• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.13-23
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• 2002

The ultimate goal of periodontal therapy is directed to arresting the progression of the disease, and regenerating the fibrous attachment. In order to achieve such treatment aim, the plaque and calculus must be eliminated and the physiological conditions of the root surface must be changed to facilitate the attachment and migration of the new fibroblasts, The method of changing the proper root surface conditions to promote the healing of periodontal tissue involves mechanical procedures, such as scaling and root planing, and chemical procedures such as tetracycline-HCl. However, the formation of a long junctional epithelium was most frequently observed type of healing. Thus, the aim of this study was to examine in vitro the influence of surface conditioning of dentin by TC-HCl on human gingival epithelial cell attachment. Human gingival epithelial cells were obtained from healthy retromolar pad area(under the age 23 years). Seventy two teeth extracted from severe periodontitis were used as study material. To evaluate the epithelial cell attachment to dentin, the prepared specimen was divided to four groups. For the control group, only scaling and root planing were carried out, and for the test group, 1 to 3, the concentration of the TC-HCl was 50, 125 and 250mg/ml respectively. After cell cultivation time of 1-, 3-. 24 hour, for the indirect quantitative assessment of gingival epithelial cell attached to dentin sample, the absorbance of epithelial cell unattached to dentin was measured. The results were as follows; 1. There was no statistically significant difference between scaling and root planing group and TC-HCl 50mg/ml 125mg/ml and 250mg/ml group about absorbance of unattached epithelial cell to dentin sample(p>0.5). 2. As time passes, the absorbance of unattached gingival epithelial cell to dentin sample was decreased statistically significant(p<0.05). 3. There was no statistically significant difference among the TC-HCl group(p>0.05) We concluded that there was similar effect on gingival epithelial cell attachment between TC-HCl conditioning on root surface and only scaling and root planing treatment

• Journal of Periodontal and Implant Science
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• 제28권2호
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• pp.351-372
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• 1998

The purpose of this study was to evaluate in vitro effects of the loss of tooth substance and root surface changes following root planing with various periodontal instruments. The 39 extracted human teeth due to severe periodontal disease were included. The total 50 root surfaces of 30 teeth were root planed with following instruments : Group 1, with Gracey curette, Group 2, with ultrasonic scaler, Group 3, with rotating root planing bur, Group 4, with Gracey curette plus rubber cup polishing, and Group 5, with ultrasonic scaler plus rubber cup polishing. Following root planing, the amount of tooth substance loss was evaluated by measuring the weight of the removed tooth substance and then 5 specimens ($5{\times}5{\times}2mm$) were randomly selected from the each group for roughness measurement. Root planed areas of each specimen were subjected to five measurements using the Profilometer and an average surface roughness values(Ra) for each group was obtained. Statistical difference for roughness values of each group was analyzed using oneway ANOVA and student t-test. For scanning electron microscopic(SEM) examination of root surface changes following root planing, 15 root surfaces of remaining 9 teeth were root planed and 3 specimens were randomly selected. The mean loss of tooth substance removed was Group 1, $7.0{\pm}1.09mg$, Group 2, $1.3{\pm}1.00mg$, Group 3, $5.8{\pm}1.72mg$, Group 4, $8.7{\pm}1.34mg$, and Group 5, $4.5{\pm}1.68mg$ following root palning, respectively. These results indicate that curette is effective instrument in the respect of diseased root substance removal. The average surface roughness values are following results : Group 1 and Group 4 were the smoothest surface ($Ra=0.34{\pm}0.06{\mu}m$, $Ra=0.34{\pm}0.04{\mu}m$, respectively) and Group 2 was the roughest surface ($Ra=2.09{\pm}0.06{\mu}m$). Statistical analysis of roughness values demonstrated a highly significant difference (P<0.05) between each experimental groups. However, no statistically significant difference in roughness values were observed between the Group 1 and Group 4. The results in this study suggest that curette and/or polishing procedure should be done after root planing with ultrasonic scaler and caution should be used with dia-mond-coated bur during routine root planing procedure.

• Journal of Periodontal and Implant Science
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• 제27권3호
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• pp.495-514
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• 1997

The purpose of this study was to evaluate the in vitro effects of Nd:YAG laser irradiation on removal of a root surface smear layer after root planing in comparison with Tetracycline HCl. The 60 extracted human teeth due to severe periodontal disease were vigorously scaled and root planed with Gracey curet. Thirty specimen($5{\times}5{\times}2mm$) were obtained from root planed surface of 30 human teeth and assigned randomly to one of three groups : root planed group(5 specimen), Tetracycline HCI group(5 specimen, burnished for 5 minutes), and Nd:YAG laser group(25 specimen, German Dental Laser, Fotona Twinlight). Nd:YAG laser group was divided into 4 subgroups according to power of 1W, 1.5W, 2W, 3W at frequency to 10Hz. The specimen were then fixed, and examed by Scanning electron microscopic study. 30 of 60 human teeth used to measurement of the intrapulpal temperature rise during laser irradiation. Laser-irradiated surface exhibited various surface texture from relative flat surface to irregular surface with patent dentinal tubules of various shape and size. In some area, the root surface alteration which are carbonization, pit and crater formation and melting and resolidification were observed. The number of exposed dentinal tubules per unit($100_{\mu}m^2$) on tetracycline HCI group was more than that in the laser group below 1.5W of power(150mJ/pulse) and was significantly less than that in laser group above 2W of power(200mJ/pulse)(P<0.OOl). As power increased the intrapulpal temperature rise also increased. The result suggested that the parameter which effectively remove root surface smear layer than tetracycline HCI may cause thermal damage to pulp and root surface alteration result from laser exposure would indicate need for additional instrumentation. Thus, Nd:YAG laser irradiation in these parameter may not be appropriate for clinical use as adjunct to conventional periodontal therapy.

• Journal of Periodontal and Implant Science
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• 제24권1호
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• pp.64-86
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• 1994

The authors have transplanted periodontally involved roots which had been root planed into healthy and periodontally involved extraction sockets, and studied the root resorption patterns as well as its effect on new bone formation and wound healing. Alveolar bone around mandibular premolars of 6 adult dogs has been surgically removed, followed by ligation of orthodontic elastic wires for 8 weeks inducing chronic periodontal disease. After removing the crown portions, roots were extracted, and notches were made on the root surfaces discriminating healthy and periodontally involved areas using burs. Controls and experimental groups were divided as follows. Control I : Transplantation of periodontally involved root into healthy extraction sockets. Control II : Transplantation of periodontally involved root into diseased extraction sockets. Experimental group I : Transplantation of root planed roots into healthy extraction sockets. Experimental group II : Transplantation of root planed roots into diseased extraction sockets. Extraction sockets were sutured after transplantations, completely submerging the roots. Healing progress was histologically observed at 2nd, 8th, 12th, and 20th weeks, and the results were as follows ; 1. No inflammation or infection within the extraction sockets had been observed in all groups throughout the experimental period. 2. Reversal lines were observed at week 2 in all groups, clearly discriminating socket walls and new bone, and numerous blood vessels were observed in the new bone trabeculae. 3. Experimental groups showed markedly less root resorption compared to the controls at week 2, but as time progressed, severe resorptions were present in all groups. 4. Localized areas of new bone ankylosis were observed, and the rest of the areas showed collagen fiber insertion with new bone formation at its periphery. 5. No clear differences were found in healing and alveolar bone regeneration between healthy and diseased extraction sockets. 6. The amount of root resorption and ankylosis had increased up to week 8 and 12, showing ankylosis of new bone and the roots. However, no further increase in ankylosis was observed at week 20. 7. Most of the cementum on healthy roots was directly ankylosed to new bone at week, 2, and were gradually resorbed and replaced by new bone thereafter. These results appear to indicate that root planing may inhibit early root resorption of transplanted roots, but gradual replacement by alveolar bone and collagen fibers eventually occur. Condition of the roots or presence of disease in extraction sockets do not appear to make marked differences in alveolar bone regeneration process.

• Journal of Periodontal and Implant Science
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• 제44권1호
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• pp.33-38
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• 2014

Purpose: Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts. Methods: Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the alveolar process with the indication of reconstruction procedures to allow rehabilitation with dental implants; and the absence of systemic disease, local infection, or inflammation. The patients were randomly divided into two groups based on whether they received a perforated (inner surface) or nonperforated graft. After a 6-month healing period, a biopsy was performed and osseointegrated implants were installed in the same procedure. Results: Fibrous connective tissue was evident at the interface in patients who received nonperforated grafts. However, full union between the graft and host bed was visible in those who had received a perforated graft. Conclusions: We found that cortical inner side perforations at donor sites increased the surface area and opened the medullary cavity. Our results indicate an increased rate of graft incorporation in patients who received such perforated grafts.

• 치위생과학회지
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• 제15권2호
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• pp.238-245
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• 2015

본 연구는 지각과민처치제에 항균 물질을 첨가하여 항균실험 및 지각과민처치제의 세포독성실험을 실시하여 다음과 같은 결과를 얻었다. 항균실험에서는 Micro Prime은 항균 약물의 농도가 높을수록 항균력도 높게 나타나 각 그룹간의 항균 범위는 통계적인 유의차를 나타내었다(p<0.05). Hurri Seal에서는 gallic acid 항균 약물 농도가 높을수록 항균력이 높게 나타났지만(p<0.05), tetracycline을 함유한 desensitizer에서는 농도가 높을수록 항균효과는 떨어지는 것으로 나타났다(p<0.05). 또한 chlorhexidine과 cetylpyridinium chloride에서는 대조군에서만 차이를 나타내고(p<0.05), 각 실험군에서 차이를 나타내지 않았다. 세포독성도를 평가한 결과 Micro Prime은 미약한 세포독성을 나타냈으며, Hurri Sea은 심한 세포독성을 나타냈다. 이상의 연구결과로 지각과민처치제에 항균물질을 첨가할 경우 우수한 항균력이 나타났기 때문에 지각과민 환자의 동통을 줄여 줄 것으로 사료되며 항균성을 가진 지각과민처치제로 사용이 가능할 것으로 판단된다.

• Restorative Dentistry and Endodontics
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• 제32권6호
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• pp.483-490
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• 2007

본 연구는 상악 측절치에서 발생한 구개-치은구로 인한 치수괴사와 치주병소에 관한 임상종례이다. 첫 번째 증례는 심한 골소실로 인하여 발거되었고, 두 번째 증례는 근관치료 후 치주외과적 수술을 통하여 구개-치은구를 제거하고, 합성골 이식 시행 후 흡수성막을 이용하여 치료하였다. 구개-치은구의 진단과 치료는 모두 어려우며, 많은 경우에서 발치가 선택되지만, 근관-치주 복합 치료를 통하여 구개-치은구의 성공적인 치료가 이루어질 수 있다.

• Journal of Periodontal and Implant Science
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• 제52권1호
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• pp.65-76
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• 2022

Purpose: The present study measured changes in arteriolar and venular capillary flow and structure in the gingival tissues during the development of plaque-induced gingival inflammation by combining dynamic optical coherence tomography (OCT), laser perfusion, and capillaroscopic video imaging. Methods: Gingival inflammation was induced in 21 healthy volunteers over a 3-week period. Gingival blood flow and capillary morphology were measured by dynamic OCT, laser perfusion imaging, and capillaroscopy, including a baseline assessment of capillary glycocalyx thickness. Venular capillary flow was estimated by analysis of the perfusion images and mean blood velocity/acceleration in the capillaroscopic images. Readings were recorded at baseline and weekly over the 3 weeks of plaque accumulation and 2 weeks after brushing was resumed. Results: Perfusion imaging demonstrated a significant reduction of gingival blood flow after 1 and 2 weeks of plaque accumulation (P<0.05), but by 3 weeks of plaque accumulation there was a more mixed picture, with reduced flow in some participants and increased flow in others. Participants with reduced flux at 3 weeks also demonstrated venular-type flow as determined by perfusion images and evidence of the development of venular capillaries as assessed by the velocity/acceleration ratio in capillaroscopic images. After brushing resumed, these venular capillaries were broken down and replaced by arteriolar capillaries. Conclusions: After 3 weeks of plaque accumulation, there was wide variation in microvascular reactions between the participants. Reduced capillary flow was associated with the development of venular capillaries in some individuals. This is noteworthy, as an early increase in venous capillaries is a key vascular feature of cardiovascular disease, psoriasis, Sjögren syndrome, and rheumatoid arthritis-diseases with a significant association with the development of severe gingival inflammation, which leads to periodontitis. Future investigations of microvascular changes in gingival inflammation might benefit from accurate capillary flow velocity measurements to assess the development of venular capillaries.

• 대한소아치과학회지
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• 제43권4호
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• pp.354-364
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• 2016

청소년기 구강건강 상태를 파악하고 그에 따른 치과치료 필요도를 평가할 목적으로, 양산시 소재 중고등학교에 재학중인 14-17세 청소년 2,062명을 대상으로 임상검사 및 설문조사를 시행하여 다음과 같은 결론을 얻었다. 치아우식증의 치료필요도는 66.7%, 치아침식증의 치료필요도는 27.8%, Molar incisor hypomineralization(MIH)의 치료필요도는 14.7%였다. 부정교합은 양호한 교합 군 67.8, 치료 불필요 군 19.7%, 약간의 치료가 필요한 군 6.8%, 치료가 반드시 필요한 군 4.5%, 가장 심한 부정교합 군 1.1%로 나타났고, 치료필요도는 12.5%였다. 치주질환은 71.2%의 유병률을 보였고, 치료 필요도도 이와 동일한 71.2%였다. 측두하악장애는 무증상 군 67.1%, 경미한 증상 군 13.4%, 심한 증상 군 19.5%의 분포를 보였으며, 치료필요도는 20.6%로 나타났다. 가장 높은 치료 필요도를 보인 질환은 치주질환이었고, 뒤를 이어 치아우식증, 치아침식증, MIH, 측두하악장애, 부정교합의 순으로 나타났다. 본 연구 결과를 통해 청소년의 전반적 구강건강상태 및 치과치료 필요도를 파악할 수 있었고, 이는 우리나라 청소년 구강건강 증진을 위한 계획수립에 있어서 기초자료로서 기여하게 되기를 기대되는 바이다.

• 대한치과보철학회지
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• 제53권1호
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• pp.51-57
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• 2015

치주질환에 의해 수평적, 수직적 골흡수를 보이는 환자에게 전악 임플란트 고정성 보철수복 치료를 계획한 경우에는 저작 기능, 심미, 발음 등을 고려한 임플란트 식립이 필요하다. 이를 위해 철저한 임상적, 방사선학적 진단이 필요하며 광범위한 골이식과 연조직 이식술이 요구되기도 한다. 아직까지도 골이식한 상악에 대한 적절한 임플란트 식립 개수, 하부구조물 분할 여부 및 상부 구조물의 유지 방법 등에 대한 명확한 지침이 마련되어 있지 않기 때문에 진단과정에서 이를 고려한 검사가 요구된다. 본 증례에서는 치주질환 병력이 있는 환자에서 상, 하악 다수 치아 발거 및 치주 치료 후, 골이식 및 연조직 이식을 동반한 다수 임플란트 식립과 하악 자연 치열에 대합되는 상악 임플란트 전악 보철수복을 통하여 기능적, 심미적으로 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.