• Journal of Periodontal and Implant Science
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• v.33 no.4
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• pp.585-597
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• 2003

Porphyromonas gingivalis has been implicated as an important periodontophathic bacterium in the etiology and progression of periodontal diseases. It has been reported that P.gingivalis may mediate periodontal destruction not only directly through its virulence factors, but also indirectly by including complex host mediated inflammatory reponses. The purpose of this study was t o evaluate the effects of P.gingivalis on the bone formation and resorption by osteoblasts. For this purpose, after determining the concentration below which sonicated P.gingivalis extracts (SPEs) have no cytotoxicity on mouse calvarial primary osteoblastic (POB) cells, we investigated the effects of SPEs on the alkaline phosphatase (ALP) activity, matrix metalloproteinase (MMP) expression (MMP-2, -9, 13), and prostaglandin $E_2$ ($PGE_2$) release in POB cells by treatment with SPEs below that concentration. The results were as follows; 1. SPEs showed no cytotoxic effect on POB cells up to a concentration of 1 ${\mu}m$/ml. 2. The treatment with SPEs reduced ALP activity in a dose-dependent manner in POB cells, In addition, when we investigated the effect of SPEs (1 ${\mu}m$/ml) on ALP activity for different exposure periods, statistically significant inhibition of ALP activity was shown at 2 days of exposure, and further significant inhibition occurred by extending the periods of exposure. 3. The treatment with SPEs stimulated the gene expression of MMP-9 in POB cells. 4. The pre-treatment with SPEs increased the amount of $PGE_2$ released in POB cells. In summary, the present study shows that P.gingivalis could inhibit osteogenesis and stimulate bone resorption not only by reducing ALP activity but also by increasing MMP-9 mRNA expression in osteoblasts, possibly through an endogenous $PGE_2$ pathway. In addition, our results suggest that if P.gingivalis affects osteoblasts in early differentiation stage, such effects by P. gingivalis could be irreversible.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.1
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• pp.108-115
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• 2017

Numerous therapeutic approaches are available for impacted teeth, including orthodontic retraction, implantation, and autogenous tooth transplantation. Autotransplantation is a promising method, especially for juvenile patients, as it enables preservation of the function of the periodontal tissues, as well as continued alveolar bone growth. This report describes autotransplantation in two cases in which the tooth was fully-ectopically impacted. With case 1, an ectopically impacted premolar was extracted and transplanted in an upright position, and regenerative endodontic treatment was performed using a platelet-rich fibrin clot and mineral trioxide aggregate (MTA). With case 2, a calcifying odontogenic cyst with an impacted left mandibular second molar was treated by enucleation. The tooth was transplanted into the proper position 3 months after enucleation, and endodontic treatment was performed using MTA. In both cases, autotransplantation appeared to provide a simple and rapid treatment option for patients with ectopically impacted teeth. These cases demonstrate that autotransplantation of ectopically impacted teeth is a viable treatment option rather than implant placement or prosthesis, especially in juvenile patients.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.197-211
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• 1993

Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So complications of the supracondyle fractures including joint stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989, Dec. To 1992, Jan. The results were as follows : 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification. 4 cases were type A, 4 in type B, 12 in type C (10 in type $C_2$&$C_3$). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in conservative treatment and 67% in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.

• Journal of Periodontal and Implant Science
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• v.33 no.1
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• pp.91-102
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• 2003

Several effective treatment methods and materials have been developed for the treatment of furcation involvement. Currently, the combination of guided tissue regeneration (GTR) and bone grafts is the most commonly prescribed method of treating furcation involved defects. But because these cases often present with poor accessibility, placement of the membrane may be difficult and consequently, clinically impractical. In this study, the alveolar bone healing patterns of adult beagle dogs presenting with alveolar bone destruction treated by one of two methods - treatment using solely bone allografts (BBP(R)), or treatment using bone allografts (BBP(R)) stabilized by a fibrin adhesive - were comp ared. The effects of the fibrin adhesive on the initial stabilization of the newly formed bone, subsequent regeneration of bone, and the feasibility of the clinical application of the fibrin adhesive were analyzed. The results of the study were as follows: 1. Clinical signs of inflammation at the 4-8 week interval were not observed: but signs of mild inflammation were histologically observed at the 4-week interval. 2. Allografts stabilized by fibrin adhesive showed good bone formation, whereas defects treated with only the allograft material showed incomplete alveolar bone regeneration. 3. Allografts stabilized by fibrin adhesive showed a decrease in the amount old bone with a concurrent increase in the formation of new lamellar bone four weeks post-op, whereas defects treated with only the allograft material showed no new lamellar bone formation at the same interval. 4. In detects treated with only the allograft material, the defective area was filled with connective tissue 8-weeks post-op, whereas fibrin adhesive stabilized allografts showed viable connections between the original bone and the newly formed bone, in addition to neovascularization 8-weeks post-op. The results of this study show that concurrent use of fibrin adhesive materials can stabilize the allograft material and aid in new bone formation Although the stability of fibrin adhesives fall short of the results achievable by GTR membranes, in cases presenting with poor accessibility that contraindicate the use of membranes, fibrin adhesive materials provide a viable and effective alternative to graft stabilization and new bone formation.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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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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• v.37 no.2
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• pp.181-192
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• 2007

Periodontal surgery as part of the treatment of periodontal disease is mainly performed 1) to gain access to diseased areas for adequate cleaning; 2) to achieve pocket reduction or elimination; and 3) to restore the periodontal tissues lost through the disease; i.e., a new attachment formation of periodontal regeneration. To accomplish the latter, often referred to as the ultimate goal of periodontal therapy, a number of surgical procedures have been advocated throughout the years. Clinical studies have demonstrated that considerable gain of clinical attachment and bone can be achieved following guided tissue regeneration (GTR) therapy of intrabony defects. The aim of this study was to analyse the radiographic bone changes 2-year after GTR using a bone graft material and nonresorbable membrane. Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of intrabony defect(s), 33 sites of 30 patients aged 32 to 56 (mean age 45.6) were treated by GTR with a bone graft material and nonresorbable membrane. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. We observed $2.86{\pm}1,87mm$ of bone fill, $065{\pm}0.79mm$ of crestal resorption, $3.49{\pm}2.11mm$ of defect resolution, and $44.42{\pm}19.51%$ of percentage of defect resolution. Mandible, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. But no difference was observed between xenograft and allograft. Outcome of GTR as a therapy of intrabony defect was better than other therapy, but herein, good oral hygiene maintenance as a anti-infective treatment and periodic recall check of patients are essential.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.2
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• pp.107-112
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• 2013

Complications increases when crown height space is excessive and one should be careful of choosing type of fixed prosthesis in case crown height space is over 12 mm. In this condition, tooth seems to be longer, therefore, it is needed to use gingival shade in aesthetically important area for fixed prosthesis. In this case, fixed prosthesis which has inappropriate maintenance and hygiene could hold food, plaque, calculus, thus increase incidence of inflammation and infection. Moreover, it could lead to chronic inflammation and infection and in that case surgical improvement could be necessary. In present case report, gingival inflammation and swelling developed around prosthesis after having made it considering articulation and aesthetic view in patient who had excessive crown height space. Finding out that design of prosthesis is a factor to make it hard to maintain oral hygiene, a temporary prosthesis which has enough interproximal space and proper emergence profile was fabricated. After two months of observation, significant abnormal symptoms are not found and oral reconstruction is performed using fixed prosthesis with zircornia infrastructure and porcelain build-up based on convenient self hygiene design. Through serial treatment, inappropriate soft tissue response is not observed and satisfactory result in functional aspect comes out.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.5
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• pp.659-674
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• 2000

A large increase in the use of thin film coating of hydroxyapatite(HA) in implant dentistry is driven by the desire to take advantage of the excellent biocompatibility and high strength of HA coating. The purpose of this study was to evaluate the effects of HA-coated implants by ion Beam Assisted Deposition(IBAD) method in comparison to the sand-blasted and machined surfaces. Osteoblast culture test, removal torque test and histomorphometric analysis were performed and the following results obtained; 1. Examination of the osteoblast cultures displayed no difference in the secretion of alkaline phosphatase between the various specimen, but IBAD with pure HA specimen showed low alkaline phosphatase secretion(p<0.05). 2. Removal torque tests showed HA-coated implants by IBAD method to be similar in high value to the implants with sand-blasted surface than the implants with machined surface. And the ovariectomized group showed low mechanical test value than the normal group(p<0.05). 3. Histomorphometrical comparisons were performed on undecalcified ground sections. HA-coated implants by IBAD method demonstrated the highest mean bone-to-metal contact ratio on all threads and 3-best consecutive threads, and the implants with sand-blasted surface and implants with machined surface was in the next consecutive order(p<0.05). HA-coated implants showed slightly higher bone-to- metal contact ratio than sand-blasted implants, but no statistically significant difference was obtained between the two materials. The ovariectomized group showed lower value of bone-to-metal contact ratio than the normal group, but no statistically significant difference was obtained between the two groups. 4. Evaluation of bone volume on all threads and 3-best consecutive threads showed no statistically significant difference among the different surface treatment groups, but showed lower bone volume in ovariectomized group than in the normal group(p<0.05). According tn these results, thin film coated implants with HA showed high bone contact ratio, bone volume and removal torque strength in the short term, but long term observation is needed.

• Journal of Biomedical Engineering Research
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• v.26 no.2
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• pp.123-127
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• 2005

Compression Hip Screw (CHS) is one of the most widely-used prostheses for the treatment of intertrochanteric fractures because of its strong fixation capability. Fractures at the neck and screw holes are frequently noted as some of its clinical drawbacks, which warrant more in-depth biomechanical analysis on its design variables. The purpose of this study was to evaluate changes in the strength with respect to the changes in design such as the plate thickness and the number of screw holes. Both mechanical test and FEM analysis were used to systematically investigate the sensitivities of the above-mentioned design variables. For the first part of the mechanical test, CHS (n=20) were tested until failure. The CHS specimens were classified into four groups: Group Ⅰ was the control group with the neck thickness of 6-㎜ and 5 screw holes on the side plate, Group Ⅱ 6-㎜ thick and 8 holes, Group Ⅲ 7.5-㎜ thick and 5 holes, and Group Ⅳ 7.5-㎜ thick and 8 holes. Then, the fatigue test was done for each group by imparting 50% and 75% of the failure loads for one million cycles. For the FEM analysis, FE models were made for each group. Appropriate loading and boundary conditions were applied based on the failure test results. Stresses were assessed. Mechanical test results indicated that the failure strength increased dramatically by 80% with thicker plate. However, the strength remained unchanged or decreased slightly despite the increase in number of holes. These results indicated the higher sensitivity of plate thickness to the implant strength. No fatigue failures were observed which suggested the implant could withstand at least one million cycles of fatigue load regardless of the design changes. Our FEM results also supported the above results by showing a similar trend in stress as those of mechanical test. In summary, our biomechanical results were able to show that plate thickness could be a more important variable in design for reinforcing the strength of CHS than the number of screw holes.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.574-581
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• 2018

Objective : The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury. Methods : Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients' clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom's criteria. Results : The C2-7 Cobb and operative segmental angles increased by $3.45{\pm}7.61$ and $2.94{\pm}4.59$ in group A; and $2.46{\pm}7.31$ and $2.88{\pm}5.49$ in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than "good" using Odom's criteria. Conclusion : The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.