• Journal of dental hygiene science
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• v.14 no.4
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• pp.477-487
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• 2014

Of the many pathogenic Candida species, Candida albicans is the main fungal pathogen of humans. The oral environmental factors considered in the Candida albicans colony forming unit test contain both host and microbial factors associated with candidiasis. In particular, Candida biofilms can develop on surfaces of prosthesis. The purpose of this study was to investigate the distribution of oral Candida species between the type of prosthesis and the situation of oral environment in patient with prosthetic appliance. The patients were 30 elderly subjects with different types of prosthesis, 7 who wore denture, 12 who wore implant and 15 who wore removable orthodontic appliance. We used Candida albicans colony forming unit test using saliva to exam the distribution of Candida albicans related with 5 oral environmental factors, gender, smoking or nonsmoking, alcohol/nonalcohol consumption, the type of prosthetic appliance and its treatment duration as well as tooth brushing frequency per day. In conclusion, for the patient's gender, site in the oral cavity and the type of prosthetic appliance and its treatment duration was associated with an increase in the distribution of Candida albicans in saliva. The distribution of Candida albicans within the oral cavity performs to be modulated to varying extents by oral environmental factors and, further investigations are required to elucidate these complex interactions.

• Journal of Periodontal and Implant Science
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• v.33 no.3
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• pp.457-474
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• 2003

The ultimate objective of periodontal treatment is to get rid of an on-going periodontal disease and further regenerate the supporting tissue, which is already destroyed, functionally. Currently, the bone grafting operation using various kinds of bone grafting materials and the operation for induced regeneration of periodontal tissue using the blocking membrane are performed for regeneration of the destroyed periodontal tissue. However, there are respective limitations Galenical preparations, which are used for regeneration of periodontal of tissue, has less risk of rejective reaction or toxicity that may be incidental to degradation and their effect is sustainable. Thus, in case they are applicable to a clinic, they can he used economically. Chitosan has such compatibility, biological actions including antibacterial activity, acceleration of wound treatment, etc., and excellent mechanical characteristics, which has recently aroused more interest in it. Also, it has been reported that it promotes osteogenesis directly or indirectly by functioning as a matrix to promote migration and differentiation of a specific precussor cell (for example, osteoblast) and further inhibiting the function of such a cell as fibroblast to prevent osteogenesis. In this study, the pure chitosan solution, which was obtained by purifying chitosan, was used. However, since this chitosan is of a liquiform, it is difficult to sustain it in a defective region. It is, therefore, essential to use a carrier for delivering chitosan to, and sustaining it gradually in the defective region. In the calvarial defect model of the Sprague-Dawley rat, it is relatively easy to maintain a space. Therefore, in this study, the chitosan solution with which ACS was wetted was grafted onto the defective region, For an experimental model, a calvarial defect of rat m s selected, and a critical size of the defective region was a circular defect with a diameter of 8 mm. A group in which no treatment was conducted for the calvarial defect was set as a negative control group. Another group in which treatment was conducted with ACS only was set as a positive control group (ACS group). And another group in which treatment was conducted was conducted with by grafting the pure chitosan solution onto the defective region through ACS which was wetted with the chitosan solution was set an experimental group (Chitosan/ACS group). Chitosan was applied to the Sprague-Dawley rat's calvarial bone by applying ACS which was wetted with the chitosan solution, and each Sprague-Dawley rat was sacrificed respectively 2 weeks and 8 weeks after the operation for such application. Then, the treatment results were compared and observed histologically and his tometrically. Thereby, the following conclusions were obtained. 1. In the experimental group, a pattern was shown that from 2 weeks after the operation, vascular proliferation proceeded and osteogenesis proceeded through osteoblast infiltration, and at 8 week after the operation, ACS was almost absorbed, the amount of osteogensis was increased and many osteoid tissue layers were observed. 2. At 2 weeks after the operation, each amount of osteogenesis appeared to be 8.70.8 %, 13.62.3 % and 4.80.7 % respectively in the experimental group, the positive control group and the negative control group. Accordingly, it appeared to be higher in the Experimental group and the positive control group than in the negative control group, but there was no significant difference statistically (p<0.01). 3. At 8 weeks after the operation, each amount of osteogenesis appeared to be 62.26.1%, 17.42.5 % and 8.21.4 % respectively in the experimental group, the positive control group and the negative control group. Accordingly, it appeared to be substantially higher in the experimental group than in the positive control group and the negative control group, and there was a significant difference statistically (p<0.01). As a result of conducting the experiment, when ACS was used as a carrier for chitosan, chitosan showed effective osteogenesis in the perforated defective region of the Sprague-Dawley rat's calvarial bone.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.103-115
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• 1999

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. Various periodontal procedures have been used throughout the years in an attempt to reestablish attachment of periodontal tissues to root surfaces affected by periodontitis. Flap debridement surgery has been demonstrated to be a successful procedure in gaining the probing attachment level and reducing probing depth. A tendency towards impaired wound healing following periodontal procedures in smokers has been clinically documented. But, previous clinical studies on healing response in smokers are based on a retrospective design. The purpose of this study was to evaluate the treatment outcome following flap debridement surgery in smokers compared to nonsmokers. 25 patients with moderate to advanced periodontitis were included for study. Among these patients, 13 patients were smokers, and 12 patients were nonsmokers. Mucoperiosteal flap was raised with the sulcular incision. No antibiotic treatment was administered postsurgery. The patients was recalled at monthly intervals during a period of 6 months following the surgery. The patients were received supragingival scaling and oral hygiene reinforcement. All the recordings, including modified O' Leary plaque control record, bleeding on probing, probing pocket depth, probing attachment level,were recorded, presurgery and 6 months postsurgery. The changes of all the recordings at 6 months after flap debridement surgery revealed the following results: 1. PI on all the dentitions and surgical sites showed no statistical significance between smokers and nonsmokers at presurgery. But, smokers demonstrated a significantly lower % of PI than nonsmokers at 6 months postsurgery. 2. Smokers demonstrated a greater % of BOP sites than nonsmokers on the surgical sites and all the dentitions, presurgery and 6 months postsurgery. But, there was no statistical significance between two groups. 3. Smokers exhibited significantly less reduction of probing depth in the 3 mm or less probing pocket depth(PPD) group, 6mm or more PPD group and total PPD group when compared to nonsmokers at 6 months postsurgery. 4. Smokers exhibited significantly less gain of probing attachment level(PAL) in the 3mm or less PPD group, 6 mm or more PPD group and total PPD group when compared to nonsmokers at 6 months postsurgery.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.51-63
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• 1999

Exposure of the root surface due to gingival recession after periodontal surgery, elicit pain response when exposed to mechanical, heat, chemical or osmotic irritation. Especially patients treated with periodontal surgery, show high frequency. There have been reports that the 1 out of 7 patients complains of dentinal hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentinal hypersensitivity. The purposes of this study were to evaluate the effect of sodium chloride and potassium oxalate and to observe the relationship between the dentinal hypersensitivity and surface characteristics such as dentinal tubule size and number. This study included 20 teeth which were scheduled for extraction and had no pulpal disease. These teeth were divided into Root planing group, EDTA group, NaCl group and Oxalate group. Dentinal hypersensitivity is measured by tactile, pressured air and cold water using NRS (Numerical Rating Scales). Teeth were extracted under local anesthesia and each specimen was sectioned to a size about 3 X 5 mm and was examined under the scanning electron microscope (X2,000) The results were as follows, 1. The EDTA group exhibited significantly increased dentinal hypersensitivity comparing with the other groups. 2. The NaCl and Oxalate groups showed significantly reduced dentinal hypersensitivity comparing with the EDTA group. 3. As a method for dentinal hypersensitivity measurement, it was presumed thet tactile sensitivity test was not sensitive method but air blast test and cold water test were adequate method. 4. In a SEM study, the root planing group exhibited amorphous smear layer and showed no dentinal tubule orifice, but the EDTA group showed the large number of dentinal tubules. On the other hand, the NaCl and Oxalate groups did not show exposed dentinal tubules. The NaCl group showed more rough root surface than the EDTA group, and the Oxalate group showed many participates to be presumed as calcium oxalate particle. As the results from this study, root planing couldn't expose the dentinal tubule and NaCl and potassium oxalate occluded exposed dentinal tubule effectively. Dentinal hypersensitivity has close relationship with the exposure of dentinal tubules, especially with it's size and number.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.469-484
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• 1999

The purpose of this study was to evaluate new bone formation following guided bone regeneration by resorbable and nonresorbable membrane. Six adult mongrel dogs were used. The first, second, third, fourth premolars in the mandible of each dog were extracted. Two months after tooth extraction, a buccal dehiscence defect was surgically created on each edentulous area. The experimental sites were divided into three groups according to the treatment modalities ; Group I-a: surgical treatment only ; Group I -b: allogenic decalcified freezed dried bone grafting ; Group II-a : e- PTFE membrane placement only ; Group II-b : allogenic decalcified freezed dried bone grafting and e-PTFE membrane placement ; Group III-a : Vicryl(R) mesh placement only ; Group III-b : allogenic decalcified freezed dried bone grafting and Vicryl(R) mesh placement . The animals were sacrificed at 8 weeks after operation and the specimens were prepared for histologic and histometric examination. The results were as follows : Clinically, all defect sites were healed without exposure of barrier membrane after the eight weeks. In Group I-a, dense connective tissues were impinged in the bony defect area. Well vascularized and fibrous bone marrow indicated that bone formation was still taking place was found. In Group I-b, in areas closer to the periphery, lamellation of the newly formed bone would found. In Group II-a, beneath the e-PTFE membrane a dense layer of connective tissue covering the most external portions of the regenerated tissue was seen. The new bone surfaces were lined with osteoid and osteoblast. In Group II-b, a dense layer of connective tissue covering the most external portions of the regenerated tissue was observed beneath the e-PTFE membrane. A notable amount of alveolar ridge regeneration was seen with new rigdes with well-contoured form. In Group III-a, the new bone surface were lined with osteoid and osteoblast, indicating active bone formation. A clear demarcation could not be noted between the host bone and new bone. In Group III-b, a notable amount of alveolar ridge regeneration was seen with new ridges assuming wellcontoured form. In areas closer to the periphery, lamellation of the newly formed bone would found. As histometric examination, the amount of bone formation was gained from $12.8mm^2$ to $26.3mm^2$. It was significantly greater in group II-b and group III-b compared to other groups(p<0.05) . These results suggest that Vicryl(R) mesh after DFDB grafting used in guided bone regeneration could create and sustain sufficient space for new bone formation.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.693-703
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• 1999

Since they were introduced by Ward in 1923, periodontal dressing have been routinely used following the periodontal surgery to avoid pain, infection, desensitizing teeth, inhibiting food impaction of the surgical areas, and immobilizing injured areas. Recently, however, the value of periodontal dressings and their effects on periodontal wound healing have been questioned, several authors have been reported that the use of dressing has little influence on healing following periodontal surgical procedures. In addition, there is evidence that when good flap adaptation is achieved, the use of a periodontal dressing does not add to patient comfort nor promote healing. The purpose of this study was to evaluate patient postoperative pain experience and discomfort with and without the use of periodontal dressing following periodontal surgery. Twenty-eight patients, 11 male and 17 female. were selected for this study; The age range was 31 to 56, with an average of 40.2years. Patient selection was based on existence of two bilateral sites presenting similar periodontal involvement, as determined by clinical and radiographic assessment, and requiring comparable bilateral surgical procedures. Using a splitmouth dressing. one site received a periodontal dressing while the other site did not. Pain assessment was made according to a horizontal, rating scale(0-10). After at least a two-week period, the second surgical precedure was performed using the alternate postoperative treatment. At the conclusion of the trial, a self-administered questionnaire on postoperative experience was administered, and were asked of their preference of either, dressed or undressed. The results were as follows: 1. A similar trend for mean pain and discomfort scores as assessed by patients both dressed and salinetreated procedures was evident during 7-day postsurgical period. 2. Statistical analysis of differences between the dressed side and salinetreated side with respect to pain, discomfort and patient's experiences revealed that both treatment sides behaved similarly at any postoperative day(P>0.05). 3. Considering the patient's preference, on the basis of pain and discomfort experienced, 43% preferred the saline-mouthwash and 32% preferred the dressing, 25% showing no preference for either the dressing or the saline-mouthwash. There is evidence to support the use of a periodontal dressing in retention of an apically positioned flap by preventing coronal displacement, or its use to provide additional support to stabilize a free gingival graft. However, there will always be a use for periodontal dressing although routine use of dressings may decrease because of better surgical techniques and the use of antibacterial mouth rinses.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.85-90
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• 2010

Purpose: The goals of a blow-out fracture reconstruction are to restore the osseous continuity, provide support for the orbital contents and prevent functional and anatomic defects. Over the past several years, a range of autogenous and synthetic implants have been used extensively in orbital reconstructions. None of these implants have any absolute indications or contraindications in certain clinical settings. However, in extensive blow-out fractures, it is difficult to restore support of the orbital contents, which can cause more complications, such as enophthalmos. This study examined the clinical outcomes of extensive or comminuted blow-out fractures that were reconstructed by the simultaneous use of a titanium mesh plate and $Medpor^{(R)}$. Methods: Eighty six patients with extensive orbital fractures, who were admitted between March 1999 and February 2007, were reviewed retrospectively. The patients' chart and CT were inspected for review. Twenty three patients were operated on with both a titanium mesh plate (Matrix MIDFACE pre-formed orbital plate, Synthes, USA) and $Medpor^{(R)}$ (Porex, GA, USA). The patients underwent pre-operative CT scans to evaluate the fracture site and measure the area of the fracture. A transconjunctival approach was used, and titanium mesh plates were inserted subperiosteally with screw fixation. $Medpor^{(R)}$ was inserted above the titanium mesh plate. The patients were evaluated post-operatively for enophthalmos, diplopia, sensory disturbances and eyeball movement for a period of at least 6 months. Results: No implant-related complications were encountered during the follow-up period. Enophthalmos occurred in 1 patient, 1 patient had permanent sensory disturbance, and 3 patients complained of ocular pain and fatigue, which recovered without treatment. Although there were no significance differences between groups, the use of 2 implants had fewer complications. Therefore, it can be an alternative method for treating blow out fractures. Conclusion: The use of both a titanium mesh plate and $Medpor^{(R)}$ simultaneously may be a safe and acceptable technique in the reconstruction of extensive blow-out fractures.

• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.545-559
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• 1998

Magnoliae cortex has been used as a drug for treatment of fractures in Chinese medicine and safflower(Carthamus tinctorius $Linn{\acute{e}}$) has been traditionally used for treatment of blood stasis. The purpose of present study was to examine the biologic effects of magnoliae cortex extract and safflower extract mixture(MSM) on human periodontal ligament cells and fetal rat calvarial osteoblasts and on healing of rat calvarial defects. The ethanolic extracts of magnoliae cortex(MCE), safflower seed(SSE), Zea May L(ZML) were prepared as positive control group. MSM mixed to the ratios of 1 : 1, 1 : 2, 1 : 5 and 1 : 10 were used as test group. The effects of each agents on the growth and survival, ALPase activity, cell proliferation and tissue regenerative effect of each extracts was evaluated by histomorphometric measuring of newly formed bone on the 8 mm defect in rat calvaria after oral administration of 2 ratio groups(1 : 5 and 1 : 10) at 3 different doses (0.1, 0.25 and 0.5g/kg per day). MSM stimulated the growth and survival rate of osteoblasts and PDL cells more than any other agents. The growth and survival rate were increased as the proportion of safflower seed extract was increased. MCE, SSE, ZML stimulated the ALPase activity of osteoblast and PDL cell in comparison to the negative control group. But all groups of MSM regardless of ratio of safflower seed extract stimulated the ALPase activity than any other agent. The ALPase activity was also increased as the proportion of safflower seed extract was increased. Although MCE, SSE, ZML stimulated the proliferation of osteoblasts. 1 : 5 and 1 : 10 ratio MSM showed significant increase in stimulation of proliferation of osteoblasts. No agent significantly increased proliferation of PDL cells. Significant new bone formation were seen where 1 : 5 ratio, 0.5g/kg group and 1 : 10 ratio, 0.25, 0.5g/kg groups were used. These results show that magnoliae cortex extract and safflower seed extract mixture can potentially increase bone regeneration ability.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.645-656
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• 2008

Purpose: To evaulate the effects of chlorhexidine and $H_2O_2$ on matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinase(TIMP-1, TIMP-2), Type 1 collagen, fibronectin and UNCL expressions in human periodontal ligament fibroblasts (hPDLF). Materials and Methods: $1.2{\times}10^{-1}%$, $1.2{\times}10^{-2}%$ and $1.2{\times}10^{-3}%$ CHX and $3{\times}10^{-3}%$, $3{\times}10^{-4}%$ and $3{\times}10^{-5}%$ $H_2O_2$ and mixture of CHX and $H_2O_2$ were applied to hPDLF for 1 min and 30 min. The mRNA expressions of MMP-1, TIMP-1 and 2, Type 1 collagen, fibronectin and UNCL in hPDLF were analysed by RT-PCR. Results: The result were as follows: 1. The expression of UNCL mRNA was higher than that of other mRNAs. 2. $1.2{\times}10^{-3}%$ CHX increased mRNA expressions of hPDLF as application time increased. 3. $H_2O_2$ lower than $3{\times}10^{-3}%$ increased expression of UNCL mRNA, and did not decrease mRNA expression of hPDLF. 4. hPDLF treatment with $1.2{\times}10^{-1}%$ CHX (with or without $H_2O_2$) resulted in no gene expression. 5. hPDLF treatment with $1.2{\times}10^{-2}%$ CHX (with or without $H_2O_2$) for 30 minutes resulted in no gene expression. Conclusion: Because low concentration of CHX and $H_2O_2$ increased UNCL mRNA expression of hPDLF, low concentraction of CHX and $H_2O_2$ may have an antioxidative effect.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.2
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• pp.161-169
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• 2011

Longitudinal serial cephalometric films in the every second year from fifty girls were used for the analysis of growth pattern of maxillary alveolar bone (MAE). Six parameters regarding MAB height were measured and were compared with stature and chronological age. Descriptive analysis. correlation coefficient test and linear regression analysis were done for the statistical analyses. 1. The height of MAE increased until 14 years although growth velocity was gradually decreased. which was different with stature growth pattern. 2. The correlation coefficients between chronological age and MAB height were high and had no statistical differences with those of stature and MAB height. In addition. the correlation coefficients between chronological age groups within each parameter of MAB were very high. 3. The growth amount of MAB could be predicted using linear regression analysis on the basis of chronological age data. The growth pattern between MAE and statue was quite different because of the growth pattern difference between skeletal and neuronal system. Therefore. growth pattern of Korean MAB must be considered in dental treatment of youth. Also. close relationship between chronological age and MAB height would be useful when clinicians want to predict growth amount of MAE for the dental implant treatment.