Adequate toothbrushing method following periodontal tissue regeneration

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The purpose of the present study was to determine an adequate stage for initiating tooth-brushing and optimal tooth-brushing force/duration following periodontal tissue regenerative therapy.Six beagle dogs were involved in the experiment First, the maxillary second premolar and mandibular third premolar were extracted. 4x4x4 mm of size, was formed between the maxillary first and third premolars and between the mandibular second and fourth premolars. Then, notch was marked on the root surface for recording the bottom of bone defect. In order to induce periodontitis, metal matrix was inserted in the area of bone defect The dogs were then kept for 8 weeks with being fed by soft food. After these treatments, the metal matrix were removed and periodontal tissue regenerative therapy was performed using Emdogain. Experimental teeth were divided into four groups according to the split-mouth design for each dog. The control tooth was given daily plaque removal using a hand instrument. The other three was given daily professional tooth-brushing following 1 day (1D), 3 days (3D), or 7 days (7D) after the periodontal regenerative therapy. The force and duration of tooth-brushing was set for 200g and 20 seconds, respectively. The stress gauze was used for controlling the tooth-brushing force.Histological observation found similar results with respect to gingival inflammation and remodeling of alveolar bone. No marked inflammation and down growth of sulcular epithelium was observed in all the groups. Newly-formed alveolar bone was found around the one-third of initial bone defect area. A little amount of newly formed cementum was observed around the notch. However, epithelial downgrowth was partially observed for 1D, 3D dogs.The results of this study indicate that tooth-brushing can be initiated next day after periodontal surgical treatment.