• 보건행정학회지
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• 제18권4호
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• pp.170-184
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• 2008

Objectives: The aim of this analysis was to investigate factors associated with dental visits in terms of getting diagnosis and receiving care for diagnosed dental diseases among Korean adults. Methods: Data used in this analysis were from the 2005 Korean National Health and Nutrition Examination Survey which involved a representative sample of 25,487 adults nineteen years of age and older who resided in Korea. This analysis used data of adults who had completed health interview survey (n = 25,215). Uni- and bi-variate analysis, Chi-square test, and logistic regression analyses. were conducted using SAS. Results: The percentages of people diagnosed (treated) dental canes, periodontal disease. and temporomandibular joint disorder were 70.4(77.1), 16.1 (55.7), and 0.6(37.4), respectively. The reception of treatment for diagnosed dental caries and periodontal disease was significantly associated with older age, high monthly household income, and high education attainment. Logistic regression model indicated that age, monthly household income, education attainment, type of health insurance, and chewing problem were significantly associated with getting diagnosis and treatments of dental diseases. Most frequently answered reason for non - or delayed treatments of diagnosed dental diseases during the last one year was cost of treatments. Conclusions: The findings indicated that socio-economic-status still significantly affected reception of needed dental treatments among Korean adults despite the national health insurance system. Oral health policy and programs should be augmented to provide further support to adults of low socio-economic-status who are more prone to dental diseases yet lack resources for needed dental treatments.

• 치위생과학회지
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• 제18권3호
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• pp.137-146
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• 2018

This systematic review aimed to investigate the effects of periodontal treatment on glycated hemoglobin A (HbA1c) levels in patients with type 2 diabetes who develop periodontal disease. The search of the MEDLINE, Embase, CINAHL, and Cochrane Library databases was completed on April 8, 2018. The study design was based on randomized clinical trials. Scaling and root planing was performed for the test group, whereas no periodontal treatment or simple oral training was performed for the control group. The main outcome variable was the change in HbA1c levels. We used the Review Manager statistical analysis software for the quantitative analysis of selected documents. Meta-analysis was performed using the inverse variance estimation method of the fixed-effect model to estimate the effects of periodontal treatment on HbA1c levels in patients with type 2 diabetes. A total of 1,011 documents were searched using search strategies, and 10 documents were included in the meta-analysis. The meta-analysis of the selected literature showed that periodontal treatment significantly reduced the HbA1c levels in patients with type 2 diabetes who develop periodontal disease (mean difference, -0.34; 95% confidence interval, -0.43 to -0.26; p<0.001). This study aimed to investigate the effects of periodontal treatment on HbA1c levels, which can be used as a basis for the increasing management of diabetic complications. To improve the quality of life and reduce the burden of medical expenses for patients with diabetes, periodontal disease management through nonsurgical periodontal treatment, such as scaling and root planing, is necessary.

• 구강회복응용과학지
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• 제37권4호
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• pp.294-300
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• 2021

치태세균에 의해 야기되는 괴사성 치주질환은 감염부위에서 위막과 치간사이의 연조직 괴사 및 출혈, 촉진시 통증과 치은 출혈이 관찰된다. 환자들의 구내 세균을 조사해보면 방추균과 나선균이 혼합하여 존재하는 방추스피로헤타 세균총을 가지고 있다. 본 증례는 괴사성 치주질환으로 잠정 진단된 환자 2명을 대상으로 비외과적 치주치료, 3% 과산화수소를 적신 면봉을 이용한 드레싱 후 국소전달항생제를 도포하였고, 치료 전과 초기 치료 3 - 5일 후 치은열구액을 채득하여 실시간 연쇄중합반응법을 이용한 정량분석으로 구강내 미생물수를 측정하였다. 비외과적 치주치료 후 감염부위 치은이 정상으로 회복되었고, 7종 이상 검출되던 치주질환 관련 미생물도 1종만 검출되었다. 결과적으로 비외과적 치주치료를 통해 괴사성 치주질환 환자들의 치주 조직을 정상으로 회복하였다.

• Journal of Periodontal and Implant Science
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• 제48권2호
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• pp.92-102
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• 2018

Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.

• 대한심미치과학회지
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• 제10권1호
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• pp.30-45
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• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

• 한국산학기술학회논문지
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• 제15권9호
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• pp.5675-5682
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• 2014

구강질환은 단독 진행만이 아닌 혼합감염증으로 발생하므로 치아우식증 및 치주질환에 관여하는 원인 균주들의 명확한 분석이 필요하다. 이에, 본 연구는 치아우식증 및 치주질환의 원인균으로 잘 알려져 있는 세균을 검출하기 위해 타액을 채취하였다. 성인의 연령, 흡연 및 음주, 질병유무에 따른 구강세균분포 차이를 보고 구강세균의 위험요소를 확인하고자 한다. 본 연구 대상은 20대 이상 65세 미만 성인 120명을 대상으로 2014년 3월 15일 - 5월 10일까지 조사하였다. 타액 내 gDNA를 추출 후 PCR 방법을 이용하여 구강질환의 균 분포도를 확인하였다. 그 결과, S. mutans는 72명, P. intermedia 88명, S. mutans와 P. intermedia 균이 모두 검출된 성인은 54명, 구강세균이 검출되지 않은 성인은 14명으로 나타났다. 구강세균의 위험 요소 결과, 흡연자는 비흡연자에 비해 S. mutans 2.8배, P. intermedia 3.5배 더 높게 나타났다. 음주자는 비음주자에 비해 S. mutans 검출 위험도가 3.3배 더 높은 것으로 나타났으며, 전신질환자는 정상인에 비해 P. intermedia 검출된 위험도가 4.1배 더 높은 것으로 나타났다. 흡연, 음주, 전신질환은 구강 내 세균 검출위험도가 높은 인자임을 확인할 수 있었다. 또한 연령이 증가할수록 치주질환 세균이 더 많이 검출되었으며, 20대는 치아우식증과 치주질환이 공존하는 연령대인 만큼 구강세균의 분포가 더 두드러지게 나타남을 알 수 있었다. 구강세균이 검출된 성인은 치아우식증과 치주질환에 이환될 위험도가 그만큼 높다고 볼 수 있으므로, 구강환경을 청결히하고 정기적인 치과방문을 통해 구강질환을 예방해야 할 것이다.

• 치위생과학회지
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• 제16권6호
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• pp.401-408
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• 2016

Periodontal disease is one of the major dental diseases. Currently, various methods are used for healing and successful regeneration of periodontal tissue damaged by periodontal disease. The periodontal ligament and alveolar bone have received considerable interest for use in periodontal tissue regeneration and induction. However, as the functions of the factors required for tooth attachment and key regulatory factors for periodontal tissue regeneration in the cementum have recently been identified, interest in cementum formation and regeneration has increased. Dental cementum forms in the late phase of tooth development because of the reciprocal regulatory interaction between cervical loop epithelial cells and surrounding mesenchymal cells, which is regulated by various gene signaling networks. Many attempts have been made to understand the regulatory factors and cellular and molecular mechanisms associated with new cementum formation. In this paper, we reviewed the study outcomes to date on the regulatory factors that induce cementum formation and regeneration, focusing on understanding the roles and functions of Wnt signaling in the regulation of cementum formation. In addition, we aimed to obtain information on the useful reciprocal regulatory factors that mediate cementum formation and regeneration through a series of molecular mechanisms.

• Journal of Periodontal and Implant Science
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• 제50권3호
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• pp.135-145
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• 2020

Purpose: The aim of this study was to evaluate the serum levels of oxidized low-density lipoprotein (oxLDL), anti-oxLDL, and myeloperoxidase (MPO) in hyperlipidemic patients with periodontal disease. Methods: This study included 123 patients with hyperlipidemia categorized based on metabolic control as mild to moderate (H1) (n=66) or poor (H2) (n=57), as well as systemically healthy controls (C) (n=68). Serum levels of lipids, oxLDL, anti-oxLDL, and MPO were evaluated, along with clinical periodontal parameters. Results: The percentage of bleeding on probing (BOP%) and the clinical attachment level were significantly higher in the H2 group than in the C group. Patients with hyperlipidemia had a relatively high risk of developing periodontal disease. The oxLDL and anti-oxLDL levels were higher in H2 patients with periodontitis than in the control or H1 patients with periodontitis. In the H1 and H2 groups, the ratio of total cholesterol to high-density lipoprotein was significantly correlated with gingival index, BOP%, and oxLDL levels. Conclusions: Our findings indicate that the lipoprotein-associated inflammatory mediators of oxLDL, anti-oxLDL, and MPO may play an important role in the relationship between periodontal disease and hyperlipidemia.

• 한국치위생학회지
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• 제24권2호
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• pp.91-98
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• 2024

Objectives: This case study aimed to evaluate changes in periodontal pathogens and systemic disease indicators following the adjunctive use of probiotics for periodontal treatment. Methods: Two adults, a 64-year-old male and 71-year-old female, were selected with ethical approval and underwent comprehensive oral and systemic health assessments before and after probiotic intake with periodontal debridement. Results: There was a significant reduction in the periodontal pathogens, particularly Porphyromonas gingivalis and Treponema forsythia, and no adverse systemic indicators were observed. Moreover, a trend toward improved lipid profiles was noted, suggesting a potential positive impact on systemic health. Conclusions: This study shows the potential role of probiotics in enhancing oral health and preventing systemic diseases, thus highlighting the need for further research and clinical trials.

• Journal of Periodontal and Implant Science
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• 제29권4호
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• pp.803-823
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• 1999

In order to reveal immunopathogenesis of periodontal tissue destruction, it is important to clarify the molecular mechanism of trafficking and retention of activated leukocytes, including monocytes/macrophages. Gingival fibroblasts may be involved in the regulation of inflammatory cell accumulation in the extravascular periodontal connective tissues via cytokine production and surface expression of adhesion molecules. In this study, it was investigated the molecular basis for the adhesive interactions between monocytes and fibroblasts such as peri-odontal ligament fibroblast(PDLF), human gingival fibroblast(HGF), and human dermal fibroblast(HDF). First, it was examined the evidence whether monocyte-fibroblast cell contact may cause signal transduction in fibroblasts. Being directly in contact with fixed human monocyte cell line THP-1, or U937, upregulation of IL-6 production, $TNF-{\alpha}$ mRNA expression and increased cell proliferation could be seen for fibroblasts. IL-6 production induced by monocyte- fibroblast coculture were further increased when fibroblasts had been pretreated with $IFN-{\gamma}$ or $IL-1{\beta}$ , and monocytes with LPS. Next, it was examined the expression of ICAM-1 which has been known to be involved in accumulation and activation of leukocytes in inflammatory diseases such as periodontitis. ICAM-1 was upregulated up to 10-fold on PDLF, HGF, and HDF by exposure to $IFN-{\gamma}$ or $IL-1{\beta}$. Furthermore, anti-ICAM-1 monoclonal antibody clearly blocked cocultureinduced IL-6 production by fibroblasts, suggesting that $ICAM-1/{\beta}_2$integrin pathway is involved in periodontal fibroblastmonocyte interaction. Overall, these findings provide evidence that periodontal fibroblasts could be involved in the accumulation and retention of monocytes/macrophages in periodontal inflammatory lesion at least in part by ICAM-1 expression. In addition, periodontal fibroblast-monocyte interaction could cause activation signals in fibroblasts intracellularly which result in cytokine production and cell proliferation. Thus, periodontal fibroblasts are speculated to play an important role in immunoregulation and tissue destruction in chronic periodontal diseases by interaction with monocytes/macrophages.