 2 years was slight. CONCLUSIONS: The simultaneous placement of non-submerged SLA implants using the BAOSFE procedure is a feasible treatment option for patients with severe atrophic posterior maxillas. However, the grafted bone height is reduced during the healing period, and patients must be selected with care.
Dental Implantation ; Floors and Floorcoverings ; Follow-Up Studies ; Humans ; Maxilla ; Maxillary Sinus ; Silicon Dioxide ; Survival Rate ; Transplants

The 16S rRNA analyzing method is a bacterial identification method that is useful in identifying bacteria which is difficult to do by other means. The following 7 types of bacteria which are Treponema, A. actinomycetemcomitans, P. gingivalis, Fusobacterium, B. forsythus, P. intermedia, P. micros were evaluated in order to study their distribution among patients with adult periodontitis. The 16S rRNA analyzing method was used to compare bacterial distribution among 3 groups. Subgingival plaque acquired from the affected sites(pocket depth > or =6mm)of 29 patients with adult periodontitis were grouped as the experimental group while plaque from the non-affected sites(pocket depth< or =3mm)were grouped as control 2 and finally plaque acquired from students with healthy periodontal tissues were grouped as control 1. The results are as follows; 1. The distribution of Treponema was 12.5% for control 1, 21.4% for control 2 and 75.4% for the experimental group. For A. actinomycetemcomitans the distribution was 0.5%, 19.0%, 44.4% in respect to the order of groups mentioned above. P.gingivalis showed 10.5%, 43.1%, 94.0% distribution, Fusobacterium 33.0%, 48.3%, 81.0% distribution, B. forsythus 9.5%, 17.2%, 65.9% distribution, P. intermedia 1.0%, 12.1%, 26.3% distribution and finally P. micros 5.0%, 19.0%, 48.7% respectively. In all 7 types of bacteria, the experimental group showed higher bacterial distribution compared to the other two groups with statistically significant difference. 2. In the case of Treponema, A. actinomycetemcomitans, P. gingivalis,Fusobacterium, B. forsythus, P. intermedia, P. micros showed significant difference between control 1 and 2. These results suggest that the 16S rRNA analyzing method which was applied on Koreans for the first time could be utilized and useful in finding potential pathogens of periodontal disease.
Adult ; Male ; Female ; Humans

The ultimate goal of periodontal disease therapy is to promote the regeneration of lost periodontal tissue, there has been many attempts to develop a method to achieve this goal, but none of them was completely successful. This study was designed to compare the effects of treatment using resorbable barrier membrane(Biomesh?) in combination with autogenous bone graft material with control treated by only modified Widman flap. 22 infrabony defecs from 10 patients with chronic periodontitis were used for this study, 10 sites of them were treated with resorbable barrier membrane and autogenous bone graft material as experimental group and 12 site were treated by only modified Widman flap as control group. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded at 6-8 months later, and the significance of the changes was statistically analyzed. The results are as follows : 1. Probing depth of the two group was reduced with statistically significance(P<0.05), but this changes were not different between the two experiment, control group with statistically significance. 2. Gingival recession showed statistically significant increase in control group(P<0.05), but not in experimental group, and initial values of the two group were in statistically significant difference(P<0.05). 3. Bone probing depth showed statistically significant decrease in experimental group(P<0.05), but not in control group, and this changes were different between the two experiment, control group with statistically significance(P<0.05). 4. Loss of attachment showed statistically significant decrease in experimental group(P<0.05), but not in control group, and this changes were different between the two experiment, control group with statistically significance(P<0.05) On the basis of these results, treatment using resorbable barrier membrane in combination with autogenous bone graft material improve the probing depth, bone probing depth and loss of attachment in infrabony defects.
Chronic Periodontitis ; Gingival Recession ; Humans ; Membranes* ; Periodontal Diseases ; Regeneration ; Transplants*