• Journal of Periodontal and Implant Science
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• v.48 no.4
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• pp.251-260
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• 2018

Purpose: The aim of this retrospective cross-sectional study was to evaluate whether salivary findings of active matrix-metalloproteinase 8 (aMMP-8) chairside (point of care; POC) tests were associated with periodontal risk assessment parameters in patients receiving supportive periodontal therapy (SPT). Methods: A total of 125 patients receiving regular SPT were included, and their records were examined. The following inclusion criteria were used: a diagnosis of chronic periodontitis, at least 1 non-surgical periodontal treatment (scaling and root planning) with following regular SPT (minimum once a year), at least 6 remaining teeth, and clinical and aMMP-8 findings that were obtained at the same appointment. In addition to anamnestic factors (e.g., smoking and diabetes), oral hygiene indices (modified sulcus bleeding index [mSBI] and approximal plaque index), periodontal probing depth simultaneously with bleeding on probing, and dental findings (number of decayed, missing, and filled teeth) were recorded. Salivary aMMP-8 levels were tested using a commercial POC test system (Periomarker, Hager & Werken, Duisburg, Germany). Statistical analysis was performed using the t-test, Mann-Whitney U test, Fisher's exact test, and ${\chi}^2$ test, as appropriate (P<0.05). Results: Only the mSBI was significantly associated with positive salivary aMMP-8 findings (aMMP-8 positive: $27.8%{\pm}20.9%$ vs. aMMP-8 negative: $18.0%{\pm}14.5%$; P=0.017). No significant associations were found between aMMP-8 and smoking, diabetes, periodontal parameters, or parameters related to the maintenance interval (P>0.05). Conclusions: Salivary aMMP-8 chairside findings were not associated with common parameters used for periodontal risk assessment in patients receiving SPT. The diagnostic benefit of POC salivary aMMP-8 testing in risk assessment and maintenance interval adjustment during SPT remains unclear.

• Journal of Periodontal and Implant Science
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• v.48 no.4
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• pp.236-250
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• 2018

Purpose: Resorption of the alveolar bone is an unavoidable consequence of tooth extraction when appropriate alveolar ridge preservation (ARP) measures are not taken. The objective of this trial was to test the hypothesis that dimensional changes in the alveolar bone after tooth extraction would be reduced by inserting an equine collagen membrane and a collagen cone to fill and seal the alveolus (as ARP), in comparison to extraction with untreated alveoli. Methods: In this randomized clinical trial, 31 patients were directly treated with the collagen material after extraction of a tooth from the maxilla (the ARP group). Twenty-nine patients served as the control group. After extraction, no further treatment (i.e., no socket preservation measures) was performed in the control group. Changes in the alveolar process immediately after extraction and after an 8 (${\pm}1$)-week healing period were evaluated 3-dimensionally. Blinded analyses were performed after superimposing the data from the digitalized impressions and surfaces generated by cone-beam computed tomography. Results: Both the ARP and control groups showed a reduction of bone in the alveolar area after tooth extraction. However, significantly less bone resorption was detected in the clinically relevant buccal region in the ARP group. The median bone reduction was 1.18 mm in the ARP group and 5.06 mm in the control group (P=0.03). Conclusions: The proposed hypothesis that inserting a combination material comprising a collagen cone and membrane would lead to a difference in alveolar bone preservation can be accepted for the clinically relevant buccal distance. In this area, implantation of the collagen material led to significantly less alveolar bone resorption. German Clinical Trials Register at www.drks.de, DRKS00004769.

• Journal of Periodontal and Implant Science
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• v.25 no.1
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• pp.89-98
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• 1995

P. intermedia are considered an important pathogen in adult periodontitis, rapidly progressing periodontitis, refractory periodontitis, pregnancy gingivitis, acute necrotizing ulcerative gingivitis, pubertal gingivitis. So far 2 DNA homology groups and 3 serotypes of P. intermedia have been reported but there is no data available as yet regarding genetic diversity for the species P. intermedia. The purpose of this study is to investigate, using bacterial DNA restriction endonuclease analysis, genetic diversity between individual strains of P. intermedia which are indistinguishable by serotyping and biotyping, occurrence of an intrafamilial transmission and genetic heterogeneity between P. intermedia strains isolated within a patient and within the same serotypes. The families who have had no systemic disease, no experience of periodontal treatment for the previous 1 year and no experience of antibiotics for the previous 6 months were selected and subgingival plaque was collected at 4 sites in each person and incubated in the anaerobic chamber. P. intermedia were identified by colony shape, gram stain, biochemical test, SK-I03(Sunstar Inc.) test and IIF using monoclonal antibody was perfomed for the determination of serotypes. P. intermedia strains were grown in BHI broth and whole genomic DNA was extracted and digested by restriction endonuclease. The resulting DNA fragments were separated by agarose gel electrophoresis, stained and photographed under UV. As the results of this study, intrafamilial vertial transmissions could be assessed in 2 families and horizintal transmissions in another 2 families. There were different DNA digest patterns within a patient, so P. intermedia showed that individuals could be colonized by multiple clonal types at anyone time. And different serotypes could be found within a patient and in the same serotype within a patient, obvius genetic heterogeneity could not be assessed. But in the same serotype in different famies, there were differences in the DNA digest patterns.

• Journal of Periodontal and Implant Science
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• v.40 no.1
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• pp.39-44
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• 2010

Purpose: Bone tissues for clinical application can be improved by studies on osteoblast differentiation. Runx2 is known to be an important transcription factor for osteoblast differentiation. However, bone morphogenetic protein (BMP)-2 treatment to stimulate Runx2 is not sufficient to acquire enough bone formation in osteoblasts. Therefore, it is necessary to find other regulatory factors which can improve the transcriptional activity of Runx2. The erythroblast transformation-specific (ETS) transcription factor family is reported to be involved in various aspects of cellular proliferation and differentiation. Methods: We have noticed that the promoters of osteoblast differentiation markers such as alkaline phosphatase (Alp), osteopontin (Opn), and osteocalcin (Oc) contain Ets binding sequences which are also close to Runx2 binding elements. Luciferase assays were performed to measure the promoter activities of these osteoblast differentiation markers after the transfection of Runx2, myeloid Elf-1-like factor (MEF), and Runxs+MEF. Reverse-transcription polymerase chain reaction was also done to check the mRNA levels of Opn after Runx2 and MEF transfection into rat osteoblast (ROS) cells. Results: We have found that MEF, an Ets transcription factor, increased the transcriptional activities of Alp, Opn, and Oc. The addition of Runx2 resulted in the 2- to 6-fold increase of the activities. This means that these two transcription factors have a synergistic effect on the osteoblast differentiation markers. Furthermore, early introduction of these two Runx2 and MEF factors significantly elevated the expression of the Opn mRNA levels in ROS cells. We also showed that Runx2 and MEF proteins physically interact with each other. Conclusions: Runx2 interacts with MEF proteins and binds to the promoters of the osteoblast markers such as Opn nearby MEF to increase its transcriptional activity. Our results also imply that osteoblast differentiation and bone formation can be increased by activating MEF to elicit the synergistic effect of Runx2 and MEF.

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.338-344
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• 2010

Objective : This study assessed the safety and efficacy of one level unilateral laminotomy bilateral decompression (ULBD) with the placement of a device for intervertebral assisted motion (DIAM) compared with one level ULBD only in elderly patients with degenerative lumbar spinal stenosis (DLSS). Methods : A non randomized prospective analysis was performed on 16 patients who underwent one level ULBD with DIAM (Group A) and 20 patients with one level ULBD only (Group B) between February 2007 and March 2008. Radiographic imaging, visual analog scale (VAS) and MacNab outcome scale were obtained before and after surgery at a mean interval of 21 months (range 17-27 months). Results : The disc height, interpedicular distance, slip distance and segmental lordotic angle were similar between two groups. In the group A, there was no significant difference between the pre- and post-operative imaging in terms of the sagittal balance and disc height. Both groups showed significant improvement in the clinical outcomes. In addition, there was significantly less low-back pain in the group A than in the group B at the last follow up, while the clinical improvement of the leg pain and MacNab outcome scale showed no significant difference in the two groups. There were no major complications or DIAM associated complications. Conclusion : ULBD with DIAM is a safe and efficacious treatment for selective elderly patients with DLSS, particularly for relieving low back pain comparing to ULBD. ULBD with DIAM did not alter the disc height or sagittal alignment at the mean 21 months follow-up interval.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.613-624
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• 2007

Full-mouth disinfection (Fdis) completes the entire scaling and root planing (SRP) in one stage within 24 hours for the prevention of microbial recolonization from untreated sites and ecological niches. The aim of this study is to compare the clinical short-term effects of modified Fdis with those of the conventional SRP in the therapy of moderate and severe chronic periodontitis. Modified Fdis group (5 patients) received the entire SRP within 24 hours using chlorhexidine solution (0.1%) and conventional SRP group (5 patients) received SRP per quadrant at one-week intervals. Clinical parameters were measured at baseline, one month and three months after both therapies. The results of this case report were as follows: 1. There were considerable decreases in sulcus bleeding index and plaque index one month after Fdis. 2. The mean probing depth of single-rooted teeth decreased more in Fdis group than conventional SRP group after therapy and, that of multi-rooted teeth decreased similarly in both groups. 3. The mean probing depth decreased 1.77mm in case of initial probing depth of 4-6mm and it decreased 4.13mm in case of initial probing depth of ${\geq}$ 7mm three months after Felis. 4. There were the smaller increases in gingival recession together with the larger gains in attachment in Fdis group than conventional SRP group after three months. Within the limitations of this study, one could conclude that Fdis has beneficial clinical effects in the treatment of moderate and severe chronic periodontitis and further research would be helpful including more subjects during a longer period to confirm the beneficial long-term effects of Fdis.

• The korean journal of orthodontics
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• v.46 no.2
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• pp.111-126
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• 2016

Objective: To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region. Methods: Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed. Results: Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ${\geq}20$ years of age, and for long MIs (${\geq}8mm$) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74). Conclusions: When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.

• Journal of Periodontal and Implant Science
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• v.29 no.2
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• pp.387-400
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• 1999

One of the fundamental causes of periodontal disease is accumulation of bacterial plaque and calculus and most effective method of removing these plaque and calculus are scaling and root planning using hand curet and ultrasonic scaler. Many studies concerning residual degenerated mineral content after periodontal therapies have been carried out, but some problems about these studies were also known. This research studies mineral concents and distribution of residual root surfaces after perfoming hand curet and ultrasonic scaler on root surfaces of single rooted teeth which were extracted for periodontal reasons. EPMA were used to avoid errors from chemical quantative analysis and in addition SEM observation was also performed. The results were as follows. 1. No differences were found between curet group andultrasonic scaler group in Ca, P, Mg and Na level. 2. Concentration level was decreased in the sequence of Ca, P, Mg and Na. 3. Ca and P level were decreased as going to apical portion at curet group and ultrasonic scaler group. 4. More cementum was removed at cervical portion compared to other portion at curet group and ultrasonic scaler group. 5. Ca, P, Mg level was higher in dentin compared to cememtum. There was no difference in mineral level for Ca, P, Mg and Na between root surfaces treated with hand curet and ultrasonic scaler.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.325-338
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• 2002

Bone graft using growth factors and guided tissue regeneration have been used for the regeneration of infrabony defects which caused by periodontal disease. Calcium sulfate which is one of the resorbable barrier materials used for guided tissue regeneration. Platelet rich plasma which is a easy method to obtain the growth factors had many common points but, platelet rich plasma was still studying. This study was the comparative study between bone graft using platelet rich plasma and guided tissue regeneration using calcium sulfate barrier material in clinical view. For the study, 28 sites(2 or 3 wall infrabony defects) were treated. 14 infrabony defects were received surgical implantation of BBP-calcium sulfate composite with a calcium sulfate barrier and the others received BBP mixed with platelet rich plasma. Clinical outcome was accessed 3 and 6 months of postsurgery. 1. There was no statistical difference between CS group and PRP group in pocket depth, gingival recession, clinical attachment level, and probing bone level at baseline. 2. There was statistically significant reduction in probing depth, clinical attachment level, and probing bone level at 3 and 6 months postsurgery(p<0.05). 3. In the probing depth and clincial attachment level PPR group had less improvement than CS group, but there was no statistically difference at 3 and 6 months postsurgery. 4. In the recession PPR group had less recession than CS group, but there was no statistically difference at 3 and 6 months postsurgery. 5. In the probing bone level PPR group had less improvement than CS group, but there was no statistically difference at 6 months postsurgery. In conclusion bone graft using platelet rich plasma and guided tissue regeneration using calcium sulfate barrier showed similar clinical improvement for the treatment of 2 or 3 wall infrabony defects.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.315-324
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• 2002

The purpose of this in vitro study was to evaluate the efficiency of Er:YAG laser on calculus removal and the morphologic changes and hardness of the irradiated surface at different power settings. This experiment used human teeth which were extracted due to periodontal disease and had a band of calculus. Forty root slabs ($5{\times}5mm$) were made and divided into control group and irradiated groups. Experimental groups were as follows; Control group (root planing), Group1 (irradiated with laser at 30mJ), Group2 (irradiated with laser at 60mJ), Group3 (irradiated with laser at 100mJ). Twelve root slab embedded in resin block were used in each group. Er:YAG laser was applied under water irrigation with the tip held perpendicular to the root surface in contact mode. The treatment time was measured until the calculus was removed completely under naked eyes. The efficiency of calculus removal was evaluated by the time for removal. Morphological changes of laser irradiated site were observed under SEM and the surface hardness was measured using a VH tester. The results were as follows; 1. The efficiency of laser scaling was increased with increasing the energy level of irradiation(p<0.05). 2. The morphological changes such as carbonization, crater and scale-like defects in the irradiated root surface were frequently observed with increasing the energy level. 3. The surface hardness tended to increase at 60mJ and 100mJ irradiated groups than that of control group. From the results evaluting on the efficiency, morphological change and surface hardness, lower energy level was suggested for the clinical application of the Er:YAG laser in scaling.