Peri-implantitis could be the result of biomechanical and occlusal overload as well as microbiologic invasion. The dental implant may be more susceptible to dental plaque than the natural tooth, as the predictability of a stable soft tissue attachment complex has not yet been confirmed. With the development of peri-implantitis, the implant surface would be exposed to the oral environment and becomes coated with bacteria. The objective of therapy for this condition is to regain integration of the implant with bone. Since fibroblast adherence to surfaces is impeded by endotoxin, it would seem that decontamination would be desirable to obtain maximum osseointegration. The purpose of this study was to determine whether various chemotherapeutic and mechanical treatments(distilled water, air-powder abrasive, hypersaturated citric acid, tetracycline) can detoxify contaminated titanium implant surface by means of kinetic LAL test. Experimental rough surface titanium disks were fabricated. All of them were divided into two groups(A.a group and P.g group) and each contaminated by A. actinomycetemcomitans and P. gingivalis suspension. Contaminated disks were treated with distilled water, air-powder abrasive, citric acid and tetracycline, and then all disks were placed into LPS-free water for elution. The results were as follows : 1. In A.a group, LPS elute level of all test groups were significantly lower than control group(p<0.05). 2. In A.a group, LPS elute level of test 2, test 3 and test4 groups were significantly lower than that of control group(p<0.05). But, among the test 2, test 3, test4 groups, the significant differences were not detected. 3. In P.g group, LPS elute level of test 2, test 3 and test 4 groups were lower than that of control group(p<0.05). But, among the test groups, the significant differences were not detected. From the result of this study, it would be concluded that air-powder abrasive, hypersaturated citric acid and tetracycline treatments may be effective at reducing endotoxin level on rough titanium implant surfaces, and can be clinically used. But the treatments in peri-implantitis differentially impact osseointegration making one method clinically superior. To gain this knowledges, further molecular biologic and histopathologic studies should be developed.
Bacteria ; Citric Acid ; Decontamination ; Dental Implants ; Dental Plaque ; Fibroblasts ; Osseointegration ; Peri-Implantitis ; Tetracycline ; Titanium* ; Tooth ; Water

A mucogingival grafting procedure has been developed to cover denuded root surface. The subepithelial connective tissue graft technique is very predictable and allows for a good esthetic results and minimum patient discomfort on the palate. However, in areas where there is a lack of vestibular depth and keratinized attached tissue, the presence of frena or heavy muscle attachment, covering the connective tissue graft with a mucosal flap is very difficult. The purpose of this study is to evaluate an alternative technique of root coverage using the free connective tissue graft. The results were as follows: 1. Probing depths didn't seem to vary significantly from the preoperative to postoperative period. 2. The amount of keratinized tissue showed an increase of 5.9+/-0.97mm from the preoperative level. 3. Total clinical exposed root coverage increase 72.2% compare with preoperative level. 4. The shrinkage from gingival margin is 4.2+/-1.15mm and the mean shrinkage rate is 40.1%. 5. The depth of the vestibule increased with the average distance from cementoenamel junction to mucogingival junction being 7.4+/-1.65mm.
Connective Tissue* ; Humans ; Palate ; Postoperative Period ; Tooth Cervix ; Transplants*

The purpose of this study was to evaluate clinical changes in graft size after treatment with connective tissue autograft in human. 40 premolar teeth in 23 patients having the following mucogingival problemswere selected. The width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth were measured at the initial examination, 2, 12 and 24 weeks following the connective tissue autograft and free gingival autograft. The change of width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth according to healing process in both graft procedures was statistically analyzed by ANOVA test and independent t-test using SPSS program. The results were as follows: 1. The change of keratinized gingiva in both grafting procedures was increased significantly at 24 weeks post-op. 2. The clinical sulcus depth exhibited no marked changes throughoutthe entire investigation in both grafting procedures. 3. After 12 weeks, no dimensional variation was seen in graft size in both grafting procedures. 4. Shrinkage differs significantly in both grafting procedures. From the day of graft to 24 weeks after surgery the percentages of shrinkage were connective tissue autograft 55% and free gingival autograft 29%.
Autografts* ; Bicuspid ; Connective Tissue* ; Gingiva ; Humans ; Tooth ; Transplants*

In periodontal regeneration treatment, access to the frucation area is very difficult. Thus complete removal of plaque, calculus and endotoxin is somewhat impossible. In this study, teeth that were extracted due to periodontal disease were used. The furcation area was treated with periodontal curette, ultrasonic scaler, roto bur and they observed using SEM. The result was follows 1. The group treatment with curette showed remaining plaque, the cementum existed in most of the surface and partial dentinal tubule orifice could be seen. 2. The group treatment with ultrasonic scaler showed less removalof plaque compared to curette and irregular surface could be seen. 3. The group treatment with roto bur showed cleaner surface and many dentinal tubule orifice could be seen compared to the curette and ultrasonic scaler groups. Thus when suing treatments such as bone grafting or guided tissue regeneration, it is considered that the furcation area should be treatment with Roto bur.
Bone Transplantation ; Calculi ; Dental Cementum ; Dentin ; Guided Tissue Regeneration ; Periodontal Diseases ; Regeneration ; Tooth ; Ultrasonics

Recently, alteration on chemical treatment on the root and removal of pathologic bacteria, which is the main reason for periodontal disease, by complete removal of infected cementum layer was been emphasied In this study, teeth extracted due to periodontal disease were root planed using periodontal curette and roto bur. Then they were treated with different concentration of Tetracycline HCl at different time. The state of root surface and change in the pre and post treatment was observed. The results were as follows. 1. The group treatment with periodontal curette and saline showed remaining plaque, debris and irregular surface and no dentianl tubule orifice could be seen. 2. The group treatment with periodontal curette and tetracycline HCl showed process compoed with decacified material and there was concanity seemed to be a lacunae of cementocyte. 3. The group treatment with roto bur and saline, there was no remaning plaque and partial dentinal tubule orifice could be seen but smear layer covering them. 4. The group treatment with roto bur and tetracycline HCl showed various shape and size dentinal tubule orifice could be seen. From the results, roto bur showed cleaner surfaces than treatment with periodontal curette. But still smear layer existed. Thus for regeneration of periodontal tissue, chemical treatment using tetracycline HCl should follow roto bur treatment. And it is considered that the treatment time is more important than the concentration of tetracycline HCl.
Bacteria ; Dental Cementum ; Dentin ; Periodontal Diseases ; Regeneration ; Root Planing* ; Smear Layer ; Tetracycline* ; Tooth

Teeth mobility is an important part of a periodontal examination, because it represents a function of the persisting height of the alveolar bone and the width of the periodontal ligament. The purpose of this study was to evaluate clinical difference in teeth mobility after treatment with the modified Widman flap and the undisplaced flap in humans. Twenty males with moderate periodontal disease were selected. The severity of periodontal disease was evaluated with sulcular bleeding index, pocket depth and attachment level and tooth mobility was measured with Periotest(Siemens Co., Germany) at the initial examination, 1, 2, 4, 6, 8 and 12 weeks following the modified Widman flap and the undisplaced flap operation using the split-mouth technique. The relation of mobility to clinical parameters was statistically analyzed by multiple regression and the change of teeth mobility according to healing process by independent t-test using SPSS program. The results were as follows: 1. There was a strong relationship between the Periotest value(PTV) and attachment level. 2. The change of teeth mobility in both flap procedures was increased significantly at 1 week post-op. and was decreased to preoperative level at 4 weeks post-op. in modified Widman flap and at 6 weeks post-op. in undisplaced flap. 3. The change of teeth mobility in premolar teeth group in undisplaced flap compared to modified Widman flap was generally increased but these changes were not statistically significant. The changes of teeth mobility in molar teeth group in undisplaced flap was increased significantly at 2 weeks post-op.. 4. The change of teeth mobility following undisplaced flap was increased significantly compared to that of modified Widman flap at 2 weeks post-op.
Bicuspid ; Hemorrhage ; Humans ; Male ; Molar ; Periodontal Diseases ; Periodontal Ligament ; Tooth Mobility ; Tooth*

No abstract available.
Cell Line* ; Humans*

PURPOSE: This study examined whether the immediate conversion of the prehospital supraglottic airway (SGA) to endotracheal intubation (ETI) is associated with the return of spontaneous circulation (ROSC) and survival to discharge among out-of-hospital cardiac arrest (OHCA) victims. METHODS: This retrospective observational study included OHCA victims aged ≥18 years who were treated from 2014 to 2016. The patient-, prehospital arrest-, and emergency department (ED)-related variables were collected based on the Utstein template. The immediate conversion of SGA to ETI was defined when it had been initiated within ≤2 minutes after arrival at the ED. To investigate the factors related to ROSC and survival to discharge, multiple logistic regression analysis of the immediate conversion of SGA to ETI and variables showing a difference (p < 0.15) on the Mann-Whitney U and chi-square test was performed. RESULTS: A total of 129 patients were enrolled, with a median age of 59 years (interquartile range, 51 to 72 years). Of these, 30 (23.3%) were female, 41 (31.8%) achieved ROSC, and 7 (5.4%) survived to discharge. Sixty-nine (53.5%) received immediate conversion showing no differences in the demographic and clinical characteristics compared to the delayed conversion group. Multiple logistic regression analysis showed that ROSC was related to the existence of lung disease, presence of witnesses, and a cardiopulmonary resuscitation duration ≤15 minutes at the ED, whereas the survival to discharge was associated with the prehospital shockable initial rhythm. Neither ROSC nor survival to discharge were related to the immediate conversion of SGA to ETI. CONCLUSION: The immediate conversion of prehospital SGA to ETI at ED in an OHCA victim might be unrelated to ROSC and survival to discharge.
Airway Management ; Cardiopulmonary Resuscitation ; Emergency Service, Hospital ; Female ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngeal Masks ; Logistic Models ; Lung Diseases ; Observational Study* ; Out-of-Hospital Cardiac Arrest* ; Retrospective Studies*

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polylactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.
Humans

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polylactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.
Humans