• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.401-420
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• 2001

A novel glucanhydrolase from a mutant of Lipomyces starkeyi(KSM 22)has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrose-dependent adherent microbial film and Lipomyces starkeyi KSM 22 dextranase has been strongly bound to hydroxyapatitie. These in vitro properties of Lipomyces starkeyi KSM 22 dextranase are desirable for its application as a dental plaque control agent. This study was performed to determine oral hygiene benefits and safety of dextranase(Lipomyces starkeyi KSM 22 dextranase)-containing mouthwash in human experimental gingivitis. This 3-week clinical trial was placebo-controlled double-blind design evaluating 1U/ml dextranase mouthwash and 0.12% chlorhexidine mouthwash. A total 39 systemically healthy subjects, who had moderate levels of plaque and gingivitis were included. At baseline, 1, 2 and 3 weeks, subjects were scored for plaque(Silness and $L{\ddot{o}e$ plaque index and plaque severity index), gingivitis($L{\ddot{o}e$ and Silness gingival index), and at baseline and 3 weeks of experiment, subjects were scored for plaque(Turesky-Quingley-Hein's plaque index and plaque severity index), tooth stain(Area and severity index system by Lang et al). Additionally, oral mucosal examinations were performed and subjects questioned for adverse symptoms. Two weeks after pre-experiment examinations and a professional prophylaxis, the subjects provided with allocated mousewash and instructed to use 20-ml volumes for 30s twice dailywithout toothbrushing. All the groups showed significant increase in plaque accumulation since 1 week of experiment. During 3 weeks' period, the dextranase group showed the least increase in plaque accumulation of Silness and $L{\ddot{o}e$ plaque index, compared to the chlorhexidine and placebo groups, but chlorhexidine group showed the least increase inplaque accumulation of Turesky-Quingley-Hein's plaque index. As for gingival inflammation, all the groups showed significant increase during 3 weeks of experiment. The dextranase group also showed the least increase in gingival index score, compared to the chlorhexidine as well as the placebo groups. Whereas the tooth stain was increased significantly in the chlorhexidine group, compared to the baseline score and the placebo group since 3 weeks of mouthrinsing. It was significantly increased after 3 weeks in the dextranase group, still less severe than the chlorhexidine group. As for the oral side effect, the dextranase group showed less tongue accumulation, bad taste, compared to the chlorhexidine group. From these results, mouthrinsing with Lipomyces starkeyi KSM 22 dextranase was comparable to 0.12% chlorhexidine mouthwashin inhibition of plaque accumulation and gingival inflammation and local side effects were if anything less frequent and less intense than chlorhexidine, in human experimental gingivitis. All data had provided positive evidence for Lipomyces starkeyi KSM 22 dextranase as an antiplaque agent and suggested that further development of dextranase formulations for plaque control are warranted.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.371-388
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• 2001

A novel glucanhydrolase(DXAMase) from a mutant of Lipomyces starkeyi(KSM 22) has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrose-dependentadherent microbial film and DXAMase has been strongly bound to hydroxyapatitie. These in vitro properties of Lipomyces starkeyi DXAMase are desirable for its application as a dental plaque control agent. This study was performed to determine the adjunctive oral hygiene benefits and safety of dextranase(Lipomyces starkeyi KSM 22 DXAMase)-containing mouthwash when used alongside normal tooth-brushing. This 6-month clinical trial was placebo-controlled double-blind design evaluating 1U/ml dextranase mouthwash and 0.12% chlorhexidine mouthwash. A total 39 systemically healthy subjects, who had moderate levels of plaque and gingivitis were included. At baseline, 1, 3 and 6 months, subjects were scored for plaque accumulation(Turesky modification of Quingley-Hein's plaque index), gingivitis status($L\ddot{o}e$ and Silness gingival index), and tooth stain(Area and severity index system by Lang et al). Additionally, oral mucosal examinations were performed and subjects questioned for adverse symptoms. Two weeks after pre-experiment examinations and a professional prophylaxis, the subjects provided with allocated mousewash and instructed to use 20-ml volumes for 30s twice daily after toothbrushing. All the groups showed significant increase in plaque accumulation since 1 month of experiment. During 6 months' period, the Dextranase mouthwash group showed the least increase in plaque accumulation, compared to the Chlorhexidine mouthwash and placebo groups. As for gingival inflammation, all the groups showed significant increase during 6 months of experiment. The Experimental group(Dextranase mouthwash) also showed the least increase in gingival index score, compared to the Positive control(Chlorhexidine mouthwash)as well as the Negative control(placebo)groups. Whereas the tooth stain was increased significantly in the Positive control group, compared to the baseline score and the Negative controlgroup since 3 months of mouthrinsing. It was significantly increased after 6 months in the Experimental group, still less severe than the Positive control group. As for the oral side effect, the Experimental group showed less tongue accumulation, bad taste, compared to the Positive control group. From these results, mouthrinsing with Lipomyces starkeyi KSM 22 dextranase provided adjunctive benefits to toothbrushing, comparable to 0.12% chlorhexidine mouthwash in inhibition of plaque accumulation and gingival inflammation and local side effects were if anything less frequent and less intense than chlorhexidine, with long-term use of the mouthwash. All data had provided positive evidence for Lipomyces starkeyi KSM 22 dextranase as an antiplaque agent and suggested that further development of dextranase formulations for plaque control are warranted.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.9 no.2
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• pp.103-106
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• 2013

The lower labial frenum attached to the free gingival margin can promote local tension, resulting in tissue ischemia, promoting the development of gingival recession, as well as complicating oral hygiene, resulting in chronic inflammation. In this case, early diagnosis and surgical treatment is recommended. This is the case about surgical treatment of heavy mandibular labial frenum in pre-school child with a history of syndactyly surgery. A 5-year-old girl visited the clinic with the chief complaint of high labial frenum of the mandible. Hyperplastic lower labial frenum was attached to the free gingival margin on the primary mandibular lateral incisor area. After fifteen month follow-up, right after the eruption of the permanent lower right lateral incisor, 6 years old patient received lower labial frenectomy to prevent periodontal diseases in permanent teeth and to reestablish normal anatomic characteristics. After 2 years of follow-ups, there were no marked complications.

• The Korean Journal of Physiology and Pharmacology
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• v.7 no.4
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• pp.199-205
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• 2003

Osteoblasts are affected by TNF-${\alpha}$ overproduction by immune cells during inflammation. It has been suggested that functional $NF-{\kappa}B$ sites are involved in TNF-${\alpha}$-induced bone resorption. Thus, we explored the effect of pyrrolidine dithiocarbamate (PDTC), which potently blocks the activation of nuclear factor $(NF-{\kappa}B)$, on the induction of TNF-${\alpha}$-induced activation of JNK/SAPK, AP-1, cytochrome c, caspase and apoptosis in MC3T3E1 osteoblasts. Pretreatment of the cells with PDTC blocked TNF-${\alpha}$-induced $NF-{\kappa}B$ activation. TNF-${\alpha}$-induced activation of AP-1, another nuclear transcription factor, was suppressed by PDTC. The activation of c-Jun N-terminal kinase, implicated in the regulation of AP-1, was also down regulated by PDTC. TNF-${\alpha}$-induced apoptosis, release of cytochrome c and subsequent activation of caspase-3 were abolished by PDTC. TNF-${\alpha}$-induced apoptosis was partially blocked by Ac-DEVD-CHO, a caspase-3 inhibitor, suggesting that caspase-3 is involved in TNF-${\alpha}$-mediated signaling through $NF-{\kappa}B$ in MC3T3E1 osteoblasts. Thus, these results demonstrate that PDTC, has an inhibitory effect on TNF-${\alpha}$-mediated activation of JNK/SAPK, AP-1, cytochrome c release and subsequent caspase-3, leading to the inhibition of apoptosis. Our study may contribute to the treatment of TNF-${\alpha}$-associated immune and inflammatory diseases such as rheumatoid arthritis and periodontal diseases.

• Journal of Periodontal and Implant Science
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• v.23 no.1
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• pp.56-66
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• 1993

The Langerhans cells are dendritic nonkeratinocytes found suprabasally in most stratified squamous epithelia, such as human epidermis and the epithelium of the oral mucosa including that of gingiva. After Paul Langerhans found it in the skin in 1968, there have been sturdies of it's function and distribution . Stingle et al. reported that the Langerhans cells seem able to present antigens and to stimulate T-lymphocytes. Shelley et al. discovered that they can take up contact allergens. Accordingly it has been suggested that Langerhans cells are important elements of p Peripheral cell mediated immune system. In this study, the gingival tissue of a adult periodontitis patient was taken and freeze dried. In one specimen, we used the CD1 monoclonal antbody to staining the Langerhans cell. The other specimen, we embedded in paraffin and staining it with S-100 monoclonal antibody. The purpose of this study was to use these specimens to find out the distribution, orientation, morphology of the Langerhans cell and to discover the increase or decrease of Langerhans cell in an increased inflammatory state. The results were obtained as follows : 1. Langerhans cells were distributed between the basal cell layer and spinous cell layer against the CD1 & S-100 monoclonal antibody. 2. Langerhans cessl were plentiful in the oral eptihelium, and there was very little in the sulcular epithelium. 3. There were no Langerhans cell in the junction epithelium and pocket lining epithelium. 4. The number of Langerhans cells that responsed to the CD1 & S-100 monoclonal antibody had a statistically difference. 5. As the infiltration of the lymphocyte into the connective tissue were increased, the number of Langerhans cells in the epithelium were increased. 6. As the inflammation was increased, Langerhans cells in the spinous cell layer were more increased than those of the basal layer.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.397-405
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• 1994

Minocline Strip(MS), a local drug delivery developed as a controlling means for microoragnisms in gingival wound and periodontitis, was implanted in the gingiva of experimental animals. The toxic effects and biodegradation of MS were studied in respect to pathological changes induced in gingival tissue. The experimental animals treated with MS had not showed significant difference in symptom, body weights, feed and water intake, and blood analysis throughout 150 days of experimental period, but revealed significantly increased values of total WBC counts and AST (SGOT) on the 7th day, compared with controls. The treated animals revealed petechial hemorrhage and severe edema accompanying degeneration and necrosis of damaged muscle fibers around the surgical wound, but no local inflammatory reaction and concerned lesions were found. The implanted MS became encapsulated by thin connective tissue, and its size and color diminished gradually according to the experimental term. The MS-like material appeared in the nearby lymphatics on the 110th day. The implated MS remained as fine granular particles or disappeared on the 130th day, and the decrease of its volume and density were variable depending on each individual. These results indicate that long-term implantation of MS may not produce inflammation or toxic effects, and eventually lead to complete biodegradation.

• Journal of Technologic Dentistry
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• v.35 no.1
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• pp.1-17
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• 2013

Purpose: This study was to assess the extents of the release of metals from the non-precious alloys used for dental casting by measuring the differences in the extents of the release of metals by types of alloys, pH level and elapsed time. Methods: Uniform-sized specimens(10 each) were prepared according to the Medical Device Standard of the Korea Food and Drug Administration(2010) and International Standard Organization(ISO22674, 2006), using four types of alloys(one type of Ni-Cr and one type of Co-Cr used for fixed prosthesis, and one type of Ni-Cr and one type of Co-Cr used for removable prosthesis). A total of 12 metal-release tests were performed at one-day, three-day, and two-week intervals, for up to 20 weeks. The metal ions were quantified using an Inductively Coupled Plasma-Atomic Emission Spectrometer. Results: The results showed that the extent of corrosion was higher in the ascending order of Jdium-$100^{(R)}$, Bellabond-$Plus^{(R)}$, Starloy-$C^{(R)}$, and Biosil-$F^{(R)}$. The lower the pH and the longer the elapsed time were, the greater the increase in metal corrosion. At pH 2.4, the release of Ni from Jdium-$100^{(R)}$, a Ni-Cr alloy, was up to 15 times greater than the release of Co from the Co-Cr alloy from two weeks over time, indicating that the Ni-Cr alloy is more susceptible to corrosion than the Co-Cr alloy. Conclusion: It is recommended that Co-Cr alloy, which is highly resistant to corrosion, be used for making dental prosthesis with a non-precious alloy for dental casting, and that non-precious alloy prosthesis be designed in such a way as to minimize the area of its oral exposure. For patients with non-precious alloy prostheses, a test of the presence or absence of periodontal tissue inflammation or allergic reaction around the prosthesis should be performed via regular examination, and education on the good management of the prosthesis is needed.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.187-199
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• 1999

Bone remodeling is characterized by the continuing processes of osteoblast-mediated bone formation and osteoclast-mediated bone resorption. Bone metabolism is tightly regulated at the local level by networks of hormones, cytokines, and other factors. In pathological conditions of bone remodeling, including osteoporosis and periodontal diseases, inflammatory cytokines and local mediators are responsible for enhancement of osteoclast resorption and inhibition of repair at the sites of bone resorption. TNF-${\alpha}$ is a pleiotropic hormone with actions on the differentiation, growth, and functional activities of normal and malignant cells from numerous tissues. TNF-${\alpha}$ has been proposed as a local mediator of the control of bone turnover in situations of chronic inflammation, and it has been assumed that the local source of TNF-${\alpha}$ is the monocyte in the adjacent bone marrow or the local circulation. TNF-${\alpha}$ is a potent inducer of bone resorption. TNF-${\alpha}$ is known to induce the activation of apoptotic signaling pathway, which leads to the apoptosis of bone cells. We demonstrated that treatment of murine osteoblastic MC3T3E1 cells with TNF-${\alpha}$ decreases proliferation as well as alkaline phosphatase (ALP) activity in a dose depenent manner. In addition, TNF-${\alpha}$ increases osteoclast-like cell formation in $1{\alpha}$, 25(OH)2D3 or PGE2-treated bone marrow cell culture. When cells were cultured in TNF-${\alpha}$ free ${\alpha}$-MEM, this inhibitory effect of ALP activity was reversible up to 10 ng/ml TNF-${\alpha}$, in contrast, at the 20 ng/ml TNF-${\alpha}$, irreversible. In this concentration, TNF-${\alpha}$ may induce apoptosis in MC3T3E1 cells. In this study, TNF-${\alpha}$ induces apoptosis resulting in chromosomal DNA fragmentation, preceded by JNK/SAPKs and caspase-3 activation. Our present results show that JNK/SAPKs and caspase-3 are activated by TNF-${\alpha}$, suggesting that the JNK/SAPKs and caspase-3 participate in the bone resorption, associated with apoptosis.

• Journal of Periodontal and Implant Science
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• v.41 no.5
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• pp.234-241
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• 2011

Purpose: One of the most frequent complications related to dental implants is peri-implantitis, and the characteristics of implant surfaces are closely related to the progression and resolution of inflammation. Therefore, a technical modality that can effectively detoxify the implant surface without modification to the surface is needed. The purpose of this study was to evaluate the effect of erbium-doped: yttrium, aluminium and garnet (Er:YAG) laser irradiation on the microstructural changes in double acid-etched implant surfaces according to the laser energy and the application duration. Methods: The implant surface was irradiated using an Er:YAG laser with different application energy levels (100 mJ/pulse, 140 mJ/pulse, and 180 mJ/pulse) and time periods (1 minute, 1.5 minutes, and 2 minutes). We then examined the change in surface roughness value and microstructure. Results: In a scanning electron microscopy evaluation, the double acid-etched implant surface was not altered by Er:YAG laser irradiation under the condition of 100 mJ/pulse at 10 Hz for any of the irradiation times. However, we investigated the reduced sharpness of the specific ridge microstructure that resulted under the 140 mJ/pulse and 180 mJ/pulse conditions. The reduction in sharpness became more severe as laser energy and application duration increased. In the roughness measurement, the double acid-etched implants showed a low roughness value on the valley area before the laser irradiation. Under all experimental conditions, Er:YAG laser irradiation led to a minor decrease in surface roughness, which was not statistically significant. Conclusions: The recommended application settings for Er:YAG laser irradiation on double acid-etched implant surface is less than a 100 mJ/pulse at 10 Hz, and for less than two minutes in order to detoxify the implant surface without causing surface modification.

• Journal of Periodontal and Implant Science
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• v.39 no.sup2
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• pp.239-251
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• 2009

Purpose: Full-mouth disinfection enables to reduce the probability of cross contamination from untreated pockets to treated ones, for completing the entire SRP under local anesthesia with chlorhexidine as a mouth wash in two visits within 24 hours. This study aimed to compare the clinical effects of modified full-mouth disinfection (Fdis) after 6 months with those of conventional SRP (cSRP). Methods: Thirty non-smoking chronic periodontitis subjects were randomly allocated two groups. The Fdis group underwent the entire SRP under local anesthesia in two visits within 24 hours, a week after receiving supragingival scaling. A chlorhexidine (0.1%) solution was used for rinsing and subgingival irrigation for Fdis. The cSRP group received SRP per quadrant under local anesthesia at one-week intervals, one week after they had received scaling. Clinical parameters were recorded at baseline, after 1, 3 and 6 months. Results: There are significant (P<0.05) decreases in the sulcus bleeding index, and plaque index, and the increases in gingival recession were significantly smaller with Fdis after six months compared with cSRP. There was significant improvement in the probing depth and clinical attachment level for initially medium-deep pockets (4-6mm) after Fdis compared with cSRP. Multi-rooted teeth showed significantly larger attachment gain up to six months after Fdis. Single-rooted teeth showed significantly more attachment gain, 1 and 6 months after Fdis. Conclusions: Fdis has more beneficial effects on reducing gingival inflammation, plaque level, probing depth, gingival recession and improving clinical attachment level over cSRP.