Platelet-derived growth factor(PDGF) and lipopolysaccharide(LPS) may be the important regualtors of bone metabolism Exogenous PDGF is recognized to have a stimulating effect on bone resorption in organ culture but to stimulate the formation of new bone ultimately. LPS is known to be a stimulating agent on the osteoclastic activity. The purpose of this study was to evaluate the effects and the interaction of PDGF and LPS on periodontal ligament(PDL) cells which have important roles in bone remodeling. Cultured human periodontal ligament cells were tented with various concentration or PDGF and/or LPS. The cellular viability was measured by Microtitration(MTT) assay according to the lapse time of culture. The obtained results were as follows: 1. The viability of PDL cells was not different from the con01 in 0.1ng/ml of PDGF, but was significantly increased to be over the level of control in 1ng/ml of PDGF at the second day of culture, and in 10ng/m1 of PDGF at the second and the third day of culture. 2. The cellular viability was decreased in $0.5{\mu}g/ml$ or $5{\mu}g/ml$ LPS at the third day of culture. 3. Incubation with both 1ng/ml or 10ng/ml of PDGF and $0.5{\mu}g/ml$ of $5{\mu}g/ml$ of LPS resulted in the increased cellular viability at the third day, which was greater than LPS only treated group. It was greater than even the control group in 10ng/m1 of PDGF. From the above findings, we could summarize that the admixture of PDGF and LPS could not less increase the viability of the human periodontal ligament cells than PDGF only.
Bone is a complex tissue in which resorption and formation continue throughout life. The bone tissue contains various types of cells, of which the bone forming osteoblasts and bone resorbing osteoclasts are mainly responsible for bone remodeling. Periodontal disease represents example of abnormal bone remodeling. Osteoclasts are multinucleated cells present only in bone. It is believed that osteoclast progenitors are hematopoietic origin, and they are recruited from hematopoietic tissues such as bone marrow and circulating blood to bone. Cells present in the osteoclast microenvironment include marrow stromal cells, osteoblasts, macrophages, T-lymphocytes, and marrow cells. These cells produce cytokines that can affect osteoclast formation. In vitro model systems using bone marrow cultures have demonstrated that $IL-l{\beta},\;IL-3,\;TNF-{\alpha},$ bFGF can stimulate the formation of osteoclasts. In contrast, IL-4 inhibits osteoclast formation. Knowledge of cytokines and bFGF that affect osteoclast formation and their capacity to modulate the bone-resorbing process should provide critical insights into normal calcium homeostasis and disorders of bone turnover such as periodontal disease, osteoporosis and Paget's disease.
An oral environment is constantly exposed to environmental factors and microorganisms. The periodontal ligament (PDL) fibroblasts within this environment are subject to bacterial infection and allergic reaction. However, how these condition affect PDL fibroblasts has yet to be elucidated. PDL fibroblasts were isolated from healthy donors. We examined using reverse transcription-polymerase chain reaction and measuring the intracellular $Ca^{2+}$ concentration ($[Ca^{2+}]_i$). This study investigated the receptors activated by exogenous bacterial pathogens (Lipopolysaccharide and peptidoglycan) and allergens (German cockroach extract and house dust mite) as well as these pathogenic mediators-induced effects on the intracellular $Ca^{2+}$ signaling in human PDL fibroblasts. Moreover, we evaluated the expression of pro-inflammatory cytokines (interleukin (IL)-$1{\beta}$, IL-6, and IL-8) and bone remodeling mediators (receptor activator of NF-${\kappa}B$ ligand and osteoprotegerin) and intracellular $Ca^{2+}$-involved effect. Bacterial pathogens and allergic mediators induced increased expression of pro-inflammatory cytokines, and these results are dependent on intracellular $Ca^{2+}$. However, bacterial pathogens and allergic mediators did not lead to increased expression of bone remodeling mediators, except lipopolysaccharide-induced effect on receptor activator of NF-${\kappa}B$ ligand expression. These experiments provide evidence that a pathogens and allergens-induced increase in $[Ca^{2+}]_i$ affects the inflammatory response in human PDL fibroblasts.
In many cases of orthodontic treatment the upper anterior teeth are retracted. Periodontal problems may arise during incisor retraction, if the amount of tooth movement and the amount of remodeling in the anterior cortical bone are not the same. Therefore in this study, to find out the relationship between the amount of tooth movement and the amount of bone remodeling during retraction of the upper anterior teeth, lateral cephalograms of 56 female patients over 18-year-old were taken before and after treatment. Among the 56 patients, two groups were divided according to the type of root movement during retraction. 26 patients mainly moved by tipping and 30 by bodily movement. The cephalograms taken before and after treatment were superimposed upon the true horizontal plane. In the Tip-Group, the horizontal bone remodeling/tooth movement ratio was 1:1.63, and in the Torque-Group it was 1:1.66. Because the amount of tooth movement and the amount of bone remodeling were not the same in both groups, in the Tip-Group the root apex moved away from the palatal cortical plate and closer to the labial cortical plate, whereas in the Torque-Group the root moved away from the labial cortical plate and closet to the palatal cortical plate. Therefore, there are limitations in the amount of incisor retraction in patients with a very thin anterior cortical plate in the maxilla, and in patients with severe skeletal discrepancies orthognathic surgery should be considered and when orthodontic camouflage treatment is the only possible method, the orthodontist must be aware of the limitations of treatment.
Introduction : The purpose of this study was to evaluate the possibility of the acellular dermal matrix (ADM) as a barrier membrane for bone regeneration, and to evaluate the osteogenic effect of ADM as a carrier system for rhBMP-2 in the rat calvarial defect model. Materials and Methods: An 8-mm, calvarial, critical-size osteotomy defect was created in each of 60 male Spraque-Dawley rats(weight $250{\sim}300g$). Three groups of 20 animals, each received either rhBMP-2(0.025mg/ml) in an ADM carrier, ADM only, or negative surgical control. And each group was divided into 2- and 8-weeks healing intervals. The groups were evaluated by histologic and histomorphometric parameters(10 animals/group/healing intervals). Data were expressed as $means{\pm}standard$ deviations($m{\pm}SD$). Comparisons between experimental and control groups were made using two-way ANOVA and post hoc t-test. Comparisons between 2 weeks and 8 weeks were made using paired t-test. The level of statistical difference was defined as P< 0.05. Results : The ADM group and rhBMP-2/ADM group results in enhanced local bone formation in the rat calvarial defect at both 2 and 8 weeks. The amount of defect closure and new bone formation were significantly greater in the rhBMP-2/ADM group relative to ADM group(P<0.05). At 8 weeks, the majority of ADM in the defect was contracted, and integrated with surrounding host tissues. In addition, host cell infiltration and neovascularization of the ADM in the absence of an inflammatory response were observed, and the newly formed bone around ADM showed a continuous remodeling and consolidation. Conclusion : The results of the present study indicated that ADM may be used as a barrier membrane for bone regeneration and that may be employed as a delivery system for BMPs.
Purpose: Cigarette smoking is a major risk factor in periodontal diseases. The pathogenesis of periodontal diseases may be affected by alterations of the inflammatory response by smoke. Nitric oxide (NO) is a gaseous, colorless, highly reactive, short-lived free radical with a pivotal role in the regulation of various physiological and pathological mechanisms in the body. It is important in host defense and homeostasis, on the one hand, whereas, on the other hand, it modulates the inflammatory response in periodontitis, leading to harmful effects. The aim of this study was to assess the levels of NO in both the serum and saliva of smokers and nonsmokers having chronic periodontitis and to compare them with periodontally healthy controls. Methods: Sixty subjects participated in the study and were divided into three groups: group I, healthy nonsmoking subjects; group II, nonsmoking patients with chronic periodontitis; group III, smoking patients with chronic periodontitis. Each group consisted of twenty subjects. The biochemical estimation of NO in the collected serum and in the saliva was performed using the Griess colorimetric reaction. Results: The results showed that the mean value of the salivary and serum NO was greater in group II than in group I, and also greater in group III than in group II. Conclusions: NO appears to play an important and rather complex role in the immuno-inflammatory process and in the remodeling and maintenance of osseous structures. It is therefore logical that modulation of this mediator has potential for the treatment of a number of inflammatory conditions including periodontal disease.
Purpose: The purpose of this study was to retrospectively evaluate the survival of periodontally hopeless teeth that were intentionally extracted and replanted after a delay and to compare the radiographic characteristics of the survival group with those of the failure group. Methods: The clinical and radiographic data from patients who underwent delayed intentional replantation between March 2000 and July 2010 were reviewed. Twenty-seven periodontally hopeless teeth were extracted and preserved in medium supplemented with antibiotics for 10-14 days. The teeth were then repositioned in the partially healed extraction socket and followed for 3 to 21 months. The radiographic parameters were analyzed using a paired t test and the cumulative survival rate was analyzed using Kaplan-Meier analysis. Results: Seven replanted teeth failed and the overall cumulative survival rate was 66.4%. In the survival group, the amount of bone loss was reduced from 68.45% to 34.66% three months after replantation. There was radiologic and clinical evidence of ankylosis with 5 teeth. However, no root resorption was found throughout the follow-up period. In the failure group, bone formation occurred from the bottom of the socket. However, a remarkable radiolucent line along the root of a replanted tooth existed. The line lengthened and thickened as time passed. Finally, in each case of failure, the tooth was extracted due to signs of inflammation and increased mobility. Conclusions: Delayed intentional replantation has many advantages compared to immediate intentional replantation and could serve as an alternative treatment for periodontally involved hopeless teeth. However, techniques for maintaining the vitality of periodontal structures on the tooth surface should be developed for improved and predictable results.
The purpose of this study was to observe the effects of the periodontal ligament on the healing and the formation of alveolar bone in the extraction socket, when this ligament had artificially remained in the socket during the tooth removal. Twenty rats aged 4 weeks were used and devided into the control groups (10) and the experimental groups (10) in this study. The maxillary right and left first molars were extracted in both groups. In the experimental groups the periodontal ligament was remained in the extraction sockets using 0.4% ${\beta}-aminopropionitrile$, and in the control the periodontal ligament was completely removed by curettage. At 1, 3, 5, 7 and 14 days after the tooth extraction, rats in both groups were serially sacrificed. And the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows ; 1. On 1 day, the periodontal ligament was only found in the extraction socket walls of the experimental groups, and there was not the distinguishable difference between the control and the experimental groups. 2. On 3 days, there were more collagen fibers and the appearance of higher cellular density in the experimental groups than in the control. And the cells and collagen of the periodontal ligament were so actively proliferated and synthesized that invaded into the connective tissue of the extraction sockets in the experimental groups. 3. In the experimental groups, the trabecular bone was formed on the basal and lateral bone surface on 5 days. However, there was not the new bone forming appearance in the control groups at this time. 4. On 7 days, the trabecular bone was formed in the control groups. 5. On 14 days, the extraction sockets were almost entirely filled with the bony trabeculae in both groups. But, compared to the control group, the experimental groups showed the prominent differences in the amount & the density of the new bone formed. In conclusion, it was suggested that the residual periodontal ligament tissue in the extraction socket will play a major role as the important cell source in the healing and the new bone formation of the extraction socket.
Periodontitis, which is a severe inflammatory disease caused by endotoxins secreted from oral pathogens, destructs gingival tissue and alveolar bone. Curcuma xanthorrhiza, commonly called Java turmeric, has been shown to possess anti-bacterial and anti-inflammatory activities. The present study evaluated the inhibitory effect of C. xanthorrhiza supercritical extract (CXS) standardized with xanthorrhizol on lipopolysaccharide (LPS)-induced periodontitis in an animal model. LPS was topically injected into the periodontium of Sprague-Dawley rats to induce periodontitis and CXS (30 and $100mg{\cdot}kg^{-1}{\cdot}day^{-1}$) was orally administered after day 12. Histologically, CXS inhibited the collapse of gingival tissue by preventing cell infiltration. CXS significantly downregulated the expression of matrix metalloproteases (MMPs) and inflammation-related biomarkers, such as nuclear factor-kappa B ($NF-{\kappa}B$) and interleukin-1 beta ($IL-1{\beta}$) in gingival tissue. CXS also improved bone remodeling by downregulating osteoclastic transcription factors, such as nuclear factor of activated T-cells c1 (NFATc1), tartrate-resistant acid phosphatase (TRAP), and cathepsin K. In addition, CXS upregulated osteoblast differentiation-related markers, alkaline phosphate (ALP) and collagen type I alpha (COLA1). Thus, CXS can ameliorate periodontitis by inhibiting inflammation and improving bone remodeling.
The objective of this study was to evaluate the changes that occurred over time in the distracted periodontal ligament space following the rapid retraction of a tooth by periodontal distraction after bone undermining surgery had been conducted in the dogs. The upper second premolars were extracted on the left and right side in 4 male beagle dogs. Immediately after extraction, the interseptal bone distal to the upper first premolar was thinned and undermined by grooving to decrease the bone resistance. Activating an individualized distraction appliance at the rate of 0.225mm twice a day, the upper first premolar was retracted rapidly toward the extraction socket. Periodontal distractions were performed for 5, 10, and 20 days, and 20-day-distraction cases were followed by maintenance periods of 0, 14, 28, and 56 days. After 20 days of rapid retraction, the average distal movement of the upper first premolar was 5.02mm, and the average mesial movement of the upper third premolars serving as an anchorage unit was 0.18 mm. On histological examination, the regeneration of bone occurred in a highly organized pattern. Distracted periodontal ligament space was filled with newly formed bone oriented in the direction of the distraction, and this was followed by extensive bone remodeling. This result was similar to those observed in other bones after distraction osteogenesis. In the periodontal ligament, the relationship between collagen fibers and cementum began to be restored 2 weeks after the distraction was completed, and showed almost normal features 8weeks after the completion of the periodontal distraction. However, on the alveolar side, the new bone formation was still in process and collagen fiber bundles and Sharpey's fibers were not present 8 weeks after the completion of the periodontal distraction. Reactions in the periodontal ligament of the anchorage tooth represented bone resorption on the compressed side and new bone deposition on the tension side as occurred in conventional orthodontic tooth movement. In conclusion, the results of this study showed that periodontal structures on the distracted side of the periodontal ligament were regenerated well histologically following rapid tooth movement.
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