• Title/Summary/Keyword: Periodontal disease/surgery

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Reconstruction of Interdental papilla through connective tissue graft with orthodontic treatment: A Clinical Case Report (교정치료를 동반한 CTG를 통한 치간유두 재생)

  • Jung, Sung Koog
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.29 no.2
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    • pp.84-91
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    • 2020
  • Regeneration of interdental papilla damaged by periodontal disease is a very challenging task. So far, many dentists have devised and introduced great surgical methods. Comparing the pros and cons of the methods introduced so far, I came up with the best way to regenerate interdental papilla. Temporarily creating space between narrow interdental papilla, which cannot be solved by periodontal surgery alone, was a great help for connective tissue graft(CTG). The CTG was performed using a microblade, and only one vertical incision was performed off the gingival margin, and the graft was performed by inserting the grafts through here. Along with the orthodontic treatment, the area between the narrow interdental papilla was widened to make it easier for the CTG was carried out. After a period of maintenance, I was able to gather the teeth again with orthodontic force and regenerate the interdental papilla. I named this method ELSA (Enlargement of space-Labial graft-Squeezing-for Augmentation of papilla) technique.

Inverse behavior of IL-23R and IL-17RA in chronic and aggressive periodontitis

  • Ruiz-Gutierrez, Alondra del Carmen;Rodriguez-Montano, Ruth;Pita-Lopez, Maria Luisa;Zamora-Perez, Ana Lourdes;Guerrero-Velazquez, Celia
    • Journal of Periodontal and Implant Science
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    • v.51 no.4
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    • pp.254-263
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    • 2021
  • Purpose: Periodontitis is associated with a dysbiosis of periodontopathic bacteria, which stimulate the interleukin (IL)-23/IL-17 axis that plays an essential role in the immunopathogenesis of this disease, leading to alveolar bone destruction through receptor activator of nuclear factor κB ligand (RANKL). IL-23 receptor mRNA (IL-23R) has been identified in periodontitis, and IL-17 receptor A mRNA (IL-17RA) and its protein have not yet been evaluated in patients with periodontitis. In this study was measure IL-23R and IL-17RA in gingival tissue (GT) from patients with generalized chronic periodontitis (GCP) and generalized aggressive periodontitis (GAP) and to explore correlations with clinical parameters. Methods: We included 16 healthy subjects (HS), 18 patients with GCP, and 14 with GAP. GT samples were collected during periodontal surgery. Both IL-23R and IL-17RA were detected by enzyme-linked immunosorbent assay. Results: The results were analyzed with Mann-Whitney U test and Spearman' rank correlation coefficients using SPSS version 25.0. We found lower IL-23R levels in patients with GCP and GAP than in HS. Contrarily, we observed higher IL-17RA levels in GCP and GAP patients than in HS. Moreover, we found negative correlations between IL-23R in GT and probing depth and clinical attachment loss (CAL). Likewise, a positive correlation of IL-17RA in GT with CAL was found. Conclusions: The results of these findings suggest that the reverse behavior between IL-23R and IL-17RA in periodontitis patients may also be involved with the activation of RANKL, which promotes alveolar bone loss.

A Case of Massive Empyema Caused by Streptococcus constellatus and Anaerobic Bacteria for Mental Retardation (정신지체환자에서 발생한 Streptococcus constellatus와 혐기성 균에 의한 거대 농흉 1예)

  • Kim, Kyeong-Hyun;Kim, Se-Hyun;Heo, Jeong-Won;Lee, Sang-Hoon;Han, Seon-Sook;Lee, Seoung-Joon;Kim, Woo-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.476-479
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    • 2011
  • The Streptococcus milleri group, which also includes S. anginosus, S. intermedius and S. constellatus, is found in the oropharynx, upper respiratory tract, gastrointestinal tract, and urogenital tract mucosa. Bacteria in the Streptococcus milleri group are associated with bacteremia and abscess formation. Most of the reports of of Streptococcus milleri group (SMG) infection occur in patients with underlying medical conditions. Predisposing factors that have been associated with S. milleri group empyema include mucosal disturbances (sinusitis, periodontal disease, enteric disease), preceding to pneumonia, thoracic surgery, malignancy, neurological disease, alcohol abuse, and also diabetes mellitus. We report on a 42-year-old man with mental retardation. He who suffered from dyspnea and a fever that he had developed for over 14 days. S. constellatus and anaerobic bacterias (Prevotella buccae and Micromonas micros) were cultured. The patient was treated with the drainage of pleural effusion and clindamycin and levofloxacin.

Effects of Gastrodia elata Blune Water Extract on RANKL-induced Osteoclast Differentiation (천마가 RANKL에 의해 유도된 파골세포의 분화에 미치는 효과)

  • Choi, Yun-Hong;Song, Jeong-Hoon;Jang, Sung-Jo;Kim, Jin-Kook;Choi, Min-Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.5
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    • pp.807-813
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    • 2010
  • Impairment of balance between bone-resorbing osteoclasts and bone-forming osteoblasts result in bone disease. Especially, increased osteoclast formation and activity are responsible for bone diseases such as osteoporosis, rheumatoid arthritis, periodontal disease. Natural metabolites of plants have recently received much attention as an alternative tools for the development of novel therapeutic strategy. The aim of this study was to search the natural products to inhibit osteoclast differentiation and was to evaluate of its mechanism. Water extract of Gastrodia elata Blune significantly inhibited receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclast differentiation in bone marrow macrophages (BMMs) in a dose dependent manner. However, water extract of Gastrodia elata Blune did not affect cytotoxicity when compared with control. The mRNA expression of c-Fos, NFATc1, and TRAP induced by RANKL was inhibited by water extract of Gastrodia elata Blune treatment. Also, water extract of Gastrodia elata Blune inhibited the protein expression of c-Fos and NFATc1 expression in BMMs treated with RANKL. Water extract of Gastrodia elata Blune suppressed the phosphorylation of p38 induced by RANKL. In general, RANKL considerably inhibited the expression level of Id2 and MafB known as negative regulators of osteoclastogenesis, but RANKL did not inhibit Id2 and MafB expression in BMMs when it was co-treated with Gastrodia elata Blune. Taken together, these results suggest that Gastrodia elata Blune may be a useful drug in the treatment of bone-related disease.

Factors affecting treatment outcomes in patients with oral lichen planus lesions: a retrospective study of 113 cases

  • Park, Shin-Young;Lee, Hyo-Jung;Kim, So-Hyun;Kim, Sung-Beom;Choi, Yong-Hoon;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of Periodontal and Implant Science
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    • v.48 no.4
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    • pp.213-223
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    • 2018
  • Purpose: Oral lichen planus (OLP) is a chronic oral mucosal disease that has been recognized as an immune condition. The purpose of this study was to evaluate factors affecting the clinical outcomes of topical corticosteroid application on OLP lesions using dexamethasone gargle and ointment. Methods: The charts of patients who were clinically diagnosed with OLP and treated with dexamethasone from July 2003 to August 2017 at the Section of Dentistry of Seoul National University Bundang Hospital were thoroughly evaluated to identify subjects who were suitable for this retrospective study. For each patient, age at the index date, gender, medical history, and dental records related to OLP lesions and dexamethasone treatment were reviewed. Results: In total, 113 of the 225 patients were included in the present study. Among them, 79 patients were female (69.9%) and 34 were male (30.1%), with a mean age of 57.6 years. The average duration of dexamethasone treatment was 4.7 months and the mean follow-up period was 2.24 years. Improvements were observed within 1 year after dexamethasone treatment in most cases, and 17.7% of patients had a new OLP lesion after treatment. New OLP lesions were more frequently gingival than mucosal, although mucosal OLP lesions were more common than gingival OLP lesions in all age groups. In age- and gender-adjusted multivariate logistic regression, a history of malignant disease was found to be a significant factor affecting the formation of new lesions. Gingival OLP lesions and intermittent use of dexamethasone showed near-significant associations. In Kaplan-Meier failure analysis, history of malignancy, menopausal status, age, and the site of the OLP lesion were significant factors affecting clinical outcomes. Conclusions: The treatment outcomes of OLP were significantly influenced by age, history of malignancy, menopausal status, and the site of the OLP lesion, but not by factors related to dexamethasone treatment.

A CLINICOSTASTICAL STUDY OF ORAL AND MAXILLOFACIAL INFECTED PATIENTS FOR THE LAST 5 YEARS (최근 5년간 구강악안면 감염 환자의 임상통계학적 연구)

  • Jang, So-Jeong;Lee, Yong-Geun;Ahn, Yung;Leem, Dae-Ho;Baek, Jin-A;Shin, Hyo-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.5
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    • pp.401-409
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    • 2006
  • Infections of the oral and maxillofacial region are one of the most common conditions for which a patient presents to a maxillofacial surgeons. Although these infections can arise from a variety of source, dental disease is the most common etiology. So, odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often respond to antimicrobial chemotherapy or surgical intervention, such as extraction of teeth, incision and drainage through clinical features. But, odontogenic infections have the potential to spread via the fascial spaces in the head and neck region, and, they spread to cavernous sinus, deep musculofascial space and other vital structure. We have undertaken clinical studies on infections in the oral and maxillofacial regions by analyzing retrospectively hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Chonbuk National University Hospital past 5 years from 2000 to 2004. And, the patients' age, sex, medical history, causes of the infection, surgical intervention, and other clinical parameters were reviewed. The obtained results were as follows : 1. The most frequent cause of oral and maxillofacial infection was odontogenic. And in the odontogenic cause, dental caries was the most common cause (47.2%). 2. The most common fascial space involved was the submandibular space (15.7%), followed by the buccal space (14.8%). 3. 60.4% of all patients required surgical drainage of the abscess, endodontic treatment or tooth extraction or periodontal treatment with drainage. 4. The most causative organism isolated from the pus culture were streptococcus viridans (53.9%). 5. Underlying medical problems were found in 136 patients (41.9%), the most common being hypertension (27.9%) and diabetes (14.7%).

An assessment of accuracy of half-guided implant surgery using implant surgical guide: A case report (임플란트 수술용 가이드를 사용한 부분 유도 임플란트 수술의 정확도 평가: 증례보고)

  • Kim, Choongkil;Lee, Wonsup;Kwon, Ho-Beom
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.2
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    • pp.150-159
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    • 2019
  • Nowadays, dental implant is one of the widely used treatment options for edentulous patients. Recently, a method of improving the accuracy of implant surgery using an implant surgical guide has been introduced and widely used in order to accurately place the implant in a proper position. Full-guided and half-guided implant surgery can be distinguished according to the level of surgical guide application during the implant surgery. It is true that full-guided implant surgery exhibits higher accuracy, but half- guided implant surgery is often performed in a clinical situation due to the factors such as the circumstances of the operation. A partially edentulous patient who lost teeth due to tooth fracture and periodontal disease was treated using implant and fixed prosthesis. Half-guided implant surgery was performed using an implant surgical guide during implant surgery, the accuracy of implant placement was analyzed.

Evaluation of deproteinized bovine bone mineral as a bone graft substitute;A comparative analysis of basic characteristics of three commercially available bone substitutes (탈단백 우골의 골이식 대체재로서의 특성에 대한 평가;세 종류의 골 대체재의 기본 특성에 대한 비교분석)

  • Park, Jin-Woo
    • Journal of Periodontal and Implant Science
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    • v.35 no.4
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    • pp.863-875
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    • 2005
  • Bovine bone-derived bone substitutes are widely used for treatment of bone defects in dental and orthopedic regenerative surgery. The purpose of this study was to evaluate the basic characteristics of deproteinized bovine bone mineral as a bone graft substitute. Commercially available products from three different bovine bone minerals-Bio-Oss(GeistlichPharma, Switzerland), BBP(Oscotec. Korea), Osteograf/N-300(Dentsply Friadent Ceramed, USA) - were investigated. They were evaluated by scanning electron microscopy(SEM), energy dispersive X-ray spectrometer(EDS), surface area analysis(BET), and Kjeldahl protein analysis. Cell viability on different products was evaluated by 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide(MTT) assay. The results of this study indicated that each bone substitute displayed distinct surface properties. Furthermore, Kjeldahl protein analysis indicated that residual crude proteins are present in deproteinized bovine bone mineral. BBP showed relatively large amount of residual protein, which indicated that the possibility of disease transmission can not be safely ruled out. Based on the results of this study, it is suggested that active quality management is strongly needed in operations that involve processing bovine bone tissue for medical use.

Clinical application of bone graft materials in dental implant (임상가를 위한 특집 3 - 기능별 뼈이식재의 임프란트 적용방법)

  • Ahn, Kang-Min
    • The Journal of the Korean dental association
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    • v.48 no.4
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    • pp.275-279
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    • 2010
  • Dental implant restoration in partial or full edentulous state has become the standard treatment in recent years. Bone graft with guided bone regeneration technique has been regarded as one of the most reliable methods to restore the bone defect area due to periodontal disease or dental trauma. Bone graft materials and membrane are the essential component of guided bone regeneration; however, a variety of bone graft materials confuse us in implant dentistry. Autogenous bone is the recognized standards in implant dentistry owing to its osteogenesis potential. Despite of its disadvantages, grafting autogenous bone is the most reliable methods. Even though the development of new bone grafts materials, autogenous bone is useful in exposed implant thread and total lack of buccal or lingual bone. Allogenic, xenogenic and synthetic bone have the osteoconductive and osteoinductive potential. These materials could be used successfully in self-contained cavity such as sinus cavity and three-wall defects. In this article, application of bone graft material is suggested according to the function of bone graft materials.

Long-Term Observation for 10 Years after Dental Implant Surgery in Hemophilia A Patients (혈우병 A 환자의 치과 임플란트 수술 후 10년 추적 관찰)

  • Jung, Seo-Yun;Kim, Hun;Kim, Chun-Sung;Jeong, Mi-Ae;Kim, Su-Gwan
    • The Journal of the Korea Contents Association
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    • v.22 no.4
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    • pp.700-705
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    • 2022
  • Hemophilia is a congenital hemorrhagic disease in which blood clotting is impaired and hemostatic abnormalities occur when even one of the 13 factors required for blood clotting are deficient. Among the 13 factors, hemophilia A (factor 8), hemophilia B (factor 9), and hemophilia C (factor 10), depending on the deficient coagulation factor. A male patient in his 40s diagnosed with hemophilia A visited the dentist at Eulji University Hospital for problems with alveolar bone absorption and periodontal abscess caused by overall chronic tooth inflammation, and showed overall bone absorption and inflammation at the time of initial diagnosis. No complications or bleeding tendency were observed in the rest of the area except for #35 and #36 due to regular visits for 10 years, overall good oral conditions, and no side effects or complications were observed.