• Journal of Periodontal and Implant Science
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• 제32권3호
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• pp.565-576
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• 2002

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Intensive research is underway to identity, purify, synthesize a variety biologic modulators that may enhance wound healing and regeneration of lost tissues in periodontal therapy. The present study evaluates the effects of ABM/P-15 on the periodontal regeneration in intrabony defects of human. We used thirty four 2-wall or 3-wall osseous defects in premolars and molars of chronic peridontitis patient that have more than 5mm pockets and more than 3mm in intrabony defect. 12 negative control group underwent flap procedure only, 11 positive control group received DFDBA graft with flap procedure, and 11 experimental group received ABM/P-15 graft with flap procedure. The changes of probing pocket depth, loss of attachment and bone probing depth following 6months after treatment revealed the following results: 1. The changes of probing pocket depth showed a statistically significant decrease between after scaling and 6months after treatment in negative control(2.0${\pm}$0.9mm), positive control(3.0${\pm}$0.9mm), and experimental group (3.4${\pm}$1.5mm) (P<0.01). Significantly more reduction was seen in experimental group compared to negative control group (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after scaling and 6months after treatment in positive control(2.0${\pm}$0.6mm), and experimental group (2.2${\pm}$l.0mm) except negative control group(0.1${\pm}$0.7mm) (P<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group(P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after scaling and 6months after treatment in positive control(2.7${\pm}$l.0mm), and experimental group (3.4${\pm}$1.3mm) except negative control(0.l${\pm}$0.9mm) (9<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group (P<0.05). The results suggest that the use of ABM/P-15 in the treatment of periodontal intrabony defects can reduce loss of attachment and bone probing depth more than flap operation only. It suggests that ABM/P-15 may be an effective bone graft material for the regeneration of periodontal tissue in intrabony defects.

• Journal of Periodontal and Implant Science
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• 제38권2호
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• pp.237-246
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• 2008

Purpose: If bone grafts and guided tissue regeneration are effective individually in treating osseous defects, then the questionis, what would happen when they are combined. Bone grafts using Calcium Carbonate(Biocoral) and Guided Tissue Regeneration using Calcium Sulfate(CALMATRIX) will maximize their advantages and show the best clinical results in intrabony defects. This study was to compare the effects of a combination of CS and CC with control treated only with modified widman flap in a periodontal repair of intrabony defects. Materials and Methods: 30 patients with chronic periodontitis were used in this study. 10 patients were treated with a combination of CS and CC as the experimental group II and another 10 patients were treated with CC as the experimental group I, and the remaining 10 patients, the control group were treated only with modified widman flap. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded 6 months later. Results: The probing depth changes were $3.30{\pm}1.34\;mm$ in the control group, $4.2{\pm}1.55\;mm$ in the experimental group I(CC) and $5.00{\pm}1.33\;mm$ in the experimental group II(CS+CC). They all showed a significant decrease 6 months after surgery(p<0.01). There was a significant difference(p<0.05) between the control and experimental group. However there were no significant difference(p<0.05) between the experimental group I and II. The gingival recession changes w $-1.30{\pm}1.25\;mm$ in the control group, This is a significant difference(p<0.01). However, there was a $-0.50{\pm}0.53\;mm$ change in the experimental group I(CC) and $-0.60{\pm}0.97\;mm$ in the experimental group II(CS+CC). In addition, in terms of gingival recession, there was a no significance difference(p<0.05) among the groups. The clinical attachment level changes were $2.00{\pm}1.33\;mm$ in the control group, $3.60{\pm}1.58\;mm$ in the experimental group I(CC) and $4.40{\pm}1.17\;mm$ in the experimental group II(CS+CC). They all showed a significant decrease 6 months after surgery(p<0.01). There was a significant difference(p<0.05) between the control and experimental group. However there was a no significance difference(p<0.05) between the experimental group I and II. The bone probing depth changes were $0.60{\pm}0.52\;mm$ in the control group, $3.20{\pm}1.48\;mm$ in the experimental group I(CC) and $4.60{\pm}1.43\;mm$ in the experimental group II(CS+CC). All of them showed a significant decrease 6 months after surgery(p<0.01), there was a significance difference(p<0.05) among the groups. Conclusion: Treatment using a combination of CS and CC have a potential to improve periodontal parameters in intrabony defects and More efficient clinical results can be expected in intrabony defects less than 2 walls grafted with CS and CC.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.205-217
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• 2005

Distraction osteogenesis is a technique of lengthening bone including soft tissue by gradual separation of surgically divided bone surfaces. Although the biomechanical, histological, and ultrastructural changes associated with distraction osteogenesis have been widely described, the molecular mechanisms governing the formation of new bone in distracted bone segments remain largely unclear. However, such information has significant clinical implications because it may enable targeted therapeutic manipulations designed to accelerate osseous regeneration. The purpose of this study was to evaluate the expression of TGF-$\beta$1, IGF-I and bFGF in distraction osteogenesis according to different distraction rates in a rabbit's mandible. When twenty-four adult rabbits underwent open osteotomy between the premolar and mental foramen, an external bilateral distraction device was applied. Latency was allowed for five days before distraction. Three different distraction rates were 0.7 mm/day (A, n=8), 1.4 mm/day (B, n=8) and 2.4 mm/day (C, n=8). The distraction device was activated with the same distraction rhythms of twice a day until 4.9 mm (A & B group) and 8.4 mm (C group) length gains was achieved. The animals were sacrificed at postoperative 3, 7, 14 and 28 days. The bony specimens were stained with H&E for histologic examination, and RT-PCR analysis was done for the identification of the expression of TGF-$\beta$1, IGF-I and bFGF. The results obtained from this study were as follows : The 0.7 mm/day and 1.4 mm/day distraction rate groups were shown to improve regenerative bone formation on radiographic and histologic examination. Also, TGF-$\beta$1, IGF-I and bFGF expression increased in the 0.7 mm/day and 1.4 mm/day distraction rate groups. But the 2.4 mm/day distraction rate group specimen was different with adjacent normal bone and hardly expressed of growth factors. These findings suggest that improved new bone formation in the 0.7 mm/day and 1.4 mm/day distraction rates is associated with enhanced expression of TGF-$\beta$1, IGF-I and bFGF by mechanical tension stress. Additionally, the 0.7 mm/day and 1.4 mm/day distraction rate groups were significantly different from the 2.4 mm/day distraction rate group in the expression of growth factors. According to the above results, it seems possible to apply a distraction rate of up to 1.4 mm/day a day in rabbit's mandible. And further studies are needed to evaluate growth factors of TGF-$\beta$1 and IGF-I, which are excellent in expression.

• The Korean Journal of Physiology
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• 제4권1호
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• pp.59-67
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• 1970

In recent observations on vestibular eye movements in mammals, reported by several different workers, it was indicated that the pattern of reflex eye movement from semicircular canal nerve stimulation in rabbits was different from that observed in the other species such as cats and dogs. Observing the different anatomical features of the extraocular muscles of rabbits, Kim ascribed the different pattern of eye movement of rabbits to the functional difference of inferior and superior oblique muscles from those of other species. Present experiment was carried out to elucidate a physiological mechanism underlying in such particular pattern of reflex eye movement in rabbits. An individual canal nerve was selectively stimulated, under a dissecting microscope, by a fine electrode induced into an ampulla through a hole provided on the wall of corresponding osseous canal, and responses of the extraocular muscles were checked by recording the isotonic changes of muscle length. Following results were obtained. 1. Direct stimulation of the superior or inferior oblique muscles Produced upward or downward movement of the eye turning toward medial side respectively. 2. Stimulation of the unilateral canal nerve Produced a marked contraction of a main contracting ocular muscle and simultaneous relaxation of an antagonistic muscle in both eyes. Less potent contraction of an additional ocular muscle was observed and it appeared to augment the function of the main contracting muscle in the ipsilateral eye. 3. Stimulation of superior semicircular canal nerve caused a primary contraction of superior rectus, synergic contraction of superior oblique and relaxation of inferior rectus in ipsilateral eye. Contraction of inferior oblique and relaxation of superior oblique were observed in the contralateral eye. 4. Stimulation of lateral semicircular canal nerve produced a primary contraction of medial rectus, synergic contraction of superior oblique and relaxation of lateral rectus in the ipsilateral eye. Contraction of lateral rectus and relaxation of medial rectus were observed in the contralateral eye. 5. Stimulation of inferior semicircular canal nerve produced a primary contraction of superior oblique, synergic contraction of superior rectus and relaxation of inferior oblique in the ipsilateral eye. Contraction of. inferior rectus and relaxation of superior rectus were observed in the contralateral eye. 6. Upon stimulation of individual canal nerve, the pattern of eye movement in rabbits is different from those of cats, however, the responses of the extraocular muscles appear to be similar in two species. Therefore, it is concluded that the different Pattern of eye movement in both species are not due to the possible difference of vestibule-ocular reflex pathways but to the functional difference of superior and inferior oblique muslces.

• 구강회복응용과학지
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• 제28권1호
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• pp.15-25
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• 2012

치주치료에 있어 교합치료의 타당성은 오래전부터 연구되어오고 있으나 아직도 논란이 많은 부분이다. 그 중에서도, 교합삭제를 이용한 수동적 정출(passive eruption)의 치료 효과에 대한 연구는 아직 보고된 바가 많지 않다. 본 연구의 목표는 교합삭제를 이용한 수동적 정출이 치주부착수준, 치주낭깊이 등의 치주임상지표들에 미치는 효과를 평가하는 것이다. 본 연구는 부산대학교 치과병원 치주과에서 중등도 치주염으로 치료받은 환자 중, 연구대상조건을 만족하는 16명의 환자, 40개의 치아를 대상으로 하였다. 연구 시작 단계에서 임의로 분류한 실험군과 대조군 치아 모두 임상적, 방사선적 검사를 시행하였다. 치석제거술과 치근활택술, 구강 위생 교육을 포함한 초기치료를 시행하고 4주 후 임상적, 방사선적 검사를 재실시하였다. 이 때 실험군은 교합면 삭제를 이용한 수동적 정출을 시행하고 대조군은 아무런 처치를 하지 않았다. 그 후 6개월 이후 임상적, 방사선적 검사를 재실시하였다. 그 결과 1)연구시작 단계와 비교 시, 초기치료에 의해 임상지표를 통한 치주조직의 염증상태가 개선되었으며, 2)실험군에서 치주낭깊이, 치아동요도, 치조골 소실 감소와 각화치은 폭경 증가가 더 큰 것으로 나타났다 (p<0.05). 이 결과로 볼 때, 초기치료와 함께 교합조정을 이용한 수동적 정출술이 치주치료에 도움을 줄 수 있을 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• 제31권2호
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• pp.185-197
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• 2006

본 연구는 2003년 10월부터 2006년 3월까지 부산대학교 병원 구강내과 구강안면통증클리닉에 내원하여 RDC/TMD에 의해 측두하악관절의 골관절염으로 진단된 환자 중 본 실험에 동의한 폐경기가 오지 않은 여성 환자를 무작위로 나누어, 주기적 내원 하에 실제로 ASU 300 mg을 연속 복용한 ASU군(총 36명)과 ASU와 동일한 제재이지만 약효가 없는 약물을 복용한 위약군(총 32명)으로 분류하여 ASU를 장기간 투여시 통증, 관절음, 개구제한(LOM), 무통성 편이 개구량(MCO)의 변화뿐만 아니라 골스캔의 단순섭취율(SUR), coronal SPECT상에서의 온점개수(HS), 그리고 CT상에서의 과두 관절면의 비교시 다음과 같은 결과를 얻었다. 1. ASU군과 위약군의 치료 전, 치료 3개월 후, 치료 6개월 후, 치료 9개월 후의 무통성 편이개구량(MCO)과 통증, 관절음, 개구제한(LOM)의 NAS를 비교시 두 군간의 유의한 차이가 없었다. 2. ASU군과 위약군의 치료 전, 치료 3개월 후, 치료 6개월 후, 치료 9개월 후의 MCO를 비교시 장치치료를 시행하지 않은 두 군간에서는 유의한 차이가 없었다. 그러나, 장치치료를 시행한 ASU군에서 위약군에 비해 치료 6개월 후, 치료 9개월 후에 MCO가 더 증가하는 경향을 보였다. 3. ASU군과 위약군을 초진시 통증에 대한 NAS가 6미만인 경우와 6이상인 경우로 분류하여 치료 전, 치료 3개월 후, 치료 6개월 후, 치료 9개월 후를 비교시 두 군 모두 치료 3개월 후, 치료 9개월 이후에 통증이 더 감소하며, 통증의 NAS가 6이상인 경우에서 ASU군이 위약군에 비해 통증이 더 감소하는 경향을 보여 주었다. 4. 주기적 내원하에 6개월간 약물치료를 시행한 ASU군(총19명)과 위약군(총 21명)의 MCO와 통증, 관절음, 개구제한의 NAS를 비교시 각 군내에서는 임상증상의 개선이 현저하였으나, 두 군간에서는 유의한 차이가 없었다. 5. ASU군과 위약군을 이환측과 비이환측으로 분류하여 측두하악관절의 골스캔의 단순섭취율(SUR)과 coronal SPECT상에서의 온점개수(HS)를 비교시 두 군 모두에서 이환측이 비이환측에 비해 단순섭취율과 온점개수 모두 높게 나타났으며, 단순섭취율과 온점개수는 상관관계를 보여주었다. 6. 이환 및 비이환 관절 모두에서 골재형성 반응이 가장 많이 관찰되었고, 골증식체는 가장 적게 관찰되었다. 치료전후의 ASU군(총 34부위)과 위약군(총 20부위)의 과두 관절면을 비교시 ASU군에서 보다 많은 침식소견의 감소경향을 보여주었다.

• 대한약리학회지
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• 제7권1호
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• pp.53-65
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• 1971

It is well known that diabetes mellitus is associated with metabolic derangements, such as hyper-glycemia, ketosis, glycosuria, and also widespread alterations in the blood vessels, kidneys, eyes, peripheral nerves and heart. It is also recognized that healing of skin wound is delayed in diabetics. In bone, according to Aegerter, osteopenia develops in diabetes mellitus and it is chiefly ascribed to overutilization of protein. Shim claims that total blood flow to the entire skeletal system is approximately 4 to 8 percent of resting cardiac output and blood supply to the skeletal system would be decreased on account of secondary arteriosclerotic changes in the diabetics. An adequate blood supply is an essential factor in the healing process of fracture, and disturbed blood flow, either local or systemic, will invariably delay union of the fragments or the fragments from being fused. As the author has encountered several cases of diabetics in whom healing of fracture was delayed or incomplete, this experimental study was undertaken to elucidate the effects of hyperglycemia and diabetes mellitus on the healing process of fracture. In this experiment adult albino rabbits, weighing about 2 kg. were used and divided into 6 groups. The femur of each animal was fractured surgically, and then the healing process of fracture was periodically checked by radiography at an interval of one week for a period of 6 weeks. Thereafter, all the rabbits were killed to obtain tissue preparation of the femur. The experimental groups were as follows; 1) Control group: Six rabbits sustained a surgical fracture to the femur, without being given any other treatment or drug. 2) Alloxan-treated group: For inducing diabetes, alloxan was given intravenously to 17 rabbits in various dose as follows; to 7 of them 40 mg/kg, to 6 rabbits 80 mg/kg and to 4 rabbits 120 mg/kg of body weight, respectively. 3) Insulin-treated group: Protamine-zinc insulin was injected subcutaneously to each of 6 rabbits in a daily dose of 1 unit per kilogram of body weight. 4) Group treated with insulin after alloxan: Four rabbits were given 80 mg of alloxan once and than 1 unit of insulin per kilogram of body weight daily. Another 5 rabbits were injected 1 unit of insulin per kg of body weight daily following administration of alloxan in a dose of 120 mg/kg. 5) Homotransplantation group: Following intravenous injection of alloxan in a dose of 120 mg/kg, 10 rabbits underwent homotransplantation of a short bone segment to the femur. Five of them were subsequently given 1 unit/kg of insulin daily. 6) Sugar-treated group: six rabbits were fed $15{\sim}20$ gm of sugar daily throughout the period of experiment. The results obtained are summarized as follows; 1. Blood sugar level and damage to the pancreatic islet increased proportionately when alloxan was given to the rabbits in various doses. No appreciable change could be observed in the islets when the blood sugar level was altered by either oral administration of sugar or subcutaneous injection of insulin. 2. Comparing with the control group, healing of fracture was delayed in the alloxan-treated group, while callus formation and periosteal reaction were shown to be more prominent in this group and subsequently, the ultimate osseous tissue formed at the fracture site was significantly smaller in amount and less compact. These findings were more marked as the amount of alloxan increased. 3. Administration of insulin prevented the delay in healing process of fracture in the rabbits with alloxan-induced hyperglycemia. In this case, the course and progression of fracture healing were almost similar to those of control group. 4. Union between the host bone and the fragment transplanted from other rabbit of the same species was more delayed in the group treated with alloxan alone than in the group to which insulin was administered after development of alloxan-induced diabetes. In both groups periosteal new bone developed from the ends of the host bone, above and below the transplanted fragment, and directly fused with failure of periosteal callus to bridge the adjacent ends of the host bone and the transplanted fragment. 5. The healing process of fracture was not inhibited by alteration in blood sugar level when the blood sugar was abnormally increased by excessive sugar intake or lowered by administration of insulin alone. The healing of fracture in these groups progressed similarly as in the control group. In brief summary, it appears that the healing process of fracture would be definitely disturbed in diabetic state brought about by damage to the pancreatic islet. As such an inhibition could be overcome with insulin, it seems that insulin plays an important role in healing of fracture, but alteration in blood sugar level alone does not modify healing process of fracture to significant degree.