• Restorative Dentistry and Endodontics
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• v.20 no.2
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• pp.627-643
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• 1995

The resistance to fracture of the restored tooth may be influenced by many factors, among these are the cavity dimension and the physical properties of the restorative material. The placement of direct composite resin restorations has generally been found to have a strengthening effect on the prepared teeth. It is the purpose of this investigation to study the relationship between the cavity isthmus and the fracture resistance of a tooth in composite resin restorations. In this study, MO cavity was prepared on the maxillary left first molar and then filled with composite resin. Three dimentional model with 3049 nodes and 2450 8-node blick elements was made by the serial photographic method and isthmus (1/4, 1/3, 1/2 and 2/3 of intercusplal distance between mesiobuccal cusp tip and mesiolingual cusp tip) was varied. Two types of model(B and R model) were developed. B model was assumed perfect bonding between the restoration and cavity wall and R model was left unfilled. A load of 1500N was applied vertically on the node from the lingual slope of the mesiobuccal cusp. The results were as follows : 1. There was a significant decrease of stress resulting in increase of fracture resistance in B model when compared with R model. 2. When it comes to stress distribution, the stress was concentrated in the facio-gingival line angle and the buccal side of the distal margin of the cavity in both Band R model. 3. With the increase of the isthmus width, the stress decreased in the area of the facio-gingival line angle, and increased in the area of facio-gingival line angle as well as the buccal side of the distal margin of the cavity in B model. In R model, the stress increased both in the area of facio-gingival line angle and the buccal side of the distal margin of the cavity, therefore the possibility of crack increased. 4. As the width of cavity increased, in B model, the direction of crack moved from horizontal to vertical on the facio-gingival line angle and the facio-pulpal line angle. In R model, the direction of the crack was horizontal on the facio-gingival line angle and moved from horizontal to the $45^{\circ}$ direction on the facio-pulpal line angle.

• Journal of Periodontal and Implant Science
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• v.36 no.4
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• pp.817-827
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• 2006

Purpose : This study was designed 1) to compare the perception of dental professionals and lay people with respect to minor variations in maxillary anterior tooth size and alignment and their relation to the surrounding soft tissues, and 2) to evaluate the normal tooth-gingiva topographical relationships in periodontally healthy young subjects, Materials and methods : Maxillary anterior teeth were intentionally diagrammed in varying degree of deviation with respect to one of three common anterior esthetic discrepancies including variations in crown length, shape of gingival margin, and length of interproximal contact, 17 images were generated to be preferentially selected by 2 groups consisting of dental professionals and lay people (total of 740). Smiling photographs of 120 dental students who had healthy periodontium were taken and the photographic images were analyzed to be classified as 17 kinds of altered image groups. Results : The results demonstrated noticeable difference between the varying levels of discrepancy. Both group preferred gingival margin of lateral incisor to be 0.5mm lower than that of central incisor. Lay people preferred the gingival margin shape that has 2/9 horizontal component of the crown width, while dental professionals preferred the gingival margin shape that has 1/9 horizontal component of the crown width. Lay people preferred longer length of the interproximal contact (two thirds of the crown length), whereas dental professionals preferred shorter length of the interproximal contact (half of the crown length). Photographic analysis of normal esthetic gingival topography revealed 2/9 horizontal component and short length of the interproximal contact which was of the hybrid nature of the preferences shared by lay people and dental professionals. Conclusion: The results of this study show that dental professionals and lay people demonstrated significant difference in their preference of dental esthetic components, which may then influence the decision making process by dental professionals with respect to designing the anterior esthetic gingival line.

• Journal of Periodontal and Implant Science
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• v.39 no.2
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• pp.111-118
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• 2009

Purpose: The integrity of interproximal hard/soft tissue has been widely accepted as the key determinant for success or degree of root coverage following the connective tissue graft. However, we reason that the gingival biotype of an individual, defined as the distance from the interproximal papilla to gingiva margin, may be the key determinant that influence the extent of root coverage regardless of traditional classification of gingival recession. Hence, the present study was performed with an aim to verify that individual gingival scalloping pattern inherent from biotype influence the level of gingival margin following the connective tissue graft for root coverage. Methods: Test group consisted of 43 single-rooted teeth from 21 patients (5 male and 16 female patients, mean age: 36.6 years) with varying degrees of gingival recession requiring connective tissue graft; 20 teeth of Miller class I and 23 teeth of Miller class III gingival recession, respectively. The control group consisted of contralateral teeth which did not demonstrate apparent gingival recession, and thus not requiring root coverage. For a biotype determination, an imaginary line connecting two adjacent papillae of a test tooth was drawn. The distance from this line to gingival margin at mid-buccal point and this distance (P-M distance) was designated as "gingival biotype" for a given individual. The distance was measured at baseline and 3 to 6 months examinations postoperatively both in test and control groups. The differences in the distance between Miller class I and III were subject to statistical analysis by using Student.s t-test while those between the test and control groups within a given patient were by using paired t-test. Results: The P-M distance at 3 to 6 months postoperatively was not significantly different between Miller class I and Miller class III. It was not significantly different between the test and control group in a given patient, either, both in Miller class I and III. Conclusions: The amount of root coverage following the connective tissue graft was not dependent on Miller's classification, but rather was dependent on P-M distance, strongly implying that the gingival biotype of a given patient may play a critical impact on the level of gingival margin following connective tissue graft.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.1
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• pp.41-50
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• 2011

The gingival zenith is the most apical point of the gingival outline. This study aimed to quantify the mesio-distal and apico-coronal displacements of gingival zenith in maxillary anterior dentition. 50 healthy patients, who ranged in age from 25 to 36 years were recruited for the study. Alginate impressions of the study group were made and poured with the type III stone. The gingival zenith positions of maxillary anterior teeth were measured in a mesial-lateral direction from the vertical bisected midline. The apico-coronal displacements of the gingival zenith of lateral incisors were measured from a line joining the gingival zeniths of the central incisor and canine. The gingival zeniths were distally displaced in 90%, 53% and 23% of the maxillary cetral incisors, lateral incisors and canines respectively. The mean distal displacements of the gingival zeniths to the vertical bisected midline of central incisors, lateral incisors and canines were 0.90 mm, 0.29 mm and 0.06 mm respectively. The gingival zeniths of lateral incisors were positioned $0.73{\pm}0.43$ mm coronally to the line joining the gingival zenith of central incisors and canines. Consideration of these findings may improve restorative procedures in the anterior maxillary dentition.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.53-65
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• 1995

The growth and synthetic activities of fibroblasts are regulated by cytokines and growth factors derived from activated inflammatory cells. Stimulatory effect of low level laser (LLL) radiation on wound healing seems to be in part due to direct stimulatory action on cell proliferation and synthetic activities of fibroblasts. Also indirect stimulatory effect on the fibroblast function through inflammatory or immune cells is another possible mechanism of biostimulatory action of LLL. This study was performed to determine the growth rate of human gingival fibroblasts obtained biopsy and culture, fibroblast cell line, and immune cell line by using $[^3H]-$ thymidine incorporation test. And gene expression pattern was also analyzed by using the DNA probe such as Hsp70, IL-1$\beta$, MIP-1$\alpha$ and actin cDNA. Proliferation rate of gingival fibroblast was increased by LLL irradiation, but no more effect was added by LPS or IL-1$\beta$ pretreatment Enhanced Hsp70 gene expression was found from gingival fibroblasts and fibroblast cell line COS by LLL irradiation., which was not more increased by LPS or IL-1$\beta$ pretreatment. LLL-irradiated promyelcytic cell line HL-60 and macrophage cell line RAW264.7 showed significant stimulatory effect of proliferation rate when compared with respective control. However there were no changes in growth rate of other immune cell tested in this study, such as B cell line WR19n.l and 230, helper T cell line Jurkat and Hut78, cytolytic T cell line CTLL-r8. By LLL-irradiation Hsp70 gene expression was increased in RAW246.7 and HL-60, not in CTLL-R8. And IL-1$\beta$ and MIP-1$\alpha$ gene expression were induced only from LLL-irradiated RAW264.7. These results led us to presume that LLL radiation may affect to the immune cells, especially to macrophage, through which it might promote wound healing process.

• Journal of Periodontal and Implant Science
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• v.51 no.2
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• pp.88-99
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• 2021

Purpose: Direct intraoral scanning and superimposing methods have recently been applied to measure the dimensions of periodontal tissues. The aim of this study was to analyze various correlations between labial gingival thickness and underlying alveolar bone thickness, as well as clinical parameters among 3 tooth types (central incisors, lateral incisors, and canines) using a digital method. Methods: In 20 periodontally healthy subjects, cone-beam computed tomography images and intraoral scanned files were obtained. Measurements of labial alveolar bone and gingival thickness at the central incisors, lateral incisors, and canines were performed at points 0-5 mm from the alveolar crest on the superimposed images. Clinical parameters including the crown width/crown length ratio, keratinized gingival width, gingival scallop, and transparency of the periodontal probe through the gingival sulcus were examined. Results: Gingival thickness at the alveolar crest level was positively correlated with the thickness of the alveolar bone plate (P<0.05). The central incisors revealed a strong correlation between labial alveolar bone thickness at 1 and 2 mm, respectively, inferior to the alveolar crest and the thickness of the gingiva at the alveolar crest line (G0), whereas G0 and labial bone thickness at every level were positively correlated in the lateral incisors and canines. No significant correlations were found between clinical parameters and hard or soft tissue thickness. Conclusions: Gingival thickness at the alveolar crest level revealed a positive correlation with labial alveolar bone thickness, although this correlation at identical depth levels was not significant. Gingival thickness, at or under the alveolar crest level, was not associated with the clinical parameters of the gingival features, such as the crown form, gingival scallop, or keratinized gingival width.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.5
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• pp.640-655
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• 2003

Statement of problem : The beauty has a little different meaning according to a time, culture, and nation. Purpose : This study was undertaken to determine the Korean perception of the altered upper anterior dental esthetics including the lack of symmetry, the midline deviation, the gingival exposure, the inclination of incisal plane, the type of incisal plane, and the type of gingival line. Material and Method : 670 subjects were participated in this survey. A questionnaire accompanied by 12 sets of computer-manipulated images using 3D MAX 4.2 software was used to record the ranking of the geometric preference related to the anterior esthetic discrepancies in three or four degrees of alteration. The statistical significance of the differences between the groups was determined by a one-way ANOVA and a t-test. Results : The results obtained were as follows: 1) The Korean perception of the anterior dental esthetics according to the subjects' occupation, sex, and age was most affected by occupation. 2) The masked image emphasizing the dentition and lips appeared stranger than the non-masked image at the same alteration. 3) The lack of symmetry, which was expressed as a unilateral discoloration of the tooth, showed incongruity in any teeth of the anterior dentition. The incongruity was more severe as the degree occurred closer to the midline. 4) The deviation of midline was showed more severe strangeness as the degree of deviation increased. However, more than half of the subjects did not perceive a deviation of 5mm. 5) During smiling, the exposure of the upper gingiva showed more severe incongruity as the degree of gingival exposure increased. 77% of the subjects perceived strangeness at the gingival exposure of 4.5mm. 6) The inclination of the incisal plane appeared stranger as the degree of inclination increased. 62% of subjects perceived strangeness at the $7.5^{\circ}$ inclination of the incisal plane. 7) The type of incisal plane showed increasing strangeness in the order of convex/downward, straight/horizontal, and concave/upward. 80% of subjects perceived strangeness at concave/upward. 8) The type of gingival line was showed increasing incongruity in the order of the same, a little above, and a little under the zenith of the lateral incisor to the line joining the zenith of the central incisor and the canine. However, less than half the subjects did not perceive strangeness at any alteration of the gingival line. Conclusion : The Korean perception of the upper anterior dental esthetics was different to the westerner's perception in the some respects.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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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.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.61-69
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• 2019

Purpose : Human gingival fibroblast cell is one of the the main cell types in periodontal tissue, which they can show anti-inflammatory activity through the production of numerous lines of inflammatory mediators such as inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-2 and interleukins. Porphyromonas gingivalis, one of the oral pathogens, has reported to play a critical role in the development of periodontal diseases. This study aimed to investigate anti-inflammatory and antioxidative activities of Gracilaria textorii ethanol extract (GTEE) in P. gingivalis derived lipopolysaccharide (LPS-PG) stimulated human gingival fibroblast (HGF)-1 cell line. Methods : In order to analyze anti-inflammatory and antioxidative activities of GTEE in HGF-1 cell line, NOS enzyme activity, expression levels of iNOS, COX-2, NAD(P)H quinone dehydrogenase (NQO)1 and their transcription factors were estimated by Griess reaction and western hybridization. Results : LPS-PG induced overexpression of iNOS and COX-2, which was significantly attenuated by GTEE treatment in a dose-dependent manner without any cytotoxicity. In addition, intracellular NOS activity was in accordance with the result of iNOS expression. Due to important role in the regulation of inflammatory responses, phosphorylated status of p65 and c-jun, each subunit of nuclear factor (NF)-κB and activator protein (AP)-1, was also dose-dependently ameliorated by GTEE treatment. One of phase II enzymes, NQO1, and its transcription factor, nuclear factor erythroid 2-related factor 2 (Nrf2), were analyzed since elevated phase II enzyme expression inhibited inflammatory response, which was significantly elevated by GTEE treatment in HGF-1 cell line. Conclusion : In conclusion, GTEE mitigated LPS-PG-stimulated inflammatory responses by attenuating NF-κB and AP-1 activation as well as accelerating NQO1 and Nrf2 expression in HGF-1 cell line. These results indicate that GTEE might be utilized a promising strategy for potential anti-inflammatory agent in periodontal diseases.

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.603-614
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• 2002

Human gingival fibroblasts have proven to useful as a species specific cell culture system in various system on periodontal disease and regeneration. However, their use is limited, since they are hard to obtain and lifespan is short due to replicative senescence. To overcome these disadvantages, we transfected primary human gingival fibroblasts by the E6 and E7 genes of the Human papilloma virus(HPV) 16. The full length of HPV 16 E6 and E7 was cloned from the pBR322 into BamHl and Sal I of a pBabe vector including hygromycin B resistance. Before pBabeE6/E7 plasmid transfection, peak 8 GFP including G418 resistance was transfected into primary GF to check the transfection efficency. PBabe E6/E7 plasmid was transfected using Lipofectamine plus following manufacter's instruction into primary normal human gingival fibroblasts in 60mm dishes with FBS free DMEM. After 2 days of transfection, the cells were treated with hygromycin for 2 weeks until the transfected control cells died. The resulting hygromycin resistant colonies were pooled, and clonned, and sucessful　transfection was established for immortalized gingival fibroblast cell lines. Immoralized GF cells showed stellate shape, that is similar to that of orange grains, and more rapid growth and higher proliferation than that of primary gingival fibroblasts. This cell lines overcame crisis and could be cultured over 30 subcultured, could be use for three dimentional culture, epithelial-mesenchymal interaction study.