• Journal of Periodontal and Implant Science
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• v.33 no.2
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• pp.277-288
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• 2003

It has been suggested that increased number and activity of phagocytes in periodontitis lesion results in a high degree of reactive oxygen species (ROS) such as superoxide anion, hydrogen peroxide, nitric oxide and peroxynitrite. There are few reports on the relationship between ROS and MMPs expressions in gingival fibroblast. We studied to elucidate whether and how ROS, especially nitric oxide affects the MMP expression. Human gingival fibroblasts and HTl080 cells (human fibrosarcoma sell line as reference) were grown in DMEM supplemented with 10 mM HEPES, 50 mg/L gentamicin, and 10% heat inactivated fetal bovine serum with addition of various reactive oxygen species (ROS). Culture media conditioned by cells were examined by gelatin zymography. HT1080 cells expressed proMMP-2 and proMMP-9, but human gingival fibroblasts (HGF) produced only proMMP-2. Hydrogen peroxide upregulated MMP-9 expression in HT1080 cells, whereas in human gingival fibroblast SNP treatment showed marked increase in MMP-2 level compared to other ROS. These results suggest that the effects of ROS on MMPs expressions are cell-type specific. RT-PCR for MMP-2 and TIMP-2 m-RNA were performed using total RNA from cultured cells under the influence various kinase inhibitors. In HT1080 cells, treatment with FPTI III (Ras processing inhibitor) and LY294002 (PI3-kinase inhibitor) resulted in inhibition of MMP-2 and MMP-9 expressions, suggesting that Ras/P13-kinase pathway is important for MMPs expression in HT1080 cells. In gingival fibroblasts, treatment with FPTI III and PDTC (NF-kB inhibitor) showed marked decrease in MMP-2 regardless of the of SNP , suggesting that Ras/NF-kB could be the key pathway for NO-induced MMP-2 expression in gingival fibroblasts. This study showed that ROS, especially nitric oxide, could be the critical mediator of periodontal disease progression through control of MMP-2 expression in gingival fibroblasts possibly via Ras/NF-kB pathway.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.907-931
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• 1996

The purpose of this study was to study of the effects of the bioglass and the natural coral on healing process of the alveolar bone defects. Three adult dogs aged 1 to 2 years were used in this study. Experimental alveolar bone defects were created surgically with surgical bur and bone chisel at the furcation area of the buccal surface of the right and left mandibular 3rd, 4th premolars. Twelve experimental alveolar bone defects were devided into four groups according to the type of graft materials. The groups were as follows : 1. flap operation with root planing & curettage(Negative control group) 2. flap operation with autogenous bone(Positive control group) 3. flap operation with bioglass(BG group) 4. flap operation with natural coral(NC group) At 2, 4, and 8 weeks, the dogs were serially sacrificed and specimens were prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows : 1. The defect areas were filled with granulation tissue at two weeks in negative control group. But in other groups, the appearance of connective tissues around graft materials were formed more densely and the response of inflammation by graft materials itself was not found. 2. In every control and experimental groups at two weeks, there was seen the accumulation of the formation of new bone trabeculae at the bottom of defects and gradually expanded toward the graft materials and in autogenous group there was slightly seen the formation of new cementum. 3. There was seen the erosion of central portion of bioglass particles at two weeks in BG group, and the erosion of the central portion was developed more progressively and was filled with bone-like tissues at eight weeks. 4. The natural coral particles were encapsulated by densely connective tissues and seen the formation of new bone tissues at four weeks and developed more new bone and cementum formation at eight weeks. From the results of this study, the bioglass and the natural coral may be biocompatible and have a weak adverse reaction to the periodontal tissues.

• Archives of Plastic Surgery
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• v.44 no.5
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• pp.407-412
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• 2017

Background Among the various signs and symptoms of orbital fractures, certain clinical findings warrant immediate surgical exploration, including gaze restriction, computed tomographic (CT) evidence of entrapment, and prolonged oculocardiac reflex. Despite proper surgical reconstruction, prolonged complications such as diplopia and gaze restriction can occur. This article evaluated the prognostic factors associated with prolonged complications of orbital fractures with muscle incarceration. Methods The medical records of 37 patients (37 orbits) with an orbital fracture with muscle incarceration from January 2001 to January 2015 were reviewed. The presence of Incarcerated muscle was confirmed via CT, as well as by intraoperative findings. Various factors potentially contributing to complications lasting for over 1 year after the injury were categorized and analyzed, including age, cause of injury, injury-to-operation time, operative time, fracture type, nausea, vomiting and other concomitant symptoms and injuries. Results All patients who presented with extraocular muscle limitations, positive CT findings, and/or a positive forced duction test underwent surgery. Of the 37 patients, 9 (24%) exhibited lasting complications, such as diplopia and gaze restriction. The mean follow-up period was 18.4 months (range, 1-108 months), while that of patients who experienced prolonged complications was 30.1 months (range, 13-36 months). Two factors were significantly associated with prolonged complications: injury-to-operation time and nausea/vomiting. Loss of vision, worsening of motility, and implant complication did not occur. Conclusions Patients who present with gaze limitations, with or without other signs of a blow-out fracture, require a thorough evaluation and emergent surgery. A better prognosis is expected with a shorter injury-to-operation time and lack of nausea and vomiting at the initial presentation.

• Journal of Periodontal and Implant Science
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• v.27 no.4
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• pp.883-908
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• 1997

Bone remodeling is characterized by the coupling of osteoclast-mediated bone resorption and osteoblast-mediated bone formation. The process is tightly regualted at the local level by an incompletely known netwotk of peptide and non-peptide fators. Nitric oxide(NO), synthesized by nitric oxide synthetase(NOS) from L-arginine, is becoming recognized as an important bioregualtory molecule in a variety of tissue, but little is known about its possible role in periodontal tissue. The purpose of this study is to investigate the expression of nitric oxide synthetase(NOS) in inflamed gingiva and the effects of cytokine on the expression of NOS protein. The expression of NOS in gingival tissue was evaluated by immunohistochemical staining for $NOS_1$, $NOS_2$, $NOS_3$. The effect of cytokine on the expression of NOS in human periodontal ligament cells and osteoblast-like HOS cells by western blot analysis. Further, we studied that NO functions in periodontal ligament cells as a regulatory molecule. PDL cells incubated with NOS inhibitor and donor. The protein expression, type I collagen & non-collagenous protein, nitrate production and cell proliferation were evaluated The results were as follows. 1. $NOS_1$, $NOS_2$, $NOS_3$ was rarely distributed in healthy gingiva, but stronger stained in gingival epithelium, endothelial cells, and mononuclear cells of inflammed gingiva. 2. The cytokine stimulated $NOS_1$, and $NOS_3$ protein were not inducing or inhibitory effect to compared with control in PDL and HOS cells. 3.Incubation of cells with combination of $TNF-{\alpha}$, $IFN-{\gamma}$, LPS result in a time dependant increase in $NOS_2$ expression, reaching a maximal level after 24 hours of stimulation. 4. The osteonectin protein inhibitory effect of NMA, inhibitor of NOS, was reversed by Larginine in dose dependant manner. 5. NMA decreased cell poliferation and nitrate production, but the inhibitory efffect of NMA was also prevented by the NO donor, sodium nitropruiside. These results suggest that exogenously synthesized NO was playing a stimulating effect on cell proliferation or on non-collagenous protein expression. Therefore NO have an important role in mediation of localized bone destruction associated inflammatory bone disease such as periodontitis.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.153-161
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• 2005

파이브로넥틴은 세포외기질에 존재하는 당단백질로 세포의 부착, 이동, 성장 및 분화에 관여하며, 섬유아세포 성장인자는 세포의 증식 이동 및 분화에 영향을 주는 중요한 성장인자로 알려져 있다. 최근 연구에 의하면, 파이브로넥틴은 조골세포의 타이태늄 임플란트 표면으로 이주와 증식 및 골생성을 촉진하며, 섬유아세포 성장 인자는 파이브로넥틴에 상승작용을 한다고 보고된 바 있다. 이 실험의 목적은 파이브로넥틴 및 섬유아세포 성장인자의 복합 단백질을 이용하여 타이태늄 임플란트의 골 반응을 알아보는 것이다. 체중 2.5 kg 내외의 건강한 18 마리의 웅성가토를 준비하여 무균 사육하였고, 순수 타이태늄을 절삭가공하여 직경 3.5mm, 길이 6mm 의 machined surface를 지니는 screw type 의 임플란트를 준비하였다. 사람의 유전자를 기초로, 유전자 재조합법을 통해, 적절한 primer를 이용하여 얻은 섬유아세포 성장인자를 파이브로넥틴 III 형 분절의 9-10 번 도메인에 결합시켜 얻은 복합 단백질을 준비된 임플란트에 표면처리하여 실험군으로 하였고, 표면처리하지 않은 임플란트를 대조군으로 하여, 가토의 좌우 경골에 각각 2 개씩의 임플란트를 식립하였다. 4주 후, 가토를 희생시켜 각 경골 당 한 개의 임플란트에서 뒤틀림 제거력을 측정하였고 나머지 임플란트 식립 부위 에서는 경골을 포함하는 조직표본을 제작하였다. 조직표본상에서 골접촉이 가장 좋은 3 개의 나사산의 길이를 측정하고, 나사와 접촉하는 골의 길이를 측정하여 골-임플란트 접촉도를 구하고, 같은 부위에서 나사산 사이의 면적과 골이 차지하는 면적을 비교하여 골생성률을 얻었다. 실험군과 대조군의 결과는 Student t-test 를 이용하여 신뢰도 95% 수준에서 통계학적 유의성을 검정하였다. 파이브로넥틴과 섬유아세포 성장인자의 복합 단백질로 표면처리된 임플란트와 표면처리를 하지 않은 임플란트는 뒤틀림 제거력에서는 통계적 유의성이 나타나지 않았으나, 골-임플란트 접촉도와 골생성률에서 복합 단백질로 처리된 임플란트가 통계적으로 유의하게 높은 결과를 보였다. 이상의 연구결과로, 섬유아세포 성장인자와 파이브로넥틴 복합 단백질로 처리한 타이태늄 임플란트가 주변 골 형성을 촉진시켜, 골유합을 증진시킴을 알 수 있었다. 따라서, 복합 단백질이 타이태늄 임플란트의 성공률을 높이기 위한 표면개질 물질로 이용될 가능성을 확인할 수 있었다.

• 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.

• Journal of Korean society of Dental Hygiene
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• v.11 no.5
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• pp.717-727
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• 2011

Objectives : This study was purposed to estimate the level of oral health quality of life and the relationship between health-related factors and oral health quality of life in patients with successful dental implants. Methods : This questionnaire survey was conducted during the period from December 2009 to March 2010 with 126 patients confirmed successful dental implants in Busan. The oral health related quality of life and oral health-related factors were estimated with OHIP-14 and 8 oral health characteristics, respectively. Data analysis was performed with descriptive analysis, t-test, ANOVA, multiple regression analysis using SAS(ver 9.1) program. Results : The score of oral health quality of life in patients with successful dental implants was $12.25{\pm}7.82$. The scores of subscale of the oral health quality of life were $1.24{\pm}1.35$ in social disability, $1.60{\pm}1.37$ in handicap, $1.60{\pm}1.44$ in psychological disability, $1.70{\pm}1.38$ in functional limitation, $1.81{\pm}1.35$ in physical disability, $2.14{\pm}1.46$ in physical pain, $2.17{\pm}1.46$ in psychological discomfort, respectively. The related factors of oral health quality of life in patients with successful dental implants were absence of other type prosthesis and experience of tooth brushing education. Conclusions : The oral health related quality of life in patients with successful dental implants was relatively good condition. Social supports and chances for high quality denture and tooth brushing educations are needed to improve oral health related quality of life in patients with dental implants.

• 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.41 no.4
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• pp.176-184
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• 2011

Purpose: The final goal of regenerative periodontal therapy is to restore the structure and function of the periodontium destroyed or lost due to periodontitis. However, the role of periosteum in periodontal regeneration was relatively neglected while bone repair in the skeleton occurs as a result of a significant contribution from the periosteum. The aim of this study is to understand the histological characteristics of periosteum and compare the native periosteum with the repaired periosteum after elevating flap or after surgical intervention with flap elevation. Methods: Buccal and lingual mucoperiosteal flaps were reflected to surgically create critical-size, "box-type" (4 mm width, 5 mm depth), one-wall, intrabony defects at the distal aspect of the 2nd and the mesial aspect of the 4th mandibular premolars in the right and left jaw quadrants. Animals were sacrificed after 24 weeks. Results: The results from this study are as follows: 1) thickness of periosteum showed difference as follows (P<0.05): control group ($0.45{\pm}0.22$ mm)> flap-elevation group ($0.36{\pm}0.07$ mm)> defect formation group ($0.26{\pm}0.03$ mm), 2) thickness of gingival tissue showed difference as follows (P<0.05): defect formation group ($3.15{\pm}0.40$ mm)> flap-elevation group ($2.02{\pm}0.25$ mm) > control group ($1.88{\pm}0.27$ mm), 3) higher cellular activity was observed in defect formation group and flap-elevation groups than control group, 4) the number of blood vessles was higher in defect formation group than control group. Conclusions: In conclusion, prolonged operation with increased surgical trauma seems to decrease the thickness of repaired periosteum and increase the thickness of gingiva. More blood vessles and high cellular activity were observed in defect formation group.

• Journal of Periodontal and Implant Science
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• v.41 no.3
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• pp.149-156
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• 2011

Purpose: Globular adiponectin (gAd) is a type of adipocytokine, which is mainly produced by adipose tissue. It has been reported that gAd acts as a pro- as well as an anti-inflammatory factor. Interleukin (IL)-6 and IL-8 are pro-inflammatory cytokines. To investigate the role of gAd on periodontal tissues, the expression of adiponectin receptor 1 (AdipoR1) and the effect of gAd on the expression of IL-6 and IL-8 were investigated in periodontal ligament (PDL) and gingival fibroblasts. Methods: PDL and gingival fibroblasts were cultured from human periodontal tissues. gAd derived from Escherichia coli and murine myeloma cells were used. The expression of AdipoR1 was estimated by reverse transcription-polymerase chain reaction and western blot The expression of cytokines was measured by enzyme-linked immunosorbent assay. Results: PDL and gingival fibroblasts expressed both mRNA and protein of AdipoR1. gAd derived from E. coli increased the production of IL-6 and IL-8, but polymyxin B, an inhibitor of lipopolysaccharide (LPS), inhibited IL-6 and IL-8 production induced by gAd in both types of cells. gAd derived from murine myeloma cells did not induce IL-6 and IL-8 production in those cells. gAd derived from E. coli contained higher levels of LPS than gAd derived from murine myeloma cells. LPS increased production of IL-6 and IL-8 in PDL and gingival fibroblasts, but pretreatment of cells with gAd derived from murine myeloma cells did not inhibit LPS-induced IL-6 and IL-8 expression. Conclusions: Our results suggest that PDL and gingival fibroblasts express AdipoR1 and that gAd does not act as a modulator of IL-6 and IL-8 expression in PDL and gingival fibroblasts.