• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.2
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• pp.143-149
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• 2005

Objects : With the advancement of tissue engineering techniques, the effort to develop bioartificial mucosa have been actively delivered. The problem we met with this technique is the lack of mechanical strength between kerationocyte layer and dermal layer, where in the normal skin and mucosa, they are tightly bound with rete ridge structure. The purpose of this study is to understand the 2D and 3D structure of rete ridge of mucosa and skin paddle for rendering more biomimetic structure to the artificial mucosa. Materials and Methods : Oral mucosa and skin from the patients who received the oral surgery and maxillofacial reconstruction were harvested. The epidermis was separated from the dermis after treating with dispase for 12-16 hours. H&E staining was performed for 2D(dimensional) structure study and confocal LASER and SEM study were performed for 3D structure. Mean height(Sc) and arithmetic mean deviation(Sa) of all surface height were calculated. Results : The average height of rete ridge of skin flap was between $67.14{\mu}m$ and $194.55{\mu}m$. That of oral mucosa was between $146.26{\mu}m$ and $167.51{\mu}m$. Pressure bearing area and attached gingiva of oral mucosa showed deeper rete ridges. Conclusion : To obtain the adequate strength of artificially cultured keratinocyte skin and mucosa flap, it is necessary to imitate the original skin and mucosa structure, especially rete ridge. Through this study, 2D and 3D rete ridge structure of normal mucosa and skin was obtained. These results can be used as basis for substrate morphology for keratinocytes culture.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.1
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• pp.34-41
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• 2017

Anticonvulsants, calcium channel blockers and immunosuppressants are representative drugs related with gingival enlargement. Clinical signs and symptoms caused by drug-induced gingival enlargment frequently appear within 1 to 3 months after medication. At initial stage, it is limited to attached gingiva but may extend coronally and interfere with esthetics, mastication and speech. Interproximal spaces are common beginning area and pathologic teeth migration could be occurred by the lesion. Withdrawal or substitution of medication would be the most effective treatment of drug-induced gingival enlargement. However, periodontal treatment and further supportive periodontal therapy should be provided where change in medication is impossible. The present study reports the cases which show the resolution of inflammation with spontaneous teeth migration without change in medication. In all cases discussed in this report could be efficiently managed with proper periodontal treatment and further supportive periodontal therapy.

• Journal of Periodontal and Implant Science
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• v.33 no.2
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• pp.289-299
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• 2003

The autogenous free gingival graft is the most predictable procedure currently used to increase the width of　the attached gingiva in periodontics. But the major disadvantage of the procedure is to create the multiple surgical wounds at both a donor site and a recipient site. The other problem is the limited amount of available　graft material in oral cavity. Therefore, recent researches have been focused to develop the biomaterial to substitute the autogenous gingival tissue. The purpose of this study was to evaluate the histologic healing after　grafting of bilayer artificial dermis, compared to the free gingival graft. Four non-smoking subjects (mean age, 32.5 years) in systemically healthy state and good oral hygiene were selected according to their particular needs for correction of mucogingival problems as suggested by Nabers(1966). The recipient sites were prepared through the procedure for the free gingival graft and were grouped according to the graft materials: Experimental group(n=5) - bilayer artifcia1 dermis ($Terudermis^{(R)}$; Terumo Co. Japan) and Control group(n=6) - free gingival graft with autogenous palatal mucosa. Biopsies were harvested at 1,2,3 and 6 weeks postsurgery to evaluate histologically. At the third week in the experimental group and at the second week of in the control group, the grafts has been clinically stabilized on the recipient bed and the graft border has been blended into the surrounding tissue. In the experimental group after 1 week of grafting, the epithelial migration from the adjacent tissue to graft material was seen and after 3 weeks of grafting, the : nflmmation decreased, collagen layer of the artificial dermis was lost and the basement membrane of epithelium was formed. After 6 weeks of grafting, both groups demonstrated orthokeratinized epithelium and increased thickness of epithelial tissue and the rete peg formation, similar to the adjacent tissue, Histologic evaluation revealed a biologic acceptance and incorporation of the collagen layers of the graft tissue to the host tissue, without foreign body reaction. In conclusion, a bilayer artificial dermis is essentially similar to autogeneous free gingival graft in the correction of mucogingival problems, and has the advantages of decreased patient morbidity (no donor site) and availability of abundant amounts of graft material when needed.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.406-414
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• 2014

PURPOSE. The objective of this study was to investigate the biologic effects of enamel matrix derivative (EMD) with different concentrations on cell viability and the genetic expression of human gingival fibroblasts (HGF) to zirconia surfaces. MATERIALS AND METHODS. Immortalized human gingival fibroblasts (HGF) were cultured (1) without EMD, (2) with EMD $25{\mu}g/mL$, and (3) with EMD $100{\mu}g/mL$ on zirconia discs. MTT assay was performed to evaluate the cell proliferation activity and SEM was carried out to examine the cellular morphology and attachment. The mRNA expression of collagen type I, osteopontin, fibronectin, and TGF-${\beta}1$ was evaluated with the real-time polymerase chain reaction (RT-PCR). RESULTS. From MTT assay, HGF showed more proliferation in EMD $25{\mu}g/mL$ group than control and EMD $100{\mu}g/mL$ group (P<.05). HGFs showed more flattened cellular morphology on the experimental groups than on the control group after 4h culture and more cellular attachments were observed on EMD $25{\mu}g/mL$ group and EMD $100{\mu}g/mL$ group after 24h culture. After 48h of culture, cellular attachment was similar in all groups. The mRNA expression of type I collagen increased in a concentration dependent manner. The genetic expression of osteopontin, fibronectin, and TGF-${\beta}1$ was increased at EMD $100{\mu}g/mL$. However, the mRNA expression of proteins associated with cellular attachment was decreased at EMD $25{\mu}g/mL$. CONCLUSION. Through this short term culture of HGF on zirconium discs, we conclude that EMD affects the proliferation, attachment, and cell morphology of HGF cells. Also, EMD stimulates production of extracellular matrix collagen, osteopontin, and TGF-${\beta}1$ in high concentration levels. CLINICAL RELEVANCE. With the use of EMD, protective barrier between attached gingiva and transmucosal zirconia abutment may be enhanced leading to final esthetic results with implants.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.4
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• pp.686-692
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• 2006

The impacted teeth were surgically exposed by the closed-eruption technique and orthodontically retracted. The subject of this study are 24 patients(Mx. insiors; 10 Mx. canines; 14) who finished their treatment. The periodontal condition of the impacted teeth and the normally erupted proximal and opposed teeth were compared and analysed. The results are the followings ; 1. When the gingival index, plaque index, pocket depth and attached gingiva in periodontal evaluation were compared, there was no significant difference between the study group and the control group (P>0.05). 2. When the alveolar bone support of the mesial and the distal surface of the maxillary central incisors and proximal teeth was compared, there was no significant difference between the study group and the control group (P<0.05). 3. When the alveolar bone support of the maxillary canines was compared, there was no significant difference between the retracted teeth and the normally erupted teeth(P>0.05). The results above showed that the surgical exposure by closed-eruption technique followed by the orthodontic retraction of the impacted teeth has a positive influence on the regeneration of gingival tissue in clinical practice and is esthetically more stable. And it is considered that the clinicians should give attention to the direction of retraction power and the maintenance of normal shape of the alveolar bone in treatment of maxillary central incisors.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.657-661
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• 2005

Various chemotherapeutic agents have been recommended for pulpotomy of primary teeth, and there are formocresol, ferric sulfate, and calcium hydroxide. Of those, formocresol has fixation effect of pulp tissue and high clinical success rate, so it is most commonly used agent. But formocresol has strong cytotoxic effects, thus many articles reported displacement and loss of permanent successor, amelogenesis imperfecta, mutation by general absorption, possibility of cancer induction. Recently, it has been reported that leakage by imperfect temporary sealing when FC-soaked cotton was inserted into the root canal caused necrosis of surrounding tissues. and that necrosis of alveolar bone related to the use of excessive formocresol. In this case, 2nd primary molar of upper left jaw was treated using formocresol in local clinic, but extracted because of lasting pain. Furthermore, symptoms didn't disappear so patient was refered to us. The patient was 8-year-old male, had foul odor from oral cavity and circular alveolar bone necrosis around the permanent successor' crown. Thus sequestrectomy was operated and observed through 19 months after operation, we found normal root development of permanent successor but no complete regeneration of alveolar bone defect and attached gingiva. Lesion of periodontal tissues by formocresol is irreversible, so we have to confirm the indication in using formocresol and pay attention to complete temporary sealing.

• The Journal of Advanced Prosthodontics
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• v.11 no.5
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• pp.239-246
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• 2019

PURPOSE. The purpose of this study was to propose and assess a shade guide for pink gingival aesthetics using a Spanish population sample. MATERIALS AND METHODS. The $L^*$, $C^*$, h, $a^*$ and $b^*$ coordinates of 259 participants were measured using a spectrophotometer in 3 standardized points along the attached gingiva of the maxillary central incisors. A hierarchical clustering analysis was applied to obtain separate solutions regarding the number of shade tabs. For each of the solutions obtained, color differences (${\Delta}E^*$) were calculated using the CIELab and CIEDE2000 formulas, and the proposed shade guide was selected considering (1) the color differences between tabs and (2) the coverage error of each of the solutions. RESULTS. The proposed shade guide consisted of 8 gingival shade tabs and achieved CIELab and CIEDE2000 coverage errors of less than the respective 50:50% acceptability thresholds (${\Delta}E^*=4.6$ units and ${\Delta}E_{00}=4.1$). The coordinates for the various gingival shade tabs were as follows: Tab 1: $L^*43.3$, $a^*21.9$, $b^*12.3$ (1.6); Tab 2: $L^*42.9$, $a^*34.1$, $b^*19.1$; Tab 3: $L^*46.5$, $a^*25.8$, $b^*10.9$; Tab 4: $L^*46.5$, $a^*27.3$, $b^*15.1$; Tab 5: $L^*49.6$, $a^*23.5$, $b^*16.8$; Tab 6: $L^*51.5$, $a^*19.7$, $b^*13.6$; Tab 7: $L^*55.9$, $a^*22.0$, $b^*15.0$; and Tab 8: $L^*56.0$, $a^*19.9$, $b^*18.8$. CONCLUSION. The CIELab and CIEDE2000 coverage errors for the 8 shade tabs of the proposed gingival shade guide were significantly lower than those of other guides. Therefore, despite the limitations of this study, the proposed guide is more appropriate for matching gingival shade in the Spanish general population.

• The korean journal of orthodontics
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• v.31 no.5 s.88
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• pp.517-523
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• 2001

Titanium miniscrews we being used increasingly as an anchorage for tooth movement, because they ate easy to place and to remove, increase the number of sites available, give minimum strain to patients regarding surgical procedures, and offer uneventful healing alter removal. The use of titanium miniscrews as an orthodontic anchorage has been reported in clinical case reports, but clinicians have experienced screw loosening when using such screws.' To our knowledge, there are no published reports evaluating the stability of miniscrews. Information about the length of miniscrews used in relation to the location is of some importance, as stability will vary depending on bone duality The purpose of this study was to evaluate a variety of Lengths of miniscrews (dimeter: 2mm) which were inserted in maxilla or mandible and to demonstrate in a dog model which miniscrew provides fundamental stability in the jaws. 10 mm long miniscrews in the maxilla and 8mm long: miniscrews in the mandible showed no clinical mobility and retained their position throughout an 8 weeks force (200g) application. The mucosal condition around the screws was healthy in cases in which miniserews were inserted in the alveolar bone between the roots and the head of the screws emerged into the attached gingiva. When the force application was terminated, radiographic analysis revealed neither rent resorption not periodontal pathology around the miniscrews that remained stable during the entire treatment period. This study suggests that if titanium miniscrews with adequate length are properly used depending on the location, they provide sufficient stability for orthodontic anchorage.