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.
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.
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.
Hong, Sung-Bin;Kusnoto, Budi;Kim, Eun-Jeong;BeGole, Ellen A;Hwang, Hyeon-Shik;Lim, Hoi-Jeong
The korean journal of orthodontics
/
v.46
no.2
/
pp.111-126
/
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.
Kim, Jae-Hyuk;Kim, Chong-Yeo;Lim, Sung-Bin;Chung, Chin-Hyung
Journal of Periodontal and Implant Science
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v.29
no.2
/
pp.387-400
/
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.
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.
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.
This study was performed to evaluate the usability of Er:YAG laser for periodontal therapy. Forty dental root slabs ($5{\times}5{\times}2mm^3$) were prepared from human periodontally diseased extracted teeth and grouped into 4 groups: 1) control (root planing only), 2) root planing and irradiated with laser at 30mJ, 3) root planing and irradiated with laser at 60mJ, and 4) root planing and irradiated with laser at 100mJ. The root slabs were embedded in resin block before laser treatment. Er:YAG laser was irradiated under water irrigation with the tip held perpendicular to the root surface in contact mode. After Er:YAG laser irradiation or planing on the root surface, morphological changes have been observed under SEM, and the micro-hardness and Ca/P ratio were compared. 1. In the Control group, the root surface showed the directional change caused by root planing instrumentation, and the presence of smear layer, and no exposure of dentinal tubule was observed. Laser irradiated group showed surface changes with rough dentin surface of niche and depression and dentinal tubule exposure by the elimination of smear layer. 2. The micro-hardness of root surface in the laser irradiated group was higher than the control group. The higher energy output was applied, the higher micro-hardness on root surface was resulted. 3. The higher energy output was applied, the higher Ca/P ratio was observed. The higher Ca/P ratio in 60mJ group and 100mJ group was statistically significantly compared to the control group and the 30mJ group. These results suggest that Er:YAG laser irradiation on the periodontally diseased root surface could remove smear layer and increase the micro-hardness on root surface and Ca/P ratio which contribute to enhance the acid resistance of periodontally treated root surface.
Kim, Il-Young;Park, Mi-Young;Choi, Seong-Ho;Cho, Kyoo-Sung;Kim, Chong-Kwan;Chai, Jung-Kiu
Journal of Periodontal and Implant Science
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v.28
no.4
/
pp.677-692
/
1998
In order to study the effects of cigarette smoking on periodontal tissue, gingival fibroblast from the smoking and nonsmoking groups were cultured and each group were treated with nicotine(50ng/ml,100ng/ml) and NNK(50ng/ml, 100ng/ml) to test their attachment ability at time intervals of 30minutes, 60minutes, 90minutes, 120minutes, and 240minutes. Using the same method, the growth each group treated with nicotine and NNK in order to compare their attachment ability and growth rate was done. The Results are as follows. 1. In comparing the attachment ability and growth rate between the smoking and non-smoking group were significantly higher in all time intervals. 2. When the attachment ability was com-pared among these two groups after treatment with nicotine and NNK, the non-smoking group showed decrease in attachment ability while the smoking group was not affected. 3. The growth rate of these two groups were compared after treating with nicotine and NNK. The growth rate of fibroblast from the non-smoking group decreased while fibroblast from the smoking group was not affected. These results suggest that fibroblast from the non-smoking group showed higher attachment ability, growth rate, and sensitivity to nicotine and NNK. This implies that fibroblast from the non-smoking group is a more reliable source in testing the cytotoxicity of nicotine and NNK. Also it could be reasonable to think that nicotine and NNK is a probable cause for problems in attachment and repair mechanism.
The purpose of this study was to an in estimate the antibiotic susceptibility of P. gingivalis and P. interrnedia isolate from the subgingival plaque to adult periodontitis. Six P. gingivalis and five P. intermedia bacterial strains were tested for their susceptibility to 10 antimicrobial agents under disc diffusion method and broth dilution method. Ten patients with deep pocket(6mm) were selected for this study. They had not taken antibiotics for 6 months and no history of dental treatment for 6 months before this study. The result were as follow : 1. For antibiotic disc diffusion method, six P. gingivalis and five P. interrnedia were tested with 10 antimicrobial agents which comprised penicillin, gentamycin, clindamycin, lincomycin, ampicillin, erythromycin, tetracycline, amikacin, chloramphenicol, vancomycin. The sensitive antibiotics were tetracycline, penicillin, ampicillin, vancomycin, chloramphenicol and resisitent antibiotics were lincomycin. The other antimicrobial agents were less active. 2. From the study of determination on the minimal inhibitory concentration(MIC) by broth dilution method, the MIC of tetracycline to P. gingivalis and P. intermedia were $0.5-1.0{\mu}g/ml$, $0.5{\mu}g/ml$, that of ampicillin were $1-8{\mu}g/ml$, that of clindamycin were $1-32{\mu]g/ml$, $8-16{\mu}g/ml$, that of lincomycin were $16-32{\mu}g/ml$, $2-32{\mu}g/ml$. These data suggest that tetracycline and ampicillin may be valuable drug in the elemination of P. gingivalis and P. interrnedia from the patients with adult periodontitis.
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