The Effect of Chlorhexidine on the formation of bone nodules by Periodontal ligament Cells in Vitro

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심한 골흡수가 진행된 상악에서의 상악동 거상술을 동반한 임프란트 동시 식립

The sinus floor elevation procedure has been used to be one of the predictable treatments for rehabilitation of atrophic and pneumatized edentulous posterior maxilla. Sinus elevation with simultaneous implant placement could be an optimal procedure due to reduction in surgical procedures and to patient’s convenience. This study reports the successful results of sinus elevation with the sand blasted, large grit, acid-etched (SLA) surfaced implant(ITI dental imiplant system, StraumannⓇ, Basel, Switzerland) placement simultaneously. In the first case, the height of residual ridge was 2~4mm. Autogeneous bone from ramus and alloplast(Macroporous biphasic calcium phosphate-MBCP, BiomatlanteⓇ Sarl, Nantes, France) were applied after sinus elevation through lateral window approach. SLA surfaced implants(ITI) were installed simultaneously. Result after 17 months was showed successfully. In the second case, the height of residual ridge was 3~5mm. Allograft(Freeze dried bone allograft-FDBA, Oragraft, Lifenet health, Virginia Beach, VA, USA) and alloplast(MBCP) were used for sinus graft. All procedures were followed as in the first case. Result after 9 months was showed successfully. In conclusion, this study presented successful results, when sinus elevation through window approach with mixed graft material was performed with simultaneous SLA surfaced implant placement on severe atrophied maxillary alveolar ridge, minimizing patient discomfort.ope

C-reactive Protein Detection in Gingival Crevicular Fluid as an Acute Systemic Inflammation Biomarker in Patients with Severe Periodontitis

Some research has indicated that inflammation in the target area for dental surgery decreases the success rate of orofacial surgery and oral implant surgery. Inflammation can arise from resident bacteria and other flora or the presence of a foreign body during surgery. (Turvey et al., 2011) To avoid this disadvantage, most surgeons perform blood tests to assess acute systemic inflammation before surgery. This test typically evaluates C-reactive protein (CRP) and interleukin (IL)-6 levels because these are common markers of acute inflammation. Although this information aids in determining the prognosis for recovery, performing the blood test regularly is often untenable because of needle phobia on the part of the patient and turnaround time for results. For these reasons, some researchers have turned to IL-6 detection in saliva instead of serum due to their easy approach.(Tishler et al., 1999) But evidence has suggested no significant association between IL-6 levels in serum and in saliva under baseline conditions because IL-6 is not only under systemic regulation but also is under local regulation.(Sjogren et al., 2006) Recently, CRP, a common marker of systemic acute inflammation secreted by liver cells under the transcriptional control of IL-6,(Pepys and Hirschfield, 2003) became another target for measurement in saliva for association with serum CRP levels.(Ouellet-Morin et al., 2011) Saliva arises mostly from the salivary gland, but it also contains some gingival crevicular fluid (GCF). Cytokines in GCF are not easily diluted while cytokines in saliva can be diluted by salivary gland stimulation. Therefore, in some studies, GCF instead of saliva has been used for detecting inflammation-related molecules and cytokines.(Dutzan et al., 2009; Shaddox et al., 2011) Periodontitis is an inflammatory disease well-known in dental departments. Periodontal pathogens affect both local and systemic immune and inflammatory responses, and cytokines from systemic immune and inflammatory responses against periodontitis are involved in destruction of both periodontal connective tissue and alveolar bone.(Noack et al., 2001) One of the cytokines that initiates a systemic acute-phase response is CRP. Recent cross-sectional studies have shown that plasma CRP in periodontitis is elevated compared with controls. (Paraskevas et al., 2008) Therefore, the aims of this study were to confirm the presence of CRP in mouth fluid, which consists of saliva and GCF, in severe chronic periodontitis patients and to assess differences in CRP concentrations in these two fluids and between healthy people and severe chronic periodontitis patients.ope

Implant-related complications and Treatment of the ailing implants

Despite the long-term predictability of endosseous dental implants, some complications do occur including surgical, biologic, mechanical(or technical) and esthetic aspects. To deal with these problems, assessments in clinical states as well as radiographic findings are important. These case reports are to show the complications occurred in the followup period of functionally loaded implants and to find out the treatments of the ailing implants. Both of the case reports showed mechanical(or technical) complications like screw loosening with peri-implant crestal bone loss and some aspects of peri-implantitis which is one of the biologic complications. Mechanical complication, the most common aspect, is known to be largely related to the stress factor. Occlusal overload might cause mechanical problems such as screw loosening, fractures of the screw, fixture body or the prosthetic components. In addition, strain and the bending moment concentrated mainly at the crestal area might cause the initial crestal bone resorption(saucerization) and the late stage bone loss together with peri-implantitis. Treatments of the complications include minimizing occlusal overload, using systemic antibacterial therapy or the chlorhexidin, and the surgical access when the implants are thought to be amendable. Minimizing occlusal overload and distributing the stress can be accomplished by increasing the number, length and the diameter of the implant, tripod positioning of the implants, selecting the implant design which maximizes the surface area and analyzing the occlusion of the patient. In the case reports, many factors were seemed to be related to the complications of the functionally loaded implants. To treat and furthermore, to prevent the complications, treatment plans should be made under the considerations of these factors.ope

Effect of aging on expression of nitric oxide and inducible nitric oxide synthase in human gingival fibroblasts

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Cetylpyridinium Chloride(CPC), NaF 및 Ursodeoxycholic acid(UDCA) 혼합물의 주요 치주병원균에 대한 in Vitro 항균효과

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재생 술식을 동반한 발치 후 즉시 임프란트 식립술

The placement of implants into fresh extraction socket provides many advantages to conventional delayed implant placement. It reduces total treatment time and surgical procedures with placement of the implant in an ideal position. However, it also has disadvantages such as creating a gap defect between the implant and alveolar bone and difficulty in primary closure of the surgical site. Therefore, need of a regenerative procedure is crucial in immediately placed sites for successful functional and esthetical outcomes. The current case report presents two cases with immediately placed implants performed in anterior and posterior region. A careful tooth extraction was performed to avoid any surgical trauma in the alveolar bone, and implants were successfully installed in both cases. Regenerative procedures such as guided bone regeneration and bone graft were performed in conjunction to fill the gap defect and compensate future ridge alterations. Both cases showed clinically successful results with functionally and esthetically high patient satisfaction. Immediate implant placement in conjunction with an appropriate regenerative procedure could provide successful outcome.ope

골이식을 동반한 구치부 임프란트의 식립 : 증례보고

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The effects of Hydroxyapatite nano-coating implants on healing of surgically created circumferential gap in dogs

Purpose: The aim of this study is to compare the healing response of various Hydroxyapatite(HA) coated dental implants by Ion-Beam Assisted Deposition(IBAD) placed in the surgically created circumferential gap in dogs. Materials and methods: In four mongrel dogs, all mandibular premolars and the first molar were extracted. After an 8 weeks healing period, six submerged type implants were placed and the circumferential cylindrical 2mm coronal defects around the implants were made surgically with customized step drills. Groups were divided into six groups : anodized surface, anodized surface with 150nm HA and heat treatment, anodized surface with 300nm HA and heat treatment, anodized surface with 150nm HA and no heat treatment, and anodized surface with 150nm HA, heat treatment and bone graft, anodized surface with bone graft. The dogs were sacrificed following 12 weeks healing period. Specimens were analyzed histologically and histomorphometrically. Results: During the healing period, healing was uneventful and implants were well maintained. Anodized surface with HA coating and 430℃ heat treatment showed an improved regenerative characteristics. Most of the gaps were filled with newly regenerated bone. The implant surface was covered with bone layer as base for intensive bone formation and remodeling. In case that graft the alloplastic material to the gaps, most of the coronal gaps were filled with newly formed bone and remaining graft particles. The bone-implant contact and bone density parameters showed similar results with the histological findings. The bone graft group presented the best bone-implant contact value which had statistical significance. Conclusion: Within the scope of this study, nano-scale HA coated dental implants appeared to have significant effect on the development of new bone formation. And additional bone graft is an effective method in overcoming the gaps around the implantsope

Histometrical evaluation of biphasic calcium phosphate in surgically created 1-wall periodontal intrabony defects in dogs

PURPOSE: The aim of this study was to evaluated biphasic calcium phosphate applied in surgically created 1-wall periodontal intrabony defects in dogs by histometrical analysis. MATERIAL AND METHOD: Critical sized(4 mm x 4 mm), one wall periodontal intrabony defects were surgically produced at the proximal aspect of mandibular premolars in either right and left jaw quadrants in four canines. The control group was treated with debridement alone, and experimental group was treated with debridement and biphasic calcium phosphate application. The healing processes were histologically and histometrically observed after 8 weeks. RESULTS: In biphasic calcium phosphate group, more new bone and cementum formation, less epithelium and connective tissue attachment were observed compared to other groups. But there was no statistical significance. CONCLUSION: Though the statistically significant difference could not be found, it seemed that there was more new bone and cementum formation with applying biphasic calcium phosphate in 1 wall intrabony defects in dogs by preventing junctional epithelium migration.ope