• 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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• 제32권3호
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• pp.643-653
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• 2002

Periodontal supporting tissue goes through destruction by chronic inflammatory periodontal disease as two aspect. One is qualitive aspect such as alteration of periodontium, the other is quantitative aspect such as alveolar bone loss. According to many authors, PDL is responsible for biting force, and there are two mean. for measuring PDL's function - mobility test and biting force test. This study was conducted to compare the biting force with remaining bone level, that is, quantitative aspect of periodontium, in anterior and premolar teeth at periodontal maintenance phase. 17 patients on periodontal maintenance phase during 6 months at minimum were selected for this study. For the same condition, 4 anterior, canine, premolar teeth were tested by MPM-3000 bite-force register at the same time(a.m.l0-12), the same position, the same posture, by the same examiner. Patients of TMI), ill-fitting pros thesis, general disease, malocclusion and the teeth of TFO, absence of opposing teeth, malposition were excluded. Remaining bone level was measured on the panorama X-ray film through 5 level from 1mm below CEJ to root apex. Teeth were examined twice, and bigger one was selected. If the values showed large difference. examinatin was re-done and the mean was selected. The results were as follows ; 1. In the 4 anterior group, as the remaining bone is decreased, the average of maximal biting force is decreased. Especially, at 3/5 bone level, maximal biting force is decreased significantly(p<0.01). 2. In the canine group, as the remaining bone is decreased, the average of maximal biting force is decreased. Especially, at 2/5 bone level, maximal biting force is decreased significantly(p<0.01). 3. In the premolar group, as the remaining bone is decreased, the average of maximal biting force is decreased. Especially, at 3/5 bone level, maximal biting force is decreased significantly(p<0.05). From the results of this study, clinicians could utilize these efficiently when they have to determine the proper restorative materials, time for tooth extraction, treatment plan, prognosis.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.161-175
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• 1996

There were many reports that elevations in the levels of active and latent collagenase in gingival crevicular fluid(GCF) have been correlated positively with periodontal disease activity. To provide a simple diagnostic approach for testing GCF collagenolytic activity, the detection limit of enzyme activity was compared using radiofibril assay(Sodek et.al.1981) and spectrophotometric collagenolytic assay(Nethery et al. 1986). The detection limits of both assay for standard bacterial enzyme were similar and the radiofibril assay showed a little (1/2) lower detection limit for tad pole collagenase. To evaluate the relationship between periodontal tissue destruction and the collagenolytic activity, GCF was collected, and latent and active enzyme activities were measured by a spectrophotometric collagenolytic assay. Twelve subjects showing progressive lesions were selected according to the presence of immediate tissue destruction, frequent abscess formation, and increasing need for tooth extraction, and the absence of underlying systemic disease and previous antibiotic medication history within 6 months. Comparisons were made between sites with either: 1) inflammation with a previous history of progressive loss of periodontal tissue and bone support(2l progressive sites): 2) previous history of bone loss and periodontal destruction but now clinically stable(12 comparably stable sites); or 3) no loss of periodontal tissue and bone support(11 control sites including 5 gingivitis sites and 6 healthy sites). Active collagenase activity was the highest in the progressive sites and decreased in the order of the gingivitis sites, the stable sites, and the healthy sites. The total enzyme activity was $2{\sim}3$ fold higher in the progressive sites and the gingivitis sites, compared to the stable and the healthy sites. The ratio of active to total collagenolytic activity was twice in the progressive sites. Analysis of active collagenase level(5mU) and the ratio of active to total collagenolytic activity(0.8) as a diagnositic test indicates that these measurements have the sensitivity of 0.81 and 0.86, the specificity of 0.70 and 0.65, and the overall agreement of 0.75 and 0.73, respectively. Thus, this method has significant merits as a diagnostic tool to determine wherher the site is in a state of remission or progression.

• 대한치주과학회:학술대회논문집
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• 대한치주과학회 2005년도 제45회 종합학술대회 연제초록
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• pp.225-225
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• 2005

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.213-224
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• 2002

The ultimate goal of periodontal disease therapy is to promote the regeneration of lost periodontal tissue, there have been many attempts to develop a method to achieve this goal, but none of them was completely successful. The purpose of this study was to compare the effects of treatment using BBP(R) with control treated by only modified Widman flap. 22 intrabony defects from 12 patients with chronic periodontitis were used for this study, 10 sites of them were treated with BBP(R) as experimental group and 12 site were treated by only modified Widman flap as control group. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded at 6 months later, and the significance of the changes was statistically analyzed. The results are as follows : 1. Probing depth of control(${\triangle}2.7{\pm}1.3mm$) and experimental group(${\triangle}3.6{\pm}1.8mm$) weres reduced with statistically significance(P<0.05), but this changes were not different between the two experiment, control group with statistically significance. 2. Gingival recession showed statistically significant increase in control group(${\triangle}2.1{\pm}1.2mm$)(P<0.05), but not in experimental group(${\triangle}0.5{\pm}0.7mm$), and this changes were different between the two experiment, control group with statistically significance(P<0.05). 3. Bone probing depth showed statistically significant decrease in experimental group(${\triangle}2.9{\pm}1.0mm$)(P<0.05), but not in control group(${\triangle}1.1{\pm}1.4mm$), and this changes were different between the two experiment, control group with statistically significance(P<0.05). 4. Loss of attachment showed statistically significant decrease in experimental group(${\triangle}3.1{\pm}1.7mm$), but not in control group(${\triangle}0.6{\pm}1.2mm$), and this changes were different between the two experiment, control group with statistically significance(P<0.05) On the basis of these results, treatment using BBP(R) improves the probing depth, bone probing depth and loss of attachment in intrabony defects.

• Restorative Dentistry and Endodontics
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• 제38권2호
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• pp.59-64
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• 2013

Apical surgery cuts off the apical root and the crown-to-root ratio becomes unfavorable. Crown-to-root ratio has been applied to periodontally compromised teeth. Apical root resection is a different matter from periodontal bone loss. The purpose of this paper is to review the validity of crown-to-root ratio in the apically resected teeth. Most roots have conical shape and the root surface area of coronal part is wider than apical part of the same length. Therefore loss of alveolar bone support from apical resection is much less than its linear length.The maximum stress from mastication concentrates on the cervical area and the minimum stress was found on the apical 1/3 area. Therefore apical root resection is not so harmful as periodontal bone loss. Osteotomy for apical resection reduces longitudinal width of the buccal bone and increases the risk of endo-perio communication which leads to failure. Endodontic microsurgery is able to realize 0 degree or shallow bevel and precise length of root resection, and minimize the longitudinal width of osteotomy. The crown-to-root ratio is not valid in evaluating the prosthodontic prognosis of the apically resected teeth. Accurate execution of endodontic microsurgery to preserve the buccal bone is essential to avoid endo-perio communication.

• Journal of Periodontal and Implant Science
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• 제52권5호
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• pp.383-393
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• 2022

Purpose: Aloe-emodin (AE), a natural anthraquinone abundant in aloe plants and rhubarb (Rheum rhabarbarum), has long been used to treat chronic inflammatory diseases. However, AE's underlying mechanisms in periodontal inflammation have not been fully elucidated. Acidic mammalian chitinase (AMCase) is a potential biomarker involved in bone remodeling. This study aimed to evaluate AE's effect on periodontitis in rats and investigate AMCase expression. Methods: Eighteen Sprague-Dawley rats were separated into the following groups: healthy (group 1), disease (group 2), vehicle (group 3), AE high-dose (group 4), and AE low-dose (group 5). Porphyromonas gingivalis ligatures were placed in rats (groups 2-5) for 7 days. Groups 4 and 5 were then treated with AE for an additional 14 days. Saliva was collected from all groups, and probing pocket depth was measured in succession. Periodontal pocket tissues were subjected to histomorphometric analysis after the rats were sacrificed. Bone marrow-derived macrophages and murine macrophages were stimulated with receptor activator of nuclear factor-κB ligand (RANKL) and treated with different concentrations of AE. AMCase expression was detected from the analysis of saliva, periodontal pocket tissues, and differentiated osteoclasts. Results: Among rats with P. gingivalis-induced periodontitis, the alveolar bone resorption levels and periodontal pocket depth were significantly reduced after treatment with AE. AMCase protein expression was significantly higher in the disease group than in the healthy control (P<0.05). However, AE inhibited periodontal inflammation by downregulating AMCase expression in saliva and periodontal pocket tissue. AE significantly reduced RANKL-stimulated osteoclastogenesis by modulating AMCase (P<0.05). Conclusions: AE decreases alveolar bone loss and periodontal inflammation, suggesting that this natural anthraquinone has potential value as a novel therapeutic agent against periodontal disease.

• Journal of Periodontal and Implant Science
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• 제32권3호
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• pp.539-554
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• 2002

It has been approximately 40 years since $Br{{\aa}}nemark$ first introduced osseo-integration for implants in the early 1960s. Unlike crown and bridge or denture treatment, implant treatment helps preserve existing bone and improve masticatory functions. Thus, the awareness of implant treatment has grown rapidly among dentists and patients alike in Korea, as it becomes a widely accepted treatment. The following results on patients type and implant distribution were compiled from 1814 implant cases of 640 patients treated at the periodontal dept. of Y University Hospital during 1992 to 2001. 1. There are no dissimilarities between men and women, with patients in their 40,50s accounting for 49% of patients and 56% of implant treatments; the largest share of patients and implant treatments. 2. Mn. posterior area accounted for 59% of implant treatments followed by Mx. posterior area(21%), Mx anterior area(l4%) and Mn anterior area 2%. 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 98% and fully edentulous patient accounted for the remaining 2% 4. The major cause of tooth loss is periodontal disease, followed by dental caries, trauma and congenital missing. Compared to women, men are more likely to suffer from tooth loss due to periodontal disease. Also, older people are more likely to suffer from tooth loss due to periodontal disease rather than dental caries. 5. The distribution of bone quality for maxillae was 52% for type III, followed by 23% for type II, 20% for type IV and 0% for type I. As for mandible, the distribution was 52% for type II, followed by 37% for type III, 7% for type IV and 4% for type I. 6. The distribution of bone quantity for maxillae was 49% for type C, followed by 34% for type B, 14% for type D, 3% for type A, and 0% for type E. As for mandible, the distribution was 52% for type B, followed by 35% for type C, 6% for type D, 3% for type A and 0% for type E. 7. The majority of implants were those of 10-14mm in length (80%) and regular diameter in width (79%). The results provided us with basic data on patient type, implant distribution, bone condition, etc. We wish that our results coupled with other research data helps assist in the further study for better implant success/survival rates, etc.

• Journal of Periodontal and Implant Science
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• 제41권2호
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• pp.98-104
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• 2011

Purpose: The aim of this study was to evaluate 3.5 years-cumulative survival rate of implants placed on augmentedsinus using Osteon, a bone graft material, and to assess the height of the grafted material through radiographic evaluation. Methods: Twenty patients were treated with maxillary sinus augmentation and 45 implant fixtures were installed simultaneously or after 6 months healing period. The height of the augmented sinus and the loss of marginal bone were measured by panoramic and intraoral radiographs immediately after augmentation and up to 42 months (mean, 19.4 months) subsequently. Changes in the height of the sinus graft material were calculated radiographically. Results: The cumulative survival rate was 95.56% in all 45 implants. Additionall, normal healing process without any complication was observed in all patients. The original sinus height was mean 4.3 mm and the augmented sinus height was mean 13.4 mm after the surgery. The mean marginal bone loss till 42 months was $0.52{\pm}0.56\;mm$. The reduced height of Osteon was $0.83{\pm}0.38\;mm$ and it did not show significant correlation with the follow up periods (P=0.102). There were no statistically significant differences in reduced height of Osteon according to the simultaneous/delayed implantation (P=0.299) and particle size of Osteon (P=0.644). Conclusions: It can be suggested that Osteon may have predictable result when it was used as a grafting material for sinus floor augmentation.

• International Journal of Oral Biology
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• 제32권2호
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• pp.67-73
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• 2007

Periodontitis is a chronic infectious disease that leads to periodontal destruction, and is one of the major causes of tooth loss in humans. The osteoclast differentiation factor (ODF), which is also known as the receptor activator of the NF-kB ligand (RANKL), is a surface-associated ligand on bone marrow stromal cells and osteoblasts. RANKL activates its cognate receptor, RANK, on osteoclast progenitor cells, which leads to the differentiation of mononucleated precursor cells. Osteoprotegerin (OPG) is a decoy receptor that is released from stromal cells and osteoblasts to inhibit the interaction between RANKL and RANK. Although the precise mechanism of bone loss in periodontitis is unknown, the differentiation and activation of osteoclasts by OPG-ODF-RANK signaling might play the role in periodontal bone destruction. The relationship between the concentration of sex hormones and the expression of ODF and OPG was examined by treating human gingival fibroblasts and periodontal ligament cells with the normal serum concentration of estrogen or progesterone during menstruation or at menopause. The ODF/OPG relative ratio was elevated at the concentration observed during ovulation in human gingival fibroblasts and at the concentration observed between ovulation and menstruation in periodontal ligament cells treated with estrogen. However, the ratio was <1 at all concentrations in both cells treated with progesterone. In the case of menopause simulated by estrogen depletion, the ratio was <1 in human gingival fibroblasts but >1 in periodontal ligament cells.