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Periodontal regeneration with nano-hyroxyapatite-coated silk scaffolds in dogs.

Cheryl YANG ; Jung Seok LEE ; Ui Won JUNG ; Young Kwon SEO ; Jung Keug PARK ; Seong Ho CHOI

Journal of Periodontal & Implant Science.2013;43(6):315-322. doi:10.5051/jpis.2013.43.6.315

PURPOSE: In this study, we investigated the effect of silk scaffolds on one-wall periodontal intrabony defects. We conjugated nano-hydroxyapatite (nHA) onto a silk scaffold and then seeded periodontal ligament cells (PDLCs) or dental pulp cells (DPCs) onto the scaffold. METHODS: Five dogs were used in this study. Bilateral 4 mmx2 mm (depthxmesiodistal width), one-wall intrabony periodontal defects were surgically created on the distal side of the mandibular second premolar and the mesial side of the mandibular fourth premolar. In each dog, four of the defects were separately and randomly assigned to the following groups: the PDLC-cultured scaffold transplantation group (PDLC group), the DPC-cultured scaffold transplantation group (DPC group), the normal saline-soaked scaffold transplantation group, and the control group. The animals were euthanized following an 8-week healing interval for clinical, scanning electron microscopy (SEM), and histologic evaluations. RESULTS: There was no sign of inflammation or other clinical signs of postoperative complications. The examination of cell-seeded constructs by SEM provided visual confirmation of the favorable characteristics of nHA-coated silk scaffolds for tissue engineering. The scaffolds exhibited a firm connective porous structure in cross section, and after PDLCs and DPCs were seeded onto the scaffolds and cultured for 3 weeks, the attachment of well-spread cells and the formation of extracellular matrix (ECM) were observed. The histologic analysis revealed that a well-maintained grafted volume was present at all experimental sites for 8 weeks. Small amounts of inflammatory cells were seen within the scaffolds. The PDLC and DPC groups did not have remarkably different histologic appearances. CONCLUSIONS: These observations indicate that nHA-coated silk scaffolds can be considered to be potentially useful biomaterials for periodontal regeneration.
Animals ; Bicuspid ; Biocompatible Materials ; Dental Pulp ; Dogs* ; Extracellular Matrix ; Inflammation ; Microscopy, Electron, Scanning ; Periodontal Ligament ; Postoperative Complications ; Regeneration* ; Silk* ; Tissue Engineering ; Tissue Scaffolds ; Transplants

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Assessment of dentists' subjective satisfaction with a newly developed device for maxillary sinus membrane elevation by the crestal approach.

Young Kyun KIM ; Yong Seok CHO ; Pil Young YUN

Journal of Periodontal & Implant Science.2013;43(6):308-314. doi:10.5051/jpis.2013.43.6.308

PURPOSE: The purposes of this study were to assess the dentists' subjective satisfaction with the crestal approach sinus (CAS) kit, a device for maxillary sinus membrane elevation by the crestal approach using a special drilling system and hydraulic pressure, and to summarize the subjective satisfaction of dental implants placed after a sinus lift procedure with the CAS kit. METHODS: Thirty dental clinicians who had experience with dental implant placement after a sinus lift procedure with the CAS kit from June 2010 to May 2012 were included in this study. The questionnaire for the evaluation of the dentists' subjective satisfaction with the CAS kit was sent to the respondents and returned. The questionnaire was composed of two main parts. The first part was related to the sinus membrane perforation rate. The second part was related to the dentists' subjective satisfaction with the CAS kit. RESULTS: A total of 28 dentists answered the questionnaire. Among 924 implant cases, sinus membrane perforation occurred in 38 cases (4.1%). Among the 28 dentists, 26 dentists (92.9%) were satisfied or very satisfied with the CAS kit. In particular, 24 dentists (85.7%) reported that safety, cutting performance, and user-friendliness of the CAS drill were advantages of the CAS kit. However, 7 dentists (25%) did not routinely use the hydraulic lifter for sinus membrane elevation. CONCLUSIONS: From the survey, it was shown that the respondents were generally satisfied with the CAS kit and that the cutting performance and safety of the drill component were considered strengths of the CAS kit.
Surveys and Questionnaires ; Dental Implants ; Dentists ; Humans ; Maxillary Sinus* ; Membranes* ; Surveys and Questionnaires

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The effect of pretreating resorbable blast media titanium discs with an ultrasonic scaler or toothbrush on the bacterial removal efficiency of brushing.

Minchul KOH ; Jun Beom PARK ; Yun Ji JANG ; Youngkyung KO

Journal of Periodontal & Implant Science.2013;43(6):301-307. doi:10.5051/jpis.2013.43.6.301

PURPOSE: This in vitro study was performed to assess the adherence of Porphyromonas gingivalis to a resorbable blast media (RBM) titanium surface pretreated with an ultrasonic scaler or toothbrush and to evaluate the effects of the treatment of the RBM titanium discs on the bacterial removal efficiency of brushing by crystal violet assay and scanning electron microscopy. METHODS: RBM titanium discs were pretreated with one of several ultrasonic scaler tips or cleaned with a toothbrush. Then the titanium discs were incubated with P. gingivalis and the quantity of adherent bacteria was compared. The disc surfaces incubated with bacteria were brushed with a toothbrush with dentifrice. Bacteria remaining on the disc surfaces were quantified. RESULTS: A change in morphology of the surface of the RBM titanium discs after different treatments was noted. There were no significant differences in the adherence of bacteria on the pretreated discs according to the treatment modality. Pretreatment with various instruments did not produce significant differences in the bacterial removal efficiency of brushing with dentifrice. CONCLUSIONS: Within the limits of this study, various types of mechanical instrumentation were shown to cause mechanical changes on the RBM titanium surface but did not show a significant influence on the adherence of bacteria and removal efficiency of brushing.
Bacteria ; Dental Scaling ; Dentifrices ; Gentian Violet ; Microscopy, Electron, Scanning ; Porphyromonas gingivalis ; Surface Properties ; Titanium* ; Toothbrushing ; Ultrasonics*

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Dissolution behavior and early bone apposition of calcium phosphate-coated machined implants.

Ji Wan HWANG ; Eun Ung LEE ; Jung Seok LEE ; Ui Won JUNG ; In Seop LEE ; Seong Ho CHOI

Journal of Periodontal & Implant Science.2013;43(6):291-300. doi:10.5051/jpis.2013.43.6.291

PURPOSE: Calcium phosphate (CaP)-coated implants promote osseointegration and survival rate. The aim of this study was to (1) analyze the dissolution behavior of the residual CaP particles of removed implants and (2) evaluate bone apposition of CaP-coated machined surface implants at the early healing phase. METHODS: Mandibular premolars were extracted from five dogs. After eight weeks, the implants were placed according to drilling protocols: a nonmobile implant (NI) group and rotational implant (RI) group. For CaP dissolution behavior analysis, 8 implants were removed after 0, 1, 2, and 4 weeks. The surface morphology and deposition of the coatings were observed. For bone apposition analysis, block sections were obtained after 1-, 2-, and 4-week healing periods and the specimens were analyzed. RESULTS: Calcium and phosphorus were detected in the implants that were removed immediately after insertion, and the other implants were composed mainly of titanium. There were no notable differences between the NI and RI groups in terms of the healing process. The bone-to-implant contact and bone density in the RI group showed a remarkable increase after 2 weeks of healing. CONCLUSIONS: It can be speculated that the CaP coating dissolves early in the healing phase and chemically induces early bone formation regardless of the primary stability.
Animals ; Bicuspid ; Bone Density ; Calcium* ; Dental Implantation ; Dogs ; Osseointegration ; Osteogenesis ; Phosphorus ; Survival Rate ; Titanium

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Association of gingival biotype with the results of scaling and root planing.

Yeon Woo SIN ; Hee Yung CHANG ; Woo Hyuk YUN ; Seong Nyum JEONG ; Sung Hee PI ; Hyung Keun YOU

Journal of Periodontal & Implant Science.2013;43(6):283-290. doi:10.5051/jpis.2013.43.6.283

PURPOSE: The concept of gingival biotype has been used as a predictor of periodontal therapy outcomes since the 1980s. In the present study, prospective and controlled experiments were performed to compare periodontal pocket depth (PPD) reduction and gingival shrinkage (GSH) after scaling and root planing (SRP) according to gingival biotype. METHODS: Twenty-five patients diagnosed with chronic periodontitis participated in the present study. The PPD and GSH of the labial side of the maxillary anterior teeth (from the right canine to the left canine) were evaluated at baseline and 3 months after SRP. Changes in the PPD following SRP were classified into 4 groups according to the gingival thickness and initial PPD. Two more groups representing normal gingival crevices were added in evaluation of the GSH. The results were statistically analyzed using the independent t-test. RESULTS: In the end, 16 patients participated in the present study. With regard to PPD reduction, there were no significant differences according to gingival biotype (P>0.05). Likewise, sites with a PPD of over 3 mm failed to show any significant differences in the GSH (P>0.05). However, among the sites with a PPD of under 3 mm, those with the thin gingival biotype showed more GSH (P<0.05). CONCLUSIONS: PPD changes after SRP were not affected by gingival biotype with either shallow or deep periodontal pockets. GSH also showed equal outcomes in all the groups without normal gingival crevices. The results of SRP seem not to differ according to gingival biotype.
Chronic Periodontitis ; Dental Scaling ; Humans ; Periodontal Pocket ; Prospective Studies ; Root Planing* ; Tooth

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Analysis of periodontal attachment loss in relation to root form abnormalities.

Young Mi CHUNG ; Seong Nyum JEONG

Journal of Periodontal & Implant Science.2013;43(6):276-282. doi:10.5051/jpis.2013.43.6.276

PURPOSE: The aim of this study was to explore root shape abnormalities, to investigate the influence of root form abnormalities on periodontal attachment loss, and to gather basic data to assist in the diagnosis and treatment of aggressive periodontitis. METHODS: From January 2010 to June 2012, a survey was conducted of all 3,284 periodontitis patients who visited the Department of Periodontology, Daejeon Dental Hospital, Wonkwang University School of Dentistry. Clinical parameters (probing depth, periodontal attachment loss, missing teeth) were measured and a radiographic examination was performed at the baseline. We classified the root shape abnormality of bicuspids and molars based on Meng classification. RESULTS: The periodontal attachment loss was the highest at the maxillary first molar (6.03 mm). The loss of the second molar was prominent. Type V deformity was shown to be the most common in the second maxillary and mandibular molars (P<0.05). Type V root shape was associated with the highest attachment loss (P=0.01). CONCLUSIONS: Considering the small population and limited design of this study, definitive conclusions cannot be drawn. We suggest larger scale, methodologically more sophisticated studies that include normal controls and chronic periodontitis patients to clarify whether root form abnormalities are a potential risk factor for aggressive periodontitis.
Aggressive Periodontitis ; Bicuspid ; Chronic Periodontitis ; Classification ; Congenital Abnormalities ; Dentistry ; Diagnosis ; Humans ; Methods ; Molar ; Periodontal Attachment Loss* ; Periodontitis ; Risk Factors ; Tooth Loss ; Tooth Root

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Comparative evaluation of NovaMin desensitizer and Gluma desensitizer on dentinal tubule occlusion: a scanning electron microscopic study.

Surabhi JOSHI ; Ashwini SHIVANANJE GOWDA ; Chintan JOSHI

Journal of Periodontal & Implant Science.2013;43(6):269-275. doi:10.5051/jpis.2013.43.6.269

PURPOSE: In this study, the effect of calcium sodium phosphosilicate (NovaMin) desensitizing agent, which is a powder-based system, and hydroxyethyl methacrylate and glutaraldehyde (Gluma desensitizer), which is liquid-based system, on dentinal tubule occlusion was analyzed by scanning electron microscope. The effects of the above two along with one control group were compared to determine the more effective method of sealing the dentinal tubules after initial application. METHODS: Twenty specimens were allocated to each of 3 groups: Control, Gluma desensitizer, and NovaMin. Two additional samples were also prepared and treated with Gluma and NovaMin; these samples were longitudinally fractured. The specimens were prepared from extracted sound human premolars and were stored in 10% formalin at room temperature. The teeth were cleaned of gross debris and then sectioned to provide one to two dentin specimens. The dentin specimens were etched with 6% citric acid for 2 minutes and rinsed in distilled water. Control discs were dried, and the test discs were treated with the desensitizing agents as per the manufacturer's instructions. The discs as well as longitudinal sections were later analyzed under the scanning electron microscope. The proportions of completely occluded, partially occluded, and open tubules within each group were calculated. The ratios of completely and partially occluded tubules to the total tubules for all the groups was determined, and the data was statistically analyzed using nonparametric tests and statistical significance was calculated. RESULTS: NovaMin showed more completely occluded tubules (0.545+/-0.051) while Gluma desensitizer showed more partially occluded tubules (0.532+/-0.075). The differences among all the groups were statistically significant (P< or = 0.05). CONCLUSION: Both materials were effective in occluding dentinal tubules but NovaMin appeared more promising in occluding tubules completely after initial application.
Bicuspid ; Calcium ; Citric Acid ; Dentin Sensitivity ; Dentin* ; Formaldehyde ; Glutaral ; Humans ; Methods ; Microscopy, Electron, Scanning ; Sodium ; Tooth ; Water

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Photobiomodulation and implants: implications for dentistry.

Elieza TANG ; Praveen ARANY

Journal of Periodontal & Implant Science.2013;43(6):262-268. doi:10.5051/jpis.2013.43.6.262

The use of dental implants has become a mainstay of rehabilitative and restorative dentistry. With an impressive clinical success rate, there remain a few minor clinical issues with the use of implants such as peri-implant mucositis and peri-implantitis. The use of laser technology with implants has a fascinating breadth of applications, beginning from their precision manufacturing to clinical uses for surgical site preparation, reducing pain and inflammation, and promoting osseointegration and tissue regeneration. This latter aspect is the focus of this review, which outlines various studies of implants and laser therapy in animal models. The use of low level light therapy or photobiomodulation has demonstrated its efficacy in these studies. Besides more research studies to understand its molecular mechanisms, significant efforts are needed to standardize the clinical dosing and delivery protocols for laser therapy to ensure the maximal efficacy and safety of this potent clinical tool for photobiomodulation.
Dental Implants ; Dentistry* ; Inflammation ; Laser Therapy ; Low-Level Light Therapy ; Models, Animal ; Mucositis ; Osseointegration ; Peri-Implantitis ; Phototherapy ; Regeneration

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Clinical treatment of postoperative infection following sinus augmentation.

Seung Bum HONG ; Jae Suk KIM ; Seung Il SHIN ; Ji Young HAN ; Yeek HERR ; Jong Hyuk CHUNG

Journal of Periodontal & Implant Science.2010;40(3):144-149. doi:10.5051/jpis.2010.40.3.144

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

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I-shaped incisions for papilla reconstruction in second stage implant surgery.

Eun Kwon LEE ; Yeek HERR ; Young Hyuk KWON ; Seung Il SHIN ; Dong Yeol LEE ; Jong Hyuk CHUNG

Journal of Periodontal & Implant Science.2010;40(3):139-143. doi:10.5051/jpis.2010.40.3.139

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

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