• International Journal of Oral Biology
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• 제35권1호
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• pp.27-33
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• 2010

Periodontal disease is a major oral disorder and comprises a group of infections that lead to inflammation of the gingiva and the destruction of periodontal tissues. $PPAR{\gamma}$ plays an important role in the regulation of several metabolic pathways and has recently been implicated in inflammatory response pathways. However, its effects on periodontal inflammation have yet to be clarified. In our current study, we evaluated the anti-inflammatory effects of $PPAR{\gamma}$ on periodontal disease. Human gingival fibroblasts (HGFs) treated with lipopolysaccharide (LPS) showed high levels of intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), matrix metalloproteinase-2 (MMP-2), and -9 (MMP-9). Moreover, these cells also showed upregulated activities for extracellular signal regulated kinase (ERK1/2), inducible nitric oxide synthase (iNOS) and cyclooxygnase-2. However, cells treated with Ad/$PPAR{\gamma}$ and rosiglitazone in same culture system showed reduced ICAM-1, VCAM-1, MMP-2, -9 and COX-2. Finally, the anti-inflammatory effects of $PPAR{\gamma}$ appear to be mediated via the suppression of the ERK1/2 pathway and consequent inhibition of NF-kB translocation. Our present findings thus suggest that $PPAR{\gamma}$ indeed has a pivotal role in gingival inflammation and may be a putative molecular target for future therapeutic strategies to control chronic periodontal disease.

• Journal of Oral Medicine and Pain
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• 제20권1호
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• pp.39-52
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• 1995

Burning mouth syndrome is characterized by a burning sensation in oral cavity without clinical signs. There has b een no established theories about the diagnosis and treatment. The purpose of this article is to examine the clinical feature of BMS patients of Korean and to present a treatment protocol that can be helpful in clinical applications. The subjects chosen for the study were 52 patients who had visited Department of Oral Diagnosis at Yonsei University Dental Hospital and were diagnosed as BMS. We did questionnaires and precise oral exam, laboratory exam, grouping of our patients, individual treatment for the groups and classification of responses to the treatment. The following results were obtained: 1. Chief complaints were throbbing (71.2%), pricking, stinging, tingling (30.8%), burning(25a%). The tongue is the most frequently affected site (82.7%), followed by full mouth, gingiva, palate, buccal mucosa, lips, throat, labial mucosa and floor of mouth. 2. The average age of onset was 48.1 year and the male to female ratio was 1 to 3. The average duration of symptom was 11.69 months for male and 23.07 months for female. 3. 32.7% of patients had appealed continuous pain, which was the most cases. Aggravating factors were peppery food, salty food, hot food, fatigue, tension conversation, sour food, cold food and toothpaste. Reducing factors were cold food, diet, going to sleep and smoking. 4. Associated symptoms were dry mouth, other life problem, altered taste perception, bad taste, throat pain, tingle and difficulty in swallowing. 5. Most of patients had appealed that there was not associated event on onset of symptom, and the order of prevalence is as fallow; dental treatment, stress, denture wearing, an attack of a systemic disease. 92.3% of patient appealed that there was no psychological withering and 7.7% of patients appealed positively. 6. There were eight males and four females that had jobs. 7. There was no family history in 100% of patients in questions about presence of family history. 8. 96.2% of patients appealed that there was no oral habits. 13.5% of patients had dryness of oral mucosa in oral exam. A significant relation to dental prosthesis was not observable, but incidence of diseases due to stress appeared high in BMS which had the clinical characteristics as above. A group having low serum iron was 63.5% and in this group period of potential iron deficiency appeared high in incidence just before move to anemia. A group represented positive response was 38.5% in fungus study for Candida albicans. Since we can expect high treatment response by prescription of iron-contained drug and antifungal drug in these patients, diagnosing patients' condition of BMS can be achieved in more various aspects through study for serum iron and Candida albicans. Furthermore, it is expected that treatment protocol can be made.

• Journal of Periodontal and Implant Science
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• 제24권3호
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• pp.661-670
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• 1994

It is well known that the application of dressings after periodontal surgery have benefits to provide the comforts to patient and to promote the healing process with action of bleeding control and temporary stabilization for the operated mobile teeth. But until recently the relationship between periodontal dressings and cells which are composed of periodontium has not been clear. The purpose of this study was to evaluate the cytotoxic effect of soluble extracts from the four different kinds of periodontal dressings, two of them were eugenol type (K.H.pack, Wondrpak) and the others were non-eugenol type (Coe-pak, Periocare), on the human gingival fibroblasts in vitro. Human gingival fibroblasts were primarily cultured from gingiva around third molar during the extraction for preventive purposes. Extracts solution were prepared with culture medium by means of imersing the consistent size of periodontal dressing made from plastic mold. Cell were inoculated into the 24 well plate with $3\;{\times}\;10^4\;cells/well$ of medium at $37\;^{\circ}C$, 100% of humidity, 5% of $CO_2$, incubator for 24 hours. After discard of the supernatant of medium, those cells were cultured with original, 1/2, 1/5, 1/10 diluted soluble extract for 24, 48 and 72 hours, and counted the number of cells using the hemocytometer at each designed time and concentration. Also, the cytotoxic effect of soluble extract was measured by Wataha's MTT assay method. In briefly, cells were inoculated and cultured into 96 well culture plate with $2\;{\times}\;10^4\;cells/well$ for 24 hours. Soluble extracts were applied to cultured cells and incubated for 48 hours at same condition. $50\;{\mu}l$ of MTT solution and DMSO were added into each well for the detection of absorbance with ELISA reader. The measured data were calculated by value of colorimetric assay for survival rate. The results were as follows ; In the case of eugenol type of dressing, original, 1/2 and 1/5 diluted extracts of K.H.pack showed very low survival rate. And original extract of Wondrpak showed strong cytotoxic effect and 1/2 diluted extract showed moderate cytotoxic effect. In the case of Non-eugenol type of dressings, only original extract of Coe-pak revealed strong cytotoxic effect and Periocare had little cytotoxic effect. It is concluded that eugenol type of dressings showed more cytotoxic effect than non-eugenol types. This study suggest that use of non-eugenol dressings after periodontal surgery is recommended.

• Journal of Periodontal and Implant Science
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• 제24권3호
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• pp.597-606
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• 1994

Oxygen derived radicals($O_2\;^-$, $H_2O_2$, and $OH^-$) are thought to play a role in a lot of human diseases. And it has been believed that antioxidant enzymes such as superoxide dismutase(SOD) and catalase could protect the tissues from damage resulting from the oxygen derived free radicals. The purpose of this study was performed to investigate the activity of the SOD(CuZn- and Mn-SOD) and catalase in inflammatory gingival tissues and the correlation between boold glucose level and antioxidants and age in non-insulin dependent diabetes mellitus(NI- DDM) patients. For this study, the patients were classified into normal, inflammatory, and diabetic, and ten their papillary bleeding index(PBI) and gingival index were checked. Subjects consisted of 11 healthy patients with no inflammatroy gingiva, 20 adult periodontitis patients, and 8 diabetic patients, aged 33 to 66(average: 44.62). The blood glucose level of diabetic group was ranged from 120ml/dl to 160ml/dl(physical status 0 : averge : 135.67ml/dl). Gingival tissues were surgically obtained from the patients during periodontal surgery, extraction, and clinical corwn lenghening procedure. The activity of CuZn and Mn- SOD and catalase in the gingival tissues was measured by using UV-spectrophotometer by the same methods that Crapo et al. And Aebi did, respectively. The results were as follows : 1. The Mn-SOD activity was significantly lower in inflammatory group in comparison to normal group(P<0.05), and the activities of antioxidants in diabetic group were not significant in comparison to normal inflammatory group(P>0.05). 2. The activities of antioxidants showed little variation among individuals of different ages (P>0.05). 3. The higher blood glucose level was, the higher gingival index was(P<0.05). 4. There was no correlation between blood glucoe level and activity of antioxidant in inflammatory gingival tissues of NIDDM patients(P>0.05). In conclusion, these results, within the limits of the present experiment, suggest that the activity of Mn-SOD might reflect the inflammatory status of gingival tissue, and the activity of antioxidants was independent of blood glucose level of diabetic patients in physical status 0.

• 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.

• Journal of Periodontal and Implant Science
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• 제33권2호
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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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• 제6권5호
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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.

• 대한치과보철학회지
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• 제52권3호
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• pp.239-245
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• 2014

총의치 보철은 잔존 자연치가 완전히 소실된 환자를 위한 상, 하악의 상실된 관련 구조물과 자연치의 수복을 포함한다. 보철치료의 궁극적인 목적중에 심미적 그리고 기능적인 회복이 포함된다. 최근에는 고령의 환자들에도 심미적인 요구가 크게 증가되고 있기에 총의치 보철치료에 있어서도 이점을 간과해서는 안 된다. 총의치 보철치료에서도 자연 치아와 유사하게 보이기 위해 치아 마모 정도 및 배열, 치경부 치은의 퇴축, 착색, 치은의 색조 개선 등을 표현하려는 다양한 시도들이 이루어져 왔다. 본 61세 여환은 5년 전 개인치과에서 제작한 의치가 부러지고 잘 맞지 않는다는 주소로 본원 보철과 내원하였고 상악 총의치 및 하악의 임플란트 피개의치를 제작하기로 계획하였다. 환자는 기본적인 저작기능의 회복을 고려하고 있었지만, 그보다는 자연스럽고 심미적인 총의치 제작에 최우선 순위를 두고 있었다. 심미적이며 자연스러운 형태를 표현하기 위하여 Aesthetic Color Set Easy system$^{(R)}$ (Candulor dental GmbH, Wangen, Germany)을 활용하여 치은의 다양한 색조를 재현한 총의치를 제작하였다. 보철물 시적이 완료되었고 총의치의 기능적인 면이 회복되었을 뿐만 아니라 환자의 심미적인 요구까지 충족시킬 수 있었다. 적절한 심미적 재료의 선택과 더불어 개개인에 적합한 특성을 잘 표현할 수 있다면 환자와 치과의사 모두에게 만족감을 주는 총의치 보철치료가 가능할 것이라고 생각된다.

• 대한치과보철학회지
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• 제54권4호
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• pp.438-444
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• 2016

상악 전치부의 보철 수복은 치과 영역의 심미 치료에 있어서 매우 중요한 치료이다. 상악 전치부의 보철 수복을 통해 치아의 형태나 배치, 색상 등을 대체함으로써 심미성의 개선이 가능하다. 이러한 치료를 계획할 때, 안모 및 치아와 입술과의 관계 분석, 치아와 치은의 분석 등을 통해 환자마다 개별적인 고려 사항에 대한 접근이 필요하다. 이러한 고려 사항 중 치아 주위 치은 구조를 적절히 형성하는 것은 매우 중요한데, 치은 변연의 높이, 치은 정점의 위치, 치간 유두의 재건, 출현 윤곽, 좌우 측의 대칭성 등을 고려해야 한다. 하지만 치은 구조가 항상 적절히 형성되어 있는 것은 아니기 때문에, 보철 치료 시 비심미적인 치은 구조의 개선을 위한 처치를 계획해야 하는 경우가 많다. 이 증례에서는 치은 외형의 결함으로 인한 비심미성을 개선하기 위해 치료를 시행한 환자들에서 외과적 처치 없이 각각 pink porcelain, 치은 연하 형태의 형성, 가공치 기저부 형태의 조정을 통해 만족할만한 심미적인 결과를 얻었기에 보고하고자 한다.

• 대한소아치과학회지
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• 제33권4호
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• pp.686-692
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• 2006

본 연구는 1998년부터 2004년까지 조선대 소아치과에 내원한 환자 중 상악 중절치와 상악 견치의 편측성 매복으로 진단되어 closed-eruption technique을 이용한 외과적 노출 후 교정 적 견인을 시행하고 치료가 끝난 24명 (상악 중절치 10명, 상악 견치 14명)의 환자를 대상으로 하여 정상적으로 맹출한 인접 및 반대측 치아와 매복치의 치주적인 상태를 비교 분석하여 다음과 같은 결과를 얻었다. 1. 치주적인 평가에서 gingival index와 plaque index, pocket depth와 부착 치은의 비교시 견인을 시행한 상악 중절치, 견치 모두 대조군과 비교하여 유의할 만한 차이가 나타나지 않았다(P>0.05). 2. 상악 중절치의 골지지도 평가에서 근심부간과 윈심부간에 인접 중절치와 비교하여 유의할 만한 차이가 나타났다(P<0.05). 3. 상악 견치의 골지지도 평가시 견인치와 정상 맹출 치아간에 유의차를 보이지 않았다(P>0.05). 이상의 결과를 종합하여 볼 때 임상에서 closed-eruption technique을 이용한 외과적 노출 후 교정적인 견인을 이용한 매복치의 치료가 치은조직의 재생에 긍정적인 영향을 주고, 심미적으로 보다 안정적임을 알 수 있었으며, 상악 중절치 치료 시 견인의 방향과 힘 적용에 있어 정상 치조골의 양상을 유지하는지 관찰하여야 할 것으로 사료된다.