• 제목/요약/키워드: gingiva

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임상가를 위한 특집 3 - 심하게 흡수된 치조제를 가진 환자에서 CAD/CAM을 이용한 임플란트 고정성 보철치료 (Implant fixed prosthetic treatment using CAD/CAM system in a patient with severe alveolar resorption)

  • 최유성
    • 대한치과의사협회지
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    • 제50권3호
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    • pp.126-139
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    • 2012
  • Loss of dentition can lead to not only compromised esthetics and functions of the patient, but also alveolar bone resorption. Bone grafting with prosthetic reconstruction of the gingiva can be selected for the treatment, and it provides many benefits as prosthetic gingival reconstruction does not require a complicated surgical process and is available within a short period of time, with stable clinical results. However, conventional porcelain fused to metal prosthesis has certain limits due to its size, and deformation after several firing procedures. In this clinical report, the author would like to introduce a patient with severe alveolar resorption who was treated with gingiva-shaped zirconia/titanium CAD/CAM implant fixed prosthesis for esthetic and functional rehabilitation. Clinical reports Clinical report 1, 2 : A case of loss of anterior dentition with atrophied alveolar bone. Implant retained zirconia bridge applied with Procera implant bridge system to simulate the gingiva. Upper structure was fabricated with zirconia all ceramic crown. Clinical report 3, 4 : A case of atrophied maxillary alveolus was reconstructed with fixed implant prosthesis, a CAD/CAM designed titanium structure covered wi th resin on its surface. Anterior dentition was reconstructed with zirconia crown. Conclusion and clinical uses. All patients were satisfied with the outcome, and maintained good oral hygiene. Zirconia/titanium implant fixed prosthesis fabricated by CAD/CAM system was highly accurate and showed adequate histological response. No critical failure was seen on the implant fixture and abutment overall. Sites of severe alveolar bone loss can be rehabilitated by implant fixed prosthesis with CAD/CAM system. This type of prosthesis can offer artificial gingival structure and can give more satisfying esthetics and functions, and as a result the patients were able to accept the outcome more fondly, which makes us less than hard to think that it can be a more convenient treatment for the practitioners.

치은증식시 세포구성과 성장인자에 관한 면역조직화학적 연구 (IMMUNOHISTOCHEMICAL STUDIES ON CELL POPULATION AND GROWTH FACTORS IN GINGIVAL HYPERPLASIA)

  • 이강남;한수부;이재일
    • Journal of Periodontal and Implant Science
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    • 제24권2호
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    • pp.357-375
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    • 1994
  • The purpose of this study was to investigate the differences of histochemical characteristics in inflammatory fibrous gingival hyperplasia (FGH), phenytoin-induced gingival hyperplasia(PIGH), idiopathic gingival hyperplasia(IDGH) and control groups (healthy and inflammatory gingiva) by immunohistochemical method with various antibodies and histomorphological analysis. In immunohistochemical finding, antibodies to inflammatory cells (T/B lymphocytes, macrophages, other monocytes), proliferating cell nuclear antigen(PCNA), epidermal growth factor(EGF), factor VIII, and type I collagen were used. 1. The inflammatory infiltrates in FGH were less than those in inflammatory gingiva. The composition of inflammatory cells of PIGH was similar with that of FGH. IDGH showed a similar histologic findings with healthy gingival tissue. 2. In FGH, the number of fibroblasts and newly-formed collagen fibers was increased. No significant increase of fibroblasts and the dense accumulation of thick collagen fibers were seen in PIGH. The increase of fibroblasts and the dense accumulation of thick collagen were seen in IDGH. 3. PCNA-positive cells were localized mainly in the area accumulated with inflammatory cells and blood vessels, significantly increased in all hyperplastic tissue groups, and distributed evenly in IDGH. 4. The distribution of EGF were not observed in healthy gingiva but detected locally in area with confluent blood vessels,without significant difference between the other tissue groups. This results suggest that inflammation plays a significant role in inducing hyperplastic change of gingival tissue. While in DIGH, drug itself as well as inflammation seems to attribute to hyperplastic change.

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더러브렛 망아지에서 발생한 골화성 치은종 (Ossifying Epulis in a Thoroughbred Foal)

  • 김준규;문성환;고규련;김재훈
    • 한국임상수의학회지
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    • 제31권2호
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    • pp.159-162
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    • 2014
  • 4개월령 더러브렛 암컷 망아지가 하악 치은의 큰 종괴로 인해 내원하였다. 증식된 종괴는 단단하고 황색 기미의 분홍색을 띠고, 하악 잇몸 전체에 분포하고 있었다. 암망아지는 종괴로 인해 입술을 다물 수 없었고, 방사선상 아래턱의 종괴 음영이 확인되었다. 종괴는 전신마취상태에서 외과적으로 제거되었다. 병리조직학적으로 잇몸 종괴는 증식된 잇몸 상피, 혈관이 발달한 교원성 기질 및 많은 골조직으로 구성되어 있었다. 이와 같은 육안 및 병리조작학적 특징을 토대로 하악 잇몸에서 발생한 골화성 치은종으로 확진되었다. 본 증례는 한국에서 더러브렛 망아지에서 발생한 골화성 치은종의 첫 보고이다.

보철 수복시 치간 유두에 대한 고려 사항

  • 이성복;이승규
    • 대한심미치과학회지
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    • 제10권1호
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    • pp.30-45
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    • 2001
  • In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

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백서 상부 소화기계의 발달 시기별 Telomerase 활성 및 PCNA(proliferating cell nuclear antigen)의 발현 변화 (THE CHANGES OF TELOMERASE ACTIVITY AND PROLIFERATING CELL NUCLEAR ANTIGEN(PCNA) EXPRESSION IN THE DEVELOPMENTAL STAGES OF RAT'S UPPER DIGESTIVE SYSTEM)

  • 성일용;김종렬
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권2호
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    • pp.85-99
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    • 2004
  • Purpose: This study observed the changes in the telomerase activity, it's developmental regulation, PCNA expression, and their correlation in rat's upper digestive organs during growth and aging. Materials and Methods: Upper digestive organs(buccal mucosa, gingiva, palate, submandibular and parotid glands, and tongue) were aseptically removed from Sprague-Dawley rats of fetal(gestational 20 days), growing(1, 2, 3, 5, and 7 weeks after birth) and adult(12 week old). Samples for telomerase activity were frozen on liquid nitrogen immediately after sacrifice, and stored until the use at $-75^{\circ}C$ in order to measure it. Telomerase activity was measured by a PCR-based telomeric repeat amplication protoco(TRAP) assay and quantitated with Photometric Telo TAGGG Telomerase PCR ELISA plus(Roche Diagnostics GmbH. Mannheim. Germany). PCNA expression were measured immunohistochemistry with anti PCNA Ab-1, Clone PC10(NeoMark. California. USA). Results: 1. Telomerase activities in buccal mucosa, palate and gingiva were the highest in fetus and decreased gradually or rapidly after birth and then diminished, but In salivary gland and tongue were the highest in fetus and also high at 1 week and then decreased rapidly. 2. PCNA expression in buccal mucosa, gingiva, Tongue and salivary gland was the highest in fetus and decreased gradually and then diminished. but only in palate decreased rapidly after birth and then diminished. Conclusion: The highest telomerase activity of embryonic stage decreased rapidly after birth in rat's upper digestive organs. There may be a developmental regulation of telomerase activity, but not a tissue-specific. This telomerase activity seems correlated closely with PCNA expression in rat's upper digestive system.

상악 전치부 치은선의 평균치에 관한 연구 (Study of Normative Gingival Proportion in Anterior Maxilla)

  • 정민영;임성빈;정진형
    • Journal of Periodontal and Implant Science
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    • 제34권1호
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    • pp.19-28
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    • 2004
  • Tooth is the most important element in esthetic consideration on facial area. Tooth alignment which is in harmony with gingiva, lips, and face is also key element. The purpose of this study was to give a clinical discipline for restoration of gingival contour, which contains a ratio of maxillary 6 anterior teeth, research for gingival contour etc., in case of rehabilitation of maxillary anterior teeth. 300 Dankook university dental school students ,who is their twenties and free from periodontitis, participate in this study. The result was from each 70 males and females who had normal occlusion and tooth alignment. Length, width and length/width ratio of maxillary 6 anterior teeth were 0.74-0.81 in male, 0.81-0.84 in female. There was significant difference between male and female. The most deepest position of gingiva in maxillary central incisor and canine was located in distal part of teeth and maxillary lateral incisor was middle portion. In maxillary central incisors, gingival line of the most deepest point appeared significant difference between male and female (p<0.01) whereas there was no difference in lateral incisors and canines. Distance between interdental papilla apex and the most deepest portion appeared significant difference between male and female. Distance of the deepest position of gingiva is statistically significant except maxillary central incisors and lateral incisors. Standard deviation and mean of the width of labio-lingual were measured in cervical area and there was a significant difference both male and female.(p<0.01) From this result, we could get the mean of maxillary anterior gingival line and these results have great value in clinical guidance in studying maxillary anterior teeth.

Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

  • Kim, Ha-Young;Shin, Sang-Wan;Lee, Jeong-Yol
    • The Journal of Advanced Prosthodontics
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    • 제6권5호
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    • pp.325-332
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    • 2014
  • PURPOSE. The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS. A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS. Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION. For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.

Tissue engineering of dental pulp on type I collagen

  • Lee, Gwang-Hee;Huh, Sung-Yoon;Park, Sang-Hyuk
    • Restorative Dentistry and Endodontics
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    • 제29권4호
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    • pp.370-377
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    • 2004
  • The purpose of this study was to regenerate human dental pulp tissues similar to native pulp tissues. Using the mixture of type I collagen solution, primary cells collected from the different tissues (pulp, gingiva, and skin) and NIH 3T3 ($1{\;}{\times}{\;}10^5{\;}cells/ml/well$) were cultured at 12-well plate at $37^{\circ}C$ for 14 days. Standardized photographs were taken with digital camera during 14 days and the diameter of the contracted collagen gel matrix was measured and statistically analyzed with student t-test. As one of the pulp tissue engineering, normal human dental pulp tissue and collagen gel matrix cultured with dental pulp cells for 14 days were fixed and stained with Hematoxyline & Eosin. According to this study, the results were as follows: 1. The contraction of collagen gel matrix cultured with pulp cells for 14 days was significantly higher than other fibroblasts (gingiva, skin) (p < 0.05), 2. The diameter of collagen gel matrix cultured with pulp cells was reduced to 70.4% after 7 days, and 57.1% after 14 days. 3. The collagen gel without any cells did not contract, whereas the collagen gel cultured with gingiva and skin showed mild contraction after 14 days (88.1% and 87.6% respectively). 4. The contraction of the collagen gel cultured with NIH 3T3 cells after 14 days was higher than those cultured with gingival and skin fibroblasts, but it was not statistically significant (72.1%, p > 0.05). 5. The collagen gel matrix cultured with pulp cells for 14 days showed similar shape with native pulp tissue without blood vessels. This approach may provide a means of engineering a variety of other oral tissue as well and these cell behaviors may provide information needed to establish pulp tissue engineering protocols.