• The Journal of Korean Medicine
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• v.29 no.2
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• pp.182-192
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• 2008

Objective: The purpose of this study was to evaluate on the antimicrobial effect on the periodontal pathogens and anti-inflammatory effect of Eriobotryae folium. Eriobotryae folium are constituent herbs of Gagamgamroum, which has been used for a long time in oriental medicine as a herbal medicine for treating halitosis and toothache. Method: Eriobotryae folium was prepared by extracting medicinal herb with water. We investigated antimicrobial activity by the minimum inhibitory concentration (MIC) test. We also investigated inhibition of $IL-1{\beta}-induced$ collagenase (mmp-1), stromelysin-1 (mmp-3), interleukin-6 gene expression in human gingival fibroblasts using RTPCR analysis. Result: The antimicrobial effects of Eriobotryae folium was evaluated with MIC against periodontopathogens; Porphyromonas gingivalis 2561, W50, A7A1-28, 9-14K-1, Prevotella intermedia 28, and Actinobacillus actinomycetemcomitans Y4. MICs of Eriobotryae folium were 1.25 mg/ml, 2.5 mg/ml, 0.625 mg/ml, 1.25 mg/ml, 10 mg/ml and 10 mg/ml. The anti-inflammatory effect of Eriobotryae folium was evaluated with influence of herbs on the $IL-1{\beta}-induced$ expression of mmp-1, mmp-3, and interleukin-6. $IL-1{\beta}$ increased mmp-1, mmp-3, and interleukin-6 mRNA levels. Eriobotryae folium significantly inhibited $IL-1{\beta}-induced$ mmp-1, mmp-3, and interleukin-6 gene expressions in a dose-dependent manner. Conclusion: These results suggested that Eriobotryae folium might reduce the excessive proteolytic capacity of the gingival fibroblast during inflammation and could be developed as a new drug for periodontitis.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.1013-1021
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• 1996

There are many important factors in periodontal inflammation. $IL-1{\beta}$, $PGE_2$ and collagenase are predorminantly key factors. These inflammatory mediators induce gingival tissue and alveolar bone destruction. For the prevention and treatment of periodontal disease, it is necessary to inhibit $IL-1{\beta}$, $PGE_2$ production and collagenase activity. Ursodeoxycholic acid(UDCA) has immunomodulatory properties, and there is evidence that some natural extracts show antiinflammatory activity to some degree. The purpose of this study was to assess the inhibitory effect of UDCA and its mixture with natural extracts on $IL-1{\beta}$, $PGE_2$ production and collagenase activity. Accordingly we assessed the effect of UDCA and its mixture combined with some natural extracts on inhibition of $IL-1{\beta}$, $PGE_2$ production and collagenase activity. For the $IL-l{\beta}$ inhibition study, cultured cells were exposed to $25{\mu}g/ml$ LPS. $IL-1{\beta}$ activity was measured by $IL-1{\beta}$ enzyme immunoassay system. Human gingival fibroblasts were prepared and cells (l05/well) were seeded into culture plates. $rhIL-1{\beta}$ was added to induce $PGE_2$. The amount of $PGE_2$ in sample media was measured using enzyme immunoassay system. Crude collagenase was prepared from Porphyromonas gingivalis and collagenolytic activity was determined using a Collageno kit CLN-100. The test inhibitor was added to the assay mixture consisting of 0.1ml of 50mM Tris buffer(pH 7.5) and 0.2ml of substrate solution. UDCA and UDCA combined with natural extracts generally inhibited $IL-1{\beta}$ production. groups above 0.01% UDCA strongly inhibited $IL-l{\beta}$ synthesis. Both groups inhibited $IL-1{\beta}-induced$ synthesis of $PGE_2$. In low concentration, the degree of inhibition was as same as prednisolone. In high concentration, each group was superior to prednisolone. UDCA group and UDCA mixture group exerted a moderate inhibition of collagenolytic enzyme. The present study suggested that UDCA and its mixture with natural extracts could be further investigated as antiinflammatory drug for periodontal disease.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.1
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• pp.19-26
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• 2007

The purpose of this study is to evaluate oral health status, caries-inducing bacterial activity of the mental retardation students, and developing motivation method for improving oral hygiene management by clarifying the relationship between caries-inducing bacterial activity and oral health status of mental retardation students. Caries experience indices, caries susceptibility test, gingival health evaluation, and oral hygiene management and oral health survey were performed. Results were as follows : 1. The DMFT index of disabled students(12 years) was 2.07. 2. The gingival inflammation was occurred more frequently in older ages. 3. There also was a high positive correlation between caries incidences and the results of caries-inducing bacterial activity test especially in deciduous teeth. This result suggested that the Dentocult SM mutans test as a caries activity test is a reliable method for measuring the status of dental caries in mental retardation students. Because it would motivate the mental retardation students to care more actively for their oral hygiene if they learn how much dental caries-inducing bacteria are living in their mouth by observing the bacterial colony on the cultured test strip, it can become a possibly efficient educational tool for the mental retardation students.

• Journal of Periodontal and Implant Science
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• v.30 no.4
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• pp.895-913
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• 2000

It is becoming increasingly clear that human gingival fibroblasts(HGF) may play a role in regulating immune responsiveness in inflammatory periodontal lesions. Stimulation of HGF with locally-secreted T cell cytokine $IFN_{\gamma}$ induces human leukocyte antigen class II(HLA II) expression on HGF, which is one of the characteristic feature of professional antigen presenting cells(pAPC). However, $IFN_{\gamma}$-treated HGF and other nonprofessional antigen presenting cells(npAPC) are known to be ineffective or less effective antigen presenter to resting T cells. This study, therefore, was undertaken in an effort to elucidate the differences in expression of cell surface molecules between npAPC in periodontal tissues, such as HGF and periodontal ligament fibroblasts(PDLF), and pAPC such as monocytes/macrophages. Using flow cytometry, the levels of cell surface expression of HLA-D, ICAM-1, LFA-3, and B7-1, which are involved in antigen presentation, were determined in HGF, PDLF and human myelomonocytic cell line THP-1. $IFN_{\gamma}$ clearly induced HLA-D expression on both of fibroblasts and monocytes dose dependently. However, expression level on monocytes were 4 to 5 times higher than that on fibroblasts, and induction rate was faster in monocytes than in fibroblasts. The levels of ICAM-1 expression on fibroblasts and monocytes were enhanced by $IFN_{\gamma}$ in a dose dependent manner. On the other hand, the expression of LFA-3 molecule, which could be detected in fibroblasts and monocytes without cytokine stimulation, was no more enhanced by addition of $IFN_{\gamma}$. B7-1, important costimulatory molecule in T cell activation and proliferation, was not detected on both of fibroblasts and monocytes even when stimulated with $IFN_{\gamma}$, except on monocytes fully differentiated by pretreatment of PMA and treated by $IFN_{\gamma}$. These results suggest that delayed expression of HLA-D and absence of B7-1 on $IFN_{\gamma}$ - treated fibroblasts may at least in part be involved in the ineffectiveness of fibroblasts as primary APC. And it is postulated that although periodontal fibroblasts may not serve as primary APC in normal periodontium, sustained expression of HLA II on ubiquitous fibroblasts in inflammatory lesions may perpetuate immune responses and produce chronic inflammation and tissue injury.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.607-622
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• 2004

Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of $PGE_2$ was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood $PGE_2$. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15% vs. 3.3%, OR 5.118,p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.

• Journal of Periodontal and Implant Science
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• v.23 no.1
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• pp.56-66
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• 1993

The Langerhans cells are dendritic nonkeratinocytes found suprabasally in most stratified squamous epithelia, such as human epidermis and the epithelium of the oral mucosa including that of gingiva. After Paul Langerhans found it in the skin in 1968, there have been sturdies of it's function and distribution . Stingle et al. reported that the Langerhans cells seem able to present antigens and to stimulate T-lymphocytes. Shelley et al. discovered that they can take up contact allergens. Accordingly it has been suggested that Langerhans cells are important elements of p Peripheral cell mediated immune system. In this study, the gingival tissue of a adult periodontitis patient was taken and freeze dried. In one specimen, we used the CD1 monoclonal antbody to staining the Langerhans cell. The other specimen, we embedded in paraffin and staining it with S-100 monoclonal antibody. The purpose of this study was to use these specimens to find out the distribution, orientation, morphology of the Langerhans cell and to discover the increase or decrease of Langerhans cell in an increased inflammatory state. The results were obtained as follows : 1. Langerhans cells were distributed between the basal cell layer and spinous cell layer against the CD1 & S-100 monoclonal antibody. 2. Langerhans cessl were plentiful in the oral eptihelium, and there was very little in the sulcular epithelium. 3. There were no Langerhans cell in the junction epithelium and pocket lining epithelium. 4. The number of Langerhans cells that responsed to the CD1 & S-100 monoclonal antibody had a statistically difference. 5. As the infiltration of the lymphocyte into the connective tissue were increased, the number of Langerhans cells in the epithelium were increased. 6. As the inflammation was increased, Langerhans cells in the spinous cell layer were more increased than those of the basal layer.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.283-302
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• 1994

Gingivectomy has been utilized as a therapeutic method to remove diseased periodontal pocket wall in order to aid in root planing. Although chemical agents and electrosurgery has been used in addition to the conventional method of using surgical blades, difficulties in controling the depth of chemical penetration and effectively regenerating the gingival tissue as well as the slow wound healing has been pointed out as shortcomings of these methods. This study was designed to assess the effect of Aloe vera on wound healing of gingivectomy sites created by $CO_2$ laser on palatal gingiva of maxillary molar region of white rats. Those sites treated by surgical blades were designated as control, by $CO_2$ laser as Experimental group I, by surgical blades in addition to topical application of Aloe vera as Experimental group II, and by $CO_2$ laser and Aloe vera application as Experimental group III. Animals were sacrificed at 2 days, 3 days, 1 week, 2 weeks and 3 weeks postoperatively, and the specimens were histologically analyzed. The results were as follows : 1. Resorption of blood clots were observed in the control at 3rd day, followed by the rest of the experimental groups at 1 week postoperatively. 2. Persistent inflammation was observed up to 1 week in the control and Experimental group II and III, and until the 2nd week in Experimental group I. 3. Granulation tissue was observed up to 1 week in the control, and 2 weeks in the rest of the groups. 4. Epithelization started on the 2nd day. The control showed the most rapid epithelization, and the process was completed by the 2nd week in all groups. 5. Experimental group II and III, which were treated with Aloe vera, showed similar healing patterns to the control and Experimental group I.

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.71-78
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• 2014

Purpose: Host modulatory therapy has been proposed as a treatment for periodontal diseases. A class of herbal medicines, known to be immunomodulators, alters the activity of immune function through the regulation of informational molecules such as cytokines. In the current study, we tested the hypothesis that herbal immunomodulator drugs act as an adjuvant to scaling and root planing (SRP) in alleviating periodontal inflammation by improving clinical and biochemical parameters. Methods: Sixty healthy subjects (30 in each group) with moderate and severe chronic periodontitis were enrolled in a double-blind, placebo-controlled, double-masked randomised controlled trial. The control group was treated with SRP and a placebo, whereas the test group was treated with SRP followed by dietary supplementation of Septilin for 3 weeks. Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated for all patients at the baseline, 3 weeks, and 6 weeks. Results: Improved gingival index scores found in the test group as compared to the control group were found to be statistically significant only after 3 weeks (P<0.001). In contrast, the decrease in the sulcus bleeding index and pocket depth scores was statistically highly significant in the test group as compared to the control group after 3 weeks and 6 weeks (P<0.001). However, reduced clinical attachment level and CRP scores, as reflected in the test group as compared to the control group, were not found to be statistically significant after both 3 weeks (P>0.05) and 6 weeks (P>0.05). Conclusions: The results of this clinical-biochemical study suggest that dietary supplementation with herbal immunomodulatory agents may be a promising adjunct to SRP and may aid in improving periodontal treatment outcomes.

• Journal of Periodontal and Implant Science
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• v.24 no.3
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• pp.529-540
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• 1994

Rapidly progressive periodontitis is known to be usually associated with systemic problems and improved with antibiotic therapy. Recent experiments in which bioresorbable polycaprolactone was polymerized with minocycline has shown that the system released effective antibiotic concentration during the 7 days' period. This clinical trial was to compare the efficacy of a minocycline film(poly-caprolactone+polyglycol+10% minocycline) insertion plus supragingival scaling(MS) or subgingival scaling & root planing(MSRP) with the scaling(S) or subgingival scaling & root planing alone(SRP), at improving the periodontal condition in RPP. Fifteen patients were examined for plaque accumulation, gingival inflammation, probing depth and attachment loss at baseline, then 1, 2, 4 and 8 weeks after 4 treatment regimens were randomly undergone in 4 comparable sites(PD>5mm, LA>3mm) in each subject. Results revealed statistically significant treatement effect with a reduction in a probing depth in SRP(2.0mm), MS(1.8mm), and MSRP(2.1mm). There was no significant reduction in the supragingival scaling alone group(0.6mm). Similarly, attachment levels were significantly improved in the SRP(1.5mm), MS(2.0mm) and MSRP(2.0mm) groups. Net % BOP reduction at 8 week compared to baseline was 6.7% (S), 26.7% (MS), 26.7% (SRP), and 33.3% (MSRP). MSRP produced the greatest improvement in BOP at 8 week. This data suggests that a subgingival minocycline delivery system as a adjunct to scaling alone or scaling & root planing may produce significant clinical benefits over scaling alone in rapidly progressive periodontitis patients.

• Journal of Periodontal and Implant Science
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• v.48 no.5
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• pp.317-325
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• 2018

Purpose: We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations. Methods: This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009-2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses. Results: The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography. Conclusions: Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.