• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.27-37
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• 2006

Although the main purpose of periodontal treatment to regenerate is the complete regeneration of periodontal tissue due to periodontal disease, most of the treatment cannot meet such purpose because healing by long epithelial junction. Therefore, diverse materials of resorbable and non-resorbable have been used to regenerate the periodontal tissue. Due to high risk of exposure and necessity of secondary surgical procedure when using non-resorbable membrane, guided tissue regeneration using the resorbable membrane has gain popularity, recently. However, present resorbable membrane has the disadvantage of not having sufficient time to regenerate date to the difference of resorption rate according to surgical site. Meanwhile, other than the structure stability and facile manipulation, acellular dermal matrix has been reported to be a possible scaffold for cellular proliferation due to rapid revascularization and favorable physical properties for cellular attachment and proliferation. The purpose of this study is to estimate the influence of acellular dermal matrix on periodontal ligament, cementum and alveolar bone when acellular dermal matrix is implanted to 1-wall alveolar bone defect. 4 dogs of 12 to 16 month old irrelevant to sex , which below 15Kg of body weight, has been used in this study. ADM has been used for the material of guided tissue regeneration. The 3rd premolar of the lower jaw was extracted bilaterally and awaited for self-healing. subsequently buccal and lingual flap was elevated to form one wall intrabony defect with the depth and width of 4mm on the distal surface of 2nd premolar and the mesial surface of 4th premolar. After the removal of periodontal ligament by root planing. notch was formed on the basal position. Following the root surface treatment, while the control group had the flap sutured without any treatment on surgically induced intrabony defect. Following the root surface treatment, the flap of intrabony defect was sutured with the ADM inserted while the control group sutured without any insertion. The histologic specimen was observed after 4 and 8 weeks of treatment. The control group was partially regenerated by periodontal ligament, new cementum and new alveolar bone. the level of regeneration is not reached on the previous formed notch. but, experimental group was fully regenerated by functionally oriented periodontal ligament fiber. new cementum and new alveolar bone. In conclusion, we think that ADM seems to be used by scaffold for periodontal ligament cells and the matrix is expected to use on guided tissue regeneration.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.125-131
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• 2011

Optimal treatment of the torn posterior cruciate ligament (PCL) remains controversial. The type of tibial fixation (transtibial vs inlay), the femoral tunnel position within the femoral footprint (central, eccentric or isometric), and the number of bundles in the reconstruction (single-bundle vs double-bundle) are controversial issues. The PCL has a better chance of spontaneously healing than the anterior cruciate ligament (ACL) because of a rich blood supply (near the branch of the middle genicular artery) and coverage with a thicker synovium. In general, for easier passage of the graft and full visualization of the original ligament attachment site during the precise positioning of the tunnel, the remaining PCL fibers are usually debrided during reconstruction. However, the remaining remnant structures would significantly contribute to the posterior stability of the knee joint, the healing of the graft, preserving proprioceptive function of the mechanoreceptors in the PCL. Double bundle PCL reconstruction may result in some surgical complications because of increased complexity of making tunnel. Therefore, single bundle PCL reconstruction with remnant preservation seems to be an effective procedure.

• Journal of Periodontal and Implant Science
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• v.28 no.1
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• pp.133-143
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• 1998

Diabetes mellitus is a systemic disease with profound effects on oral health and periodontal wound healing. Uncontrolled diabetes adversely affects surgical wound healing and is often associated with abnormal proliferation of fibroblasts. Human gingival fibroblasts and PDL cells were chosen because they are intimately involved in periodontal therapy and are important for the success of surgical procedure such as guided tissue regeneration. The aim of the present study was to elucidate whether cellular activity and collagen synthesis by glucose pre-treated human gingival fibroblasts and PDL cells are influenced by insulin, and whether healthy cells differ from glucose treated cells. Cells were cultured with DMEM at $37^{\circ}C$, 5% $CO_2$, 100% humidified incubator. To evaluate the effect of glucose on gingival fibroblasts and periodontal ligament cells, the cells were seeded at a cell density of $1{\times}10^4\;cells/well$ culture plates and treated with 20 and 50mM of glucose for 5 days. Then MTT assay was carried out. To evaluate the effect of insulin on glucose-pretreated cells, the cells were seeded at a cell density of $1{\times}10^4\;cells/well$ culture plates and treated with 20 and 50mM of glucose for 5 days. After incubation, $10^3$, $10^4$ and $10^5mU/l$ of insulin were also added to the each well and incubated for 2 days, respectively. Then, MTT assay and collagen synthesis assay were carried out. The results indicate that cellular activity of gingival fibroblasts significantly increased by glucose while periodontal ligament cells were unaffected and cellular activity of gingival fibroblasts and periodontal ligament cells were unaffected by insulin. Collagen synthesis of gingival fibroblast with 20mM glucose and insulin unaffected, but 50mM glucose and insulin increased than control. Collagen synthesis of periodontal ligament cell with 20mM glucose and $10^5mU/l$ insulin significantly increased than other groups and 50mM glucose pretreated PDL cells significantly increased at $10^3mU/l$ insulin but decreased at $10^4mU/l$ insulin. Our findings indicated that these cell types differed in their growth response to glucose, and the increase in collagen synthesis was significantly raised at insulin level of $10^3mU/l$ in gingival fibroblasts and periodontal ligament cells except 20mM glucose pretreated periodontal ligament cells.

• Journal of Periodontal and Implant Science
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• v.25 no.3
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• pp.623-634
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• 1995

Periodontitis is characterized by gingival inflammation and results in periodontal pocket formation with loss of the supporting alveolar bone and connective tissue around the teeth. Therapeutic modalities should therefore aim not only at eliminating the gingival inflammatory process and preventing the progression of periodontal disease but also at reestablishing and regenerating the periodontal tissue previously lost to the disease. To achieve periodontal regeneration, progenitor cells must migrate to the denuded root surface, attach to it, proliferate and mature into an organized and functional fibrous attachment apparatus. Likewise, progenitor bone cells must also migrate, proliferate, and mature in conjunction with the regenerating periodontal ligament. Significant advances have been made during the last decade in understanding the factors controlling the migration, attachment and proliferation of cells. A group of naturally occuring molecules known as polypeptide growth factors in conjunction with certain matrix proteins are key regulators of these biological events. Of these, the fibroblast growth factor(FGF), platelet-derived growth factor(PDGF) , insulin like growth factor(CIGFs), transforming growth factor(TGFs), epidermal growth factor(EGF) and bone morphogenetic growth factor(BMPs) apper to have an important role in periodontal wound healing. The purpose of this study was to determine the effects of BMP on periodontal ligament cells. Human periodontal ligament cells were cultured from extracted tooth for non-periodontal reason. Cultured periodontal ligament cells were treated with BMP. Cellular activities were determined by MTT(3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) assay and ALP(alkaline phosphatase) activity. The results were as follows ; Regardless of cultured time, cellular activities were stimulated by BMP. Also, BMP greatly increased alkaline phosphatase(ALP) in periodontal ligament cells. These results suggest that BMP not only have no cytotoxic effect on periodontal ligament cells, but also have osteogenic stimulatory effect on periodontal ligament cells.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.188-201
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• 1996

One of the initial events required for periodontal regeneration is the attachment, spreading and proliferation of fibroblasts at the healing sites. These have been reported that minocycline stimulates the attachment of gingival fibroblasts and periodontal ligament cells and $TGF-{\beta}1$ enhances the proliferation of periodontal ligament cells. The purpose of this study was to evaluate and confirm the effect of minocycline and $TGF-{\beta}1$ on human gingival fibroblasts and periodontal ligament cells. That gingival fibroblasts and periodontal ligament cells used in this study were obtained from the explants of healthy periodontal ligaments and gingival tissues of extracted 3rd molars or premolar teeth extracted from the patients with orthodontic treatment. The cells were cultured in ${\alpha}-MEM$(minimal essential medium) supplemented with antibiotics and FBS(fetal bovine serum) at $37^{\circ}C$ in a humidified atmosphere of 5% carbon dioxide-95% air. Cells were used between the 5th to 8th passage in this study. The attachment and activity of both cells were evaluated by MTT assay. The results were as follows: 1. Maximum gingival fibroblast attachment was seen at a $50{\mu}g/ml$ dose of minocycline, while maximum periodontal ligament cell attachment was seen at a $100{\mu}g/ml$, and exposure of both cells to minocycline above maximal attachment dose results in a decline from maximum attachment. 2. The activity values of both cells tested minocycline were below to the control activity values at all concentrations. 3. The attachment values of both cells tested $TGF-{\beta}1$ were below or similar to control attachment values. On the above the findings, minocycline stimulated the cell attachment of gingival fibroblasts and periodontal ligament cells and $TGF-{\beta}1$ enhances the cell activity of periodontal ligament cells.

• Journal of Periodontal and Implant Science
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• v.25 no.2
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• pp.438-457
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• 1995

The origin of fibroblasts, their proliferative activity and roles in the early stages of periodontal regeneration were investigated in order to better understand the periodontal healing process in furcation defects of the beagle dog after guided tissue regeneration. Newly divided cells were identified and quantitated by immunolocalization of bromodeoxyuridine (BrdU) injected 1 hour prior to sacrificing the animals. The results were as follows :1. During periodontal healing in horizontal furcation defect, three different stages, namely the granulation tissue, connective tissue, and bone formation stages, were identified on the basis of major types of cells and tissue. 2. In the early stages of periodontal regeneration, both the remaining periodontal ligament and alveolar bone compartment were the major sources. 3. The majority of BrdU-labeled fibroblasts were located at the following areas ; 1) the coronal zone of the defect in case of the connective tissue fanned on the root surface. 2) the area within an 400 ${\mu}m$ distance from the remaining bone level in case of the periodontal ligament. 3) the area within an 100 ${\mu}m$ distance from the bone surface in case of areas of active bone formation.4. The highly proliferative fibroblasts adjacent to bone surface played a major role in the formation of osteoblast precursor cells, whereas both paravascular and endosteal cells played a minor role in new bone formation, In conclusion, it was suggested that the fibroblasts in the remaining periodontal ligament and bone will play a major role in periodontal regeneration, whereas both paravascular and endosteal cells will play a minor role in new bone formation.

• Knee surgery & related research
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• v.30 no.4
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• pp.275-283
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• 2018

Purpose: To compare the clinical outcomes between the open posterior approach and arthroscopic suture fixation for displaced posterior cruciate ligament (PCL) avulsion fractures. Methods: A literature search was performed on MEDLINE, EMBASE, and the Cochrane Library databases. The inclusion criteria were as follows: papers written in English on displaced PCL avulsion fractures, clinical trial(s) with clear description of surgical technique, adult subjects, a follow-up longer than 12 months and modified Coleman methodology score (CMS) more than 60 points. Results: Twelve studies were included with a mean CMS value of 72.4 (standard deviation, 7.6). Overall, 134 patients underwent the open posterior approach with a minimum 12-month follow-up, and 174 patients underwent arthroscopic suture fixation. At final follow-up, the range of Lysholm score was 85-100 for the open approach and 80-100 for the arthroscopic approach. Patients who were rated as normal or nearly normal in the International Knee Documentation Committee subjective knee assessment were 92%-100% for the open approach and 90%-100% for the arthroscopic approach. The range of side-to-side difference was 0-5 mm for both approaches. Conclusions: Both arthroscopic and open methods for the treatment of PCL tibial-side avulsion injuries resulted in comparably good clinical outcomes, radiological healing, and stable knees.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.15-19
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• 2003

Although the number of anterior cruciate ligament reconstruction is increasing, complications after primary ACL reconstruction are more difficult to determine. Intraoperative and postoperative complications can lead to ultimate failure of a primary reconstructive procedure. Therefore, surgical success in ACL reconstruction requires detailed knowledge and technical advancements about ACL reconstruction. Preoperatively surgeon must pay attention to selection of grafts and methods of fixation, and intraoperatively, attention to the harvest of graft, passage of graft, intraarticuar placement of the graft, notchplasty, proper tensioning of the graft, and others. Postoperative complications must be detected early, including infection, abnormal healing responses, arthrofibrosis, graft rejection, and reflex sympathetic dystrophy. Careful patient selection, appropriate surgical timing, careful surgical technique, and supervised preoperative and postoperative rehabilitation can minimize postoperative complications.

• Restorative Dentistry and Endodontics
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• v.24 no.2
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• pp.426-429
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• 1999

When the tooth avulsion occur in accidents the drying damage to the periodontal ligament has extremely detrimental effects on healing. Pulp necrosis always occurs after an avulsion injury, but revascularization can only take place in teeth with immature apexes. Therefore complications after avulsion injuries are common, and treatment must be carried out in a timely and correct fashion to prevent or limit these complications. Every effort should be made to replant the tooth within the first 15 to 20 minutes. If doubt exists that the tooth can be replanted adequately, the tooth should quickly be stored in an appropriate medium until the patient can get to the dental office for replantation. A complication of inflammatory root resorption is occurred by bacterial infection of periodontal ligament and dental pulp. Therefore aseptic endodontic treatment must be carried out in a timely and systemic antibiotics given at the time of replantation and before endodontic treatment are effective in preventing bacterial invasion. Further studies are needed to establish the clinical importance of preparation of the socket and root.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.841-858
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• 1996

Epidermal growth factor(EGF) is one of polypeptide growth factors. EGF has been reported as a biological mediator which regulates activities of wound healing process including the cell proliferation, migration and metabolism. The purposes of this study is to evaluate the effects of EGF on the human periodontal ligament cells and human gingival fibroblast cells that promote regeneration of periodntal tissue. The mitogenic effects of epidermal growth factor on human periodontal ligament cells and human gingival fibroblasts were evaluated by determining the incorporation of 5-Bromo-2'-deoxy-uridine into DNA of the cells in a dose dependent manner. The prepared cells were the primary cultured gingival fibroblast and periodontal ligament cells from humans, the fourth or sixth subpassages were used in the experiments. Cells were seeded in DMEM containing 10% FBS. 1, 10, 50, 100, $200{\eta}g/ml$ and epidermal growth factor were added to the quiescent cells for 24 hours, 48 hours and 72 hours. They were labeled with $10\{mu}l/200{\mu}l$ 5-Bromo-2'-deoxy-uridine for the last 6 hours of each culture. The results of the five determinants were presented as mean and S.D.. The results were as follows : The DNA synthetic activity of human gingival fibroblasts were increased dose dependently by epidermal growth factor at 24 hours, 48 hours and 72 hours. The mitogenic effects were similar at the 24 and 48 hours of epidermal growth factor, but the DNA synthetic activity of human gingival fibroblasts generally decreased at 72 hours. The DNA synthetic activity of human periodontal ligament cells were increased dose dependently by epidermal growth factor at 24 hours but the DNA synthetic activity decreased at $200{\eta}g/ml$ of each hour. Generally the maximum mitogenic effects were observed at the 48 hours application of epidermal growth factor. The DNA synthetic activity of human periodontal ligament cells generally decreased lower at 24, 72 hours than at 48 hours the application of epidermal growth factor. In the comparison of DNA synthetic activity between human gingival fibroblasts and human periodontal ligament cells, human periodontal ligament cells had slightly higher proliferation activity than human gingival fibroblasts for a longer time at the high dosage of the epidermal growth factor. In conclusion, epidermal growth factor have important roles in the stimulation of DNA synthesis in human periodontal ligament cells and human gingival fibroblasts, and thus may be useful for clinical applications in periodontal regenerative procedures.