• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.643-653
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• 2002

Periodontal supporting tissue goes through destruction by chronic inflammatory periodontal disease as two aspect. One is qualitive aspect such as alteration of periodontium, the other is quantitative aspect such as alveolar bone loss. According to many authors, PDL is responsible for biting force, and there are two mean. for measuring PDL's function - mobility test and biting force test. This study was conducted to compare the biting force with remaining bone level, that is, quantitative aspect of periodontium, in anterior and premolar teeth at periodontal maintenance phase. 17 patients on periodontal maintenance phase during 6 months at minimum were selected for this study. For the same condition, 4 anterior, canine, premolar teeth were tested by MPM-3000 bite-force register at the same time(a.m.l0-12), the same position, the same posture, by the same examiner. Patients of TMI), ill-fitting pros thesis, general disease, malocclusion and the teeth of TFO, absence of opposing teeth, malposition were excluded. Remaining bone level was measured on the panorama X-ray film through 5 level from 1mm below CEJ to root apex. Teeth were examined twice, and bigger one was selected. If the values showed large difference. examinatin was re-done and the mean was selected. The results were as follows ; 1. In the 4 anterior group, as the remaining bone is decreased, the average of maximal biting force is decreased. Especially, at 3/5 bone level, maximal biting force is decreased significantly(p<0.01). 2. In the canine group, as the remaining bone is decreased, the average of maximal biting force is decreased. Especially, at 2/5 bone level, maximal biting force is decreased significantly(p<0.01). 3. In the premolar group, as the remaining bone is decreased, the average of maximal biting force is decreased. Especially, at 3/5 bone level, maximal biting force is decreased significantly(p<0.05). From the results of this study, clinicians could utilize these efficiently when they have to determine the proper restorative materials, time for tooth extraction, treatment plan, prognosis.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.419-429
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• 2000

Prevotella intermedia has been implicated as a potent pathogen in many kinds of periodontal, pulpal and periapical diseases. However, it has been isolated from periodontally healthy adults and from edentulous children as well. The intraspecies heterogeneity of Prevotella intermedia has been demonstrated in early studies and finally Shah & Gharbia confirmed the existence of 2 DNA homology groups and proposed dividing Prevotella intermedia into 2 species, Prevotella intermedia and Prevotella nigrescens. This study was designed to examine the frequency of Prevotella intermedia and Prevotella nigrescens in diseased periodontal pockets and healthy gingival sulcus of Korean people by PCR based on 16s ribosomal DNA sequence. One hundred adults who had adult periodontitis but not taken any periodontal treatment or antibiotics during previous 6 months and 50 adults who had healthy periodontal tissue were selected for this study. The sulcular fluid was collected into VMGA by sterilized paper point and diluted to 1,000 times in anaerobic chamber. $100{\mu}{\ell}$ of sample was cultured in $37^{\circ}C$ for 10 days. Among the bacterial colonies, BPB were selected and cultured in BHI broth and then Prevotella intermedia was identified through Gram staining and biochemical test. Identified Prevotella intermedia was cultured again and centrifuged. DNA was extracted from the pellet using several reagents. PCR was performed by previously designed primer. The results were followed. 1. BPB were isolated from 39 of 100 samples of diseased periodontal pockets(39%). 2. Prevotella intermedia was identified from 24 of 39 BPB samples. 3. Among 24 Prevotella intermedia, 21 were confirmed as Prevotella inter - media(87.5) and 2 were confirmed as Prevotella nigrescens(8.33%). 4. BPB were isolated from 9 of 50 samples of periodontally healthy patients. Among them only two were identified as Prevotella intermedia, that is, one was confirmed as Prevotella intermedia and the other was Prevotella nigrescens.

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.555-584
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• 2002

Exposed root surfaces can cause esthetic problems, hypersensitivity, and root caries. Numerous efforts have been tried to cover the recessed root surfaces, and various techniques have been developed and introduced. Among these, subepithelial connective tissue graft which shows high coverage rate in various researches, has the advantage of good color match, less discomfort to the donor site, rich vascularity, and high predictability. Following results were obtained after investigating 6 and 18 months post operatively, 98 cases of subepithelial connective tissue graft from 48 patients who underwent subepithelial connective tissue graft procedure in the department of periodontology, college of dentistry, Yonsei university. 1. The total average root coverage of Miller class I, II & III were 76.2?24% at 6 months follow-up and 75?25.2% at 18 months follow-up with no statistically significant difference between the follow-up periods.(p<0.05) 2. The percentage of teeth showing complete coverage were 41.9% at 6 months follow-up and 39.2% at 18 months follow-up. 3. At 6 months follow-up, Miller classification I showed 84.9?20.7%, class II showed 82.5?17.7%, and class III showed 62.3?24.5% of coverage. In class III recession, statistically significantly less root coverage was observed compared to class I & II. (p(0.05) 4. At 18 months follow-up, Miller classification I showed 92.2?13.5%, class II showed 84.3?17.4%, and class III showed 59.5?24.5% of coverage. In class III recession, statistically significantly less root coverage was observed compared to class I & II. (p<0.05) In conclusion, subepithelial connective tissue graft for class I and II recession can be used as a clinically predictable treatment modality for root coverage.

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.665-683
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• 2002

A novel glucanhydrolase from a mutant of Lipomyces starkeyi KSM 22 has additional amylase activity besides mutanolytic activity and has been suggested as promising anti-plaque agent. It has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrose-dependent adherent microbial film and has been strongly bound to hydroxyapatitie. These in vitro properties of Lipomyces starkeyi KSM 22 glucanhydrolase are desirable for its application as a dental plaque control agent. In human experimental gingivitis　model and 6 month clinical trial, mouthrinsing with Lipomyces　starkeyi KSM 22 dextranase was comparable to 0.12% chlorhexidine mouthwash in inhibition of plaque accumulation and gingival inflammation and local side effect was negligible. This study was aimed to evaluate the cytotoxic effect of Lipomyces starkeyi KSM 22 glucanhydrolase on human gingival fibroblasts. Primary culture of human gingival fibroblasts at the 4th to 6th passages were used. Glucanhydrolase solution was made from lyophilized glucanhydrolase powder from a mutant of Lipomyces stakeyi KSM 22 solved in PBS and added to DMEM medium to the final concentration of 0.5, 1, and 2 unit. Cells were exposed to glucanhydrolase solution or 0.1 % chlorhexidine and the cells cultured in DMEM with 10% FBS and 1% antibiotics as control. After exposure, the morphological change, cell attachment, and cell activity by MTT assay were evaluated in 0.5, 1.5, 3, 6, 24 hours after treatment. The cell proliferation and cell activity was also evaluated at 2 and 7 days after 1 minute exposure, twice a day. The cell morphology was similar between the Lipomyces smkeyi KSM 22 glucanhydrolase groups and control group during the incubation periods, while most fibroblasts remained as round cell regardless of incubation time in the chlorhexidine group. The numbers of the attached cells in the glucanhydrolase groups were comparable to that of control and significantly higher than the chlorhexidine group. The numbers of the proliferated cells in the glucanhydrolase groups at 7 days of incubation were comparable to the control group and higher than the chlorhexidine group. The cell activity in glucanhydrolase groups paralleled with the increased cell number by attachment and proliferation. According to these results, Lipomyces starkeyj KSM 22 glucanhydrolase has little harmful effect on attachment and proliferation of human gingival fibroblasts, in contrast to 0.1% chlorhexidine which was cytotoxic to human gingival fibroblasts. Therefore this glucanhydrolase preparation is considered as a safe and promising agent for new mouthwash formula in the near future.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.751-765
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• 1999

Several growth factors and polypeptidesare not commonly yet used for regenerators of bone tissue or alveolar bone because of the insufficiency of studies on their side effects, genetic engineering for mass production and stability for clinical application. Recently, many natural medicines, which have advantage of less side effects and possibility of long-term use, have been studied for their capacity and effects of anti-bacterial, anti-inflammatory and regenerative potential of periodontal tissues. Olibanum, Myrrha, Phlomis Radix, and Cimicifugae Rhizoma have been traditionally used as a drug for treatment of bone disease in oriental medicine. The objective of this study was to examine the ability of alkaline phosphatase(ALP) synthesis of rat calvarial osteoblast(MC3T3-E1) when several natural medicines were supplemented. MC3T3-E1 cells were cultured with ${\alpha}$-MEM(negative control), dexamethasone(positive control), and each natural medicines for 3 and 5 days. And then ALP synthesis was measured by spectrophotometer for enzyme activity and by naphthol AS-BI staining for morphometry. All of the natural medicines induced higher activity of ALP synthesis than the negative controls. Especially Olibanumind uced the higher activity than the positive controls (p<0.05). In the aspects of culturing time, except Cimicifugae Rhizoma, the natural medicines induced higher activity of ALP synthesis at 5 days than at 3 days (p<0.05). In morphometry, all of the natural medicines showed statistical significance compared to the negative control (p<0.05). Myrrha a n d Phlomis Radix showed larger positively stained area at 5days than at 3 days, whereas the others did not showed the difference between at 5 and at 3 days(p<0.05). These results indicate that several natural medicines have an inducing ability of ALP synthesis in MC3T3-E1 cells.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.737-749
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• 1999

Recently many researches on plaque removal effect and therapeutic effect of toothpaste containing natural medicines are being studied in early periodontal diseases. The purpose of this study is to examine the clinical and microbiological effect of toothpaste containing natural medicines such as camomile, rhatany, myrrh，sage oil, glycyrrhetinic acid and vitamin E. Sixty three subjects with gingivitis were divided into an experimental group which performed normal oral hygiene procedure with toothpaste containing natural medicines and vitamine E and a control group which also performed normal oral hygiene procedure with Syrinmed? toothpaste without containing herbal extracts and vitamine E. At the baseline, 2 weeks, and 4 weeks, subjects were analyzed for clinical study and microbiological study. After 2 weeks and 4 weeks use of their respective toothpastes, statistically significant decreases of gingival index, plaque index, and bleeding index were shown in both the control and the experimental group. The degree of decrease was more significant in the experimental group than the control group. A statistically significant decrease of pocket depth, and gingival crevicular fluid were shown in both the control and lie experimental group. A statistically significant increase of cocci was shown in both the control and the experimental group, the degree of increase was more significant in the experimental group than control group. A statistically significant decrease ofnon-motile rods, and motile rods were shown in both the control and the experimental group, the degree of decrease was more significant in the experimental group than the control group. Spirochetes increased weakly in both the control and the experimental group but a statistic significance was not shown. A statistically significant decrease of anaerobic bacteria, aerobic bacteria, and black pigmented Bacteroides were shown in both the control and the experimental group. These results indicate that the use of toothpaste containing natural medicines is effective in the prevention and the treatment of periodontal diseases.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.359-374
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• 2000

Cyclosporine A(CsA) is a widely used immunosuppressant for transplant patients and is also used for the treatment of a wide variety of systemic diseases with immunologic disorders. However, its use is frequently limited because of complications such as nephrotoxicity or gingival hyperplasia. Although several hypotheses have been postulated for CsA-induced gingival hyperplasia, i.e. various cytokine effects of inflammatory cells, existence of plaque or CsA itself, but its pathogenesis is still unclear. For experimental chronic CsA toxicity, salt depletion has been shown to increased susceptibility of rodents to the effects of CsA, and this maneuver facilitates production of arteriolopathy and interstitial fibrosis in kidney that mimic the changes found in human. The purpose of this study was to evaluate pathogenesis of CsA-induced gingival hyperplasia by comparing changes between CsA administration groups of normal standard diet and those of low salt diet group. Specific pathogen-free, 20 to 25 days old(120 to 150 g), male Fisher-344 rats(KIST, Korea), 120 to 150g of body weight, were assigned to four groups of six animals each after one week of adaptation period for powder food. Group 1 received olive oil($300{\mu}l/g\;of\;diet$) with normal standard diet(0.4% of sodium)(NSD). Group 2 received CsA(Cypol-N, Jonggundang, Korea; $300{\mu}g/g\;of\;diet$) with normal standard diet(NSD+CsA). Group 3 received same amount of olive oil with low salt diet(0.05 % of sodium, Teklad Premier, U.S.A.)(LSD). Group 4 received same dose of CsA with low salt diet(LSD+CsA). Rats were pair fed and were sacrificed after six weeks. Renal histologic lesions associated with CsA, consisted of cortical interstitial fibrosis, tubular atrophy and hyalinization of arterioles and the impairment of renal function including increase of serum creatinine and decrease of glomerular filtration rate was more severe in low salt diet group. These were proved as the results of activated of renin-angiotensin system in the kidney by low salt condition. Meanwhile the degree of gingival hyperplasia at incisor and molar tooth was less severe in low salt diet group compared with normal sodium diet group. Hyperplastic gingiva showed mild epithelial hyperplasia and expanded underlyng stroma which consisted of matrix increasement, capillary proliferation and dilatation. While the number and the activation of fibroblasts were increased, inflammatory cells were rare in the stroma. The immunohistochemistry for TGF-${\beta}_1$ in the kidney and gingiva revealed stronger positive in LSD+CsA in kidney but in gingiva of NSD+CsA. These results suggested followings; Gingival hyperplasia can be developed without inflammatory cells infiltration and seemed not induced by CsA by itself. The major role for gingival hyperplasia by CsA would be the secondary effect of TGF-${\beta}$, which maybe upregulated by CsA administration. Low salt diet can attenuate this hyperplasia perhaps by decreasing the activation of $TGF-{\beta}$.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.99-109
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• 2005

It has been focused on the importance of the host inflammatory response in periodontal pathogenesis and progression, treatment has been introduced to control the host response and the method, which diminishes production and activity of MMP by doxycycline, has been used in periodontal field. MMP is a proteolytic enzyme which plays a major role in tissue destruction and MMP-1 is secreted in the periodontally healthy tissue, while MMP-8, 9, 13, etc in the inflammatory state. Among these, MMP-13 has been discovered lately and reported to degrade primarily type II collagen. Periodontal ligament (PDL) cell plays a role in destruction of periodontal tissue. This study was to evaluate the effect of doxycycline and mefenamic acid, non-steroidal antiinflammatory drug on MMP-13 mRNA expression in the rat PDL cell. Doxycycline concentration of $1{\sim}100\;{\mu}g/ml$ was added rat PDL cell and cell activity was measured by MIT assay at day 1 and 3. MMP-13 gene expression was evaluated by RT-PCR after PDL cells were pre-treated for 1hour with doxycycline (50 ${\mu}g/ml$) alone or with mefenamic acid ($10^{-6}M$), then added $IL-1{\beta}$(1.0 ng/ml) and incubated for 16-18 hours. The results are as follows: 1. Cell activity decreased Significantly at 24 and 72 hours in 100 ${\mu}g/ml$ (p<0.05). 2. Level of MMP-13 mRNA was in 20.2% increase by $IL-1{\beta}$ and in pre-treating doxycycline group, expression of $IL-1{\beta}$ induced MMP-13 mRNA was inhibited by 31% than $IL-1{\beta}$ treated only. 3. Mefenamic acid did not inhibit on the expression of $IL-1{\beta}$ induced MMP-13 mRNA, while mefenamic acid in combination with doxycycline inhibited the expression by 41% compared to only $IL-1{\beta}$ stimulation. These results suggest that doxycycline synergistically inhibit the expression of $IL-1{\beta}$ induced MMP-13 mRNA in combination with mefenamic acid.

• Reproductive and Developmental Biology
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• v.28 no.4
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• pp.211-219
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• 2004

The effects of adenosine 5'-triphosphate (ATP) and ATP analogs, P/sub 2y/ purinoceptor agonists, on growth of normal mouse mammary epithelial cells (NMuMG) were examined. Cells were plated onto 24 well plates in DMEM supplemented with 10 % fetal calf serum. After serum starvation for 24 hours, ATP, P/sub 2y/ purinoceptor agonists (AdoPP[NH]P, ATP-α-S, ATP-γ-S, β, γ-me-ATP and 2me-S-ATP), P/sub 2u/ purinoceptor agonist (UTP) and P/sub 2y/ purinoceptor antagonists (Reactive Blue 2, more selective to P/sub 2y/ receptor than PPADS; PPADS) were added. DNA synthesis was estimated as incorporation of 3H-thymidine into DNA (1 hour pulse with 1 μ Ci/ml, 18～19 hours after treatment). ATP, Adopp[NH]P, ATP-α-S or ATP-γ-S, significantly increased DNA synthesis at 1, 10 and 100 μM concentrations with dose-dependency (P<0.05), and the maximum responses of ATP and ATP analogs were shown at 100 μM concentration (P<0.05). The potency order of DNA synthesis was ATP≥ATP- γ -S>Adopp [NH]P>ATP-α-S. β, γ -me-ATP, 2me-S-ATP and UTP did not increase DNA synthesis. In autoradiographic analysis of percentage of S-phase cells, similar results were observed to those of DNA synthesis. Addition of 1, 10 or 100 μM Reactive Blue 2 or PPADS significantly decreased ATP (100 μM)-induced DNA synthesis, however, PPADS was less effective than Reactive Blue 2. In Elvax 40P implant experiment, ATP directly stimulated mammary endbud growth in situ suggesting the physiological regulator of ATP in mammary growth. ATP 100 μM rapidly increased MAPK activity, reaching a maximum at 5 min and then gradually decreasing to the base level in 30 min. ATP analogs, Adopp[NH]P and ATP-γ-S also increased MAPK activity, however, β, γ-me-ATP and 2me-S-ATP did not. The inhibitor of the upstream MAPK kinase (MEK), PD 98059 (25 μM), effectively reduced ATP (100 μM) or EGF(10 ng/ml, as positive control)-induced MAPK activity and DNA synthesis (P<0.05). These results indicate that ATP-induced DNA synthesis was prevented from the direct inhibition of MAPK kinase pathway. Overall results support the hypothesis that the stimulatory effects of normal mouse mammary epithelial growth by addition of ATP or ATP analogs are mediated through mammary tissue specific P/sub 2y/ purinoceptor subtype, and MAPK activation is necessary for the ATP-induced cell growth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.107-116
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• 2006

Purpose:Maxillay sinus grafting is an effective treatment procedure to improve bone height in the posterior maxillar area for implant installation. Beta-tricalciumphosphate(${\beta}$-TCP) was introduced to be grafting substitute material, providing a reasonable bio-degradation time, no need for harvesting procedure. The purpose of this study is to evaluate bone healing & regeneration phase using histomorphometric and immunohistochemical analysis. Material & Methods:Sixteen rabbits were divided into 4 groups. Bi-lateral maxillary sinus membranes were elevated at each rabbits, ${\beta}$-TCP was augmented in left sinus, autogenous bone was augmented in right sinus. The rabbits were sacrificed at 2, 4, 8 and 12 weeks. We investigated the bone regeneration & growth factor expression. Results: 1. The mean new bone volume formation was 28.99${\pm}$6.55%, 49.54${\pm}$5.47%, 69.09${\pm}$8.90% in autogenous grafted area, and 22.86${\pm}$5.56%, 24.00${\pm}$4.09%, 34.11${\pm}$3.37% in ${\beta}$-TCP area at 4, 8, 12 weeks. Therefore, new bone formation in autogenous bone was significantly higher than ${\beta}$-TCP (p<0.05). 2. The BMP 2/4 expression in autogenous bone grafted area was higher at 4, 8 weeks. 3. There was no difference in expression pattern of BMP-7/PDGF/VEGF during grafted bone regeneration. Conclusion:The authors we conclude that the autogenous bone graft was faster than ${\beta}$-TCP in bone regeneration, and the BMP 2/4 were more important in graft bone regeneration.