• Journal of Periodontal and Implant Science
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• 제33권3호
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• pp.373-382
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• 2003

The successful use of osseointegrated implants to replace missing teeth has been demonstrated for both the completely and the partially edentulous patients. Many studies have confirmed an excellent long-term prognosis. The successful outcome of any implant procedure is surely dependent on the interrelationship of the various components that includes the following: biocompatibility of the implant material, macroscopic and microscopic nature of the implant surface, the status of the implant bed in both a health(noninfected) and a morphologic(bone quality) context, the surgical technique, the undisturbed healing phase, the subsequent prosthetic design, and long-term loading phase. Periodontally compromised patients have poor status of the implant bed and periodontal pathogen. No longitudinal data are available whether these factors affect the prognosis of implants. In this study, 102 machined $Br{{\aa}}nemark$ implants are inserted to analyze the success rate of 1-4 years and marginal bone loss in 49 chronic periodontitis patients. The following conclusions could be drawn from this study. 1. The cumulative success rate of implants at the 4-year of loading was 95.10%. 2. 5 failed implants have been removed. One implant have been removed due to infection, two implants were removed due to failure of osseointegration. and other two implants were removed due to mechanical failure caused by over-loading. 3. Mean marginal bone loss from the time of loading was 0.94mm at first year, 1.12mm at second year, 1.25mm at third year. These results suggest that implant therapy is good treatment modality in chronic periodontitis patients, and periodontal treatment including oral hygiene program is completed prior to insertion of implants.

• Journal of Periodontal and Implant Science
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• 제24권3호
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• pp.493-502
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• 1994

The benefits in using controlled delivery approaches include improved pharmacokinetic response, greater ability to localize the drung adjacent to the disease, and more control of local concentration at a lower total dosage. The purpose of this study was to evaluate the efficacy and safety of Minocline strip on chronic marginal periodontitis. Minocline Strip was applied in the periodontal pocket of 94 patients with a clinically diagnosed as a chronic marginal periodontitis, 4 sites for each patients with a 5mm probing pocket depth were selected in split mouth design and were divided into two group, ie., placebo group ($C_1$, $C_2$) and experimental group ($E_1$, $E_2$). Supragingival scaling and oral hygiene instruction were performed 1 week before experiment. Minocline Strip was applied on day 0 and 7, weekly, Clinical and microbiological tests were performed on day 0, 7, 14, 28 and 42. The results were as follows ; 1. Minocline Strip showed significant improvement on Chronic Marginal Periodontitis in 77 patients (82.0%) and improvement rate was more than 66.7% of all investigational items. 2. Only 6 patients complained mild pruritis during the early therapy but not needed discontinuence of the therapy. 3. The availability of Minocline Strip was 72 patients (76.6%) synthetically evaluating efficacy and safety. In conclusion, Minocline Strip appears to be effective and safe for the treatment of Chronic Marginal Periodontitis.

• Journal of Periodontal and Implant Science
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• 제39권4호
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• pp.391-398
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• 2009

Purpose: The purpose of this study was to quantify and compare the expressions of CRP and M-CSF in the gingival tissues of the patients with chronic periodontitis associated to hypertension. Methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. Clinically healthy gingival tissue samples from systemically healthy 12 patients were categorized as group 1 (n=12). Inflammatory gingival tissue samples from patients with chronic periodontitis were categorized as group 2 (n=12). Inflammatory gingival tissue samples from patients with chronic periodontitis associated with hypertension were categorized as group 3 (n=12). Tissue samples were prepared and analyzed by Western blotting. The quantification of CRP and M-CSF were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. Results: There were significant differences between group 1 and group 2 and between group 1 and group 3 in both CRP and M-CSF. The differences between group 2 and group 3 were not statistically significant in both proteins. However, the expression levels of CRP and M-CSF in hypertensive inflammatory gingiva showed increased tendency compared to non-hypertensive inflammatory gingiva. Conclusions: It is suggested that CRP and M-CSF might be used as inflammatory and bone resorption markers in periodontal diseased tissue. It is assumed that hypertension may be associated with the progression of periodontal inflammation and alveolar bone resorption.

• Journal of Periodontal and Implant Science
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• 제39권1호
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• pp.37-44
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• 2009

Purpose: Tetracycline and its chemically modified non-antibacterial analogues can inhibit certain host-derived tissue destructive collagenases such as matrix metalloproteinases. The purpose of this study was to evaluate clinical and microbiologic effects of the subantimicrobial dose of doxycycline(SDD) in conjunction with scaling and root planing. Materials and methods: A total of 30 patients with chronic periodontitis who were going to receive scaling and root planing were randomly allocated to receive either a doxycycline hyclate for 3 months or nothing. Clinical probing depth, clinical attachment level, gingival recession, and bleeding on probing were measured by one periodontist. After a periodontal examination, microbial samples were collected using sterile paper points. The effect of SDD in conjunction with scaling and root planing on alterations of the periodontal pathogens (Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis) were also assessed using l6S rRNA polymerase chain reaction. Results: During the treatment period, clinical parameters for both treatment group and control group were improved. After 3 months, reductions in probing depth and gains in clinical attachment level were significantly greater for the SDD group than control group. Microbial analysis showed that there was no alteration of the periodontal pathogens and no difference between the groups. Conclusion: This study suggested that the subantimicrobial dose of doxycycline as an adjunct therapy with scaling and root planing might be effective and safe in the management of chronic periodontitis.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.849-857
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• 2007

Purpose: The purposes of this study were to compare and quantify the expressions of RANK and RANKL in the gingival tissues of non-periodontitis patient and patients with chronic periodontitis, in order to understand the contribution of these proteins to periodontal destruction. Material and methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was divided into two groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from non-periodontitis patients. Group 2 (n=8) is inflammed gingiva from patients with chronic periodontitis. Tissue samples were prepared and analyzed by Western blotting. The quantification of RANK and RANKL were performed using a densitometer and statistically analyzed by Student's t-Test. Results: The expression of RANK were similar in group 1 and 2. The difference between group 1 and 2 was not statistically significant. And the mean amount of RANKL was more increased in group 2 than group 1. The difference between group 1 and group 2 was statistically significant. Conclusion: The expression level RANK didn't show any significant difference between healthy tissue from non-periodontitis patients and inflamed tissue from chronic periodontitis, but the expression level of RANKL in inflammed tissue from chronic periodontitis showed significantly increased tendency compared to healthy gingiva from non-periodontitis patients. Therefore, characteristics of RANK and RANKL in progress of chronic periodontitis would be basis of further studies in diagnostic method and treatment index of the disease.

• 치위생과학회지
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• 제18권4호
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• pp.210-217
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• 2018

치주질환은 광범위한 만성 염증질환으로 삶의 질, 영양섭취에 큰 영향을 준다. 몇몇의 연구에서 치주질환과 골밀도가 낮은 사람과의 연관성이 보고되고 있으며 비타민 D는 골밀도뿐 아니라 항염증효과도 있기 때문에 치주질환에도 좋은 영향을 줄 것으로 예측된다. 하지만 연구에 따라 다른 결과를 보이고 한국에서는 이에 대한 연구가 부족하므로, 한국인에서 비타민 D와 치주질환의 관계를 알아보기 위하여 본 연구를 시행하였다. 본 연구는 대한민국에서 실시한 국민건강영양조사 2012~2014년의 3개년도 23,626명 중 20세 이상, 비타민 D 혈중농도, 치주질환의 유무가 있는 8,783명을 대상으로 다중선형회귀분석을 시행하여 연령별, 성별 비타민 D 혈중농도와 치주질환이 관계가 있는지 살펴보았다. 치아 상실과 비타민 D의 농도는 음의 상관관계를 가졌다(${\beta}=-0.028$, p=0.008). 또한 대상군 중 50세 이하의 남성에서 비타민 D의 농도가 낮을수록 치주질환의 유병률이 높은 것으로 나타났다(Q1: 1.769 [1.125~2.782], Q2: 1.182 [0.743~1.881], Q3: 0.676 [0.400~1.881]; p=0.001). 비타민 D의 결핍과 치주질환은 진료현장에서 흔히 볼 수 있는 질환이다. 비타민 D의 보충으로 치주질환 및 낙상, 골다공증, 골관절염, 암 등에서 좋은 영향을 미칠 것으로 기대되므로 치주질환이 있는 환자에게는 치주질환의 관리뿐만 아니라 삶의 질 향상을 위해 비타민 D 농도의 일정수준 유지가 도움이 될 수 있겠다. 따라서 본 연구에서와 같이 노인뿐만 아니라 50세 이하 성인남성에서도 연관이 있으므로, 성인에서도 비타민 D 농도의 일정수준 유지에 관심을 가져야 할 것이다.

• 한국미생물·생명공학회지
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• 제44권4호
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• pp.557-562
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• 2016

치주질환은 만성염증성 질환으로 치조골소실을 일으켜 성인치아상실을 유발하는 요인 중 하나이다. 그람 음성세균인 Aggregatibacter actinomycetemcomitans와 Porphyromonas gingivalis는 치주질환환자의 병소에서 쉽게 동정된다. 지질다당체(Lipopolysaccharide; LPS)는 그람 음성세균의 핵심 독력인자로 알려져 있다. 이러한 세균과 LPS는 파골세포에 의한 골소실을 조절하는 요인 중 하나이다. 그러므로 본 연구에서는 동물모델을 활용하여 A. actinomycetemcomitans와 P. gingivalis의 의한 골소실 여부를 확인하고, 기전규명을 위하여 A. actinomycetemcomitans, P. gingivalis, A. actinomycetemcomitans와 P. gingivalis에서 분리한 LPS에 의한 파골세포분화 영향을 연구하였다. 열사멸한 A. actinomycetemcomitans (HKAa)와 열사멸한 P. gingivalis (HKPg)가 복강으로 투여된 쥐의 대퇴골은 대조군에 비해 감소된 골량을 보여주었다. 이러한 골소실의 증가가 파골세포분화 때문인지 확인하기 위해 파골세포분화를 연구한 결과, bone marrow-derived macrophage (BMM)의 RANKL-매개 파골세포분화를 감소시켰으나, committed osteoclast precursor의 파골세포분화를 유도함을 확인하였다. 세균에 의한 파골세포분화 결과와 동일하게 A. actinomycetemcomitans와 P. gingivalis에서 분리한 LPS 역시 RANKL-매개 파골세포분화는 감소시키고, committed osteoclast precursor의 파골세포분화를 유도하였다. 결과적으로 치주원인균인 A. actinomycetemcomitans와 P. gingivalis는 committed osteoclast precursor의 파골세포분화를 증가시키는데, 이 세균들의 LPS가 핵심 역할을 수행하는 것으로 판단되며 이를 통해 골 흡수를 유발함을 알 수 있었다.

• Journal of Periodontal and Implant Science
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• 제32권2호
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• pp.415-428
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• 2002

Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.

• Journal of Periodontal and Implant Science
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• 제38권2호
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• pp.143-152
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• 2008

Purpose: Specific bacteria are believed to play an important role in chronic periodontitis. Although extensive microbial analyses have been performed from subgingival plaque samples of periodontitis patients, systemic analysis of subingival microbiota has not been carried out in a Korean population so far. The purpose of this study was to investigate the prevalence of 29 putative periodontal pathogens in Korean chronic periodontitis patients and evaluate which pathogens are more associated with Korean chronic periodontitis. Material and Methods: A total of 86 subgingival plaque samples were taken from 15 chronic periodontits(CP) patients and 13 periodontally healthy subjects in Korea. CP samples were obtained from the deepest periodontal pocket (>3 mm probing depth[PD]) and the most shallow periodontal probing site ($\leq$3 mm PD) in anterior tooth and posterior tooth, respectively, of each patient. Samples in healthy subjects were obtained from 1 anterior tooth and 1 posterior tooth. Polymerase chain reaction (PCR) of 16S ribosomal DNA (rDNA) of subgingival plaque bacteria was performed. Detection frequencies(% prevalence) of 29 putative periodontal pathogens were investigated as bacterium-positive sites/total sites. Results: With the exception of Olsenella profuse and Prevotella nigrescens, the sites of diseased patients generally showed higher prevalence than the healthy sites of healthy subjects for all bacteria analyzed. Tanerella forsythensis (B.forsythus), Campylobacter rectus, Filifactor alocis, Fusobacterium nucleatum, Porphyromonas endodontalis and Porphyromonas gingivalis were detected in more than 80% of sites with deep probing depths in CP patients. In comparison between the sites (deep or shallow PD) of CP patients and the healthy sites of healthy subjects, there was statistically significant difference(P<0.05) of prevalence in T.forsythensis (B.forsythus), C.rectus, Dialister invisus, F.alocis, P.gingivalis and Treponema denticola. Conclusion: Our results demonstrate that the four putative periodontal pathogens, T.forsythensis (B.forsythus), C.rectus, P.gingivalis and F.alocis are closely related with CP patients in the Korean population.

• 구강회복응용과학지
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• 제28권3호
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• pp.277-290
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• 2012

최근 치과 임플란트는 구강 내 무치악 부위의 보편적인 수복 방법으로 임상가 뿐만 아니라 환자들에게도 널리 인식되어 있다. 외상, 만성 치주염 등 다양한 원인에 의해 상악 전치부는 발치 후 급속한 순측 골흡수가 진행될 수 있다. 그로 인해 협소한 순구개 폭경을 가진 상악 전치부 치조제 상에 임프란트 식립 시 열개 및 천공형 골결손이 발생할 수 있다. 이 경우 골유도 재생술을 사용하여 상악 전치부 치조제를 증강시킬 수 있다. 골유도 재생술시 골이식재에 조직 접착제를 혼합하여 기계적 및 생물학적 이점을 얻을 수 있다. 본 증례에서는 순설 폭경이 얇은 상악 전치부 치조제 상에 임플란트 식립에 의한 열개 및 천공형 골결손 발생시 자가골을 제외한 동종골, 이종골, 그리고 합성골 입자형 골이식재 등을 다양하게 조합한 후 조직 접착제와 혼합하여 골유도 재생술을 진행하였다. 모든 증례에서 양호한 치조제 증강을 보였음에 보고하는 바이다.