• Journal of Periodontal and Implant Science
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• 제34권3호
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• pp.593-605
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• 2004

tachment level was changed from $8.67{\pm}1.72mm$ to $7.00{\pm}1.60mm$ (control); from $8.93{\pm}2.23mm$ to $6.00{\pm}1.92mm$ (test); and bone probing depth was decreased from $10.20{\pm}1.90mm$ to $9.07{\pm}1.95mm$ (control); from $10.14{\pm}2.14mm$ to $7.43{\pm}2.06mm$ (test). This study indicates that treatment of periodontal intrabony defects with EMD is clinically superior to treatment without EMD (OFD alone) in every parameter evaluated. Within the limits of this study, the application of EMD in intrabony defects resulted in clinically significant gain of clinical attachment level and decrease of bone probing depth. And further controlled clinical studies are required to confirm the effectiveness of the EMD in the treatment of various osseous defects.

• Journal of Periodontal and Implant Science
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• 제38권1호
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• pp.7-14
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• 2008

Purpose: Chitosan & chitosan derivative(eg. membrane) have been studied in periodontal regeneration, and recently many studies of chitosan have reported good results. If chitosan's effects on periodontal regeneration are enhanced, we can use chitosan in many clinical and experimental fields. For this purpose, this study reviewed available literatures, evaluated comparable experimental models. Materials and Methods: Ten in vivo studies reporting chitosan's effects on periodontal tissue regeneration have been selected by use of the 'Pubmed' and hand searching. Results: 1. In Sprague Dawley rat calvarial defect models, amount of newly formed bone in defects showed significant differences between chitosan/chitosan-carrier/chitosan-membrane groups and control groups. 2. In beagle canine 1-wall intrabony defect models, amount of new cementum and new bone showed significant differences between chitosan/chitosan-membrane groups and control groups. The mean values of the above experimental groups were greater than the control groups. Conclusion: The results of this study have demonstrated that periodontal regeneration procedure using chitosan have beneficial effects, which will be substitute for various periodontal regenerative treatment area. One step forward in manufacturing process of chitosan membrane and in use in combination with other effective materials(eg. bone graft material or carrier) may bring us many chances of common use of chitosan in various periodontal area.

• 대한소아치과학회지
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• 제33권1호
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• pp.35-42
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• 2006

정상적인 치열의 형성 및 치아의 생성과정을 분석하고 실제로 임상에 적용하기 위해 치아의 발생과정을 연구하는 것은 매우 중요하다. 본 연구는 이식된 태아 치아싹의 석회화가 가능하고 정상적인 구조로 발육할 수 있는지 밝히기 위해, 그리고 악골 자체가 새로운 이식 공여부로 사용가능한지 알기 위해 흰쥐의 발치와에 치아싹을 이식하여 치아의 형성을 살펴보고자 하였다. 이를 위하여 성숙한 흰쥐의 상악 제 1구치를 발거한 발치와에 13.5일된 태아쥐의 치아싹을 이식한 후 4, 8주 후에 희생하여 조직학적 및 방사선학적으로 관찰하여 다음과 같은 결과를 얻었다. 1. 이식된 치아싹에서 상아질과 백악질, 치수, 치주인대의 소견을 갖는 석회화된 조직이 형성되었다. 2. 형성된 경조직 및 연조직은 정상적인 치아형성과정에 비해 발육이 늦었으며 유착 및 골양상아질(osteodentin)과 같은 비정상적 조직이 관찰되었다. 3. 석회화된 조직은 8주내에 악궁으로 맹출하는 소견이 관찰되지 않았다.

• 대한소아치과학회지
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• 제27권3호
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• pp.394-399
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• 2000

치아종은 치아 조직의 비정상적인 과성장으로 인해 형성되는 외배엽성 상피세포와 중배엽성 세포로 이루어진 혼합종양이라고 정의되며 양성 치성 종양 중에서 가장 흔한 질환이다. 최근 연구에 따르면 치아종은 신생물(neoplasm)보다는 형태와 조직 분화가 다양한 양상을 보이는 형성이상이나 과오종으로 보고 있다. 치아종은 복합 치아종(Compound Type), 복잡 치아종(Complex Type) 그리고 법랑아 섬유치아종(Ameloblastic fibroodontoma)으로 구분하고 있다. 복합 치아종은 치아와 유사한 형태를 띠고 있으며 전체 발생 비율의 약 2/3를 차지하고 있다. 복잡 치아종은 치성 조직의 비조직화된 형태로서 악골에 고르게 분포되어 발생하고 있다. 법랑아 섬유치아종의 발생은 드물다. 치아종의 병인으로는 외상, 감염, 유전 혹은 치아 발육의 유전적 조절을 방해하는 돌연변이 유전자 등이 언급되고 있다. 치아종은 종종 다양한 맹출 장애와 치아 위치에 있어 문제를 유발할 수 있다. 따라서 치아종의 가장 빈번한 발견 요인으로서는 유치의 만기 잔존과 더불어 영구치의 매복이 있다. 치아종으로 인한지연 맹출과 감별 진단해야 할 것으로서는 과잉치, 만곡치, 법랑 진주 그리고 유치의 조기 상실 등이 있다. 치아종으로 인한 매복 치아의 치료 방법으로는 우선 치아종을 제거한 후 매복 치아의 자발적 맹출을 기대하는 것이다. 이때 매복된 치아의 자발적 맹출을 기대하기 위해선 악골내 충분한 맹출 공간을 평가한 후 공간의 확보와 치근 발육이 진행중이라는 전제 조건이 수반되어야 한다. 만일 치아종을 제거한 후에도 불구하고 매복 치아의 맹출이 이루어지지 않을 경우에는 매복 치아의 노출 후 교정적 부착장치를 위치시킨 후 강제 견인한다. 본 증례는 치아종으로 인해 영구 계승치가 매복된 환아에게서 매복치의 외과적 노출 시행 후 교정적 치료방법을 사용해 비교적 양호한 결과를 얻었기에 보고하는 바이다.

• 대한소아치과학회지
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• 제27권4호
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• pp.524-534
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• 2000

유치 치근 흡수가 일어나는 경우는 임상에서 많이 접할 수 있다. 유치 치근 흡수는 나이에 따른 생리적 흡수와 치아우식증 및 외상 등으로 비정상적으로 흡수되는 염증성 흡수로 나눌 수 있다. 염증성 흡수는 그 시기와 양상이 생리적인 치근 흡수와는 다르며, 흡수기전이나 흡수면의 미세구조에 있어서도 많은 차이가 있을 것으로 사료된다. 유치 치근 흡수면의 미세구조에 대한 연구는 많이 있었으나, 생리적 흡수면과 염증성 흡수면의 미세구조를 비교한 연구는 드물다. 본 연구는 생리적 흡수면과 염증성 흡수면의 형태 및 인접한 세포를 연구하기 위하여 생리적 및 염증성 흡수로 인해 발거된 유치 치근의 흡수 표면을 주사전자현미경상으로, 조직학적 형태를 광학현미경상으로 관찰하여 다음과 같은 차이점을 알 수 있었다. 1. 주사전자현미경상에서 생리적 유치 치근 흡수 표면은 타원형, 원형 및 다각형 모양의 흡수소와가 관찰되었고, 염증성 흡수 표면은 크기가 작으며 형태가 다양하고 매우 불규칙한 무정형 형태의 흡수소와가 관찰되었다. 2. 광학현미경상에서 생리적 유치 치근 흡수면은 흡수소와로 구성된 규칙적인 큰 흡수와가 관찰되었고, 염증성 흡수면은 불규칙한 흡수소와가 관찰되었다. 3. 광학현미경상에서 생리적 유치 치근 흡수면에는 다핵거대세포가 흡수소와에 직접 접하고 있었으며, 염증성 흡수면은 간엽세포 및 염증세포가 많이 관찰되었다. 4. 광학현미경상에서 염증성 치근 흡수면에서는 상아질 흡수를 보상하는 부분적인 백악질 형성이 관찰되었다.

• Journal of Periodontal and Implant Science
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• 제30권1호
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• pp.145-157
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• 2000

Cytotoxic substances in dental calculus and root cementum of periodontally diseased teeth inhibit new attachment and regeneration. The purpose of scaling and root planing is to remove pathologic structures harboring these cytotoxic substances in order to create a biologically acceptable root surface. However, these procedures inevitably leave a non-biocompatible smear layer. Conventionally, the smear layer has been removed with low pH etching agents such as citric acid, phosphoric acid and tetracycline hydrochloride(TC). Lately, a supersaturated neutral pH etching solution of ethylene diamine tetraacetic acid(EDTA) has been found to be as effective as low pH etchants with respect to smear removal and to be superior in exposing root surfaceassociated collagen. The aim of the present study was to determine the effect of root surface treatment using EDTA on the initial attachment of human gingival fibroblasts. 27 human teeth, extracted due to severe periodontitis, were cut into dentin slices after root planing. The specimens were divided into TC group(treated with $50㎎/m{\ell}$ tetracycline-HCl, pH 1.52), EDTA group(treated with 17% EDTA, pH 7.4), and non-treated control group. After sterilization, 5th subcultured human gingival fibroblasts were seeded in each culture well containing a prepared root slice and incubated for 15 min., 60 min., and 4 hours in 5% $CO_2$ incubator at $37^{\circ}C$. At each incubation time, the number of attached fibroblasts were counted on the microphotographs taken at a magnification of x100. The difference of the number of attached cells between groups was statistically analyzed by the ANOVA followed by Duncan test in SPSS/PC＋programs. The results were as follows : 1. After incubation for 15 min, the attached cells were significantly more in EDTA group and TC group than non-treated control group(p<0.05), but there was no significance in the difference between EDTA group and TC group(p>0.1). 2. After incubation for 60 min and 4 hours, there was no significant difference in the number of attached cells between all groups(p>0.1). 3. In both EDTA group and TC group, there was no significant difference in the number of attached cells between different incubation(p>0.1). But in control group, the number of attached cells was significantly increased after incubation for 60 min, compared with incubation for 15 min(p<0.05). The above results suggest that root surface treatment using EDTA could enhance the initial attachment of gingival fibroblasts to root surface as effective as tetracycline-HCl.

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.385-396
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• 2006

For the regeneration of periodontal tissues, the microenvironment for new attachment of connective tissue fibers should be provided, At this point of view, cementum formation in root surface plays a key role for this new attachment. This study was performed to figure out which factor promotes differentiation of cementoblast Considering anatomical structure of tooth, we selected the cells which may affect the differentiation of cementoblast - Ameloblast, OD11&MDPC23 for odontoblasts, NIH3T3 for fibroblsts and MG63 for osteoblasts. And OCCM30 was selected for cementoblast cell line. Then, the cell lines were cultured respectively and transferred the conditioned media to OCCM30. To evaluate the result, Alizarin red S stain was proceeded for evaluation of mineralization. The subjected mRNA genes are bone sialoprotein(BSP), alkaline phosphate(ALP) , osteocalcin(OC), type I collagen(Col I), osteonectin(SPARC ; secreted protein acidic and rich in cysteine). Expression of the gene were analysed by RT-PCR, The results were as follows: 1. For alizarin red S staining, control OCCM30 didn't show any mineralized red nodules until 14 days. But red nodules started to appear from about 4 days in MDPC-OCCM30 & OD11-OCCM30. 2. For results of RT-PCR, ESP mRNAs of control-OCCM30 and others were expressed from 14 days, but in MDPC23-OCCM30 & OD11-OCCM30 from 4 days. Like this, the gene expression of MDPC23-OCCM30 & OD11-OCCM30 were detected much earlier than others. 3. For confirmation of odontoblast effect on cementoblast, conditioned media of osteoblasts(MG63) which is mineralized by producing matrix vesicles didn't affect on the mineralized nodule formation of cementoblasts(OCCM30). This suggest the possibility that cementoblast mineralization is regulated by specific factor in dentin matrix protein rather than matrix vesicles. Therefore, we proved that the dentin/odontoblast promotes differentiation/mineralization of cementoblasts. This new approach might hole promise as diverse possibilities for the regeneration of tissues after periodontal disease.

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.515-529
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• 2006

Periodontal regeneration refers to the restoration of bone, cementum and periodontal ligament to their original levels before damage from periodontal disease process. Various surgical techniques to the promotion of periodontal regeneration have been used. Bone graft and guided tissue regeneration have used for the regeneration of furcation involvements which caused by periodontal disease. Fibrin adhesive is agents that have been shown to be effective in periodontal regeneration and biological carrier. Calcium sulfate which is one of the resorbable barrier materials has used for guided tissue regeneration. The purpose of this study was to compare the clinical effects between bone graft using fibrin adhesive and calcium sulfate barrier in the mandibular class II furcation involvement. For the study, twenty-six class II furcation involved teeth were surgically treated. 13 furcation defects(test group) were treated with bonegraft and fibrin adhesive and the others(control group) were treated with bone graft and calcium sulfate barrier. Pocket depth, clinical attachment level and gingival recession were measured at baseline, postoperative 3 and 6 months. The results of the study are as follows: 1. The change of pocket depth and clinical attachment level in both groups was decreased significantly at 3, 6 months than at baseline(p<0.05). 2. The change of gingival recession in both groups was increased significantly at 3, 6 months than at baseline(p<0.05). 3. The change of pocket depth and clinical attachment level in both groups was decreased at 3, 6 months, and the change of gingival recession in both groups was increased at 3, 6 months but there were no statistically or clinically significant differences with both groups. 4. The significant reduction of the pocket depth and clinical attachment level exhibited marked changes at 3 months in both groups. In conclusion, the results of this study suggest that there are no statistically or clinically significant differences between fibrin adhesive and calcium sulfate barrier in the treatment of class II furcations using xenograft.

• Journal of Periodontal and Implant Science
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• 제40권5호
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• pp.232-238
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• 2010

Purpose: To prolong the degradation time of collagen membranes, various cross-linking techniques have been developed. For cross-linking, chemicals such as formaldehyde and glutaraldehyde are added to collagen membranes, but these chemicals could adversely affect surrounding tissues. The aim of this study is to evaluate the ability of porous non-chemical cross-linking porcine-derived collagen nanofibrous membrane to enhance bone and associated tissue regeneration in one-wall intrabony defects in beagle dogs. Methods: The second and third mandibular premolars and the first molars of 2 adult beagles were extracted bilaterally and the extraction sites were allowed to heal for 10 weeks. One-wall intrabony defects were prepared bilaterally on the mesial and distal side of the fourth mandibular premolars. Among eight defects, four defects were not covered with membrane as controls and the other four defects were covered with membrane as the experimental group. The animals were sacrificed 10 weeks after surgery. Results: Wound healing was generally uneventful. For all parameters evaluating bone regeneration, the experimental group showed significantly superior results compared to the control. In new bone height (NBh), the experimental group exhibited a greater mean value than the control ($3.04{\pm}0.23\;mm/1.57{\pm}0.59$, P=0.003). Also, in new bone area (NBa) and new bone volume (NBv), the experimental group showed superior results compared to the control (NBa, $34.48{\pm}10.21%$ vs. $5.09{\pm}5.76%$, P=0.014; and NBv, $28.04{\pm}12.96$ vs. $1.55{\pm}0.57$, P=0.041). On the other hand, for parameters evaluating periodontal tissue regeneration, including junctional epithelium migration and new cementum height, there were no statistically significant differences between two groups. Conclusions: Within the limitations of this study, this collagen membrane enhanced bone regeneration at one-wall intrabony defects. On the other hand, no influence of this membrane on periodontal tissue regeneration could be ascertained in this study.

• 대한소아치과학회지
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• 제32권3호
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• pp.403-408
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• 2005

치아유착은 치근의 상아질 또는 백악질이 치조골과 융합된 것으로 치아의 맹출이상을 야기하여 치조골 성장의 장애를 일으킨다. 본 6세 여아는 유구치의 유착과 영구 소구치의 결손을 주소로 본과에 의뢰되었으며 특이할 만한 의과적, 치과적 병력은 없었다. 구강 검진 소견상 상, 하악의 좌, 우측 유구치에서 저위교합이 관찰되었으며, 다수의 치아우식증이 존재하였다. 방사선 사진 검사 소견상 상악의 좌, 우측 영구 견치와 계승 소구치의 결손, 상악 유구치의 치근흡수와 하악 유구치의 치주인대공간의 소실 및 미약한 치근흡수가 관찰되었다. 계승 영구치의 결손을 동반한 유구치 유착시 치료목표는 적절한 치조골 성장과 유치의 유지이며, 유착의 발현 시기와 치근의 흡수 정도에 따라 관찰, 수복 또는 발치 등의 치료를 고려할 수 있다. 유착치아의 발치는 인접 치조골 성장에 문제가 없고 인접치의 경사가 일어나지 않도록 최대성장점(growth spurt)을 고려하여 그 시기를 결정해야 한다.