PURPOSE: Chitosan & chitosan derivative(eg. membrane) have been studied in periodontal regeneration, and recently many studies of chitosan have reported good results. If chitosan's effects on periodontal regeneration are enhanced, we can use chitosan in many clinical and experimental fields. For this purpose, this study reviewed available literatures, evaluated comparable experimental models. MATERIALS AND METHODS: Ten in vivo studies reporting chitosan's effects on periodontal tissue regeneration have been selected by use of the 'Pubmed' and hand searching. RESULTS: 1. In Sprague Dawley rat calvarial defect models, amount of newly formed bone in defects showed significant differences between chitosan/chitosan-carrier/chitosan-membrane groups and control groups. 2. In beagle canine 1-wall intrabony defect models, amount of new cementum and new bone showed significant differences between chitosan/chitosan-membrane groups and control groups. The mean values of the above experimental groups were greater than the control groups. CONCLUSION: The results of this study have demonstrated that periodontal regeneration procedure using chitosan have beneficial effects, which will be substitute for various periodontal regenerative treatment area. One step forward in manufacturing process of chitosan membrane and in use in combination with other effective materials(eg. bone graft material or carrier) may bring us many chances of common use of chitosan in various periodontal area.
Animals ; Chitosan ; Dental Cementum ; Hand ; Membranes ; Rats ; Regeneration ; Transplants

PURPOSE: The purpose of this study was to evaluate the effects of hydroxyapatite containing toothpaste for patients who received periodontal therapy and felt hypersensiptivity. MATERIAL AND METHODS: After application of toothpaste, patients were evaluated for VAS(Visual Analog scale) scores to a cold stimulate on baseline, 1 week, and 4 weeks. VAS scores were analyzed by statistical methods. RESULTS: The results of this study were as follows. 1. VAS scores in control group on baseline, 1 week, 4 weeks were 5.39+/-2.05, 4.75+/-2.00, 4.21+/-1.75. 2. VAS scores in experimental group on baseline, 1 week, 4 weeks were 5.61+/-2.37, 4.81+/-2.46, 4.08+/-2.54. 3. Decrease of VAS scores on hypersensitivity after 1week was 0.64+/-0.49(p<.0001) in control group, 0.80+/-1.65 (p<.0001) in experimental group. 4. Decrease of VAS scores on hypersensitivity after 4weeks was 1.18+/-1.60(p<.0001) in control group, 1.53+/-1.88 (p<.0001) in experimental group. 5. When compared, decrease of VAS scores after 1 week between 2 groups were not statistically different(p=0.2622). 6. When compared, decrease of VAS scores after 4 weeks between 2 groups were not statistically different(p=0.1219). CONCLUSION: It was confirmed that hydroxyapatite containing toothpaste have the similar effect with pre-existing proven dentifrice for relieving teeth hypersensitivity.
Cold Temperature ; Dentifrices ; Durapatite ; Humans ; Hypersensitivity ; Tooth ; Toothpastes

CADIA(Computer-assisted densitometric image analysis) method is used to analyze bone density changes around the implants. The usefullness and reproducibility of the method was assessed. We tried to find out if there is any possibility to quantitiate and qualitify peri-implant bone density change as time passes. And we concluded that this newly developed linear analysis is efficient for analyzing peri-implant bone density change non-invasively. In this study, 2152 machined Branemark fixtures installed from 1994 to 2002 in the department of Periodontics, Dental hospital of College of Dentistry, Yonsei University were included. Of these fixtures 22 radiographically analyzable failed fixtures were used as experimental group, and 22 successful implants placed in the same patient were used as control group. 1. 57 out of 1635 machined Branemark standard and Mk II implants system failed, the survival rate was 96.5%. And 11 out of 517 machined Branemark Mk III and Mk IV implants system failed, the survival rate was 97.9%. Total survival rate was 96.8%. 2. 22 failed implants were used for the analysis, 10 of which failed before prosthetic treatment due to infection and overheating. 12 failed due to overload after prosthetic treatment, 63.6% of which failed during the early phase of functional loading, i.e. before 1 year of loading. 3. Bone density change values around coronal region of the failed implants were -6.54 +/- 6.35, middle region were -3.53 +/- 5.78, apical region were -0.75 +/- 10.33, resulting in average of -3.71 +/- 8.03. 4. Bone density change values around coronal region of the successful implants were 4.25 +/- 4.66, middle region were 6.33 +/- 5.02, apical region were 9.89 +/-4.67, resulting in average of 6.27 +/- 5.29. 5. There was a statistically significant difference between two groups (p<0.01). In conclusion, the linear analysis method using computer-assisted densitometric image analysis could be a useful method for the analysis of implants, and could be used for future implant researchs.
Bone Density* ; Dentistry ; Humans ; Periodontics ; Survival Rate

Periodontal regenerative therapy and tissue engineering on defects destructed by severe periodontitis need maintaining of space, which provides the environment for cell migration, proliferation and differentiation. Application of bone grafts may offer this environment in periodontal defects. This study evaluated bone graft materials, MBCP(R) and Algipore(R), in surgically created 1-wall periodontal intrabony defects of minipigs by histological analysis. Critical sized(4mmX4mm), one wall periodontal intrabony defects were surgically produced at the proximal aspect of mandibular premolars in either right and left jaw quadrants in four minipigs. The control group was treated with debridement alone, and experimental group was treated with debridement and MBCP(R) and Algipore(R) application. The healing processes were histologically observed after 8 weeks and the results were as follows. 1. In the control group, limited new bone formation was observed. 2. In MBCP group, more new bone formation was observed compared to other groups. 3. Histologically, dispersed mixture of new bone, biomaterial particles and connective tissue were shown and osteoblasts, osteoclasts and new vessels were present in this area. 4. Defects with Algipore showed limited new bone formation and biomaterial particles capsulated by connective tissue. 5. Histologically, lots of osteoclasts were observed around the biomaterial but relatively small numbers of osteblasts were shown. Within the limitation to this study protocol, MBCP(R) application in 1-wall intrabony defect enhanced new bone formation rather than Algipore(R) application.
Bicuspid ; Calcium* ; Cell Movement ; Connective Tissue ; Debridement ; Jaw ; Osteoblasts ; Osteoclasts ; Osteogenesis ; Periodontitis ; Swine, Miniature* ; Tissue Engineering ; Transplants

The purpose of this study was to measure the thickness of masticatory mucosa in the hard palate as a donor site for mucogingival surgery by using computerized tomography(CT). Thickness measurements were performed in 84 adult patients who took CT on maxilla for implant surgery and 24 standard measurement points were defined in the hard palate according to the gingival margin and mid palatal suture. Radiographic measurements were utilized after calibration for standardization. Data were analyzed to determine the differences in mucosal thickness by gender, age, tooth positions and depth of palatal vault. The results of this study were as follows: 1. Mean thickness of palatal masticatory mucosa was 3.93+/-0.6mm and females had significantly thinner mean masticatory mucosa(3.76+/-0.56mm) than males(4.04+/-0.6mm)(p<0.05). 2. The thickness of palatal masticatory mucosa increased by aging. 3. Depending on position, masticatory mucosa thickness increased from canine to premeolar, but decreased at the first molar, and increased again in the second molar region(p<0.0001). 4. No significant difference in mean thickness of palatal masticatory mucosa were indentified between low palatal vault group and high palatal vault group(p>0.05). The results suggest that canine and premolar area appears to be the most appropriate donor site for soft tissue grafting procedure. The measurement of the thickness of palatal masticatory mucosa by using computerized tomography can offer useful information clinically but further studies in assessing the validity and reliability of the method using computerized tomography is needed.
Adult ; Aging ; Bicuspid ; Calibration ; Female ; Humans ; Maxilla ; Molar ; Mucous Membrane ; Palate, Hard ; Reproducibility of Results ; Sutures ; Tissue Donors ; Tissue Transplantation ; Tooth ; Transplants

This study is an analysis of types of patients and distribution of implant site and survival rate of Xive(R) implant. The following results on patient type, implant distribution and survival rate were compiled from 324 implant cases of 140 patients treated at the periodontal dept. of Yonsei University Hospital and G dental clinic between February 2003 and April 2006. 1. There are no dissimilarities between men and women, with patients in their 30, 40, 50s accounting for 80% of patients and accounted for 82% of implant treatments; the largest share of patients and implant treatments. 2. Mn. posterior area accounted for 57% of implant treatments followed by Mx. posterior area(29%), Mx. anterior area(8%) and Mn. anterior area(6%). 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 96% and fully edentulous patient accounted for the remaining 4%. 4. The major cause of tooth loss is periodontal disease, followed by dental caries, trauma and congenital missing. 5. The distribution of bone quality for maxillae was 54.2% for typeIII, followed by 30.8% for type II, 15% for typeIV and 0% for typeI. As for mandible, the distribution was 63% for typeII, followed by 34% for typeIII, 2.5% for typeI and 0.5% for typeIV. 6. The distribution of bone quantity for maxillae was 55% for type C, followed by 35% for type B, 8% for type D and 2% for type A. As for mandible, the distribution was 60% for type B, followed by 32% for type C, 7% for type A and 0% for type D. 7. The majority of implants were those of 9.5-13 mm in length(95%) and regular diameter in width(82%). 8. The total survival rate was 98%. The survival rate was 97% in the maxillae region and 99% in the mandible region. 9. The survival rate in typeI was 83%, in typeII was 99%, in typeIII was 97% and in typeIV was 100%. As for the bone quantity, the survival rate in type A and D(100%) was most, followed by type B(99%) and type C(96%). The results showed that Xive(R) implant could be used satisfactorily compare for the other implant system. But we most to approach carefully in certain extreme condition especially with poor bone quality and quantity.
Crowns ; Dental Caries ; Dental Clinics ; Female ; Humans ; Male ; Mandible ; Maxilla ; Periodontal Diseases ; Prostheses and Implants ; Retrospective Studies* ; Survival Rate* ; Tooth Loss

The ultimate goal of periodontal treatment is to regenerate the lost periodontal apparatus. Many studies were performed in developing an ideal bone substitute. Anorganic bovine-derived xenograft is one of the bone substitues, which were studied and have been shown successful for decades. The aim of this study is to evaluate the effect anorganic bovine-derived xenograft. Total of 20 patients, with 10 patients receiving only modified widman flap, and the other 10 receiving anorganic bovine-derived xenograft and flap surgery, were included in the study. Clinical parameters were recorded before surgery and after 6 months. The results are as follows: 1. The test group treated with anorganic bovine-derived xenograft showed reduction in periodontal pocket depth and clinical attachment level with statistically significance(p<0.001) after 6 months. The control group treated with only modified Widman flap showed reduction only in periodontal pocket depth with statistically significance(p<0.001) after 6 months. 2. Although periodontal probing depth change during 6 months did not show any significant differences between the test group and the control group, clinical attachment level gain and recession change showed significant differences between the two groups(p<0.05). On the basis of these results, anorganic bovine-derived xenograft improves probing depth and clinical attachment level in periodontal intrabony defects. Anorganic bovine-derived xenograft could be a predictable bone substitute in clinical use.
Bone Substitutes ; Heterografts ; Humans ; Periodontal Pocket

PURPOSE: Developments in micro/macrostructures of implants and surgical techniques brought out stable outcomes of implant dentistry. The aim of this study was to evaluate the distributions of implant patients, the types of implanted sites, and the success or survival rates of various implant systems and to analyze the implant placement done at each specificintraoral site and situation. MATERIALS AND METHODS: The data of dental implantations collected between 1992 and 2006 at the Department of Periodontology in 00000 University Hospital were analyzed. RESULTS: 1. Largest part of the patients were at the age of 40s and 50s in bothgender who lost their teeth mostly by periodontaldiseases and caries at the posterior intraoral sites as major ones. Bone densities of type II(mandible) and III(maxilla) were likely to be seen with quantity of type B. Lengths of the implants between 10 and 15 mm and wide platform took the largest part. 2. Survival rates of Implantium(R)(98.8%), Xive(R)(100%) and ITI TE(R)(100%) were high when Frialit-2(R) showed 82%(poor bone density area) or 87.2%(combined with additional therapy). IMZ(R) had lowest cumulative survival(67.5%) and success rate(49.4%) amongst all. 3. Replacement with 2 wide or 3 regular platforms showed no significant differences in survival rate and marginal bone loss atmandibular posterior area. In single restoration of mandibular second molar, 5-year success rate of machined surface Branemark(R)(70.37%) was lower than that of rough surface ITI(R) SLA(100%). 4. Replacement of single tooth in anterior area showed high survival rate of 94.5%. 5. The success rates of Branemark Ti-Unite and ITI SLA at posterior maxilla with poor bone density both showed stable outcomes. 6. 10-year cumulative survival rate of implants with maxillary sinus augmentation by lateral window approach appeared to be 96.60%. Low survival rate(75%) was shown when there were more than two complications combined. Height of grafted bone remained stable above the implant apex. CONCLUSIONS : Rough surfaced implants showed stable outcomes in most of the situation including poor bone density and additional therapy combined.
Bone Density ; Dental Implants* ; Dentistry ; Humans ; Maxilla ; Maxillary Sinus ; Molar ; Retrospective Studies* ; Survival Rate ; Tooth ; Transplants

Bone morphogenetic proteins have been shown to possess significant osteoinSductive potential, but in order to take advantage of this effect for tissue engineering, carrier systems are essential. Successful carrier systems must enable vascular and cellular invasion, allowing BMP to act as a differentiation factor. The carrier should be reproducible, non-immunogenic, moldable, and space-providing, to define the contours of the resulting bone. The purpose of this study was to review available literature, in comparing various carriers of BMP on rat calvarial defect model. The following conclusions were deduced. 1. Bone regeneration of ACS/BMP, beta-TCP/BMP, FFSS/BMP, FFSS/beta-TCP/BMP, MBCP/BMP group were significantly greater than the control groups. 2. Bone density in the ACS/BMP group was greater than that in beta-TCP, FFSS, FFSS/beta-TCP carrier group. 3. Bone regeneration in FFSS/BMP group was less than in ACS/BMP, beta-TCP/BMP, MBCP/BMP group. However, New bone area of FFSS/beta-TCP/BMP carrier group were more greater than that of FFSS/BMP group. ACS, beta-TCP, FFSS, FFSS/beta-TCP, MBCP were used for carrier of BMP. However, an ideal carrier which was reproducible, non-immunogenic, moldable, and space-providing did not exist. Therefore, further investigation are required in developing a new carrier system.
Animals ; Bone Density ; Bone Morphogenetic Proteins* ; Bone Regeneration ; Rats* ; Tissue Engineering

PURPOSE: Various bone graft materials are being used for periodontal tissue regeneration.Th materials are being developed continuously for ideal clinical effects. Therefore, it is necessary to identify the clinical characteristics of each bone graft material through comparing the various bone graft materials statistically and in doing so, proposing a more efficient bone graft material. In this study, the following results were attained through comparing the clinical effects among the bone graft materials, using the statistical method based on the clinical studies published at the department of periodontology of Yonsei hospital. MATERIALS AND METHOD: 6 selected studies of department of Periodontology at Yonsei University Hospital were based on clinical study of bone grafting in intrabony defects. It was compared the clinical parameters among the 6 clinical studies, using the statistical META analysis. RESULT: When comparing the probing depth reduction, there was a relatively great amount of decrease when using the xenograft, Anorganic Bovine Derived Hydroxapatite Bone Matrix/Cell Binding Peptide(ABM/P-15: PepGen P-15(R)) and the autogenous bone and absorbable membrane, d,l-alctide/glycolide copolymer(GC: Biomesh(R)). The allogfrafts showed a relatively low decrease in the probing depth and clinical attachment change. It also showed a slight decrease in the bone probing depth. The allografts showed various results according to different bone graft materials. When comparing the ABM/P-15 and bovine bone powder(BBP(R)), ABM/P-15 showed a relatively high clinical attachment level and the bovine bone powder showed a relatively high clinical attachment level. The probing depth change and gingival recession change showed a lower value than the mean value between the two bone graft materials. The synthetic bone showed a relatively high decrease in clinical attachment level and periodontal probing depth change. There was a relatively larger amount of gingival recession when using Bioactive Glass(BG) but a relatively low bone regeneration effect was seen. CONCLUSION: Good restorative results of the periodontal tissue can be attained by applying the various bone graft materials being used today after identifying the accurate clinical effects.
Allografts ; Alveolar Bone Loss ; Bone Regeneration ; Bone Transplantation ; Gingival Recession ; Heterografts ; Membranes ; Transplants*