Journal of Periodontal and Implant Science

  • 제35권3호
  • /
  • Pages.703-718
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  • 2005
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  • 2093-2278(pISSN)
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  • 2093-2286(eISSN)
대한치주과학회 (Korean Academy of Periodontology)
권호 표지

하악 2급 치근 이개부 병소에서 키토산 나노 차폐막을 이용한 치주조직 재생의 임상적 효과에 관한 비교 연구

A comparative study of the clinical effects of chitosan nanofiber membrane in the treatment of mandibular class II furcation defects

  • 최한선 (단국대학교 치과대학 치주과학교실) ;
  • 정임 (주식회사 나이벡) ;
  • 김정빈 (주식회사 나이벡) ;
  • 홍기석 (단국대학교 치과대학 치주과학교실) ;
  • 임성빈 (단국대학교 치과대학 치주과학교실) ;
  • 정진형 (단국대학교 치과대학 치주과학교실)
  • Choi, Han-Sun (Department of Periodontology, College of Dentistry, Dan-Kook University) ;
  • Jeong, Lim (Nibec Co., Ltd) ;
  • Kim, Jeong-Bin (Nibec Co., Ltd) ;
  • Hong, Ki-Seok (Department of Periodontology, College of Dentistry, Dan-Kook University) ;
  • Lim, Sung-Bin (Department of Periodontology, College of Dentistry, Dan-Kook University) ;
  • Chung, Chin-Hyung (Department of Periodontology, College of Dentistry, Dan-Kook University)
  • 발행 : 2005.09.30
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초록

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polvlactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.

키워드

참고문헌

  1. Socransky SS. Haffajee AD. Goodson JM. Linde J. New concepts of destructive periodontal disease. J Clin Periodontol 1984: 11:21-32 https://doi.org/10.1111/j.1600-051X.1984.tb01305.x
  2. Kalkwarf K. Kadahl WE. Patel KD. Evaluation of fur cation region response to periodontal therapy. J Periodontol 1988: 59: 794-804 https://doi.org/10.1902/jop.1988.59.12.794
  3. Matia JI. Bissada NF. Maybury JE. Efficiency of scaling of the molar furcation area with and without surgical access. Int J Periodontics Restorative Dent 1986:6:25-35
  4. Parashis A, Anagnou-Vareltzides A, Demetriou N. Calculus removal from multirooted teeth with and without surgical access. J Clin Periodontol 1993;20:294-298 https://doi.org/10.1111/j.1600-051X.1993.tb00361.x
  5. Waerhaug J. The fur cation problem. Etilogy, pathogenesis. diagnosis. therapy. and prognosis. J Clin Perodontol 1980: 7:73-95 https://doi.org/10.1111/j.1600-051X.1980.tb01951.x
  6. Payot P. Bickel M. Cimasoni G. Longitudinal quantitative radiodensitometric study of treated and untreated lower molar furcation involvements. J Clin Periodontol 1987; 14: 8-18 https://doi.org/10.1111/j.1600-051X.1987.tb01506.x
  7. Wang H, Burgett F. Shyr Y. Ramfyord S. The influence of molar furcation involvement and mobility on future clinical periodontal attachment loss. J Periodontol 1994:65:25-29 https://doi.org/10.1902/jop.1994.65.1.25
  8. Melcher AH. On the repair potential of periodontal tissue. J Periodontol 1976: 47:256-260 https://doi.org/10.1902/jop.1976.47.5.256
  9. Gottlow J. Nyman S. Lindhe J, Karring T, Wennstrom J. New attachment formation in the human periodontium by guided tissue regeneration. Case reports. J Clin Periodontol 1986: 13:604-616 https://doi.org/10.1111/j.1600-051X.1986.tb00854.x
  10. Nyman S, Lindhe J, Karring T, Rylander H. New attachment following surgical treatment of human periodontal disease. J Clin Periodontol 1982: 9: 290-296 https://doi.org/10.1111/j.1600-051X.1982.tb02095.x
  11. Nyman S, Gottlow J, Lindhe J, Karring T. Wennstrom J. New attachment formation by guided tissue regeneration. J Periodont Res 1987: 22: 252-254 https://doi.org/10.1111/j.1600-0765.1987.tb01581.x
  12. Pontorieto R, Nyman S, Lindhe J, Rosenberg E, Sanavi F. Guided tissue regeneration in the treatment of furcation defects in man. J Clin Periodontol 1987:14:618-620 https://doi.org/10.1111/j.1600-051X.1987.tb01526.x
  13. Becker W, Becker B. Berg L, Prichard J, Caffesse R, Resenberg E. New attachment after treatment with root isolation and vertical osseous defects. lnt J Periondontics Restorative Dent 1988:8:8-23
  14. Pontoriero R, Lindhe J, Nyman S, Karring T, Rosenberg E, Sanavi F. Guided tissue regeneration in degree II furcation-involved mandibular molars. A clinical study. J Clin Periodontol 1988: 15 :247-254 https://doi.org/10.1111/j.1600-051X.1988.tb01578.x
  15. Lekovic V, Kenney EB, Kovacevic K. Carranza Jr. F.A. Evaluation of guided tissue regeneration in class II furcation defects. A clinical re-entry study. J Periodontol 1989: 60: 694-698 https://doi.org/10.1902/jop.1989.60.12.694
  16. Pontoriero R. Lindhe J, Nyman S, Karring T, Rosenberg E, Sanavi F. Guided tissue regeneration in the treatment of fur cation defects in mandibular molars. A clinical study of degree III involvements, J Clin Periodontol 1989: 16:170-174 https://doi.org/10.1111/j.1600-051X.1989.tb01635.x
  17. Caffesse R. Smith BA, Duff B, Morrison EC, Merrill D, Becker W. Class II furcations treated by guided tissue regeneration in humans. Case reports. J Periodontol 1990:61:510-514 https://doi.org/10.1902/jop.1990.61.8.510
  18. Gottlow J, Karring T. Maintenance of new attachment gained through guided tissue regeneration. J Clin Periodontol 1992:19:315-317 https://doi.org/10.1111/j.1600-051X.1992.tb00651.x
  19. Scantlebury TV. A decade of technology development for guided tissue regeneration. J Periodontol 1993:64(11 suppl): 1129-1137 https://doi.org/10.1902/jop.1993.64.11s.1129
  20. Caffesse RG, Dominguez LE, Nasjleti CE, Castelli WA, Morrison EC, Smith BA, Furcation defects in dogs treated guided tissue regeneration(GTR). J Periodontol 1990: 61: 45-50 https://doi.org/10.1902/jop.1990.61.1.45
  21. Selvig KA, Kersten BG. Wikesho UME. Surgical treatment of intrabony periodontal defects using expanded polytetrafluoroethylene barrier membranes: influence of defect configuration on healing response. J Periodontol 1993:64: 730-733 https://doi.org/10.1902/jop.1993.64.8.730
  22. Becker W, Becker BE, McGuire MK. Localized ridge augmentation using absorbable pins and e-PTFE barrier membranes: a new surgical technique. Case reports. lnt J Periodontics Restorative Dent 1994: 14: 48-61
  23. Murphy K.G. Postoperative healing complication associated with Gore-Tex periodontal material. Part I. Incidence and characterization. Int J Periodont Rest Dent 1995; 15: 363-375
  24. Warrer K. Karring T, Nyman S, Gogolewski S. Guided tissue regeneration using biodegradable membranes of polylactic acid or polyurethane. J Clin Periodontol 1992; 9: 633-640
  25. Vuddhakanok S, Solt CW, Mitchell JC, Foreman DW, Alger Fa. Histologic evaluation of periodontal attachment apparatus following the insertion of a biodegradable copolymer barrier In humans. J Periodontol 1993:64:202-210 https://doi.org/10.1902/jop.1993.64.3.202
  26. Blumenthal NM. A clinical comparison of collagen membranes with e-PTFE membranes in the treatment of human mandibular buccal class II furcation defects. J Periodontol 1993:64:925-933 https://doi.org/10.1902/jop.1993.64.10.925
  27. Gottlow J. Guided tissue regeneration using bioresorbable and non-resorbable devices: initial healing and long-term results. J Periodontol 1993:64(11 Suppl) : 1157-65 Review https://doi.org/10.1902/jop.1993.64.11s.1157
  28. Caffesse RG, Nasjleti CE, Morrison EC, Sanchez R. Guided tissue regeneration: comparison of bioabsorbable and nonbioabsorbable membranes. Histologic and histometric study in dogs. J Periodontol 1994:65: 583-591 https://doi.org/10.1902/jop.1994.65.6.583
  29. Hugoson A, Ravalk N, Formell J, Johard G, Teiwik A, Gottlow J. Treatment of class II furcation involvements in humans with bioresorbable and nonresorbable guided tissue regeneration barriers. A randomized multi-center study. J Periodontol 1995: 66: 624-634 https://doi.org/10.1902/jop.1995.66.7.624
  30. Becker W. Becker BD, Melloning J, Caffesse RG, Warrer K, Caton JG, Reid T. A prospective multi-center study evaluation periodontal regeneration for class II furcation invasions and intrabony defects after treatment with a bioabsorbable barrier membrane: 1-year results. J Periodontol 1996:67:641-649 https://doi.org/10.1902/jop.1996.67.7.641
  31. Caffesse RG, Mota LF, Quinones CR. Morrison EC. Clinical comparison of resorbable and non-resorbable barriers for guided periodontal tissue regeneration. J Clin Periodontol 1997:24:747-752 https://doi.org/10.1111/j.1600-051X.1997.tb00192.x
  32. Kind GM. Bines SD, Staren ED, Templeton AJ, Economou SG. Chitosan: evaluation of a new hemostatic agent. Curr Surg 1990:47:37-39
  33. Klokkevold PR. Lew DS, Ellis DG, Bertolami CN. Effect of chitosan on lingual hemostasis in rabbits. J Oral Maxillofac Surg 1991:49:858-863 https://doi.org/10.1016/0278-2391(91)90017-G
  34. Klokkevold PR. Subar P, Fukayama H, Bertolami CN. Effect of chitosan on lingual hemostasis in rabbits with platelet dysfunction induced by epoprostenol. J Oral Maxillofac Surg 1992: 50:41-45 https://doi.org/10.1016/0278-2391(92)90194-5
  35. Azad AK, Sermsintham N, Chandrkrachang S, Stevens WF. Chitosan membrane as a wound healing dressing: characterization and clinical application. J Biomed Mater Res 2004: 69B: 216-222 https://doi.org/10.1002/jbm.b.30000
  36. Aspinall GO. The polysaccharides. Chitin and chitosan. New York: Academic Press 1983: Inc.2: 386
  37. Klokkevold PR. Vandermark L, Kenney EB, Bernard GW. Osteogenesis enhanced by chitosan(Poly-N-Acetyl Glucosaminoglycan) in vitro. J Periodontol 1996:67: 1170-1175 https://doi.org/10.1902/jop.1996.67.11.1170
  38. 백정원, 이현정, 유윤정, 조규성, 김종관, 최성호. 키토산이 치주인대 섬유아세포에 미치는 영향. 대한치주과학회지 2001; 31(4) : 823-832
  39. 계승범, 손성희, 최상묵. Chitosan과 chitosan-cellulose를 이용한 차폐막의 골조직 재생유도 능력에 관한 연구. 대한치주과학회지. 1998;28 :611-32
  40. Mallette WG. Quigley HJ. Adickes ED. Chitin in nature and technology. In: Muzzarelli RA. Jeuniaux C. Gooday GW eds. Chitosan Effect in Nature and Technology. New York: Pleum Press 1986; 435-442
  41. Muzzarelli RA. Biagini G. Pugnaloni A. Filippini O. Baldassarre V. Reconstruction of periodontal tissue with chitosan. Biomaterials 1989; 10: 598-603 https://doi.org/10.1016/0142-9612(89)90113-0
  42. 신승윤, 박호남, 김경화, 이승진, 박윤정, 구영, 류인철, 한수부, 정종평. 키토산 나노 차폐막의 골조직 재생유도 능력에 관한 조직학적 연구. 대한치주과학회지 2004: 34: 543-9
  43. Glickman I. Bifurcation involvement in periodontal disease. J Am Dent Assoc 1950:40: 528
  44. Silness J. Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964:22:121-135 https://doi.org/10.3109/00016356408993968
  45. Loe H. The gingival index. the plaque index and the retention index systems. J Periodontol 1974:38:610-616 https://doi.org/10.1902/jop.1967.38.6.610
  46. 설양조, 김태일, 이재일, 배철민, 이승진, 정종평. 수종의 생분해성 차폐막의 생체친화도 및 조직재생유도 능력에 관한 실험적 연구. 대한치주과학회지 1995: 25: 603-613
  47. Pangburn SH. Trescony PV, Heller J. Lysozyme degradation of partially deacetylated chitin, its films and hydrogels. Biomaterials 1982: 3: 105-8 https://doi.org/10.1016/0142-9612(82)90043-6
  48. Shigemasa Y. Saito K. Sashiwa H. Saimoto H. Enzymatic degradation of chitins and partially deacetylated chitins. Int J Biol Macromol 1994: 16:43-49 https://doi.org/10.1016/0141-8130(94)90010-8
  49. Onishi H. Machida Y. Biodegradation and distribution of water-soluble chitosan in mice. Biomaterials 1999:20: 175-82 https://doi.org/10.1016/S0142-9612(98)00159-8
  50. Balassa LL, Prudden JF. Applications of chitin and chitosan in wound healing acceleration. In: Muzzarelli RA, Pariser ER eds. Proceedings of the 1st International Conference on Chitin and Chitosan. Cambridge, MA: MIT Press 1978
  51. Muzzarelli RA, Mattioli-Belmote M, Tiez C, Biagini R, Feriolo G, Brunelli MA, Fini M, Giardino R, Ilari P, Biagini G. Stimulatory effect on bone formation exerted by a modified chitosan. Biomaterials 1994:15:1075-1081 https://doi.org/10.1016/0142-9612(94)90093-0
  52. Mima S, Miya M. Iwamoto R, Yoshikawa S. Highly deacetylated chitosan and its properties. J Appl Polym Sci 1983:28: 1909-1917 https://doi.org/10.1002/app.1983.070280607
  53. Minami S, Okamoto A Matsuhashi A. et al. Applications of chitin and chitosan in animals. In: Brine CJ, Sanford PA Zikakis JP, eds. Advanced in chitin and chitosan. London: Elsevier Applied Science 1992:61-69
  54. Iglhaut J, Suggs C, Borjesson B, Aukhil I. Apical migration of oral epithelium in experimental dehiscence wounds. J Clin Periodontol 1987; 14: 508-514 https://doi.org/10.1111/j.1600-051X.1987.tb00991.x
  55. Dahlin C. Lindhe A. Gottlow J. Nyman S. Healing of bone defects by guided tissue regeneration. Plast Reconstr Surg 1988; 81: 672-676 https://doi.org/10.1097/00006534-198805000-00004
  56. Dahlin C. Andersson L, Lindhe A. Bone augmentation at fenestrated implants by an osteopromotive membrane technique. A controlled clinical study. Clin Oral Implants Res 1991:2: 159-65 https://doi.org/10.1034/j.1600-0501.1991.020401.x
  57. Hench LL. Biomaterials. Science 1980, 23:208(4446) :826-31. Review