• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.219-237
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• 1994

The ultimate goal of clinical periodontal therapy is to achieve regeneration of a healthy connective tissue reattachment. Conventional therapy including scaling, root planing, gingival curettage, gingivectomy and flap procedures of various types results primarily in repair rather than regeneration of the periodontium. In order for periodontal regeneration to occur, progenitor periodontal ligament cells must migrate to the denuded root surface, attach to it, proliferate and mature into an organized and functional fibrous attachment apparatus. Polypeptide growth factors belong to a class of potent biologic mediators which regulate cell differentiation, proliferation, migration and metabolism. Insulin-like growth factor-I (IGF- I ) of these factors appear to have an important role in periodontal wound healing and bone formation. The purpose of this study is to evaluate the effects of IGF- I on the periodontal ligament cells to use as a regeneration promoting agent of periodontal tissue. Human periodontal ligament cells were obtained from periodontal tissue explants culture of the first premolar tooth extracted for the orthodontic treatment. Cells were cultured in Dulbecco's modified Eagle medium(DMEM) with 10% fetal bovine serum. Fourth to seventh passage cells were plated in 24 well tissue culture plates and medium changed to serum-free medium prior to addition of growth factors. Cell proliferation was measured by the incorporation of $[^3H]-thymidine$ into DNA, Protein synthesis was determined by measurement of $[^3H]-proline$ incorporation into collagenase-digestible protein(CDP) and noncollagenous protein(NCP) according to the method of Peterkofsky and Diegelmann (1971), And alkaline phosphatase activity was measured as one parameter of osteoblastic differentiation. The results were as follows : The DNA synthetic activity was increased in a dose-dependent manner with IGF- I except for 0.1ng/ml concentration of IGF- I At the concentration of 10, 100ng/ml, IGF- I significantly increased the DNA synthetic activity(P<0.05) The total protein, collagen and noncollagen synthesis was increased in a dose-dependent manner with IGF- I except for 0.1ng/ml concentration of IGF- I. At the concentration of 1, 10, 100ng/ml, IGF- I significantly increased the total protein, collagen and noncollagen synthesis activity(P<0.95, P<0.001). The % of collagen was not effected according to the concentration of IGF- I. The alkaline phosphatase activity was increased in a dose-, time-dependent manner with IGF- I (10, 100ng/ml). In conclusions, the present study shows that IGF- I has a potentiality to enhance the DNA synthesis of periodontal ligament cells with including the increase of the total protein and collagen synthetic activity. The use of IGF- I to mediate biological stimulation of periodontal ligament cells shows promise for future therapeutic applications.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.989-1002
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• 1996

The purpose of this study was to determine the effect of a pulsed Nd:YAG laser irradiation on human gingival tissues. The patients, who were planned to be treated by clinical crown lengthening procedure and gingivectomy, were selected. All the patients received oral hygiene instruction, scaling and root planing at preoperation. The crest of gingival tissue on upper and lower anterior teeth was irradiated by a pulsed Nd:YAG laser(El. EN. EN060, Italy) with a fiber optic of 300 m in contact mode for 20 seconds. Gingival tissues were divided into 4 groups according to the laser power of 1.0W(10Hz, 100mJ), 2.0W(20Hz, 100mJ), 3.0W(30Hz, 100mJ) and 4.0W(40Hz, 100mJ). Immediately after the laser irradiation, the specimens were excised, fixed 10% neutral formalin, sectioned $4-6{\mu}m$ thick, stained by Hematoxylin-Eosin and Periodic Acid Schiff stain and observed under light microscope. The removed tissue depth and the coagulated layer depth due to a laser irradiation by a laser irradiation were measured on the microphotographs. The difference of measurements according to the different laser power was statistical1y analyzed by Kruskal Wallis Test with SAS program. The results were as follows : 1. In histologic findings of irradiated gingival tissues; a. In the irradiated gingival specimen with 1.0W laser power, some vesicles were observed in limited superficial layer of gingival epithelium. b. In the irradiated gingival specimen with 2.0W and 3.0W laser power, the epithelium was almost removed except for the traces of viable basal cell remnants at ret peg, and coagulation necrosis related with the thermal effect of laser was noted. c. In the irradiated gingival specimen with 4.0W laser power, complete removal of epithelium, partial removal of underlying connective tissue, and the coagulation necrosis of subjacent gingival tissue were shown. 2. The removed tissue depth was deeper in the irradiated specimens with higher power. There was a statistical significance in the difference of removed tissue depth between 1.0W group ($44.54{\pm}6.99um$) and 3.0W group ($99.75{\pm}6.64{\mu}m$), and between 1.0W group($44.54{\pm}6.99{\mu}m$) and 4.0W group($111.36{\pm}4.50{\mu}m$), and between 2.0W group($98.01{\pm}4.53{\mu}m$) and 4.0W group($111.36{\pm}4.50{\mu}m$)(P<0.05). 3. The coagulated layer depth was deeper in the irradiated specimens with higher power. There was a statistical significance in the difference of coagulated layer depth between 1.0W group($31.82{\pm}8.99{\mu}m$) and 3.0W group($55.99{\pm}20.94{\mu}m$), and between 1.0W group($31.82{\pm}8.99{\mu}m$) and 4.0W group($83.68{\pm}10.34{\mu}m$)(P<0.05). From this study, the results demonstrated that the effects of a pulsed Nd:YAG laser irradiation on gingival tissues seemed to depend on the laser power and that the irradiation with high power could be harmful to adjacent healthy tissue.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.125-137
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• 2006

1. 목적 흡연은 치주질환의 주요한 위험 인자 중의 하나이다. 일반적으로 흡연자는 비흡연자보다 비외과적 및 외과적 치주치료에 대한 반응이 덜 효과적인 것으로 알려져 있다. 이 연구에서는 중등도의 만성 치주염이 존재하는 한국인 흡연자와 비흡연자를 대상으로 하여, 비외과적 치주치료인 치석 제거술과 치근 활택술을 시행한 후 6개윌 동안의 임상적 치유 반응을 비교해 보고자 하였다. 2. 방법 20명의 중등도 만성 치주염 환자(흡연자 10명, 비흡연자 10명)를 대상으로 치주낭 깊이(Probing Pocket Depth, PPD), 치은퇴축(GR), 치주탐침시 출혈유무(BOP), #16, 12, 24, 32, 36, 44의 치태지수(Plaque Index, Silness & $L{\"{o}}e$ 1964)를 임상변수로 측정하였다. 치주낭 깊이 (PD)와 치은퇴축(GR)은 전자 탐침(Florida $Probe^{(R)}$ Co. Gainesville, FL)을 이용하여 각 치아당 6군데를 측정하였다. 임상적 부착 수준(CAL)은 치주낭 깊이(PD)와 치은퇴축(GR)의 합으로 계산하였다. 초진시에 전악 임상 검사를 시행하였고, 초진시의 치주낭 깊이에 따라 조사 대상이 되는 치아 부위를 선정하였다. 치주적으로 건강한 부위 $(PD{\leq}3mm)$를 대조군인 1군으로 하고 치주낭 깊이가 4 mm를 초과하고 5 mm 미만인 부위를 2군, 5 mm 이상의 치주낭 깊이를 가지는 부위를 3군으로 설정하였다. 비외과적 치주치료인 치석 제거술, 치근 활택술과 구강위생 교육을 시행하였고 2개월(T1), 4개윌(T2), 6개윌(T3)에 선정된 해당 치아 부위에 대해 임상 재검사를 시행하였다. 3. 결과 BOP와 Plaque Index는 초진, 2, 4, 6개월에 흡연자와 비흡연자 간에 유의할 만한 차이가 없었으나 전반적으로 감소하는 경향이 나타났다. 대조군인 l군에 서는 흡연자와 비흡연자 간에 모든 시기에서 PD, GR, CAL에 유의할 만한 차이가 없었다. 치주낭 깊이가 4 mm를 초과하고 5 mm 미만인 2군에서는 비흡연자에서 6개월에 유의할 만한 치주낭 깊이 감소가 나타났으며, 4개월과 6개윌에 유의할 만한 부착수준의 증가가 관찰되었다(p<0.05). 치주낭 깊이가 5 mm이상인 3군에서는 비흡연자에서 치주낭 깊이 감소가 일관되게 더 많이 나타났으나 통계학적으로 유의할 만한 차이는 6개월째에서만 관찰되었다. 2군과 유사하게 치주낭 갚이 감소는 흡연자보다 비흡연자에서 0.6 mm 더 크게 나타났다. 부착수준의 획득은 2군에서는 4, 6개월째에, 3군에서는 6개월째에 비흡연자에서 유의하게 더 많이 일어났다. 초진시의 치주낭 깊이와 각 시기별 ${\Delta}PD$ 간의 상관관계에서는 치주낭 갚이가 5mm 이상인 3군에서 비흡연자의 경우 6개월째에 가장 강한 상관성이 나타났다($r_s=0.43$, p<0.05). 흡연자에서는 3군에서 어떠한 유의한 상관관계도 나타나지 않았다. 결론적으로 중등도 만성 치주염 환자를 대상으로 한 6개윌의 단기간 연구에서 비외과적 치주치료 후 흡연자에서 비흡연자보다 치주낭 깊이 감소의 개선과 부착수준의 획득이 더 적게 나타나 임상적 치유반응이 좋지 않음을 확인하였다. 이는 흡연이 숙주의 치유반응 부정적인 영향을 주기 때문으로 생각된다.