• 대한미생물학회지
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• 제21권4호
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• pp.503-513
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• 1986

치주질환의 처치에 있어서 tetracycline의 전신적 투여는 치은연하 세균의 제거 및 감소에 매우 효과가 있는 것으로 알려져 있다. 본 연구는 전신적 투여시의 문제점 보완과 국소적 투여시 기할 수 있는 병소부위의 보다 높은 농도의 유지를 위하여 국소도포용 tetracycline gel을 제조하여 예비실험을 시행하였으며, 본 실험에서는 치주낭 깊이 $4{\sim}6mm$의 중등도 치주염 환자 13명에서 double-blind, split-mouth design으로 상악 또는 하악중 한악은 scaling 및 root planing을 시행하였고, 나머지 악은 그대로 두었으며, 좌측 또는 우측중 한측에는 예비실험결과 가장 효과가 있는 것으로 나타난 국소도포용 3% tetracycline gel을 치주낭내 깊숙히 주2회 2주간 투여하여, (1) tetracycline-scaled (2) tetracycline-unscaled (3) placebo-scaled (4) placebo-unscaled의 4군에서 0일, 14일, 49일에 임상적, 미생물학적 검사를 시행하여 각기 그 효과를 비교하였다. 또한 치주질환과 관련이 깊은, 그람 음성혐기성 세균, 특히 black-pigmented Bacteroides의 분포 변화를 관찰하기 위하여, 시험부위에서 치은연하 치태세균을 채취하여 pre-reduced Ringer액에 혐기성조건으로 보관 운반하여 $37^{\circ}C$혐기성 세균 배양기 내에서 혈액배지에 담아 7일간 배양하여 분리한 후, 생화학 검사를 통하여 Bacteroides균주를 검정하였으며, 이로써 tetracycline투여와 관련된 치주질환의 disease activity를 분석 검토하였다. 이상의 임상적, 미생물학적 검사결과 다음과 같은 결론을 얻었다. 1. 예비실험 결과 국소도포시 가장 효과가 있었던 3% tetracycline gel은 본 실험사용시 치주질환치료 및 치은연하 세균분포변화에 매우 효과가 있으며, 임상적으로 scaling, root planing과 병행시에 가장 효과가 있는 것으로 나타났다. 2. Bacterial morphotype의 관찰결과 tetracycline투여군에서 coccal form의 증가와 spirochetes의 현저한 감소를 보였으며, non-motile rods와 motile rods의 비율에는 다소증감이 있었으나 의미있는 변화는 없었다. 3. Streptococcus균주간의 분포 비율은 tetracycline-scaled군에서 S. sanguis I은 14일에 현저히 증가하였고, 49일에는 다소 감소하였으며, S. mitis는 증가하는 경향을 보였다. 4. Tetracycline-scaled군에서는 black-pigmented Bacteroides의 비율이 현저히 감소하였으며, tetracycline 투여만으로도 black-pigmented Bacteroides 비율은 감소되었다. 그러나 scaling만으로는 black-pigmented Bacteroides 비율에는 변화를 주지못했다. 5. Black-pigmented Bacteroides 균주간의 분포를 보면 실험 및 대조군 모두에서 B. loeschii가 가장 많이 나타났으며, 시간의 경과에 따라 거의 변화가 얼었다. 또한 tetracycline 투여군에서는 B. intermedius와 B. gingivalis가 감소하였고, B. melaninogenicus는 증가하였다.

• Journal of Periodontal and Implant Science
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• 제27권1호
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• pp.79-90
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• 1997

The purpose of this study was to evaluate the substantivity of experimentally developed gel type tetracycline HCl and a mixture of tetracycline-citric acid gel, and compare to those of solution type tetracycline HCl. 11 extracted anterior teeth were subjected to this study. After scaling and root planing teeth were randomly divided into 3 treatments groups : group 1; 3 teeth were irrigated with tetracycline HCl(50mg/ml) solution , group 2; tetracycline gel (5%) was inserted in the periodontal pockets of 3 teeth, group 3; a mixture of tetracycline and citric acid gel was inserted in the pockets of 3 teeth. And 2 teeth treated in 0.9 % sterile saline served as controls. After 5-minute exposure, each tooth immediately extracted and incubated at room temperature for 22 days in tris-buffered saline as a desorption media. The total volume of TBS was removed and replaced with fresh TBS, at 24-h intervals. Removed desorption media transferred to a sterile vial and stored at -70 oC. This procedure was repeated every 24 h throughout the 22-day desorption period. Using Porphyromonas gingivalis as an indicator organism, a microtiter assay was used to evaluate antimicrobial activity desorbed from the teeth. 1. 50mg/ml tetracycline HCl solution exhibited the longest antimicrobial activity. Compared to saline treated group, it showed significant difference on the day 1 and day 2 desorption period. 2. The ODs of 5% tetracycline gel and a mixture of tetracycline-citric acid gel were significantly different during the first 24 hour only. 3. There was no statistically significant difference after the day 3 between the groups.(p<0.05). Despite our expectation a mixture of tetracycline-citric acid gel did not show longer antimicrobial activities than those of tetracycline gel, and the solution type exhibited the longest activities. Because the gel type agents may stay in the subgingival environment longer than the solution, if the teeth were not extracted immediately after the delivery of the agent, the result could be different. hus this result suggests the possibilities of practical use of these kind of gel type agents.

• Journal of Periodontal and Implant Science
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• 제41권6호
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• pp.285-292
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• 2011

Purpose: The aim of this study was to elucidate the effect of a bovine hydroxyapatite/collagen (BHC) block in one-wall intrabony periodontal defects in dogs. Methods: A one-wall intrabony periodontal defect (4 mm wide and 5 mm deep) was prepared bilaterally at the mesial side of the mandibular fourth premolar in five beagle dogs. After thorough root planing, block-type BHC ($4{\times}5{\times}5$ mm) was placed on one side. The contralateral defect area did not receive any material as a sham-surgery control. Histological analysis of the sites was performed after an 8-week healing period. Results: Two of five samples in the experimental group healed well without dissipation of the graft materials, and histological analysis revealed excellent regeneration of the periodontal tissues. However, most of the grafted materials had been displaced in the other three samples, leaving only a small portion of the graft. The measured parameters exhibited large standard deviations, and the mean values did not differ significantly between the experimental and sham-surgery control sides. Conclusions: The application of BHC alone-without a barrier membrane-to wide, one-wall intrabony periodontal defects yielded inconsistent results regarding both periodontal regeneration and substantivity of the graft materials. Thus, the use of a barrier membrane for noncontained-type defects is recommended to improve the stability of the grafted material, and to condense it.

• Journal of Periodontal and Implant Science
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• 제47권2호
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• pp.116-131
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• 2017

Purpose: The entry of bacteria or harmful substances through the epithelial seal of human gingival keratinocytes (HGKs) in the junctional epithelium (JE) is blocked by specialized intercellular junctions such as E-cadherin junctions (ECJs). However, the influence of roughened substrates, which may occur due to apical migration of the JE, root planing, or peri-implantitis, on the development of the ECJs of HGKs remains largely unknown. Methods: HGKs were cultured on substrates with varying levels of roughness, which were prepared by rubbing hydrophobic polystyrene dishes with silicon carbide papers. The activity of c-Jun N-terminal kinase (JNK) was inhibited with SP600125 or by transfection with JNK short hairpin RNA. The development of intercellular junctions was analyzed using scanning electron microscopy or confocal laser scanning microscopy after immunohistochemical staining of the cells for E-cadherin. The expression level of phospho-JNK was assessed by immunoblotting. Results: HGKs developed tight intercellular junctions devoid of wide intercellular gaps on smooth substrates and on rough substrates with low-nanometer dimensions (average roughness $[Ra]=121.3{\pm}13.4nm$), although the ECJs of HGKs on rough substrates with low-nanometer dimensions developed later than those of HGKs on smooth substrates. In contrast, HGKs developed short intercellular junctions with wide intercellular gaps on rough substrates with mid- or high-nanometer dimensions ($Ra=505.3{\pm}115.3nm$, $867.0{\pm}168.6nm$). Notably, the stability of the ECJs was low on the rough substrates, as demonstrated by the rapid destruction of the cell junction following calcium depletion. Inhibition of JNK activity promoted ECJ development in HGKs. JNK was closely associated with cortical actin in the regulation of ECJs in HGKs. Conclusions: These results indicate that on rough substrates with nanometer dimensions, the ECJs of HGKs develop slowly or defectively, and that this effect can be reversed by inhibiting JNK.

• Journal of Periodontal and Implant Science
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• 제29권3호
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• pp.539-553
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• 1999

The purpose of this 6-months study was to compare the clinical and radiographic outcomes following guided tissue regeneration treating human mandibular Class II furcation defects with a bioabsorbable BioMesh barrier(test treatment) or a nonabsorbable ePTFE barrier(control treatment). Fourteen defects in 14 patients(mean age 44 years) were treated with BioMesh barriers and ten defects in 10 patients(mean age 48 years) with ePTFE barriers. After initial therapy, a GTR procedure was done. Following flap elevation, root planing, and removal of granulation tissue, each device was adjusted to cover the furcation defect. The flaps were repositioned and sutured to complete coverage of the barriers. A second surgical procedure was performed at control sites after 4 to 6 weeks to remove the nonresorbable barrier. Radiographic and clinical examinations(plaque index, gingival index, tooth mobility, gingival margin position, pocket depth, clinical attachment level) were carried out under standardized conditions immediately before and 6 months after surgery. Furthermore, digital subtraction radiography was carried out. All areas healed uneventfully. Surgical treatment resulted in clinically and statistically equivalent changes when comparisons were made between test and control treatments. Changes in plaque index were 0.7 for test and 0.4 for control treatments; changes in gingival index were 0.9 and 0.5. In both group gingival margin position and pocket depth reduction was 1.0mm and 3.0mm; clinical attachment level gain was 1.9mm. There were no changes in tooth mobility and the bone in radiographic evaluation. No significant(p${\leq }$0.05) difference between the two membranes could be detected with regard to plaque index, gingival index, gingival margin position, pocket depth, and clinical attachment level. In conclusion, a bioabsorbable BioMesh membrane is effective in human mandibular Class II furcation defects and a longer period study is needed to fully evaluate the outcomes.

• Journal of Periodontal and Implant Science
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• 제40권1호
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• pp.3-10
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• 2010

Purpose: Periodontal regenerative therapies for defects created by severe periodontitis are mainly focused on bone regeneration. Although cementum regeneration needs to be better understood, it is believed to play an important role in periodontal regeneration. The first step toward a full understanding of cementum regeneration is to compare repaired cementum to pristine cementum. This study, which used histological techniques, was designed to focus on cementum regeneration and to compare pristine cementum to repaired cementum after surgical procedures with 8 and 24 week healing periods in a canine model. Methods: Buccal and lingual mucoperiosteal flaps of 10 beagle dogs were surgically reflected to create critical-sized defects. Intrabony one-wall defects, of which dimension is 4 mm width and 5 mm depth, were made at the distal aspect of mandibular second premolars and the mesial aspect of mandibular fourth premolars in the right and left jaw quadrants. Animals were sacrificed after 8 and 24 weeks post-surgery for histological specimen preparation and histometric analysis. Results: The repaired cementum was composed mostly of acellular cementum and cellular mixed fiber cementum and was thicker in the apical area than in the coronal area. The acellular cementum of the supracrestal area appeared to be amorphous. The newly formed cellular cementum was partially detached from the underlying circumpulpal dentin, which implied a weak attachment between new cementum and dentin, and this split was observed to a lesser extent in the 24 week group than in the 8 week group. The vertical height of the repaired cementum was greater in the 24 week group than in the 8 week group. Conclusions: Within the limitations of this study, we can conclude that repaired cementum after root planing was mainly acellular cementum and cementum tissue that matured to a shape similar to pristine cementum as the healing progressed from 8 to 24 weeks.

• Journal of Periodontal and Implant Science
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• 제31권1호
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• pp.207-227
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• 2001

스프린트는 치주처지료에서 부가적 처치법으로 널리 사용되고 있으며, 한편, 디지털 공제 활영술은 기존방사선촬영술의 한계점을 극복하기 위해 기발된 새로운 방법이다. 이번 연구에서는 치근활택술 단독시행시와 스피린트 병행 처치시의 효과를 임상적, 방사선학적으로 비교하였다. 중정도의 성인성 치주염을 가진 20명의 환자를 대상으로 하되 10명은 치근활택술 단독으로, 나머지 10명은 스프린트 병행처치로 처치하였다. 임상적, 방사선학적인 평가는 처치전, 처치후 6개월에 행하고, 임상적 평가의 경우 3개월에 추가로 실시하였다. 이번 연구에서 사용된 임상 지수로는 치태지수, 치은지수, 치은퇴축, 치주낭깊이, 임상부착수준, 임상부착증가, 탐침시출혈, 치아동요도 등이며, 방사선학적 평가는 기존 방사선촬영술에 의한 방법과 디지털 공제촬영수렝 의한 방법으로 행하였다. 디지털 공제 촬영술에 의한 평가시, 영상은 Digora 프로그램에 의해 획득하고 Emago 프로그램으로 처리 하여 다음과 같은 결론을 얻었다. 1. 처치후 3개월에 치태지수, 치은지수, 치은퇴축, 치주낭깊이, 임상적부착수준, 탐침시 출혈 등의 임상지수들이 변했으며, 특히 이러한 변화는 치주낭깊이, 치은퇴축, 탐침시출혈에서 유의성이 있었다. ( p<0.05 ) 그러나 두군간 차이는 인정되지 않았다. ( p>0.05 ) 2. 처치후 6개월에도 치태지수, 치은지수, 치은퇴축, 치주낭깊이, 임상적부착수준, 탐침시출혈, 치아동요도 등의 임상지수들이 변했으며, 특히 이러한 변화는 치주낭깊이, 치은퇴축, 탐침시출혈, 치태지수, 치아동요도에서 유의성이 있었다. ( p<0.05 ) 그러나 두 군간 차이는 인정되지 않았다. ( p>0.05 ) 3. 켄달 상관분석시, 임상적 평가와 기존 방사선 촬영술에 의한 평가사이의 관련성을 낮았으며 거의 0에 가까운 수치를 보였으며 (r=0.110, p=0.639 ) 임상적 평가와 디지털 공제 방사선 촬영술에 의한 평가사이에서 약간 높은 관련성을 보였다. ( r=0.257, p=0.315 ) 즉 치주치료후의 골변화는 디지털 공제 방사선 촬영술에 의한 평가시 기존 방사선 사진보다 임상적 부착증가와 더욱 긴밀한 관련성을 보여준다. 이상의 결과로 볼 때, 스프린팅 처치는 치주 치료에 있어 치근활택술에 부가적 표과를 제공하지 못한다.

• 치위생과학회지
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• 제3권1호
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• pp.1-4
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• 2003

본 고는 치위생 임상업무를 수행하는 과정에서 발생할 수 있는 외상성 치은 손상에 대처하기 위한 방법으로서 조직접착제의 활용 방안에 대해 검토하고자 하였다. 시아노아크릴레이트 조직접착제는 조직 표층의 열창을 기존 봉합법에 의하지 않고 화학물질에 의한 접착 방식으로 폐쇄하기 위한 용도로서 그 동안 구강외과나 치주수술 분야에서 그 응용이 모색되어 왔다. 치과위생사가 치석제거 및 치근활택술 등의 시술 과정에서 부적절하거나 과도한 기구조작에 의해 치은이나 구강점막에 열창이 초래될 수 있다. 이러한 상황에 발생하였을 경우, 조직접착제를 이용하여 열창을 폐쇄하면 매우 효과적이며 단순하고 편리하다. 조직접착제는 n-butyl-2-cyanoacrylate로 구성되어 있으며, 조직의 수분과 접촉하면 빠르게 중합되어 접착력을 나타낸다. 조직접착제를 이용한 치은열창의 처치는 그 심미적 결과가 양호하며, 추가적인 조직 손상이 없을 뿐 아니라 시술 방법이 간단하여 시간이 적게 소요된다. 또한 국소마취가 필요치 않으며, 창상 소독이나 봉합사 제거를 위해 환자가 다시 내원하지 않아도 되는 등의 여러 임상적 장점이 있다. 창상의 감염 방지나 지혈 작용 등에도 효과적이다. 조직접착제는 치위생 임상에서 발생할 수 있는 조직손상에 대한 처치법으로서 환자나 치과위생사 모두에게 유용하게 활용될 수 있다.

• Journal of Periodontal and Implant Science
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• 제26권4호
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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.

• Journal of Periodontal and Implant Science
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• 제25권3호
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• pp.529-538
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• 1995

It has been believed that the increased release of free oxygen radicals ($O_2^-,H_2O_2$, and $OH^-$) might be a factor in the pathogenesis of periodontal diseases. Antioxidant enzymes such as glutathione peroxidase(GSH-PX) and catalase can protect the tissue damage from the $H_2O_2$. In order to investigate the GSH-PX and catalase activity in the blood plasma and red blood cells(RBCs) of the patients with periodontitis, 19 patients who had good general health, attachment loss more than 6 mm and bone loss were selected as periodontitis group, 7 patients who had severely inflamed gingiva were selected as gingivitis group, and 15 volunteers with good general and periodontal health were selected as normal group. 17 of 26 patients were performed scaling and root planing to reduce the gingival inflammation for gingivitis and periodontitis groups, and were selected as posttreatment group. After blood plasma and RBCs were collected and separated 1 ml of peripheral blood from each subject, GSH-PX activity in blood plasma and RBCs was measured by the same method that Stefan et al. did, and catalase activity in RBCs was measured by the same method that Beers et al. did. The difference of GSH-PX and catalase activity between normal, gingivitis, and periodontitis groups was statistically analyzed by ANOVA with SPSS/PC+ program, and the difference between pretreatment and posttreatment groups was analyzed by Student t-test. The results were as follows : 1. GSH-PX activity in blood plasma was significantly lower in the gingivitis group($0.8683{\pm}0.0658$), periodontitis group($0.7130{\pm}0.1333$) than in the normal group($1.0241{\pm}0.0801$)(p<0.05), and GSH-PX activity in RBCs was significantly lower in the gingivitis groupt. $0.8156{\pm}0.1167$), periodontitis group($0.7533{\pm}0.1185$) than in the normal group($l.1963{\pm}0.2044$)(P<0.05), but there was no statistical significance in the difference of GSH-PX activity in RBCs between the gingivitis group and periodontitis group(p>0.05). 2. Catalase activity in RBCs was siginficantly lower in the periodontitis group($117.34{\pm}35.01$) than in the normal group($l52.38{\pm}32.09$)(p<0.05). 3. GSH-PX activity in blood plasma was significantly increased in the posttreatment groupe $1.0376{\pm}0.2820$) compared to the pretreatment group(0.7608 0.1600) (p<0.05), and GSH-PX activity in RBC was significantly increased in the posttreatment group($1.0421{\pm}0.2330$) compared to the pretreatment group($0.7728{\pm}0.1210$)(p<0.05). 4. There was no statistical significance in the difference of catalase activity in RBCs between the pretreatment group($112.04{\pm}43.65$) and posttreatment group($l33.41{\pm}39.16$)(p>0.05).The results, within the limits of the present experiment, suggest that the lowered activity of GSH-PX and catalase in blood plasma and RBCs may be related with periodontopathogenesis.