• 제목/요약/키워드: localized periodontitis

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조기발병형 치주염의 표현형적 소집단의 IgG Subclass에 대한 연구 (The IgG subclass responses in the phenotypic subsets of the early-onset periodontitis)

  • 최점일
    • Journal of Periodontal and Implant Science
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    • 제29권1호
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    • pp.251-264
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    • 1999
  • 본 연구는 조기발병형 치주염의 서로 다른 4가지 표현형에 있어서 Porphyromonas gingivalis(Pg) 381과 Actinobacillus actinomycetemcomitans(Aa) Y4에 대한 상승된 IgG subclass의 양상을 평가하기 위해 시행하였다. Subform I(distinctive localized juvenile periodontitis pattern)에서 3명 subform II(post juvenile periodontitis pattern)에서 19명, subform III (localized but rapidly progressing pattern)에서 15명, subform IV(distinctive rapidly progressing periodontitis pattern)에서 15명의 환자를 조사하여 Pg에 대한 그들의 total IgG level과 각각의 IgG subclass level 및 Aa에 대한 IgG level을 검사했다. Pg에 대한 total IgG level은 subform II와 IV보다 subform I과 III에서 훨씬 높게 나타났다. IgG3 level이 subform I과 IV사이에서 현저한 차이가 있다는 점을 제외하고는, 다른 IgG subclass level에서 subform 사이에 아무런 차이가 없었다. Pg에 대한 IgG subclass는 single class 혹은 다양한 group에서 상승되어 나타났으며, IgG1+2+4가 가장 흔하게 발견되었고, 다음으로 IgG4 단독, IgG2 단독, IgG2+4, IgG2+3+4의 순으로 발견되었다. IgG2와 IgG4가 빈번히 상승되어 발견되었는데, 특히 severe form(subform III & IV)에서 그러했다. 뿐만 아니라, IgG level은 subform II, III, IV와 일치하여 점차적으로 증가하였고, 반면에 IgG1/IgG4 ratio는 그와 일치하여 감소되었다. 이러한 ratio의 감소는 단백질성의 오래된 항원의 과부하로 인해 immunoglobulin gene의 전환을 가능하게 한다는 것을 나타내고 있다. Aa에 대한 IgG2 level은 다른 유형보다 subform I에서 상당히 높았다. Pg에 대한 IgG2 levels이 subform I의 국소 부위에서 발생하는 disease activity와 밀접한 관련이 있으며, Aa의 경우에는 이러한 관련성이 나타나지 않았다. Pg에 대한 IgG2 level은 18-25세에서 훨씬 높은 동시에 26-35세에서는 감소했으며 결국 30대 후반에서는 더 높은 수치로 되돌아갔다. 이러한 결과는 Pg에 대한 IgG2 및 IgG responsiveness (single 혹은 combined)가 EOP의 severe form의 발달에 중요하게 작용하며 IgG2 levels은 IgG1/IgG4 ratio와 더불어 EOP의 localized type이 generalized type으로 계속 진행하는 것을 조절하는 역할을 하는 것으로 보인다는 것을 강하게 시사하였다.

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조기발병형 치주염의 임상적 및 면역유전학적 연구 (CLINICAL AND IMMUNOGENETIC STUDY ON THE EARLY-ONSET PERIODONTITIS)

  • 김준홍;김성조;최점일
    • Journal of Periodontal and Implant Science
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    • 제25권3호
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    • pp.568-586
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    • 1995
  • 542 periodontal patients having early-onset periodontitis(EOP) have been reclassified into a more homogeneous phenotypic subsets by newly revised radiographic criteria. Representative patients of each EOP subform have been examined of serum IgG subclass antibodies against periodontopathic bacteria, Porphyromonas gingivalis(Pg) 381 and of genetic markers for IgG allotypes to clarify the relationship between these parameters and phenotype expression of each subform. The early onset periodontitis could be reclassified by the radiographic parameters combining the mean interproximal alveolar bone loss(BL) and the radiographic ratio(between 1st molars and the adjacent teeth: Ratio) with statistical significance(p<0.001 by MANOVA). Moreover these EOP subforms could clearly be delineated from adult periodontitis. Of subform I and II(localized type EOP) patients with minimal mean bone loss(BL<5.0), patients demonstrating disease activities in localized areas(Ratio.>1.5) showed the elevated responses in all the IgG subclasses against Pg compared with those of patients without disease activity(Ratio <1.5). There were gradual increase in the IgG2 and IgG4 titers against Pg as the disease developed into the generalized forms suggesting the possible role of these antibodies in modulating the phenotype expression. The genetic marker study for IgG allotype revealed that mean IgG2 and IgG4 subclass titers were significantly higher(p<0.01, p<0.05, respectively) in patients who were positive for G2m(n). This indicated that IgG subclass responsiveness against the bacterial antigens are under the immnuogenetic control. The observed frequencies of G2m(n) were significantly higher (p<0.05) in subfrom IV patients who had the characteristic features of classical rapidly progressing periodontitis indicating the possible genetic predisposition in these patients.

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The clinical assessment of aggressive periodontitis patients

  • Cho, Chan-Myung;You, Hyung-Keun;Jeong, Seong-Nyum
    • Journal of Periodontal and Implant Science
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    • 제41권3호
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    • pp.143-148
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    • 2011
  • Purpose: Few epidemiologic studies have investigated aggressive periodontitis in Koreans, but such studies of disease prevalence and other clinical characteristics would be invaluable in providing proper treatment. The aim of this study was to assess the prevalence of aggressive periodontitis and to measure the extent of associated periodontal breakdown. Methods: The study population consisted of 1,692 patients who visited the Department of Periodontology, Wonkwang Daejeon Dental Hospital from January to December, 2010. Clinical parameters (probing depth, gingival recession, periodontal attachment loss) were measured by a single examiner, and radiographic examination was performed at the baseline. Results: Twenty-eight (1.65%) patients showed clinical features of aggressive periodontitis, of which 27 patients exhibited the generalized form, and 1 exhibited the localized form. There was no significant difference between the percentage of male and female patients. The probing pocket depth of the maxillary first molar was deeper than that of the other teeth and gingival recession was also the most serious at the maxillary first molar. The periodontal attachment loss was the highest at the maxillary first molar. The average number of missing teeth was 1.29 per subject. Loss of the second molar was prominent. Conclusions: Within the limitations of this study, the periodontal breakdown evaluated by attachment loss was found to be most severe at the first molars of aggressive periodontitis patients. However, further large scale multicenter studies are necessary to access more precise data, including prevalence.

제 1, 2 대구치 치근융합의 발생빈도와 분포 및 국소적 치주염과의 관련성 조사 (A study of distribution, prevalence and relationship of the localized periodontitis of first and second molar root fusion)

  • 최병국;홍기석;정진형;임성빈
    • Journal of Periodontal and Implant Science
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    • 제36권2호
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    • pp.503-513
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    • 2006
  • The purpose of this study was to determine the distribution, prevalence and relationship of the localized periodontitis of root fusion in maxillary and mandibular molars. One hundred patients who had eight maxillary and mandibular molars(third molars excluded) were consecutively selected for the study subjects. The subjects provided a total of 800 molars, i. e., 400 maxillary and 400 mandibular molars. A decision about root fusion was made on the radiographic examination. Probing depth, plaque index, gingival index and mobility were measured. The results were as follows. 1. 15.9% of the molars had a fused root. 22% of the maxillary molars and 9.8% of the mandibular molars had a fused molars. 2. In maxillary molars, the results of probing depth, plaque index, gingival index, mobility are more higher in test group than in control group, and there was a significantly difference except plaque index of maxillary first molars group(p<0.01). 3. In mandibular molars, the results of probing depth, plaque index, gingival index, mobility are more higher in test group than in control group, and there was a significantly difference(p<0.01). As a result of this study, it can be concluded that, in management of molars with a root fusion, we should detect the molars through the precise radiographic examination, early periodontal treatment and systematic treatment plan should be chosen. And postoperative continuing supportive periodontal therapy is needed.

치주적 손상을 유발하는 latex-elastic ring의 부적절한 사용에대한 증례보고 (A CASE REPORT ON INADEQUATE USE OF LATEX-ELASTIC RING INDUCING PERIODONTAL DAMAGE)

  • 최병재;최원경;이제호;손흥규
    • 대한소아치과학회지
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    • 제24권3호
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    • pp.597-601
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    • 1997
  • This paper presents improper use of latex-elastic ring in movement of teeth and its consequence. Simple orthodontic movement of teeth including closure of diastema may be achieved by the use of simple method with fixed or removable appliance associated with latex-elastic ring. But, if it is used alone, it acts as a local irritant and then produces localized periodontitis. In case of localized periodontitis resulting from latex-elastic ring, diagnosis is difficult because the patient is usually unaware of the presence of the rings on the roots of the involved teeth and because the ring is not probed and is radiolucent and therefore not discernible radiographically and clinically. Occasionally, surgery is requred for the detection. This case emphasizes the necessity that the use of latex-elastic ring in closing diastema should be accompanied with removable or fixed appliance as well as close professional supervision. Its use without adequate provision for stabilization or retention on the crowns of teeth results in destruction of periodontal support and the teeth may be lost.

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조기발병형 치주염환자의 표현형에 따른 IgG subclass에 따른 면역 유전학적 연구 (Immunogenetic Study on the IgG Subclass Responses in the Phenotypic Subsets of the Early-Onset Periodontitis)

  • 최점일;김준홍;하미혜;김성조
    • Journal of Periodontal and Implant Science
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    • 제29권3호
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    • pp.655-664
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    • 1999
  • 본 논문은 조기발병형 치주염에 이환된 환자의 immunoglobulin allotype markers(Gm)에 대한 연구를 한 것이다. 원래 이전의 논문에서 Porphyromonas gingivalis(Pg)에 대한 항체 역가를 측정하기위해 선택되었던 환자로 이는 subform I(distinctive localized juvenile periodontitis(LIP) pattern)으로부터 3명, subtype II(post-LJP pattern)으로부터 19명, subform III(localized but rapidly progressing pattern)으로부터 15명 그리고 subform Ⅳ(distinctive rapidly pregressing periodontitis(RPP)으로부터 24명을 추출하여 구성하였고, 각각 인종과 나이에 맞게 50명의 대조군을 구성했다. Gm type은 hemagglutination inhibition assay; b0b1b3b5, G3m(s), G3m(t)를 포함한 G1m(a), G1m(x), G1m(f), G2m(n), G3m(g), G3m(b)로 확인했었다. 관찰되어진 Gm haplotypes의 도수는 각각의 EOP subform에 따라 계산되었고 Gm phenotype은 각 환자에서 발견된 증가된 IgG subclass responses의 다양성에 따라 구분했다. 환자들 중에서 관찰된 9개의 Gm phenotype 은 4개의 Gm haplotype으로 나타났다. subform Ⅳ에서 관찰되어진 모든 4개의 Gm haplotype의 도수는 대조군과 유의성있는 차이가 났다. 특히 haplotype afnb(Gm(n))의 그것이 유의성있게 높았다. 더욱이 G2m(n)은 IgG4와 IgG1의 level뿐만 아니라 IgG2 level의 증가와 밀접한 관련이 있었다. Gm phenotype을 검사 할 때 IgG1+2와 IgG1+2+4모두에서 antibody level이 증가한 모든 환자가 일관되게 Gm phenotype agfnb나 axfnb를 가졌다. 결론적으로, IgG subclass response는 개인의 immunogenetic marker에 의해 조절되었고 genetic predisposition의 가능성은 EOP subform IV환자에서 관찰할 수 있었다. 더욱이 G2m(n)과 Gm phenotype agfnb나 axfnb 모두 IgG1+2 나 IgG1+2+4 antibody의 증가와 밀접한 관련이 있었다.

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