• Journal of Periodontal and Implant Science
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• v.32 no.4
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• pp.733-744
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• 2002

The fibroblasts are the principal cells in the periodontal ligament of peridontium. As the periodontal ligament fibroblasts (PDLF) show similar phenotype with osteoblasts, the PDLF are thought to play an important role in alveolar bone remodeling. Cell-to-cell contacted signaling is crucial for osteoclast formation. Recently it has been reported that PDLJ enhance the bone resorbing activity of osteoclasts differentiated from hematopoietic preosteoclasts. The aims of this study were to $clarify\;^{1)}$ the mechanism of PDLF-induced osteoclastogenesis $and\;^{2)}$ whether we can use preosteoclast cell line instead of primary hematopoietic preosteoclast cells for studying the mechanism of PDLF-induced osteoclastogenesis. Osteoclastic differentiation of mouse macrophage cell line RAW264.7 was compared with that of mouse bone marrow-derived M-CSF dependent cell (MDBM), a well-known hematopoietic preosteoclast model, by examining, 1) osteoclast-specific gene expression such as calcitonin receptor, M-CSF receptor (c-fms), cathepsin K, receptoractivator nuclear factor kappa B (RANK) ,2) generation of TRAP(+) multinucleated cells (MNCs), and 3) generation of resorption pit on the $OAAS^{TM}$ plate. RAW264.7 cultured in the medium containing of soluble osteoclast differentiation Factor (sODF) showed similar phenotype with MDBM-derived osteoclasts, those are mRNA expression pattern of osteoclast-specific genes, TRAP(+) MNCs generation, and bone resorbing abivity. Formation of resorption pits by osteoclastic MNCs differentiated from sODF-treated RAW264.7, was completely blocked by the addition of osteoprotegerin (OPG), a soluble decoy receptor for ODF, to the sODF-containing culture me야um. The effects of PDLF on differentiation of RAW264.7 into　the TRAP(+) multinucleated osteoclast-like cells were examined using coculture system. PDLF were fxed with paraformaldehyde, followed by coculture with RAW264.7, which induced formation of TRAP(+) MNCs in the absence of additional treatment of sODF. When compared with untreated and fixed PDLF (fPDLF), IL-1 ${\beta}$-treated, or lipopolysaccha-ride-treated and then fixed PDLF showed two-folld increase in the supporting activity of osteoclastogenesis from RAW264.7 coculture system. There were no TRAP(+) MNCs formation in coculture system of RAW264.7 with PDLF of no fixation. These findigs suggested that we can replace the primary hematopoietic preosteoclasts for RAW264. 7 cell line for studying the mechanism of PDLF-induced osteoclastogenesis, and we hypothesize that PDLF control osteoclastogenesis through ODF expression which might be enhanced by inflammatory signals.

• Journal of Periodontal and Implant Science
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• v.28 no.1
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• pp.37-56
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• 1998

The purpose of this study was to evaluate the clinical and microbiological outcomes following the use of 30% minocycline-loaded polycaprolacton film and 2% minocycline-loaded gel that was applied locally into pockets combined with scaling and root planing. 25 human subjects who were non-pregnant, non-lactating, aged 20-50 and diagnosed as moderate to advanced adult periodontitis were enrolled. Subjects were excluded if they had a history of severe acute or chronic systemic disease, if they required antibiotic prophylaxis for dental treatment for any reason, or if they reported a history suggestive of hypersensitivity reactions to minocycline or tetracycline. 4quadrants that had several teeth with a 5-8mm probing pocket depth and radiographic evidence of alveolar bone loss for each patient were selected and divided into test sites and control sites according to the split-mouth design. Scaling and root planing was done for each site at baseline(0week). Test sites received the minocycline gel and strip and control sites had saline irrigation. The patients received both treatments simyltaneously. Subgingival irrigation of sterile saline was applied to the control sites for approximately 30 seconds. Minocycline strip and gel was applied into the periodontal pocket at 1, 2, 3, 4 weeks each after scaling and root planing in the test sites. The clinical and microbiological measurements were made at baseline and at the follow-up visits 6, 10, 14, 20 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth and Periocheck test was significantly reduced and the relative proportions of spirochetes and motile rods were significantly reduced and the proportion of cocci was correspondingly increased, in locally delivered minocycline strip group compared to saline irrigation group. 2. In locally delivered minocycline gel group, The effect was the same with minocycline strip group as compared with saline irrigation therapy. 3. There was no significant differences between minocycline strip group and minocycline gelgroup. In conclusion, minocycline HCl local drug delivery combined with scaling and root planing may provide added improvement of clinical and microbiological responses by inhibiting bacterial recolonization of treated sites. It is suggested that the local administration of minocycline-HCl in the periodontal pocket is effective when combined with subgingival mechanical debridement.

• Journal of Periodontal and Implant Science
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• v.36 no.3
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• pp.591-600
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• 2006

Purpose: This study assessed the impact of self-reported periodontal health on the oral health-related quality of life among elderly Koreans. Methods: Four hundred twenty one elderly Koreans in Seoul and suburban areas were selected with a cluster (institution) sampling method, and were requested to take oral examinations and finish questionnaires on the Oral Health Impact Profile-14(OHIP-14). and self-reported periodontal health status, such as periodontal symptoms, self-rated periodontal health and periodontal treatment need. As the dependent variable, OHIP-14 showed a positive skewed distribution (skewness: 1.17), we transformed to square-root form to apply parametric analyses. Bivariate analysis by t-test and ANOVA, and multivariate analysis with the two-level regression model accounting clusters were implemented. Results: Mean age of the subjects was 74.6 years and 66.5% were women. Fourteen items of OHIP-14 were summarized to one factor explaining 78.6% of total variance and produced the Chronbach alpha coefficient of 0.92. Results from the multivariate model, adjusting for age, sex, type of institutions, ability to pay, and number of teeth present, showed significantly lower OHIP-14 with reporting less than 3 periodontal symptoms (p(O.OOO1), rating their own periodontal health as above average level (p=O.0144), and thinking they don't need any periodontal treatments in the near future (p=O.0148), than their counterparts. The intraclass-corrrelation estimated by the final model was 0.028. Conclusion: This study demonstrates a significant association between self-reported periodontal health status and the oral health-related quality of life.

• Journal of Periodontal and Implant Science
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• v.24 no.1
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• pp.1-14
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• 1994

Dental calculus which is calcifing and/or calcified dental plaque is divided into supragingival calculus and subgingival calculus according to the position of deposit to gingival margin. Subgingival calculus has more important clinical significance in diagnosis and treatment of periodontal disease than supragingival calculus. In order to investigate the deposition pattern of subgingival calculus on each root surface of different tooth type, extracted 192 teeth due to excessive destruction of periodontal tissue were divided according to tooth type and the deposition pattern of subgingival calculus was classified into linear type, veneer type, scattered type, and aggregated type according to the configuration and the extent of deposit. The difference of percentage between each deposition pattern was statistically analyzed by Chi-Square test. Following results were obtained : l. In maxillary incisors, linear type and aggregated type were predominant deposition pattern of subgingival calculus on labial(45.5%, 36.4%) and palatal(36.4%, 36.4%) root surface, aggreated type(72.7%) was on mesial surface, and aggregated type(54.5%) and scattered type(36.4%) was on distal suface. 2. In mandibular incisors, scattered type, linear type and aggregated type were predominant deposition pattern of subgingival calculus on labial(33.3%, 30.6%, 27.8%) and lingual(36.1%, 30.6%, 25.0%) root surface, aggregated type(33.3%), scattered type(27.8% ), and veneer type(27.8%) were on mesial surface, and aggregated type(38.9%) and scattered type(33.3%) on distal surface. 3. In maxillary peremolars, the predominant deposition patterns of subgingival calculus were linear type(28.6%) on buccal root suface, scattered type(35.7%) and linear type(28.6%) on palatal surface, scattered type(39.3%) on mesial surface, aggregated type(46.4%) on distal surface, and aggregated type(53.6%) on furcation area. 4. In mandibular premolars, scattered type was predominant deposition pattern of subgingival calculus on buccal(39.3%) and lingual(50.0%) root surface, scattered type(32.1%) and aggregated type(32.1% ) were on mesial surface, and aggregated type(42.9%) was on distal surface. 5. In maxillary molars, aggregated type(40.0%) and scattered type(32.5%) were predominat deposition pattern of subgingival calculus on buccal root surface, aggregated type was on distal(40.0%) and furcation area(50.0%), but there was no predominat pattern on palatal and mesial root surfaces. 6. In mandibular molars, aggregated type(39.5%) and scattered type(28.9%) were predominant deposition patterns of subgingival calculus on buccal root surface, aggregated type(36.8%) was on lingual surface, linear type(39.5%) and aggregated type(34.2%) were on furcation area, but there was no predominant pattern on mesial and distal root surfaces.

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.823-837
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• 2005

The purpose of this study was to study the histopathological correlation between the use of platelet-rich plasma and enamel matrix protein used in conjunction with xenograft. compared to a control group with regards to bone regeneration at the grade III furcation area in beagle dogs. Control group was treated with bovine derived bone $powder(Biocera^{(R)})$, and experimental I group was treated with bovine derived bone powder and Platelet-rich plasma and experimental II group was treated with bovine derived bone powder and Enamel matrix $protein(Emdogain^{(R)})$. The regeneration rate of bone formation was observed and compared histopathologically at 2. 4, and 8 weeks after surgery. The results were as follows: 1. In control group and both experimental groups. inflammatory cells were observed but, new bone formation wasn't. 2. In control group, new cementum on the notch was found in 4 weeks, less mature periodontal ligament when compared to that of experimental group was found and cementum formation was great but, regeneration couldn't be seen in 8 weeks. 3. Experimental I group. new bone formation in the area adjacent to alveolar bone and graft material surrounded by more dense connective tissue were found in 4 weeks. New bone formation up to crown portion was found and periodontal ligament was aligned functionally and cementum more mature. 4. Experimental II group, new bone formation was found under the defect area in 4 weeks and new bone formation around graft material in 8 weeks, too, and there were a number of fibroblasts, blood vessels, acellular cementum, which was less mature when compared to that of experimental I group, and dense collagen fiber like which normal periodontal ligament has in periodontal ligament of experimental II group in 8 weeks. 5. As a result of histologic finding, bone formation rate were 18.0${\pm}$7.87%(control group), 34. 05${pm}$7.25%(experimental I group), 19.33 ${pm}$5.15%(experimental II group) in 4 weeks and 21.89${pm}$1.58%(control group), 38.82${pm}$3.2(experimental I group), 37.65${pm}$9.22%(experimental II group) in 8 weeks. 6. Statistically significant ratio of bone formation was observed in experimental I group in 4 weeks and in experimental II group in 8 weeks. When experimental I group was compared to experimental II group, the ratio of bone formation in experimental I group was higher than that in experimental II group in 4 weeks(p<0.05). This results suggest that platelet-rich plasma showed more new bone formation than enamel matrix protein within 4 weeks. And use of enamel matrix protein in the treatment of periodontal bone defects starts to enhance regeneration after 8 weeks in beagle dogs.

• Journal of Periodontal and Implant Science
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• v.31 no.3
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• pp.611-623
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• 2001

Cyclosporin A is a cyclic polypeptide produced by the metabolism of fungi. It is widely used at present as immunosuppressive treatment following organ transplants. It is also used to deal with autoimmune diseases such as rheumatoid arthritis or type II diabetes. Gingival hyperplasia is one of the most frequent side-effects associated with the prescription of Cyclosporin A. The mechanisms involved in Cyclosporin A induced gingival hyperplasia are not yet clear. In vitro Cyclosporin A promotes proliferation of gingival fibroblasts, that Cyclosporin A act as a mitogen. Its action is based on mitosis of gingival fibroblasts regulated by cell cycle regulatory proteins. It was the purpose of the present study to examine the effects of Cyclosporin A on human gingival fibroblasts by means of biological and biochemical criteria. In this present study, we examined change of cell proliferation, cell activity, cell viability and cell cycle progression after application of Cyclosporin A. We also examined expression of cell cycle regulatory proteins by western blot analysis. Human gingival fibroblasts were cultured for 48 hours with application of Cyclosporin A at concentrations of 0.01, 0.1, 1, and 10 ng/ml. Cyclosporin A(1 ng/ml) significantly increased the cell activity of gingival fibroblast. Proliferation and viability of gingival fibroblasts were also increased in group treated with 1 ng/ml of Cyclosporin A compared to control group. In the cell cycle analysis, S phase was increased and G1 phase was decreased in the group treated with 1 ng/ml of Cyclosporin A. Cyclosporin A increased the expression of cdk4 and inhibited the expression of pRB and p21. These results suggest that 1 ng/ml of Cyclosporin A may increase the cell cycle progression of human gingival fibroblasts, and its mechanisms may increase the expression of cdk4 and decrease the expression of pRB and p21.

• Journal of Periodontal and Implant Science
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• v.31 no.3
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• pp.597-610
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• 2001

Normal gingival fibroblasts functioning is fundamental for the maintenance of periodontal connective tissue as well as wound healing. Nicotine have been found to affect DNA synthesis and cell proliferation, which appear to depend on the type of cells. This in vitro study was done to determine the effects of nicotine, a major component of tobacco, on cell proliferation, viability, activity, cell cycle distribution, and expression of cell cycle regulatory proteins in human gingival fibroblasts. Nicotine has been tested for 2 days or 4 days in 5 different concentrations; $0.1{\mu}g/ml$; $1{\mu}g/ml$; $10{\mu}g/ml$; $100{\mu}g/ml$; $1000{\mu}g/ml$. To assess cell proliferation and viability, viable and non-viable cells were counted by hemocytometer; to evaluate cellular activity, MTT assay was employed; to analyze cell cycle distribution, fluorescent propidium iodide-DNA complex were measured using fluorocytometer; to determine the expression of cell cycle regulatory proteins, western blot analysis was performed. After 2 days and 4 days incubation respectively, at concentrations of $1{\mu}g/ml$ - $1000{\mu}g/ml$, nicotine significantly inhibited proliferation comparing to non-supplemented controls. The cell viability was significantly decreased after 2 days and 4 days at concentrations of $1{\mu}g/ml$ - $1000{\mu}g/ml$ and at $10{\mu}g/ml$ - $1000{\mu}g/ml$ respectively. After 2 days and 4 days, the cellular activity was significantly decreased at concentrations of $10{\mu}g/ml$ - $1000{\mu}g/ml$. Treatment with $100{\mu}g/ml$ nicotine for 48 hours caused an increase in the proportion of G1-phase cells (from 46.41% to 53.46%) and a decrease in the proportion of S-phase cells (from 17.80% to 14.27%). The levels of cyclin $D_1$ and CDK 4 proteins in nicotine-treated fibroblasts were lower than that of controls, whereas the levels of p16 and pRB were higher than that of controls. These results suggest that the decrease of cell proliferation and lengthened Gap phases (G1) by nicotine may due to the increased expression of p16 and pRB as well as decreased expression of cyclin $D_1$ and CDK 4 in human gingival fibroblasts.

• Journal of Periodontal and Implant Science
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• v.28 no.2
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• pp.291-310
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• 1998

This study was performed to evaluate the effects of extracts of Drynariae Rhizoma on the characteristics of rat calvaria cells(RCV) and bone marrow cells(RBM) which have the important role on the bone formation in vitro. Drynariae Rhizoma has been known as the useful herbal medicament for treatment of the wound healing including regeneration of bone fracture, and also has been used to treat the periodontal lesions, tooth mobility, gingival bleeding and pus discharge via sulcus in Oriental Medicine. In control group, the cells were cultured alone with Dulbeco's Modified Eagle's Medium contained with 10% fetal bovine serum, 100U/ml penicillin, $100{\mu}g/ml$ streptomycin, $0.5{\mu}g/ml$ amphotericin-B. In experimental group, extracts of Drynariae Rhizoma(0.1, 1, 5, 10, $50{\mu}g/ml$) were added into the above culture condition. And then each group was characterized by examing the cell proliferation at 1, 3, 7, 14, 21, 30th day, the amount of total protein synthesis and alkaline phosphatase activity of RCV at 2,4th day and those of RBM at 3, 6th day. And also, the calcified nodule of RCV was examed at 3, 5th day in three goup, control, experimental, culture with the PDGF group. The results were as follow ; 1. Both RCV and RBM cells in Drynariae Rhizoma-treated experimental group proliferated more rapidly than nontreated control group. The experimental group below $5{\mu}g/ml$ Drynariae Rhizoma-treated showed more prominent cell proliferation from the 7th day to the 21st day than the control group and above $10\;{\mu}g/ml$ treated group in RCV. 2. Amount of total protein synthesis was more increased in Drynariae Rhizomatreated group than in control group. In $5{\mu}g/ml$ Drynariae Rhizoma-treated group showed most prominent protein synthesis of the any other exrperimental group and control group. 3. Alkaline phosphatase activity also more increased in Drynariae Rhizomatreated group than control group. 4. Mineralized nodules in Drynariae Rhizoma-treated group were more than not in control group but also in PDGF-treated group. From the above results, Drynariae Rhizoma appeared to enhanced the proliferation, protein synthesis, alkaline phosphatase activity and cellular ability of mineralized nodule formation than PDGF. So that, we conclude that Drynariae Rhizoma enhances the activities of bone cells which have the important role on the periodontal regeneration and optimal application of Drynariae Rhizoma was thought to be useful as the means in bone regeneration.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.223-237
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• 2006

The purpose of the present study was to evaluate the effect of bone graft materials including deproteinized bovine bone(DBB), demineralized freeze-dried bone(DFDB), freeze-dried bone(FDB) on bone formation in guided bone regeneration using perforated titanium membrane(TM). 16 adult male rabbits(mean BW 2kg) were used in this study and 4 rabbits allotted to each test group. Intramarrow penetration(diameter 6.5mm) was done with round carbide bur on calvaria to promote blood supply and clot formation in the wound area. The test groups were devided into 4 groups as follows: TM only(test 1), TM +DBB(test 2), TM +DFDB(test 3), TM +FDB(test 4). Perforated titanium membrane was contoured in rectangular parallelepiped shape(0.5mm pore diameter, 10mm in one side, 2mm in inner height), filled the each graft material and placed on the decorticated carvaria. Perforated titanium membrane was fixed with resorbable suture materials. The animals were sacrificed at 2, 8 weeks after the surgery. Non-decalcified preparations were routinely processed for histologic analysis. The results of this study were as follows: 1. Perforated titanium membrane was biocompatible. 2. Perforated titanium membrane had capability of maintaining the space during the healing period but invasion of soft tissue through the perforations of titanium membrane decreased the space available for bone formation. 3. In test 1 group without bone graft material, the amount of bone formation and bone maturation was better than other test groups. 4. Among the graft materials, the effect of freeze-dried bone on bone formation was best. 5. In the test groups using deproteinized bovine bone, demineralized freeze-dried bone, bone formation was a little. The spacemaking capability of the membrane may be crucial for bone formation. The combined treatment with the perforated titanium membrane and deproteinized bovine bone or demineralized freeze-dried bone failed to demonstrate any added effect in the bone formation. Minimization of size and numbers of perforations of titanium membrane or use of occlusive titanium membrane might be effective to acquire predictable results in the vertical bone formation.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.359-373
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• 1993

The ultimate objective of periodontal therapy is not only stopping the progression of periodontal disease, but also promoting the regeneration of lost periodontal tissue. Guided Tissue Regeneration, which is based on the principle that the goal of periodontal regeneration can be achieved by preventing apical migration of gingival epithelium and blocking cells originating from connective tissue, has been developed and used as a clinical procedure, and although it has shown excellent results in connective tissue healing, there have not been many studies showing its effect on the regeneration of alveolar bone loss due to periodontal disease. The objectives of this study are to investigate the result of 12 months-long treatment following guided tissue regeneration using expanded polytetrafluoroehylene membrane, and to observe the presence of regenerated alveolar bone. Forty-one teeth from 28 patients with clinical diagnosis of periodontitis has been selected. In fifteen of those interproximal intrabony defects, only flap operation had been carried out, and designated as the control group. Twenty-six intrabony defects received e-PTFE membrane following flap operation, and designated as the experimental group. Eleven teeth whose membrane had been exposed were excluded from the experiment. Various measurements including probing depth, loss of attachment, probing bone level and gingival recession have been recorded at 6th month and 12th month, and the significance of the changes has been analyzed. The results are as follows: 1. Probing depth at 6th and 12th month has shown a significant decrease in both groups (p<0.01), but significantly higher decrease was found in the experimental group compared to the control at the month(p<0.05). 2. Loss of attachment at 6th and 12th month has shown a significant decrease in both groups, but significantly higher decrease was found in the experimental group compared to the control (p<0.05). 3. Probing bone level at 6th and 12th month has shown a insignificant decrease in the control group and significant decrease in the experimental group (p<0.01). Significantly higher decrease in probing bone level was found in the experimental group (p<0.05). 4. Gingival recession at 6th and 12th month has shown a statistically significant increase (p<0.05), and the control group showed higher increase compared to the experimental group although no statistical significance was found. As these results have shown, the use of e-PTFE membrane in intrabony pockets results in marked decrease in the loss of attachment and probing bone level. This seems to indicate that e-PTFE membrane may play a role in alveolar bone regeneration in intrabony defects.