Purpose: Fibronectin(FN), one of the major components of ECM, mediates wide variety of cellular interactions including cell adhesion, migration, proliferation and differentiation. In this study, we used synthetic peptides based on fibrin binding sites of amino-terminal of FN and evaluated their biologic effects on periodontal ligament(PDL) cells. Materials and methods: PDL cells were cultured on synthetic oligopeptides coated dishes and examined for cell adhesion, proliferation via confocal microscope. For detection of ERK1/2, cells were plated and Western blot analysis was performed. Results: PDL cells on synthetic oligopeptide coated dishes showed enhanced cell adhesion and proliferation. Western blot analysis revealed increased level of ERK1/2 phosphorylation in cells plated on FN fragment containing fibrin-binding domain(FF1 and FF5) coated dishes. Conclusion: These results reveals that FN fragment containing fibrin-binding domain possess an enhanced biologic effect of PDL ligament cells. (J Korean Acad Periodontol 2009;39:45-52)
Objective: This systematic review evaluates implant survival and the change in the width of the horizontal ridge following immediate implant placement with or without a regenerative procedure. Materials and methods: An electronic search of MEDLINE, EMBASE, and the LILACS database of the Cochrane Central Register of controlled trials was performed, along with a manual search, up to April 2018. Randomized controlled trials (RCTs) and quasi-randomized controlled clinical trials (CCTs) with >10 subjects were eligible for this systematic review. A meta-analysis of the risk difference in implant failure between the regenerative and non-regenerative procedure groups was performed using a fixed-effect model. In addition, a meta-analysis of the change in alveolar bone width was conducted using a fixed-effect model. Results: Seven studies (six RCTs and one CCT) were included. A meta-analysis of three studies found no statistically significant risk difference in implant failure between the regenerative procedure and non-regenerative procedure groups. A meta-analysis of four studies showed that horizontal shrinkage of the alveolar ridge in the site of immediate implant placement was statistically significantly lower with the regenerative procedure than without it (<1 year follow up studies: weighted mean difference (WMD) 0.75 mm, 95% confidence interval 0.41–1.09, p p = .00006; total: WMD 0.84 mm, 95% confidence interval 0.53–1.14, pConclusion: Within the study limitations, immediate implant placement with a regenerative procedure showed similar implant survival and less shrinkage of the ridge width than immediate implant placement without a regenerative procedure. Due to the high risk of bias and small sample sizes of the included studies, further clinical studies are warranted to draw definitive conclusions.
This study was conducted to compare the cumulative survival rates (CSRs) and the incidence of postloading complications (PLCs) between a bone-level internal connection system (ICS-BL) and an external connection system (ECS).The medical records of patients treated with either a ICS-BL or ECS between 2007 and 2010 at Asan Medical Center were reviewed. PLCs were divided into two categories: biological and technical. Biological complications included >4 mm of probing pocket depth, thread exposure in radiographs, and soft tissue complications, whereas technical complications included chipping of the veneering material, fracture of the implant, fracture of the crown, loosening or fracture of the abutment or screw, loss of retention, and loss of access hole filling material. CSRs were determined by a life-table analysis and compared using the log-rank chi-square test. The incidence of PLC was compared with the Pearson chi-squared test.A total of 2,651 implants in 1,074 patients (1,167 ICS-BLs in 551 patients and 1,484 ECSs in 523 patients) were analyzed. The average observation periods were 3.4 years for the ICS-BLs and 3.1 years for the ECSs. The six-year CSR of all implants was 96.1% (94.9% for the ICS-BLs and 97.1% for the ECSs, P=0.619). Soft tissue complications were more frequent with the ECSs (P=0.005) and loosening or fracture of the abutment or screw occurred more frequently with the ICS-BLs (P<0.001).Within the limitations of this study, the ICS-BL was more prone to technical complications while the ECS was more vulnerable to biological complications.
Purpose:The aim of this study was to determine the relationship between buccal bone thickness and gingival thickness by means of a noninvasive and relatively accurate digital registration method.Methods: In 20 periodontally healthy subjects, cone-beam computed tomographic images and intraoral scanned files were obtained.Measurements of buccal bone thickness and gingival thickness at the central incisors, lateral incisors, and canines were performed at points 0-5 mm from the alveolar crest on the superimposed images.The Friedman test was used to compare buccal bone and gingival thickness for each depth between the 3 tooth types.Spearman's correlation coefficient was calculated to assess the correlation between buccal bone thickness and gingival thickness.Results: Of the central incisors, 77% of all sites had a buccal thickness of 0.5-1.0mm, and 23% had a thickness of 1.0-1.5 mm.Of the lateral incisors, 71% of sites demonstrated a buccal bone thickness <1.0 mm, as did 63% of the canine sites.For gingival thickness, the proportion of sites <1.0 mm was 88%, 82%, and 91% for the central incisors, lateral incisors, and canines, respectively.Significant differences were observed in gingival thickness at the alveolar crest level (G0) between the central incisors and canines (P=0.032) and between the central incisors and lateral incisors (P=0.013).At 1 mm inferior to the alveolar crest, a difference was found between the central incisors and canines (P=0.025).The lateral incisors and canines showed a significant difference for buccal bone thickness 5 mm under the alveolar crest (P=0.025). Conclusions:The gingiva and buccal bone of the anterior maxillary teeth were found to be relatively thin (<1 mm) overall.A tendency was found for gingival thickness to increase and bone thickness to decrease toward the root apex.Differences were found between teeth at some positions, although the correlation between buccal bone thickness and soft tissue thickness was generally not significant.
The purpose of this retrospective study with 4-12 years of follow-up was to compare the marginal bone loss (MBL) between external-connection (EC) and internal-connection (IC) dental implants in posterior areas without periodontal or peri-implant disease on the adjacent teeth or implants. Additional factors influencing MBL were also evaluated.This retrospective study was performed using dental records and radiographic data obtained from patients who had undergone dental implant treatment in the posterior area from March 2006 to March 2007. All the implants that were included had follow-up periods of more than 4 years after loading and satisfied the implant success criteria, without any peri-implant or periodontal disease on the adjacent implants or teeth. They were divided into 2 groups: EC and IC. Subgroup comparisons were conducted according to splinting and the use of cement in the restorations. A statistical analysis was performed using the Mann-Whitney U test for comparisons between 2 groups and the Kruskal-Wallis test for comparisons among more than 2 groups.A total of 355 implants in 170 patients (206 EC and 149 IC) fulfilled the inclusion criteria and were analyzed in this study. The mean MBL was 0.47 mm and 0.15 mm in the EC and IC implants, respectively, which was a statistically significant difference (P<0.001). Comparisons according to splinting (MBL of single implants: 0.34 mm, MBL of splinted implants: 0.31 mm, P=0.676) and cement use (MBL of cemented implants: 0.27 mm, MBL of non-cemented implants: 0.35 mm, P=0.178) showed no statistically significant differences in MBL, regardless of the implant connection type.IC implants showed a more favorable bone response regarding MBL in posterior areas without peri-implantitis or periodontal disease.
Purpose: The objective of this clinical presentation was to present a clinical case series report of socket preservation, sinus augmentation, and bone grafting using a horse-derived biomaterial. Methods: A horse-derived biomaterial was used in 8 patients for different indications including socket preservation following tooth extraction, osseous bone grafting, and sinus augementation procedures. Surgeries were performed by a well trained specialist and clinical radiographs were obtained at designated intervals. Biopsy cores of 2 × 8 mm prior to implant placement was obtained following a healing interval of 4 - 6 months. A clinical and histologic evaluation was performed to evaluate the clinical effectiveness and biocompatibility of the biomaterial. Results: All surgeries in 8 patients were successful with uneventful healing except for one case with membrane exposure that eventually resulted with a positive outcome. Radiographic display of the healing phase during different intervals showed increased radiopacity of granular nature as the healing time increased. No signs of adverse effect or infection was observed clinically and the tissues surrounding the biomaterial seemed well-tolerated with good intentional healing. The augmented sinuses healed uneventfully suggesting in part, good biocompatibility of the biomaterial. Dental implants placed following socket preservation were inserted with high initial torque suggesting good initial stability and bone quality. Conclusions: Our results show that at least on a tentative level, a horse-derived biomaterial may be used clinically in socket preservation, sinus augmentation, bone grafting techniques with good intentional healing and positive results. (J Korean Acad Periodontol 2009;39:287-291)
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