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Background/purpose: Due to the pneumatization of the maxillary sinus, the sinus floor augmentation is often performed to implant placement in the maxillary posterior region. The aim was to perform radiographic and histomorphometric evaluation after placement of mixed allografts (cortical freeze-dried bone allograft [FDBA] 50%:cancellous FDBA 50%) during sinus floor augmentation. Materials and methods: In 37 patients, anorganic bovine bone (ABB, sites = 16), mineralized cancellous bone allograft (MCBA, sites = 15), and mixed allografts (Mixed AG, sites = 20) were placed during sinus floor elevation via the lateral approach (LSFE), at total 51 sites with residual alveolar bone height (RBH) 0.05). The mean ABH of ABB, MCBA, and mixed AG groups after 6 months was similar (13.72 ± 4.55 mm, 11.83 ± 3.31 mm, and 12.53 ± 2.97 mm, respectively; P > 0.05). In the ABB, MCBA, and mixed AG groups, the proportion of newly formed bone (NB) was similar (36.13 ± 10.01%, 39.26 ± 10.72%, and 31.27 ± 18.31%, respectively; P > 0.05). Conclusion: This result demonstrated that mixed AG led to sufficient bone augmentation and histologically comparable NB formation as compared to ABB and MCBA for sinus floor augmentation.

Oro-antral communication (OAC) acts as a pathway for bacteria between the maxillary sinus and oral cavity, and is a common complication after the removal of a dental implant or extraction of a tooth from the maxillary posterior area. In the case of an untreated OAC, oro-antral fistula develops and becomes epithelialized. We aimed to introduce a treatment for OAC closure via a sinus bone grafting procedure using bone tacks and a collagen membrane with an allograft. The procedure was performed by applying an absorbable membrane made in pouch form. This membrane acted as a barrier for closing the large sinus membrane perforation. Bone tacks were used to fix the membranes. Subsequently, the maxillary sinus was filled with the allograft, and the absorbable membrane was reapplied. Primary closure was achieved by performing a periosteum-releasing incision for a tension-free suture. After 6 months, sufficient bone dimensions were gained without any occurrence of maxillary sinusitis or recurrence of OAC. Additional bone grafts and implantation could be performed to rehabilitate the maxillary posterior area. We conclude that this technique might be a useful treatment for reconstructing the maxillary posterior area with simultaneous sinus bone graft and OAC closure.

This study aimed to clinically and radiographically evaluate the results of guided bone regeneration (GBR) using three-dimensional preformed titanium mesh (3-D-PFTM) for non-contained horizontal defects in 100 consecutive cases. This study involved 100 patients (129 implants) with peri-implant non-contained horizontal defects. The patients were divided into three groups: 3-D-PFTM alone (Group 1), 3-D-PFTM plus cross-linked collagen membrane (Group 2), and 3-D-PFTM plus non-cross-linked collagen membrane (Group 3). Each implant was evaluated radiographically using CBCT at baseline and 6 months postoperatively. At the platform level, the mean horizontal hard tissue gain of all the sites was 3.1 &plusmn, 1.3 mm at 6 months postoperatively. The mean rate of mesh exposure was 11.8% in Group 1, 4.2% in Group 2, and 5.0% in Group 3. The mean hard tissue gain rate was 71.0 &plusmn, 23.0% in group 1, 84.2 &plusmn, 21.5% in group 2, and 84.0 &plusmn, 22.9% in group 3. Groups 2 and 3 showed significantly higher hard tissue gain rates than group 1. However, there was no significant difference between the rates in groups 2 and 3. Within the limitations of this study, 3-D-PFTM should be considered as a valuable option for GBR for peri-implant non-contained horizontal defects. The use of an additional resorbable collagen membrane provides additional advantages.

Purpose This study aimed to clinically evaluate the efficacy of vestibuloplasty around lower molar implants using 3 different modalities: apically positioned flap alone (APF), APF with a free gingival graft (FGG), and APF with modified periosteal fenestration (mPF). Methods Three different vestibuloplasty procedures during second-stage implant surgery were performed at the mandibular molar area in 61 patients with a shallow vestibule and insufficient keratinized tissue (KT). The clinical measurements of KT width were recorded at baseline, immediately after surgery (T0), 6 months after surgery (T6), and 12 months after surgery (T12). Soft tissue esthetic scores were measured. Results An additional KT width gain from baseline to T12 of approximately 2 mm was obtained with FGG and mPF compared to that with APF. Shrinkage of the re-established tissue was lower with mPF and FGG than with APF, whereas the esthetic profile was better with APF and mPF than with FGG. Conclusions Within the limitations of this study, mPF showed potential as a promising approach for vestibuloplasty around the lower molar implants compared to the traditional APF and FGG., Graphical Abstract

Root coverage in the mandibular anterior region is challenging because of a thin gingival biotype, shallow vestibule, and high frenum attachment. Several methods have been introduced to predict the root coverage in this area. Stimmelmayr proposed a method of performing root coverage using a combination epithelialized-subepithelial connective tissue graft (CTG). However, it is difficult to precisely acquire connective tissue according to this method. Therefore, in this case report, we would like to introduce a technique to harvest a partially deepithelialized CTG (PE-CTG) aided by a high-speed handpiece, which helps in procuring the graft easily and quickly. This method could lower the patient’s morbidity at donor sites and enhance the healing process. Additionally, it could increase the amount of keratinized gingiva in the mandibular anterior region without reducing the vestibular depth. Therefore, PE-CTG using a high-speed handpiece can be a promising treatment option for the root coverage of the mandibular anterior teeth.

In the recent years, the immediate placement of dental implants into fresh extraction sites has become an acceptable treatment approach. However, immediate molar implant placement presents specific challenges because of the anatomical and physiologic limitations. Such implant surgeries commonly require procedures that use a barrier membrane to generate bone and soft tissue or one that seals the molar extraction socket through a coronally advanced flap. Here, as an alternative, we report a method for treating molar extraction socket wounds in the hard and soft tissues after immediate placement of an implant using a silicone sheet.

Purpose Obtaining predictable and aesthetically pleasing interdental papilla is challenging in dental reconstruction. Hyaluronic acid gel has been successfully used to reduce facial creases and similar abnormalities. The purpose of this study was to clinically assess the efficiency of interdental papilla reconstruction with injectable hyaluronic acid gel. Materials and Methods Ten patients with 43 treated sites in the maxillary anterior region were studied. Photographic standardization devices were designed for image analysis before treatment. This treatment was repeated up to five times during 3-week intervals. Patients were followed 6 months after initial gel application. Results Twenty-nine sites had complete papilla reconstruction and 14 sites improved from 39 to 96% of interdental papilla reconstruction rate. Complete interdental papilla reconstruction was performed when black triangle at initial examination had area of ≤0.25 mm2, height of ≤1mm, or width of ≤0.5mm. Conclusion Injectable hyaluronic acid gel may be a promising treatment for enhancing papillary esthetics. Clinical Significance Interdental papilla reconstruction with injectable hyaluronic acid gel can be suggested as a minimally invasive treatment option for interdental papilla deficiencies in small areas. However, long-term results of this treatment beyond 6 months are not yet known. (J Esthet Restor Dent 28:221–230, 2016)

Purpose The purpose of this study was to evaluate the effects of platelet-rich plasma (PRP) on periodontal healing of replanted root surfaces in dogs histologically and histomorphometrically. Methods A total of 36 roots of mandibular incisors and premolars from 6 mongrel dogs were used. The roots were randomly divided into 3 groups: 1) a positive control group (n=12), in which the periodontal ligament (PDL) and cementum were retained and the roots were soaked in saline; 2) a negative control group (n=12), in which the PDL and cementum were removed and the roots were soaked in saline; and 3) an experimental group (n=12), in which the PDL and cementum were removed and the roots were soaked in PRP. After soaking the root surfaces, the extracted roots were replanted into the extraction sockets. The roots were covered using a coronally repositioned flap Results Histologically, irregular-thickness PDL-like and cementum-like tissues were observed in the 4-week experimental group and the positive control group. PDL-like tissue and cementum-like tissue with a more uniform thickness were observed at 8 weeks. In the negative control group, PDL-like tissue and cementum-like tissue were rarely found, and root resorption and ankylosis were observed. In the cross-sectional histomorphometric analysis, the experimental group demonstrated a higher rate of formation of cementum-like tissue and a lower tooth ankylosis rate than the positive and negative control groups at 4 and 8 weeks. Although there was a significant difference in the tooth ankylosis rate and the formation of cementum-like tissue across the 3 groups (P0.017). Conclusions Applying PRP to root surfaces during tooth replantation in dogs can reduce tooth ankylosis and increase PDL-like and cementum-like tissue formation., Graphical Abstract

Background and Objective The predictability of conventional periodontal treatments for damaged periodontal tissue is limited, particularly on the regeneration of new cementum. As signaling molecules, a range of growth factors has been used to promote periodontal regeneration on periodontal ligament (PDL) and cementum defects. A preameloblast-conditioned medium (PA-CM) was prepared from cultured murine apical bud cells, which can differentiate into ameloblasts. We examined the effect of PA-CM on PDL cells and cementoblasts in vitro and evaluated histologically the effects of PA-CM on the regeneration of experimentally induced periodontal defects in vivo. Material and Methods In vitro, the effects of PA-CM on the migration of human PDL cells were examined using a scratch wound healing assay and a transwell assay. The differentiation and mineralization potential of PA-CM-treated human PDL cells and murine cementoblastic OCCM-30 cells was examined by real-time polymerase chain reaction and Alizarin red-S staining. In vivo, six mongrel dogs (12–16 kg; 6–8 mo old) were used. Twenty-four roots were replanted with either, (i) only periodontal defects (n = 12; control group), or (ii) periodontal defects and PA-CM treatment (n = 12; experimental group). In the experimental group, the PDL and cementum between notches was removed using a Gracey curette and soaked in 0.08 mL water containing 80 μg of a PA-CM for 2 min. The dogs were killed at 4 and 8 wk post-surgery. Results The in vitro results showed that PA-CM stimulated the migration of PDL cells and promoted the differentiation and mineralization of PDL cells and cementoblasts. Real-time polymerase chain reaction analysis revealed stronger expression of Runx2, Osx, OC, Bsp and Cap mRNAs in the PA-CM-treated PDL cells and cementoblasts than those in the control cells. In vivo, newly formed PDL-like tissue and cementum-like tissue were observed partially between the root surfaces and newly formed bone in the experimental group. The regenerated PDL-like tissue in the experimental group was significantly higher than that in the control group at 8 wk (p

Cornus officinalis has been widely used as herbal medicine exerting various pharmacological actions such as diuretic, anti-allergic, hypotensive and antibiotic activities. Thus we studied the effect of Cornus officinalis on the proliferation, differentiation and matrix mineralization of MC3T3-E1 osteoblast-like cell line. To do the experiments, Cornus officinalis extract (COE) was prepared using ethanol at different concentrations. The cytotoxic effect and the osteogenic differentiation were examined using MTT assay, alkaline phosphatase (ALP) activity, ALP staining, Alizarin red S staining and reverse transcriptase-polymerase chain reaction for osteogenic differentiation markers such as collagen type I (Col-I), ostoecalcin (OCN). The results indicated that there was no effect on cell proliferation on both 1st and 3rd days after treatment in MC3T-E1 cells. The level of ALP, Col-I mRNA, OCN mRNA and mineralized nodule were significantly higher in COE treated group than no treated group. Our results suggest that the COE promotes the osteoblast differentiation and mineralization without observable cytotoxicity. Therefore, it may play an important role in osteoblastic bone formation, and may possibly to be an effective measure for bone regeneration.

The objective of this study was to evaluate the effect of absorbable atelocollagen sponge on healing of hard tissue of buccal dehiscence defects in mongrel dogs. The mandibular second and fourth premolars of 12 dogs were extracted. Group 1 and Group 2 consisted of dogs without and with an inserted atelocollagen sponge after extraction with buccal plate preservation; Group 3 and Group 4 consisted of dogs without and with an inserted atelocollagen sponge after removing two thirds of the buccal wall. At 10 weeks, Group 4 presented a significantly greater increase in the height of the alveolar bone crest than that of Group 3. Histologically, Group 2 and Group 4 showed better new bone formation ability than Groups 1, 3 at 6 weeks after extraction. The new bone formation ability of Group 3 was the poorest at 10 weeks. The results showed that the transplantation of absorbable atelocollagen sponge in the extraction socket can promote new bone formation and compensate marginal ridge reconstruction.

Purpose The purpose of this study was to evaluate the clinical efficacy of enhancing deficient interdental papilla with hyaluronic acid gel injection by assessing the radiographic anatomical factors affecting the reconstruction of the interdental papilla. Methods Fifty-seven treated sites from 13 patients (6 males and 7 females) were included. Patients had papillary deficiency in the upper anterior area. Prior to treatment, photographic and periapical radiographic standardization devices were designed for each patient. A 30-gauge needle was used with an injection-assistance device to inject a hyaluronic acid gel to the involved papilla. This treatment was repeated up to 5 times every 3 weeks. Patients were followed up for 6 months after the initial gel application. Clinical photographic measurements of the black triangle area (BTA), height (BTH), and width (BTW) and periapical radiographic measurements of the contact point and the bone crest (CP-BC) and the interproximal distance between roots (IDR) were undertaken using computer software. The interdental papilla reconstruction rate (IPRR) was calculated to determine the percentage change of BTA between the initial and final examination and the association between radiographic factors and the reconstruction of the interdental papilla by means of injectable hyaluronic acid gel were evaluated. Results All sites showed improvement between treatment examinations. Thirty-six sites had complete interdental papilla reconstruction and 21 sites showed improvement ranging from 19% to 96%. The CP-BC correlated with the IPRR. More specifically, when the CP-BC reached 6 mm, virtually complete interdental papilla reconstruction via injectable hyaluronic acid gel was achieved. Conclusions These results suggest that the CP-BC is closely related to the efficacy of hyaluronic acid gel injection for interdental papilla reconstruction., Graphical Abstract

The excessive administration of estradiol valerate induces polycystic ovary syndrome by formation of follicular cysts. Secretory leukocyte protease inhibitor (SLPI) promotes wound healing by decreasing the excessive inflammatory response, stimulating keratinocyte proliferation and increasing collagen deposition through the inhibition of protease activity. In this study, SLPI expression was high in the ovarian stroma, corpus luteum, unilaminar primary follicle, multilaminar primary follicle and granulose layer of the antral follicle in polycystic ovary (PCO) compared to the normal ovary. SLPI was expressed strongly in the theca around the cyst in PCO compared to the mature follicle in the normal ovary. The levels of SLPI mRNA and protein expression were higher in PCO than in the normal ovary, and the level of MMP-2 expression was lower in PCO. These results showed that the formation of a cyst was initiated from a multilaminar primary follicle and SLPI expression was increased depending on the morphological changes in the follicle and ovarian stroma. Therefore, an increase in SLPI may be related to the suppression of tissue disruption, and act as a protease inhibitor in PCO, suggesting that SLPI increases independently of the estrogen concentration in pathological tissues.

Purpose The purpose of this study was to evaluate the effects of 1,25-dihydroxyvitamin D3 on the proliferation, differentiation, and matrix mineralization of MC3T3-E1 osteoblast-like cells in vitro. Methods MC3T3-E1 osteoblastic cells and 1,25-dihydroxyvitamin D3 were prepared. Cytotoxic effects and osteogenic differentiation were evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, alkaline phosphatase (ALP) activity assay, ALP staining, alizarin red S staining, and reverse transcription-polymerase chain reaction (RT-PCR) for osteogenic differentiation markers such as ALP, collagen type I (Col-I), osteocalcin (OCN), vitamin D receptor (VDR), and glyceraldehyde 3-phosphate dehydrogenase. Results The MTT assay showed that 1,25-dihydroxyvitamin D3 did not inhibit cell growth and that the rate of cell proliferation was higher than in the positive control group at all concentrations. ALP activity was also higher than in the positive control group at low concentrations of 1,25-dihydroxyvitamin D3 (10−10, 10−12, and 10−14 M). RT-PCR showed that the gene expression levels of ALP, Col-I, OCN, and vitamin D receptor (VDR) were higher at a low concentration of 1,25-dihydroxyvitamin D3 (10−12 M). Alizarin red S staining after treatment with 1,25-dihydroxyvitamin D3 (10−12 M) showed no significant differences in the overall degree of calcification. In contrast to the positive control group, formation of bone nodules was induced in the early stages of cell differentiation. Conclusions We suggest that 1,25-dihydroxyvitamin D3 positively affects cell differentiation and matrix mineralization. Therefore, it may function as a stimulating factor in osteoblastic bone formation and can be used as an additive in bone regeneration treatment., Graphical Abstract

Objectives The purpose of this study was to evaluate the effects of decortication during bone grafting in defect areas surrounding particulate dentin-coated implants. Study design Six dogs were randomly assigned to 3 groups, and each group was further divided into 2 subgroups. The subgroups consisted of dogs that received particulate dentin-coated implants after 4 or 8 weeks. The defects were treated as follows: control group, unfilled defect; experimental group 1, defect filled with Tutoplast without decortication; experimental group 2, defect filled with Tutoplast with decortication. Histologic sections and histomorphometric analysis were obtained 4 and 8 weeks after surgery. Results Compared to the 4-week subgroup, statistically significant new bone formation was observed in the 8-week subgroup. In the 4-week subgroup, the area of new bone formation was larger in the group that underwent cortical bone perforation with bone grafting; however, no significant difference was detected within the 8-week subgroup. Conclusion According to these results, decortication increases early bone formation after implant placement.

The purpose of this study is to figure out the effect of maintaining period of PTFE membrane used in GBR with autogeonous bone, heterogeneous bone and synthetic bone on bone formation on rabbits' cranial defect. Eight adult New Zealand white rabbits were used in this study. Four defects were surgically made in their calvaria. Using a trephine bur, 4 'through and through' defects were created and classified into 4 groups, which were consisted of control (no graft), experimental group 1 (autogeonous bone) and experimental group 2 (deproteinized bovine bone: OCS-B®; NIBEC, Korea), experimental group 3 (synthetic bone: MBCP; Biomatlante, France). The defects were covered with PTFE membrane (Cytoplast®, Innova, Canada). Membranes were removed after 1, 2, 4 and 8 weeks post-GBR in each 2 rabbits. And then, all rabbits were sacrificed; specimens were taken and observed histologically..: After removing the membranes after 1 week of the experiment, bone formation was not evident in a control group but the area was replaced with only loose fibrous connective tissue. In group 1(autogeonous bone), thin bone formation and infiltration of connective tissue on the superficial layer were observed. Initial bone formation and infiltration of fibrous connective tissue were evident in group 2(deprotenized bovine bone) and 3(synthetic bone). When the membranes were removed after 2 weeks of the experiment, bridge shaped bone formation was shown in control group but mostly connective tissue took place. More increased bone thickness was evident in group 1 and increased bone formation than first week was shown in group 2 and 3. When the membranes were removed after 4 weeks of the experiment, 2/3 of normal bone thickness was formed in control group still with infiltration of connective tissue. In group 1, regular bone formation with normal bone thickness was shown and in group 2 and 3, similar bone thickness to the normal was evident. After the removal of the membranes in 8 weeks, bone thickness formed in control group was more increased than 4th week, but could not reach normal bone thickness. In group 1, normal bone thickness was formed and similar bone thickness to that of the normal was observed in group 2 and 3. Within the limited study, when performing the GBR procedure, at least 4-week period of the membrane retention is required, and more retention time of the xenograft or synthetic bone is needed than that of autogenous bone for better bone regeneration.

This study evaluated the efficacy of periodontal tissue regeneration using guided tissue regeneration (GTR) with a mixture of tooth ash and plaster as a bone substitute material in the treatment of class II furcation defects in dogs. GTR was performed at the site of a surgically formed mandibular premolar bifurcation area in dogs. Four adult dogs were used in the animal study. The animals were in a good periodontal state without any systemic disease. A resorbable membrane (Bio-Gide®, Swiss) and bone graft material using a mixture of tooth ash and plaster were used to examine the biological activity. The defect in the control group was filled a Bio-Gide® only. For the experimental group, the defects were filled with a mixture of tooth ash and plaster and covered by a Bio-Gide®. Oral rinsing with 0.12% chlorhexidine was performed twice a day for 2 weeks. In control group, new bone formation was observed adjacent to the preexisting bone. Soft tissue ingrowth was also noted. In experimental group, new lamellar type trabecular bone formation as well as centum and PDL regeneration was observed in the base of the infrabony pocket. More bone regeneration would be expected when GTR is performed using a mixture of human tooth-ash and plaster of Paris as a bone graft material.

The purpose of this study is to evaluate the new bone formation of sinus augmentation with using ICB (Irradiated Cancellous Bone & Marrow; Rockey Mountain Tissue Bank, Denver, Co) and MBCP (Micro-Macroporous Biphasic Calcium Phosphate;Biomatlante, France). Study population consisted of 4 patients with maxillary posterior edentulous dentition and ridge heights were less than 5 mm. ICB (Rockey Mountain Tissue Bank, Denver, Co) and MBCP (Biomatlante, France) is mixed with 50: 50. After 6 months, the bone biopsies were done with 2mm trephine bur from lateral window opening. Mean new bone formations were 26.84 %, the residual grafts were 4.92 and soft tissues were 67.98 %. The small number of biopsies did not permit analysis of statistical significance. The variability of individual patient factors do not permit definitive conclusions. The mixtures of ICB & MBCP were superior or comparable to another various bone alternative materials in new bone formation of sinus floor elevation.

This study evaluated the histology results of surgically created bone cavities in the calvaria of rabbits that were subsequently filled with a HA/ß-TCP composite powder developed in Korea (Dentium, Korea). Ten young adult rabbits were used. Four defects were surgically produced in the calvaria of each rabbit. These defects were classified into 4 groups: the control group, no graft materials; experimental group I, normal saline + graft materials; experimental group II, venous blood + graft materials; and experimental group III, graft materials only. The defects were randomly filled with the graft materials. The rabbits were sacrificed with at 1-, 2-, 4-, 6- and 8- weeks after surgery. The histology specimens were prepared using the general method with H & E staining at a 6 ㎛ thickness. Histologically, the degree of new bone formation was similar in all experimental groups. However, for experimental group II, many cells had gathered around the graft materials 1-week after surgery, and new bone formed slightly faster and than in the other groups. No bone formation was observed in the control group. Based on histology findings, the new HA/ß- TCP composite powders appeared to act as a scaffolding material for the regeneration of osseous defects.

This study investigated the existence of interdental papillae at certain distances from the contact point to the alveolar crest, depending on the interproximal distance between roots.A total of 206 papillae from 80 patients were examined after the inflammation of the papillae had been minimized using non-surgical periodontal therapy. The existence of the interdental papillae was determined using the following categorization: 1) papillae were deemed to be absent if they did not extend all the way up to the contact point between the teeth; and 2) papillae were determined to be present if they filled up to the entire proximal space. The interproximal distance between roots and the distance from the contact point to the alveolar crest were measured when a full-thickness flap was used. The number of papillae present interproximally between roots, according to the distance from the contact point to the alveolar crest, was analyzed using the x2 analysis method, and the linear-by-linear association analysis method was used for trend analysis.The number of papillae that filled the interproximal space decreased with increasing distance from the contact point to the alveolar crest (P0.05). In addition, the number of papillae that filled the interproximal space decreased with increasing interproximal distance between roots (P0.05) and became more prominently decreasing with the increasing distance from the contact point to the alveolar crest (especially 4, 5, and 6 mm) (P0.05).The results suggest that the interproximal distance between roots and the distance between the contact point and the alveolar crest have an independent and combined effect on the existence of interproximal papillae.

Purpose This study examined immunohistochemical changes in the craniomandibular joints of rabbits after distraction osteogenesis following mandibular corticotomy. Materials and methods The experimental animals (n = 8) were divided into 3 groups that underwent 2, 3.5, and 5 mm of unilateral distraction osteogenesis (groups 1, 2, and 3, respectively). After corticotomy of the left mandibular body and a 7-day healing period, a second operation was performed to expose the device. Distraction was then performed at the rate of 0.5 mm/d. A 14-day consolidation period was allowed after the distraction was complete. Changes in cartilage, osteoblast activity, and osteoclast activity were then examined. Results The differentiation and proliferation of cartilage increased in groups 1 and 2, were highest in group 2, and decreased in group 3. Group 2 also showed the greatest increase in the width of the hypertrophic chondrocyte layer. Relative to the control group, osteoclast activity was only somewhat higher in groups 1 and 2 but was significantly higher in group 3. Osteoblast activity was significantly higher in groups 1 and 2 than in the control group. However, the osteoblast activity in group 3 was slightly lower than that in group 2. At the time of unilateral mandibular distraction, no degenerative changes of the temporomandibular joint were observed in groups 1 or 2, but bone resorption was observed in group 3. Conclusions The unilateral mandibular distraction of 2 or 3.5 mm was acceptable in that no degenerative changes of the temporomandibular joint were observed on either the distraction or the nondistraction sides. Five millimeters of distraction might be beyond physiologic limits.

Epidemiological studies suggest a relationship between periodontitis and coronary artery disease, but the mechanism has not been established. Recent studies in animals indicate that low dose endotoxin, as in a gram-negative infection, can induce hyperlipidemia and myeloid cell hyperactivity. The association between periodontitis, systemic exposure to Porphyromonas gingivalis, lipopolysaccharides (LPS), and hyperlipidemia has not been examined in humans.Sera were obtained from 26 adult periodontitis patients and 25 healthy control (C) subjects selected from patients and staff. Serum antibodies against Porphyromonas gingivalis and its LPS were analyzed by enzyme-linked immunosorbent assay (ELISA) and Western blotting, respectively. Serum triglycerides (TG) and cholesterol (CHOL) were assayed by a commercial laboratory. The associations between AP and blood levels of TG, CHOL, and anti-P. gingivalis whole cells and LPS were examined by logistic regression analysis. Peripheral blood polymorphonuclear leukocytes (PMNs) from 6 healthy fasted donors were incubated with purified TG (0.1 mg/ml) for 2 hours at 37 degrees C, stimulated with 100 ng/ml P. gingivalis LPS, and the release of IL-1beta measured by ELISA.The presence of periodontitis was significantly associated with age (odds ratio = 3.5, P = 0.04), elevated TG levels (odds ratio = 8.6, P = 0.0009), elevated CHOL levels (odds ratio = 7, P = 0.004), elevated ELISA titer (odds ratio = 35, P = 0.003) and reactivity with P. gingivalis LPS (odds ratio = 41, P = 0.001). PMNs from all 6 healthy patients released modest levels of IL-1beta (10 to 60 pg/ml) when stimulated with 100 ng/ml P. gingivalis LPS. Addition of TG resulted in a significant increase (P0.05) in IL- 1beta secreted that ranged from 7 to 150% over LPS alone. No IL-1beta was elicited by TG or vehicle alone.The results of this study indicate the presence of a significant relationship between periodontitis, hyperlipidemia, and serum antibodies against P. gingivalis LPS that warrants further examination in a larger patient population. Furthermore, these studies indicate that elevated triglycerides are able to modulate IL-1beta production by PMNs stimulated with P. gingivalis LPS.

Saussurea lappa Dence (Compositae) is used as a traditional herbal medicine to treat abdominal pain and tenesmus in East Asia. Current studies have shown that S. lappa has anticancer activity in divergent of cancer cells. However, the effects of S. lappa on oral cancer and its mechanisms of action have yet to be elucidated.To explore its potential chemotherapeutic effects and mechanism of cell growth inhibition on human oral cancer cells.The dried roots of S. lappa were used in this study. Cell viability of KB cells was evaluated by 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide assay after treatment with 30 µg/ml of methanol extract from the dried roots of S. lappa. To understand whether its effect on cell death is related with apoptosis pathway, we performed DNA fragmentation assay, western blot, caspase activity assay and fluorescence-activated cell sorting (FACS) analysis.Treatment of S. lappa extract onto KB cells reduced cell viability significantly with an IC50 value of 30 µg/ml. The formation of a DNA ladder was observed starting at the 24 h treatment. In western blotting analysis, the S. lappa extract induced the proteolytic processing of caspase-3, -9 and poly (ADP-ribose) polymerase, a significant increase of Bax and marked reduction of Bcl-2. We also confirmed the activation of caspase-3/-7 in living KB cells by fluorescence microscopy.These results suggested that S. lappa extract inhibited cell proliferation through the apoptosis pathway in KB human oral cancer cells.

Secretory leukocyte protease inhibitor (SLPI) and estrogen promote wound healing through a decrease in the excessive inflammatory response, accelerating re-epithelialization and increasing the amount of collagen deposition. The excessive administration of estradiol valerate (EV) using hormonal therapy decreases the concentration of estrogen abruptly and induces the polycystic ovary syndrome (PCOS). In this study, the PCOS rat skin wound area was wider than that of the normal groups and the rate of keratinocyte migration in PCOS was lower than the normal group. The numbers of inflammatory cells and macrophages recruited in the PCOS group were larger than that of the normal group. More collagen was deposited in the healing area of the normal group than in the PCOS group. The level of SLPI expression was higher in the PCOS group than the normal group after wounding, with the exception of the epithelium. On the other hand, mRNA and protein expression levels of transforming growth factor-β1 (TGF-β1) were lower in the PCOS group than in the normal group. Matrix metalloproteinase-2 (MMP-2) and MMP-9 levels in the PCOS group were significantly lower than that of the normal group. Therefore, increased SLPI in PCOS skin wounds may help prevent an excessive inflammatory response and aberrant collagen deposition but not are sufficient to accelerate PCOS skin wound healing, suggesting that SLPI may act as a local rather than a systemic modulating molecule in PCOS rat skin wounds.

Purpose The purpose of the present study was to evaluate the clinical application of resorbable and nonresorbable plates for correction of facial asymmetry. Patients and Methods A total of 272 patients who had undergone orthognathic surgery were enrolled. The site of osteotomy was fixed using a nonresorbable plate in group I (n = 152) and using a resorbable plate in group II (n = 120). The postoperative complications included postoperative anterior open bite, infection, temporomandibular joint dysfunction, and postoperative relapse. The incidence of all complications was examined. Results The surgical outcome was successful in 269 patients (98.89%). Of the 152 patients with a titanium plate, 13 (8.6%) developed complications. Of the 120 patients with a resorbable plate, 22 (18.3%) developed complications. A greater degree of postoperative open bite and a trend toward relapse were observed in patients' cases in which an absorbable fixation plate was used. Postoperative infection occurred in patients with an absorbable fixation plate. Conclusion On the basis of these data, we have concluded that an absorbable fixation plate should be used instead of a titanium fixation plate in indicated patients.

Ethnopharmacological relevance Cordyceps militaris , one of traditional herbal ingredient in oriental medicine, has been known to promote anticancer and immunomodulatory activities in vitro and in vivo . However, the biological mechanism of anticancer activity has been unknown. Objective To investigate the effect of Cordyceps militaris extract on expression of interferon gamma (IFN-γ) through interlukin-18 (IL-18) induction and its biological mechanism in vitro and in vivo . Materials and methods Mice were administrated orally with solution extracted from Cordyceps militaris . The transcription level of IL-18 and IFN-γ production were measured by reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry. RAW 264.7 cells were transiently transfected with pCATp1 and pCATp2 for IL-18 promoter functional analysis. Results Cordyceps militaris extracts treatment significantly induced level of IL-18 transcription in mouse brain and liver and enhanced IL-18 transcription level and activated the IFN-γ production in RAW 264.7 cells. Furthermore, Cordyceps militaris extract led to increase the activity of pCATp1 construct containing the 5′ franking region of IL-18 promoter in RAW 264.7 cells. Conclusion Cordyceps militaris extract induced IL-18 mRNA level via enhancing of P1 promoter region result in activation of IFN-γ production, indicating its potential as an immune activator or anticancer drug.

Purpose The purpose of this animal study was to perform a histological and histomorphometric analysis in order to elucidate the effect of fibroblast growth factor-2 (FGF-2) on injured periodontal ligament (PDL) and cementum after tooth replantation in dogs. Methods The roots of 36 mandibular premolars from six mongrel dogs were used in this study. The roots were randomly divided into three groups: (1) a positive control group (n=12), in which the PDL was retained; (2) a negative control group (n=12), in which the PDL and the cementum between the notches were removed; and (3) an experimental group (n=12), in which the PDL and the cementum between the notches were removed and the roots were soaked in an FGF-2 solution (30 µg/0.1 mL). After treating the root surfaces, the extracted roots were replanted into extraction sockets. The animals were sacrificed four and eight weeks after surgery for histologic and histomorphometric evaluation. Results At four and eight weeks, normal PDLs covered the roots in the positive control group. In the negative control group, most replanted roots showed signs of replacement resorption. In the experimental group, new PDL-like tissue and cementum-like tissue were observed to partially occupy the region between the root surfaces and the newly formed bone. Histomorphometric analysis showed that the mean length of the newly formed cementum-like tissue on the roots treated with FGF-2 was significantly greater than that of the tissue on the roots in the negative control group (four weeks, P=0.008; eight weeks, P=0.042). However, no significant differences were observed between the roots treated with FGF-2 and the negative control roots with respect to newly formed PDL-like tissue. Conclusions The results of this study suggest that use of FGF-2 on injured root surfaces promotes cementogenesis after tooth replacement in dogs. Graphical Abstract

This article describes a procedure for performing simultaneous sinus lifting and alveolar distraction to augment an atrophic maxillary alveolus. This technique is a 1-stage operation that is indicated when the amount of native sinus floor bone is minimal (

This article describes a pooled analysis of 41 Korean patients with metastatic oral tumours. The data reviewed are from Korean dental and medical case reports published between 1983 and 2004. The mean age was 55.2 years, and the male-to-female ratio was 1.9:1. There were more metastases in the jawbone than in oral soft tissues. The lung was the most common primary site for jawbone metastases, whereas the liver was for those of oral soft tissues. In contrast to reports in Western literature of the breast being the most common primary site, the liver was the most common primary site, followed by the lung and thyroid. These differences may be caused by a relatively high incidence rate of hepatocellular carcinoma in Korea.