PURPOSE: The aim of this report is to investigate the efficacy of anorganic bovine bone xenograft(Bio-Oss(R) ) at maxillary sinus floor augmentation. MATERIALS AND METHODS: Two male patients who missed maxillary posterior teeth were included. They were performed maxillary sinus floor augmentation using anorganic bovine bone xenograft(Bio-Oss(R) ). After 10 or 13 months, the regenerated tissues were harvested using trephine drills with 2 or 4mm diameter and non-decalcified specimens were made. The specimens were examined histologically and histomorphometrically to investigate graft resorption and new bone formation. RESULTS: Newly formed bone was in contact with Bio-Oss(R) particles directly without any gap between the bone and the particles. The proportions of newly formed bone were 23.4~25.3% in patient 1(Pt.1) and 28.8% in patient 2(Pt.2). And the proportions of remained Bio-Oss(R) were 29.7~30.2% in Pt.1 and 29.2% in Pt.2. The fixtures installed at augmented area showed good stability and the augmented bone height was maintained well. CONCLUSION: Anorganic bovine bone xenograft(Bio-Oss(R) ) has high osteoconductivity and helps new bone formation, so that it can be used in maxillary sinus floor augmentation.
Humans ; Male ; Mandrillus ; Maxillary Sinus ; Osteogenesis ; Sinus Floor Augmentation ; Tooth ; Transplants

PURPOSE: Many researches showed loss of alveolar bone in fresh extraction socket and even in case of immediate implant placement. The aim of this study was to evaluate the effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets. MATERIALS AND METHODS: Immediate implants were placed into artificially induced periapical lesion of mandibular premolars after complete debridement using buccal bone defect made by a 6mm trephine bur in 4 mongrel dogs. Before flap repositioning, a non-resorbable barrier membrane was placed on the buccal defect in the experimental group. No membrane was placed in the control group. In 12 weeks after placement, the dogs were sacrificed and undecalcified histologic specimens were prepared. The vertical distance from the smooth-rough surface interface(SRI) to gingiva, 1st bone contact and bone crest were measured in buccal and lingual side. The horizontal thicknesses of gingiva and bone at 0, 1, 2 and 3 mm below SRI were measured. RESULTS: The buccal bone was resorbed more than lingual bone in both groups and there was statistical significance(p<0.05). The distances from SRI to 1st bone contact were 2.45+/-2.35 mm in experimental group and 4.49+/-3.10 mm in control group. In all vertical level, lingual bone was thicker than buccal bone(p<0.05). CONCLUSION: Buccal bone was reduced more than lingual bone in immediate implant placement into periapically infected extraction sockets. Placement of non-resorbable barrier membrane reduced the buccal bone resorption. However there was no statistical significance.
Animals ; Bicuspid ; Bone Resorption ; Debridement ; Dogs ; Gingiva ; Hyoid Bone ; Membranes

BACKGROUND: Repeated dis/re-connection of implant abutment caused bone loss around implant fixtures due to the new formation of biologic width of the mucosal-implant barrier. The aim of this clinical study was to evaluate whether the repeated dis/re-connection of implant abutment cause bone loss clinically and the effect of cleansing methods on a bone loss during the early healing period. METHODS: A total 50 implants were installed in 20 patients and repeated dis/re-connection of abutment was performed at the time of surgery and once per week for 12 weeks. 0.9% normal saline solution as group1 and 0.1% chlorhexidine solution as group 2 was used to clean abutments. All patients had radiographs taken at the placement of implant and 4, 8, and 12 weeks postoperatively. The data for bone loss around implant were analyzed. RESULTS: The marginal bone loss at 12 weeks were 1.28+/-0.51mm, 1.32+/-0.57mm in the mesial and distal sides in group1, 1.94+/-0.75mm, 1.81+/-0.84mm in group 2, respectively. In view of marginal bone loss, there was not a significant statistical difference between groups. CONCLUSIONS: Repeated dis/re-connection of implant abutment may not cause marginal bone loss around implant fixture although limited samples and short-term observation period. In spite of more bone loss in group 2, there was no statistical significant difference between groups. In context of those results, the clinical significance of the repeated dis/re-connection of implant abutment and the cleansing method of abutments is debatable when it comes to marginal bone loss during early healing period.
Alveolar Bone Loss ; Chlorhexidine ; Humans ; Sodium Chloride

BACKGROUND: TiUnite(TM) is a highly crystalline and phosphate enriched titanium oxide surface which has a unique porous surface structure. This improved implant surface enhances bone response and reduces healing period. It also assures early stability of implant. These help to increase the success of implant. The aim o f this s tudy i s to e valuate the survival r ate of TiUnite TM surfaced single implant. MATERIALS AND METHODS: A retrospective analysis of 89 TiUnite(TM) surfaced implants replacing a single tooth was assessed according to their dental record. The age of the patients ranged from 17 to 82 years (mean age: 45.8 +/- 14.6). Data were recorded regarding the survival rate of these implants. RESULTS: Fifty-two implants (57%) were placed in the maxilla, and 37 (43%) in the mandible. Over 75% were placed in the posterior area. Of the placed implants, 67% were the wide type, while 25% were the regular type and only 8% were of the narrow type. The single implants produced an overall clinical survival rate of 96.6% over the observation period (mean 17.9 months). Among 89 implants, only 2 implants were removed and one implant was submerged. CONCLUSION: According to t he se data, TiUnite(TM) surfaced implant in a single tooth restoration showed favorable survival rate although this study was done in a short term period.
Crystallins ; Dental Records ; Humans ; Mandible ; Maxilla ; Retrospective Studies ; Survival Rate* ; Titanium ; Tooth

PURPOSE: The aims of this study were to measure the distance of the intraosseous vascular anastomosis in the anterolateral wall of the maxillary sinus from different reference points, and to correlate the location of the intraosseous vascular anastomosis with the tooth position and the residual bone height of the maxilla. METHODS: Computed tomography (CT) images were taken from 283 patients undergoing dental implants placement in the posterior maxilla. Three horizontal lines were drawn at the ridge crest, maxillary sinus floor, and the position of the anastomosis. A vertical second line at the center of each tooth was drawn perpendicular to the horizontal lines. The distance from the ridge crest to the maxillary sinus floor and the distance from the maxillary sinus floor to the bony canal were measured from the intersections of the horizontal and vertical lines. The residual alveolar bone height was used to categorize three groups: group 1,<4 mm; group 2, between 4 and 8 mm; and group 3, >8 mm. RESULTS: The residual bone height values of different tooth positions were significantly different (P=0.0002). The distance from the maxillary sinus floor to the intraosseous vascular anastomosis was significantly different between groups 1 and 3 (P=0.0039). At the molar sites, a moderate negative correlation was found between the residual bone height and the distance from the maxillary sinus floor to the intraosseous anastomosis. The distances of the alveolar ridge crest and the maxillary sinus from the intraosseous vascular anastomosis were not significantly different between sexes. CONCLUSIONS: Within the limitations of this study, sites with a higher residual bone height in the molar regions were at a relatively high risk of artery damage during window osteotomy preparation; therefore, we recommend taking more precautions when using a lateral approach for sinus elevation.
Alveolar Bone Loss ; Alveolar Process ; Arteries ; Dental Implants ; Humans ; Maxilla ; Maxillary Artery ; Maxillary Sinus ; Molar ; Mouth, Edentulous ; Osteotomy ; Sinus Floor Augmentation ; Tomography, X-Ray Computed ; Tooth*

Chitosan has been known as a wound healing agent. The purpose of this study was to evaluate the biocompatibility and guided bone regenerative effect of chitosan and chitosan-cellulose membranes. The effects of chitosan and chitosan-cellulose membranes on the growth and survival of human periodontal ligament cells were examined by rapid colorimetric MTT(tetrazolium) assay, and the tissue response and resorption pattern were observed by implanting the membranes into the subcutaneous tissue of the back of rats for 6 weeks. To evaluate the guided bone regenerative potential of membranes, the amount of newly formed bone in the rat calvarial defects(8mm in diameter) was measured by histomorphometry and radiomorphometry 1,2 and 4 weeks after implantation of membranes. Chitosan and chitosan-cellulose membranes showed no adverse effect on the growth and survival of human periodontal ligament cells. When membranes were subcutaneously implanted, inflammatory reaction was observed at 1 week and which gradually subsided 2 weeks after implantation. Membranes remained intact throughout the experimental period of 6 weeks. Radiomorphometric analysis of the craniotomy sites revealed that chitosan and chitosan-cellulose membrane implanted sites showed increased radiopacity over control. Statistically significant differences with control were found in chitosan-cellulose membrane implanted group at 2 and 4 weeks, and chitosan membrane implanted group at 4 weeks(P<0.05). Histomorphometric data indicated a pattern of osseous healing similar to radiomorphometric analysis. There was a statistically significant difference between control and chitosan-cellulose membrane implanted group at 4 weeks(P<0.05). These results implicate that chitosan and chitosan-cellulose membrane might be useful for guided bone regeneration.
Humans ; Rats ; Animals

The purposes of this study were to investigate the relationship between cigarette smoking levels and periodontal status. 199 subjects, consisting of male 127 and female 72, classified by smoking levels and duration were selected: Patients who had smoked for more than 20 cigarettes/day were considered heavy smokers, 10 to 19, moderate smokers ; 1- 9, light smokers; 0, non-smoker. And smokers were divided into ones who had smoked for more than 20 years, 10-19 years, less than 10 years and non-smokers. Heavy smokers and moderate smokers showed significantly greater pocket depths, less clinical attachment levels, more molar furcation involvements, greater alveolar bone loss and higher scores of plaque index than light smokers and non-smokers, (p < 0.05). When the duration of smoking was considered as a factor, scores of clinical parameters were worse and alveolar bone loss were significantly greater in long-term smokers, who had smoked for more than 20 years. In conclusion, cigarette smoking is associated with periodontal status.
Alveolar Bone Loss ; Female ; Humans ; Male ; Molar ; Smoke ; Smoking* ; Tobacco Products*

The oral cavity is easily accessible for direct exposure of a malignant disease. 1 percent of the oral malignant tumors are of metastatic origin and approximately 10 percent to 25 percent of the 1 percent fraction originate from the lungs. A case of metastatic lung carcinoma to the gingiva in a 88-year-old male is reported. He complained of pain and swelling between right maxillary 1st premolar and 2nd molar. Although surgical excision of the lesion has been done, the gingival lesion developed as a quickly growing mass and recurred 2 weeks after surgical excision. The gingival mass was histopathologically diagnosed as an undifferentiated carcinoma. Epithelial layer was continuous without ulceration and it seems that the cancer cells are originated from primary tumor. Infiltrated cancer cells were pleomorphic and dyskeratotic. The cells had 2 or more nuclei, not showing squamous or glandular differentiation. Immunohistochemical study revealed the cells originated from the epithelial cells. The prognosis is poor, because prognosis depends on surgical elimination of the primary tumor.
Aged, 80 and over ; Bicuspid ; Carcinoma ; Epithelial Cells ; Gingiva ; Humans ; Lung Neoplasms ; Lung* ; Male ; Molar ; Mouth ; Neoplasm Metastasis ; Periodontium* ; Prognosis ; Ulcer

PURPOSE: The guided bone regeneration (GBR) technique is widely used in periradicular surgery. However, there is still some controversy regarding the effectiveness of GBR in promoting bone healing after periradicular surgery. The purpose of this study was to evaluate the resorbable membrane on the osteointegration of immediate implants in sites with periradicular lesion that had been removed by periradicular surgery. MATERIALS AND METHODS: Six roots of lower second premolars and 15 roots of lower third and fourth premolars of dogs were used as control and experimental teeth, respectively. Periradicular lesions were induced only in the experimental teeth. Twelve weeks later, the control and experimental teeth were extracted and implants were placed immediately. Periradicular lesions were removed with osteotomy, curettage and saline irrigation. Resorbable membranes were used in experimental group 1 but not in experimental group 2. After 12 week of healing period, the implants were clinically not mobile and showed no signs of infection. Data obtained by histomorphometric analysis were analyzed by Kruskal-Wallis test. RESULTS: The control group showed a significantly higher bone to implant contact (BIC) (74.14+/-16.18) than experimental group 1 (40.28+/-15.96) and 2 (48.70+/-17.75)(p<0.05). However, there was no significant difference between experimental group 1 and 2. CONCLUSION: Although BIC in experimental groups were lower than in control group, immediate implant can be successfully placed at extraction socket with periradicular lesion and osseous defect. However, the use of resorbable membrane in bony defect created during periradicular surgery was questioned.
Animals ; Bicuspid ; Bone Regeneration ; Curettage ; Dogs ; Membranes ; Nitrogen Mustard Compounds ; Osteotomy ; Tooth

PURPOSE: The aim of this study was to compare the number of live and dead bacteria attached to, or within, the stratified squamous epithelium lining the tissue side of the gingival sulcus. MATERIALS AND METHODS: A total of 50 patients was examined and classified into healthy or diseased sites according to inflammatory status of the gingival tissue. The surface of stratified squamous epithelium was removed by gentle scraping of the gingival sulcus with curettes. The cells were processed in the laboratory by density-gradient centrifugation to separate the epithelial cells from the loose bacteria and debris. The LIVE/DEAD(R) BacLight(TM) Bacterial Viability Kit was applied and the specimens were observed by an epifluorescent microscope and the number of bacteria was counted. RESULTS: Live and dead bacteria were stained to green and red, irrespectively. Generally, the number of total bacteria in the diseased sites was significantly higher than in the healthy sites. The mean number of detected bacteria in the diseased sites was 58.6+/-36.0 (red bacteria 10.4+/-9.2 / green bacteria 48.2+/-30.5), while it was 1.5+/-1.7 in the healthy sites (red bacteria 0.1+/-0.3 / green bacteria 1.4+/-1.5). The percentage of red bacteria was 17.5+/-11.2% in the diseased sites and 2.0+/-5.8% in the healthy sites. CONCLUSION: The total number of bacteria in the diseased sites was significantly higher than that of the healthy sites. The ratio and the number of red bacteria were also significantly higher in the diseased sites.
Bacteria ; Bacterial Adhesion ; Centrifugation ; Epithelial Cells ; Epithelium ; Humans ; Microbial Viability