Various periodontal barrier membranes used in many clinical and experimental fields, and many recent studies of membranes have reported good results. To improve clinical results, selection of barrier membranes is an important factor. So, we need not only to evaluate various barrier mem-branes, but also to understand the property of barrier membranes appropriate to defect characteristics. For this purpose, this study reviewed available literature, evaluated comparable experimental models, and compared various barrier membranes. From above mentioned methods, the following conclusions are deduced. 1. In i-wall periodontal defect models, new bone formation showed a consistent result, almost 30% of the defect size. New cementum formations measured mostly 40% of the defect size, but showed more variations than new bone formations. This seems to be resulted form difference in experimental methods, so standardization in experimental methods is needed for future studies. 2. Application PLGA barrier membrane to periodontal defect demonstrated improved healing in new bone and new cementum. 3. There was a minimal periodontal regeneration with calcium sulfate barrier membrane only. But, there was better healing pattern in combination of calcium sulfate membrane with bone graft material, such as DFDBA, 4. There was no significant difference between the experimental group that used chitosan mem-brane only and the control group. But, in combination with bone graft material for space maintanence, periodontal regeneration was improved. Overall, Space maintenance is a critical factor for Guided tissue regeneration using barrier membranes. Also, a barrier membrane itself that has difficulty in maintaining space, achieved better result when used with graft material.
Purpose: Autogenous transplantation of teeth can be defined as transplantation of teeth from one site to another in the same individual, involving transfer of impacted or erupted teeth into extraction sites or surgically prepared sockets". Successful autogenous transplantation of teeth depends upon a complex variety of factors. Such factors include damage to the periodontal ligament of the donor tooth, residual bone height of the recipient site, extra-oral time of tooth during surgery. Schwartz and Andreasen previously reported that autogenous transplantation of teeth with incomplete root formation demonstrated higher success rate than that of teeth with complete root formation. Gault and Mejare yielded similar rate of successful autogenous transplantation both in teeth with complete root formation and in teeth with incomplete root formation when appropriate cases were selected. This case report was aimed at the clinical and radiographic view in autogenous transplantation of teeth with complete root formation. Materials and Methods: Patients who presented to the department of periodontics, Chonnam National University Hospital underwent autogenous transplantation of teeth. One patient had vertical root fracture in a upper right second molar and upper left third molar was transplanted. And another patient who needed orthodontic treatment had residual root due to caries on upper right first premolar. Upper right premolar was extracted and lower right second premolar was transplanted. Six months later, orthodontic force was applied. Results: 7 months or 11/2 year later, each patient had clinically shallow pocket depth and normal tooth mobility. Root resorption and bone loss were not observed in radiograph and function was maintained successfully. Conclusion: Autogenous transplantation is considered as a predictive procedure when it is performed for the appropriate indication and when maintenance is achieved through regular radiographic taking and follow-up.
People with class I intellectual disability need lifelong assistance and protection from their surroundings due to impaired adaptive functioning. They have poor oral health and show higher prevalence of dental caries, periapical inflammation and tooth loss that require proper prosthetic restoration. Because removable prostheses for intellectually disabled patients often lack stability, retention, and maintenance, fixed prostheses are essential and the only available option is dental implants. In this case, a 45 year-old male patient with class I intellectual disability had poor oral hygiene with most of his teeth missing and visited the clinic to recover his masticatory function. Due to such systemic conditions, the definitive restoration of choice was the implant-supported fixed dental prosthesis made of biocompatible and highly strong monolithic zirconia. In consequence of the treatment process, the patient was able to improve his oral environment aesthetically and functionally.
Periodontal ligament (PDL) is the connective tissue located between the tooth root and alveolar bone. In a previous study, PDLs22 was isolated as a PDL-specific gene by using subtractive hybrid-ization between cultured PDL fibroblasts and gingival fibroblasts. It was also suggested that PDLs22 plays important roles in the development, differentiation and maintenance of periodontal tissues. However, little is known about functional study of PDLs22 using recombinant protein in PDL fibroblast differentiation and periodontium formation. In this study, in order to produce the PDLs22 recombinat protein, PDLs22 expression vector were constructed and expressed its protein in various host cell and temperature conditions. The results were as follows: 1. PDLs22 protein was not strongly expressed In the induction system using pRSET-PDLs22 construct. 2. When the BL21(DE3) pLysS was used as a expression host, PDLS22 protein was strongly ex-pressed in the induction system using pHCEIIBNd-PDLs22 construct. 3. The PDLs22 protein was recognized at a molecular weight of 28 kDa in western blots. 4. Almost of the expressed PDLs22 protein was not soluble and observed like as inclusion body. 5. The protein solubility was not improved after modification of induction time and temperature during PDLs22 protein production. In this study, the system for the PDLs22 protein production was connstructed. However, the re-results suggest that further studies will be needed to produce the considerable amount of PDLs22 re-combinat protein, which can use for the periodontal regeneration.
The Journal of the Korea institute of electronic communication sciences
/
v.7
no.2
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pp.447-455
/
2012
The present study was carried out with a view to examine the protective actions of physical and occupational therapists for patients's privacy. For this purpose, a survey was conducted with the questionnaires that were distributed to 297 physical and occupational therapists engaged in general hospitals as well as in rehabilitation clinics across the country from January 2 to 13, 2012. From the survey, it was made known that the overall extent of protective actions practiced by them was $3.54{\pm}.733$ in average. Divided by area, the average protective action in communication was $3.62{\pm}.776$, followed by $3.57{\pm}1.013$ in direct contact and $3.53{\pm}.780$ in maintenance and management, respectively. The analysis of general characteristics by each area showed that the older their age gets and the longer their career is, the more the protective action is practiced by them. Although they are well aware of the fact that the medical information of patients should be kept 100% secret and they practice it to almost excellent grade (5), the physical and occupational therapists, as key experts in charge of improving functions of patients, were found to have little concern for and little knowledge about contents of protecting medical information. It is thus required to perform public relation and instruction continuously to intensify their awareness of needs to protect patients' privacy and to implant ethical sense in this regard deep in their mind.
Periodontal disease research has been focused on understanding the immunopathologic mechanisms which may operate in the development and maintenance of peiodontal inflammatory changes. Immunologic and inflammatory responses may relate to the etiology and pathogenesis of periodontal disease. In order to research immunopathology of periodontal disease, previous investigators have spent much time on the distribution of lymphocyte subpopulations and NK cells but they have spent less time on the changes of those cells to the periodontal disease severity. The purpose of study was performed to investigate the changes of the distribution of T lymphocytes, B lymphocytes, T lymphocyte subsets, and Natural Killer cells in the gingival epithelium and connective tissue of the periodontal disease with the various clinical parameters including Gingival Index, Sulcular Bleeding Index, and pocket depth. Gingival tissues were obtained from 25 patients with different severity of periodontal disease. Serial cryostat sections displaying a cross section of gingiva were labelled with monoclonal antibody for pan T cells, T cytotoxic/suppressor cells, T helper/inducer cells, pan B cells, and NK cells were develped using an avidin-biotin-peroxidase system. Lymphocyte populations were enumerated in repeatable fields from gingival section. 1. T cells were more increased at grade 1 and 3 than at grade 0 of gingival index (p<0.05). Helper T cells and NK cells were significantly increased at grade 1, 2, 3 than at grade 0(p<0.05). 2. T cells were more decreased at grade 3 and 4 than at grade 1 of sulcular bleeding index (p<0.01, p<0.05). Especially, Natural Killer cells were significantly increased at grade 1, 2, 3, 4 than at grade 0 (p<0.05, p<0.001). 3. The ratios of helper T/suppressor T cells were more decreased at grade 4 than at grade 0 and at grade 4 than at grade 2 of sulcular bleeding index (p<0.05, p<0.05). 4. Helper T cells were significantly decreased at grade II and III than at grade I, however the Natural Killer cells showed a increasing tendency with the increase of the pocket depth, there were no significant differences between each grade of pocket depth. 5. The ratios of helper T/suppressor T cells were tended to be decreased with the increase of the pocket depth, there were no significant differences between each grades of pocket depth. There was a very weak change in the distribution of T lymphocytes, B lymphocytes, T lymphocyte subsets, and Natural Killer cells in the gingival epithelium and connective tissue of the periodontal lesion with the various clinical parameters including gingial index, sulcular bleeding index, and pocket depth. But, the number of T lymphocytes and Natural Killer cells were significantly changed in gingival index and sulcular bleeding index.
Kim, Tak;Kim, Jae-ho;Pi, Sung-Hee;Kim, Eun-Cheol;You, Yong-Ouk;You, Hyung-Keun;Shin, Hyung-Shik
Journal of Periodontal and Implant Science
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v.31
no.3
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pp.597-610
/
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.
Periodontal surgery as part of the treatment of periodontal disease is mainly performed 1) to gain access to diseased areas for adequate cleaning; 2) to achieve pocket reduction or elimination; and 3) to restore the periodontal tissues lost through the disease; i.e., a new attachment formation of periodontal regeneration. To accomplish the latter, often referred to as the ultimate goal of periodontal therapy, a number of surgical procedures have been advocated throughout the years. Clinical studies have demonstrated that considerable gain of clinical attachment and bone can be achieved following guided tissue regeneration (GTR) therapy of intrabony defects. The aim of this study was to analyse the radiographic bone changes 2-year after GTR using a bone graft material and nonresorbable membrane. Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of intrabony defect(s), 33 sites of 30 patients aged 32 to 56 (mean age 45.6) were treated by GTR with a bone graft material and nonresorbable membrane. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. We observed $2.86{\pm}1,87mm$ of bone fill, $065{\pm}0.79mm$ of crestal resorption, $3.49{\pm}2.11mm$ of defect resolution, and $44.42{\pm}19.51%$ of percentage of defect resolution. Mandible, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. But no difference was observed between xenograft and allograft. Outcome of GTR as a therapy of intrabony defect was better than other therapy, but herein, good oral hygiene maintenance as a anti-infective treatment and periodic recall check of patients are essential.
Rho, Kyoung Hwan;Yoon, Eul Sik;Yoon, Byung Min;Dhong, Eun Sang
Archives of Plastic Surgery
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v.36
no.5
/
pp.623-628
/
2009
Purpose: In cases where nasal fractures involve frontal process of maxilla or perpendicular plate of ethmoid, 4 - 5 days of nasal packing may not provide sufficient support for avoiding displacement after packing removal. Therefore a single Kirschner - wire(K - wire) is used as an internal splint when nasal fractures involve the above two areas. Methods: Thirty five patients during the last 3 practical years were treated with a K -wire pinning according to the anatomic locations of nasal fractures. We performed a retrospective study using 13 nasal fractures out of total 35 patients. Among 13 cases, 10 patients involved frontal process of maxilla, and 3 patients were diagnosed as bilateral nasal side wall fractures accompanied with fractures of perpendicular plate of ethmoid. One patient of the last three cases had been augmented with dorsal silicone implant long before the trauma. We analyzed the anteroposterior displacement of key stone area and the width between both lateral walls by comparing immediate postoperative radiographs with 2 month follow - ups. To reduce the errors, the same measurements were taken by two different inspectors, and the mean of each inspector's measurements was compared. Patient satisfaction was analyzed using a questionnaire regarding the esthetic and functional outcomes. Results: Ten patients underwent a longitudinal K - wire fixation in submucoperiosteal plane underneath the frontal process of maxilla. And three patients underwent a transverse K - wire fixation from the one side of lateral wall to the perpendicular plate of ethmoid and to the other side of lateral wall. The mean postoperative anteroposterior displacement of the key stone area measured by two inspectors were 1.84% and 3.06%; mean narrowing of bony pyramid were 1.33% and 1.48%, respectively. Subjective satisfaction scores regarding the esthetic appearance and the maintenance of nasal shape compared with immediate post - operative state with the long term ones were not different (p>0.05). Conclusion: K - wire pinning after closed reduction is a reliable and useful method for the treatment of nasal fractures involving frontal process of maxilla or perpendicular plate of ethmoid. This is because it achieves longer intranasal support after reduction. This method also leaves conspicuous external scar, and minimal soft - tissue injury.
Choi, EunHa;Um, Heung-Sik;Chang, Beom-Seok;Lee, Si Young;Lee, Jae-Kwan
Journal of Periodontal and Implant Science
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v.51
no.1
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pp.53-62
/
2021
Purpose: This study aimed to evaluate the clinical and microbiological efficacy of adjunctive local delivery of minocycline (Periocline®) in patients receiving supportive periodontal therapy (SPT) after initial treatment. Methods: The participants were 16 men and 8 women (age, 20-65 years) who had at least 15 natural teeth, underwent SPT for more than 1 year due to chronic periodontitis, had 4 or more periodontal pocket sites deeper than 5 mm, and showed >25% gingival bleeding on probing (BoP). They were randomly assigned to the test and control groups. In the test group, mechanical debridement and local antibiotic delivery were performed for all periodontal sulci/pockets; in the control group, mechanical debridement and saline irrigation were performed. In patients who underwent SPT for more than 1 year, clinical and microbiological examinations were performed at baseline and 1 and 3 months after SPT. The clinical examination included an assessment of the periodontal pocket depth, clinical attachment level, plaque index, and BoP. Microbial tests were performed using real-time polymerase chain reaction; the relative ratios of Porphyromonas gingivalis and Fusobacterium nucleatum were determined. Results: Both groups showed significant improvements in clinical parameters at 1 and 3 months from baseline; there were no significant changes between months 1 and 3. Intergroup differences were insignificant. The microbiological analysis revealed no significant differences in P. gingivalis and F. nucleatum ratios across time points. While intergroup differences were insignificant, there was a tendency for the P. gingivalis and F. nucleatum ratios to decrease in the test group. Conclusions: Mechanical debridement in patients receiving maintenance therapy resulted in clinically significant improvement; the effectiveness of additional local delivery of antibiotics was not significant. The ratios of P. gingivalis and F. nucleatum showed a tendency to decrease in the test group, although it was not significant.
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