• Journal of Periodontal and Implant Science
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• 제30권3호
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• pp.539-555
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• 2000

Recently, it was reported that enamel matrix derivative may be beneficial in periodontal regeneration procedures in expectation of promoting new bone and cementum formation. The aim of present study was to evaluate the effect of enamel matrix derivative($Emdogain^?$)and Caso4 sulfate paste in 1-wall intrabony defects in beagle dogs. Surgically created 1-wall intrabony defects were randomly assigned to receive root debridement alone or $Emdogain^{(R)}$ or $Emdogain^{(R)}$ and Caso4. Clinical defect size was 4 X 4mm. The control group was treated with root debridement alone,and Experimental group I was treated with enamel matrix derivative application, and Experimental group II was treated with enamel matrix derivative and Caso4 sulfate paste application,. The healing processes were histologically and histometrically observed after 8 weeks and the results were as follows: 1. The length of junctional epithelium was $0.41{\pm}0.01mm$ in the control group, $0.42{\pm}0.08mm$in the experimental group I and $0.50{\pm}0.13mm$in the experimental group II. 2. The connective tissue adhesion was $0.28{\pm}0.02mm$ in the control group, $0.13{\pm}0.08mm$ in the experimental group I and $0.19{\pm}0.02mm$ in the experimental group II. 3. The new cementum formation was $3.80{\pm}0.06mm$ in the control group, $4.12{\pm}0.43mm$ in the experimental group I and $4.34{\pm}0.71mm$ in the experimental group II. 4. The new bone formation was $1.43{\pm}0.03mm$ in the control group, $1.53{\pm}0.47mm$ in the experimental group I and $2.25{\pm}1.35mm$ in the experimental group II. Although there was limitation to present study, the use of enamel matrix derivative in the treatment of periodontal 1-wall intrabony defect enhanced new cementum and bone formation. Caso4 sulfate paste will be the candidate for carriers to deliver enamel matrix derivative, and so enhance the regenerative potency of enamel matrix derivative.

• Journal of Periodontal and Implant Science
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• 제33권1호
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• pp.61-77
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• 2003

The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. Bone graft & guided tissue are being used for the regeneration of destroyed periodontium these days. Non-resorbable membranes were used for Guided tissue regeneration in early days, however more researches are focused on resorbable membranes these days. The aim of this study is to evaluate the osteogenesis of paradioxanone membrane on the calvarial critical size defect in Sprague Dawley rats. An 8 mm diameter surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into three groups: Untreated control group, Biomesh(R) group and paradioxanone group. The animals were sacrificed at 4, 8 and 12 weeks after surgical procedure. The specimens were examined by histologic, histomorphometric analyses. The results are as follows: 1. In histological view on Biomesh(R), no visible signs of resorption was observed at 4 weeks but progressive resorption was observed at 8 weeks through 12 weeks. Paradioxanone membrane expanded at 4 weeks, and rapid resorption was observed at 8 weeks. In both the membranes, inflammatory cells were observed around them. Inflammatory cells decreased with time but were still present at 12 weeks. More inflammatory cells were observed in paradioxanone membranes than in Biomesh(R) membrane. 2. The area of newly formed bone in the defects were 0.001${\pm}$0.001, 0.006${\pm}$0.005, 0.002${\pm}$0.003 at the 4 weeks, 0.021${\pm}$0.020, 0.133${\pm}$0.073, 0.118${\pm}$0.070 at the 8 weeks and 0.163${\pm}$0.067, 0.500${\pm}$0.197, 0.487${\pm}$0.214 at the 12 weeks in the control group, Biomesh(R) group and experimental group respectively. Compared to the control group, Biomesh(R) group displayed significant differences at 4,8, and 12 weeks and the paradioxanone group at 8 and 12 weeks.(P<0.05)

• Journal of Periodontal and Implant Science
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• 제38권2호
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• pp.171-178
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• 2008

Purpose: The aim of this study was to evaluated biphasic calcium phosphate applied in surgically created 1-wall periodontal intrabony defects in dogs by histometrical analysis. Material and Method: Critical sized($4\;mm\;{\times}\;4\;mm$), one wall periodontal intrabony defects were surgically produced at the proximal aspect of mandibular premolars in either right and left jaw quadrants in four canines. The control group was treated with debridement alone, and experimental group was treated with debridement and biphasic calcium phosphate application. The healing processes were histologically and histometrically observed after 8 weeks. Results: In biphasic calcium phosphate group, more new bone and cementum formation, less epithelium and connective tissue attachment were observed compared to other groups. But there was no statistical significance. Conclusion: Though the statistically significant difference could not be found, it seemed that there was more new bone and cementum formation with applying biphasic calcium phosphate in 1 wall intrabony defects in dogs by preventing junctional epithelium migration.

• Journal of Periodontal and Implant Science
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• 제47권1호
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• pp.30-40
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• 2017

Purpose: Optical coherence tomography (OCT) is a noninvasive diagnostic technique that may be useful for both qualitative and quantitative analyses of the periodontium. Micro-computed tomography (micro-CT) is another noninvasive imaging technique capable of providing submicron spatial resolution. The purpose of this study was to present periodontal images obtained using ex vivo dental OCT and to compare OCT images with micro-CT images and histologic sections. Methods: Images of ex vivo canine periodontal structures were obtained using OCT. Biologic depth measurements made using OCT were compared to measurements made on histologic sections prepared from the same sites. Visual comparisons were made among OCT, micro-CT, and histologic sections to evaluate whether anatomical details were accurately revealed by OCT. Results: The periodontal tissue contour, gingival sulcus, and the presence of supragingival and subgingival calculus could be visualized using OCT. OCT was able to depict the surface topography of the dentogingival complex with higher resolution than micro-CT, but the imaging depth was typically limited to 1.2-1.5 mm. Biologic depth measurements made using OCT were a mean of 0.51 mm shallower than the histologic measurements. Conclusions: Dental OCT as used in this study was able to generate high-resolution, cross-sectional images of the superficial portions of periodontal structures. Improvements in imaging depth and the development of an intraoral sensor are likely to make OCT a useful technique for periodontal applications.

• 대한치과의사협회지
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• 제49권10호
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• pp.618-627
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• 2011

Cigarette smoking is a significant risk factor for periodontaldiseases and implant treatments. Smoking control is regarded as a key to the success of dental treatments as well as the well-being of the patients. The aim of this study was to reviewthe effects of smoking on periodontal health, and the results of periodontal therapy and implant treatments. Also, in vitro, microbiological, immunological and epidemiological relationships were studied. In vitro studies show that smoking interferes with normal healing process and increased tissue destruction. There is still controversy on the population of microbes of smokers. Smokers showed significantly less gingival inflammation and bleeding on probing compared with non-smokers. After periodontal treatments, a compromised clinical outcome was noted for smokers in terms of pocket depth reduction and gain in attachment levels. In conclusion, data from in vitro, epidemiological, cross-sectional and case-control studies strongly suggest that quitting smoking is beneficial to patients before periodontal and implant treatments.

• Journal of Periodontal and Implant Science
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• 제49권2호
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• pp.90-104
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• 2019

Purpose: The aim of this study was to evaluate clinical and radiographic changes and the survival rate after periodontal surgery using deproteinized bovine bone mineral (DBBM) with 10% collagen or DBBM with a collagen membrane in endo-periodontal lesions. Methods: A total of 52 cases (41 patients) with at least 5 years of follow-up were included in this study. After scaling and root planing with or without endodontic treatment, periodontal regenerative procedures with DBBM with 10% collagen alone or DBBM with a collagen membrane were performed, yielding the DBBM + 10% collagen and DBBM + collagen membrane groups, respectively. Changes in clinical parameters including the plaque index, bleeding on probing, probing pocket depth, gingival recession, relative clinical attachment level, mobility, and radiographic bone gains were evaluated immediately before periodontal surgical procedures and at a 12-month follow-up. Results: At the 12-month follow-up after regenerative procedures, improvements in clinical parameters and radiographic bone gains were observed in both treatment groups. The DBBM + 10% collagen group showed greater probing pocket depth reduction ($4.52{\pm}1.06mm$) than the DBBM + collagen membrane group ($4.04{\pm}0.82mm$). However, there were no significant differences between the groups. Additionally, the radiographic bone gain in the DBBM + 10% collagen group ($5.15{\pm}1.54mm$) was comparable to that of the DBBM + collagen membrane group ($5.35{\pm}1.84mm$). The 5-year survival rate of the teeth with endo-periodontal lesions after periodontal regenerative procedures was 92.31%. Conclusions: This study showed that regenerative procedures using DBBM with 10% collagen alone improved the clinical attachment level and radiographic bone level in endo-periodontal lesions. Successful maintenance of the results after regenerative procedures in endo-periodontal lesions can be obtained by repeated oral hygiene education within strict supportive periodontal treatment.

• Journal of Periodontal and Implant Science
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• 제50권5호
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• pp.327-339
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• 2020

Purpose: The purpose of this study was to examine the local tissue reactions associated with 3 different poly(lactic-co-glycolic acid) (PLGA) prototype membranes and to compare them to the reactions associated with commercially available resorbable membranes in rats. Methods: Seven different membranes-3 synthetic PLGA prototypes (T1, T2, and T3) and 4 commercially available membranes (a PLGA membrane, a poly[lactic acid] membrane, a native collagen membrane, and a cross-linked collagen membrane)-were randomly inserted into 6 unconnected subcutaneous pouches in the backs of 42 rats. The animals were sacrificed at 4, 13, and 26 weeks. Descriptive histologic and histomorphometric assessments were performed to evaluate membrane degradation, visibility, tissue integration, tissue ingrowth, neovascularization, encapsulation, and inflammation. Means and standard deviations were calculated. Results: The histological analysis revealed complete integration and tissue ingrowth of PLGA prototype T1 at 26 weeks. In contrast, the T2 and T3 prototypes displayed slight to moderate integration and tissue ingrowth regardless of time point. The degradation patterns of the 3 synthetic prototypes were similar at 4 and 13 weeks, but differed at 26 weeks. T1 showed marked degradation at 26 weeks, whereas T2 and T3 displayed moderate degradation. Inflammatory cells were present in all 3 prototype membranes at all time points, and these membranes did not meaningfully differ from commercially available membranes with regard to the extent of inflammatory cell infiltration. Conclusions: The 3 PLGA prototypes, particularly T1, induced favorable tissue integration, exhibited a similar degradation rate to native collagen membranes, and elicited a similar inflammatory response to commercially available non-cross-linked resorbable membranes. The intensity of inflammation associated with degradable dental membranes appears to relate to their degradation kinetics, irrespective of their material composition.

• 치위생과학회지
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• 제19권4호
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• pp.254-260
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• 2019

Background: The primary aims of periodontal disease treatment is to remove dental plaque and calculus, the main causes of tooth loss, and restore periodontal tissue destroyed by inflammation. Periodontal disease treatment should also help maintain the alveolar bone, alleviate inflammation, and promote periodontal ligament cell proliferation, which is essential for tissue regeneration. Conventional antibiotics and anti-inflammatories have adverse side effects, especially during long-term use, so there is a need for adjunct treatment agents derived from natural products. The purpose of this study was to investigate whether the herbal flavone baicalein has the osteogenic activity under inflammatory conditions, and assess the involvement of osteoblast immediate early response 3 (IER3) expression. Methods: Human osteoblastic MG-63 cells were cultured with the pro-inflammatory cytokines tumor necrosis factor α and interleukin 1β in the presence and absence of baicalein. Proliferation was assessed using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay, and expression of IER3 mRNA was assessed using real-time polymerase chain reaction. The expression of IER3 protein levels and activation of associated signal transduction pathways were assessed using western blotting. Results: Baicalein increased IER3 mRNA and protein expression synergistically. In addition, baicalein reversed the suppression of cell proliferation, and the downregulation of osteogenic transcription factor runt-related transcription factor 2 and osterix induced by pro-inflammatory cytokines. Baicalein also upregulated the phosphorylation of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated kinase (ERK 1/2). The upregulation of IER3 by pro-inflammatory cytokines was blocked by pretreatment with inhibitors of AKT, p38, JNK, and ERK 1/2. Conclusion: Baicalein mitigates the deleterious responses of osteoblasts to pro-inflammatory cytokines. Further, IER3 enhanced the effect of baicalein via activation of AKT, p38, JNK, and ERK pathways.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.317-333
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• 1996

The main goal of periodontal regeneration is to be achieved by epithelial exclusion, periodontal ligament cell activation or alveolar bone regeneration. The purpose of this study was to investigate on the physico- chemical and biological characteristics of biodegradable chitosan beads. Chitosan beads were fabricated by ionic gelation with sodium tripolyphosphate and they had the size in 300um diameter. As therapeutic agent, flurbiprofen was incorporated into the beads by 10, 20% loading contents. The release of drugs from the chitosan beads was measured in vitro. Also, biological activity tests of flurbiprofen loaded chitosan beads including cytotoxicity test, ihhibition of $IL-1{\beta}$ production, suppression to $PGE_2$ production, collagenase inhibition test, the ability of total protein synthesis, and tissue response were evaluated. The amount of flurbiprofen released from chitosan was 33-50% during 7 days. Minimal cytotoxicity was observed in chitosan beads. Flurbiprofen released from chitosan beads significantly suppressed the $IL-1{\beta}$ production of monocyte, $PGE_2$ production and markedly inhibited collagenase activity. Meanwhile, flurbiprofen released from this system showed increased ability for protein synthesis. Throughout 4 -week implantation period, no significant inflammatory cell infiltrated around chitosan bead and also fibroblast like cell types at the beads - tissue interface were revealed with gradual degradation of implanted chitosan beads. From these results, it was suggested that flurbiprofen loaded chitosan beads can be effectively useful for biocompatible local delivery system in periodontal regeneration.

• Journal of Periodontal and Implant Science
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• 제24권1호
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• pp.39-49
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• 1994

It has been believed that antioxidant enzymes such as CuZn- and Mn-superoxide dismutase and catalase protect the tissue from damage resulting from the oxygen derived free radicals($O_2\;^-$, $H_2O_2$ and OH ). The purpose of this study was to investigate the relationship between activity of antioxidant enzymes including CuZn- and Mn- superoxide dismutase and catalase and inflammatory periodontal disease and periodontal parameters. For this study, the patients were classified into normal, gingivitis, adult periodontitis and rapidly progressive periodontitis, and then their papillary bleeding index(PBI) and probing depth were checked. Gingival tissues were surgically obtained from the patients during periodontal surgery, extraction, and clinical crown lengthening procedure. The activity of CuZn- and Mn- superoxide dismutase and catalase in the gingival tissues was measured by using UV-spectrophotometer by the same methods as Crapo et al. And Aebi did, respectively. The results were as follows : 1. CuZn- and Mn- and total-superoxide dismutase activity were significantly low in rapidly progressive periodontitis group in comparison to normal group (P<0.05). 2. In comparison of the antioxidant enzyme activity according to papillary bleeding index group(PBI), Mn-superoxide dismutase activity only was significantly lower in PBI 2, 3, and 4 groups than PBI 0 group(P<0.05). 3. Superoxide dismutase activity failed to show any significant difference according to probing depth. But significant]y high catalase activity was shown in deep pocket group (${\ge}7mm$)(P<0.05). In conclusion, these results suggest that the activity of Mn-superoxide dismutase among the antioxidant enzymes may reflect the inflammatory status of gingival tissue and that the decreased activity of superoxide dismutase may be one of responsibe factors for progression of rapidly progressive periodontitis.