• Title/Summary/Keyword: 급속진행형 치주염

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Matrix metalloproteinases and Tissue inhibitors of matrix metalloproteinases in gingival crevicular fluids of periodontitis patients (치주염 환자의 치은열구액에서 MMPs와 TIMPs의 양의 변화)

  • Lee, Sun-Yun;Jung, Yeoun-Ho;Kim, Kyoung-Hwa;Yang, Byung-Keun;Han, Soo-Boo;Chung, Chong-Pyoung;Kim, Tae-Il;Ku, Young;Lee, Yong-Moo;Ko, Jae-Seung;Rhyu, In-Chul
    • Journal of Periodontal and Implant Science
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    • v.34 no.1
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    • pp.139-148
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    • 2004
  • MMPs(Matrix metalloproteinases)는 치주질환에서 주된 조직파괴단백분해효소인 것은 알려져 있고 TIMPs(Tissue inhibitor of Matrix metalloproteinase)는 MMPs의 작용을 억제한다라고 알려져 있다. 이 둘간의 불균형으로 인해서 조직파괴가 더 가속화될 수 있다. 이 두 연구의 목적은 ELISA kit를 사용하여 특정 MMPs(1,2,3,8,9,13)과 TIMPs(1,2)의 양이 건강한 환자와 비교하여서 치주염 환자에서 달라지는지 알아보고 MMPs(1,2,3,8,9,13), TIMPs(1,2)와 치은열구깊이와 GI score와의 관계를 알아보기로 한다. 8명의 만성 치주염 환자와 4명의 급속진행형 치주염 환자가 실험군으로 참여하였고 5명의 건강한 치주조직을 환자가 대조군으로 참여하였다. 임상적인 측정은 GI score와 치주낭측정을 통하여 이루어졌다. 8명의 만성 치주염을 가진 환자와 4명의 급속진행형 치주염을 가진 환자에서 각각 치주낭 깊이가 3mm이하인 부위에서 6개의 치은열구액 표본과 치주낭 깊이가 6mm 이상인 곳에서 6개의 치은열구액 표본을 채취하였다. 건강한 치주조직을 가진 5명의 환자는 단지 치주낭깊이가 3mm 이하인 건강한 부위에서만 치은열구액 표본을 제공하였다. MMPs(1,2,3,8,9,13)과 MIMPs(1,2)의 측정은 Human Biotrack ELISA kit를 사용하여서 측정하였다. 통계처리는 MMPs, MIMPs의 실험군과 대조군의 차이는 Kruskal-Wallis test를 사용하였고 MMPs, TIMPs와 치주낭 깊이와 GI score의 관계정도는 Pearson's correlation coefficient를 사용하였다. 실험결과 대조군과 비교하여 만성 치주염 환자에서 치주낭 깊이가 6mm 이상인 부위에서 MMP9의 수치가 통계적으로 유의할만하게 높았으며(p=0.04) MIMP2의 수치가 대조군과 비교하여 치주낭 깊이가 3mm 이하인 부위를 가진 만성치주염 환자에서 통계적으로 유의할만하게 높았다(=0.049). MMPs(1,2,3,8,9,13), MIMPs(1,2)의 활동성과 치주낭 깊이의 관계에서 둘간의 통계적으로 유의할만한 관계는 존재하지 않았으나 MMP1(r=0.35)과 MMP2(r=0.31)가 상대적으로 높은 관계를 보였다. 또한 MMPs(1,2,3,8,9,13), MIMPs(1,2)의 활동성과 GI score의 관계에서도 둘간의 통계학적으로 유의할만한 관계는 존재하지 않으나 MMP1(r=0.4), MMP2(r=0.29), MMP9(r=0.26)가 상대적으로 높은 관계를 보였다. 이 실험의 결과로 볼 때 MMP9가 만성치주염 환자의 질환이 있는 부위에서만 염증의 지표가 될 수 있으며 MIMP2가 만성치주염 환자의 염증이 없는 부위에서 높은 농도로 존재하는 것으로 보아서 MIMP2가 MMPs에 대한 억제작용을 하여서 염증의 진행을 방해하는 역할을 한다라고 볼 수 있다.

IgG subclass-dependent Recognition of Porphyromonas Gingivalis Antigens in the Early-onset Periodontitis (조기발병형 치주염환자의 IgG subclass 별 Porphyromonas gingivalis 항원인지에 대한 연구)

  • Choi, Jeom-Il;Yoshimobu, Fuminobu;Schifferle, Robert E.;Okuda, Katsuji
    • Journal of Periodontal and Implant Science
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    • v.29 no.4
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    • pp.953-964
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    • 1999
  • 본 연구는 세 종류의 Porphyromonas gingivalis(Pg) antigen의 IgG subclass associated recognition을 평가하기 위해 수행했었다. 총 35명의 조기발병형치주질환자중, Pg381에 대한 IgG2항체의 증가를 보이는 5명이 급속진 행형 치주질환자, IgG4의 증가를 보이는 6명의 환자(국소유년형 치주질환자 2명과 급속진행 형 치주질환자 4명), IgG2+4의 증가를 보이는 2명의 급속진행형 치주질환자 그리고 IgG1+2+4의 증가를 보이는 8명의 환자(국소 유년형 치주질환자 2명과 급속진행형 치주질환자 6명)으로 구성된 21명의 환자를 dot immunoblot analysis를 위해 선택했다. 실험에 사용된 정제된 항원은 Pg381에서 추출한 43-kd fimbrilin protein과 lipoplysaccharide(LPS), Pg A7A1-28(ATCC 53977)에서 추출한 capsularpolysaccharide(CPS)였다. Immunoblotting pattern은 IgG4 antibody가 fimbrial antigen에 강력히 반응함을 보여주었다. Fimbriae에 잘 반응하는 몇몇의 IgG4 antibody역시 antigen에 대해 양성반응을 보였다. 대조적으로 IgG2는 CPS antigen을 일차적으로 인식했다. 전부는 아니지만 대부분의 경우, single이나 group화된 IgG subclass는 모두 LPS antigen을 인식하지 못했다. 같은 group에서 염색강도의 개인적인 차이는 증명되었다. 이런 결과는 조기발 병형 치주질환에서 Pg의 fimbriae와 CPS가 immunodominant antigen이 될 수 있음을 제시한다. 더욱이 IgG subclass antibody가 이런 Pg의 immunoglobulin antigen을 선택적으로 인식함을 알았고, 이는 조기발병형치주질환의 병리에 immunodominant antigen과 함께 IgG의 기능적인 역할을 고려해야 함을 제시한다.

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CLINICAL AND MICROBIOLOGICAL EFFECT OF MINOCYCLINE-LOADED POLYCAPROLACTONE FILM ON RAPIDLY PROGRESSIVE PERIODONTITIS (급속진행형 치주염에서 Minocycline을 함유한 Polycaprolactone film의 임상 및 미생물학적 효과에 관한 연구)

  • Choi, Hyun-Soon;Um, Heung-Sik;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.24 no.2
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    • pp.421-432
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    • 1994
  • The local route of antibiotic administration can accomplish higher therapeutic doses in subgingival sites than those possible by systemic therapy. This investigation assessed on the clinical and microbiological effect of 30% Minocycline loaded polycaprolactone film (Mino-strip) on rapidly progressive periodontitis. Mino-strip was applied in the periodontal pockets of 15 patients with clinically diagnosed as a rapidly progressive periodontitis. 8sites for each patient with a 5mm probing pocket depth were selected in split mouth design and were assigned into group. i.e., placebo(group 1), supragingival scaling and R/P(group 2), Mino-strip applied only(group 3), R/P and Mino-strip applied(group 4). Supragingival scaling and oral hygiene instruction were performed 1 wk before experiment. Mino-strip was applied weekly on day 0 and 7. Clinical and microbiological test were performed on day 0, 7, 14, 28, 56. In R/P and Mino-strip applied group, Gingival index, GCF volume, probing depth and loss of attachment level were significantly reduced after the first weeks following treatment. In R/P and Mino-strip applied group, the relative proportions of spirochetes and motile rods were significantly reduced and the proportions of cocci and non motile rod were correspondingly increased for eight weeks following treatment. In R/P and Mino-strip treated group, total anaerobic and aerobic bacterial count were significantly decreased for the first two weeks following treatment and streptococcus count was decreased for eight weeks following treatment. In R/P and Mino-strip applied group, P. gingivalis, P. intermedius, B. forsythus, A. actinomycetemcomitans, F. nucleatum, E. corrodens, C. rectus counts were significantly reduced after the first week following treatment. According to this study, it is appeared that 30% Minocycline-loaded polycaprolacton film was effective in the treatment on rapidly progressive periodontitis.

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THE COMBINED EFFECT OF A LOCAL MINOCYCLINE DELIVERY SYSTEM AND MECHANICAL DEBRIDEMENT IN RADIDLY PROGRESSIVE PERIODONTITIS (급속진행형치주염에서 치석제거술과 국소 약물송달제재의 병용효과)

  • Chung, Hyun-Ju;Jin, Yu-Nam;Song, Woo-Sung;Kim, Young-Jun
    • Journal of Periodontal and Implant Science
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    • v.24 no.3
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    • pp.529-540
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    • 1994
  • Rapidly progressive periodontitis is known to be usually associated with systemic problems and improved with antibiotic therapy. Recent experiments in which bioresorbable polycaprolactone was polymerized with minocycline has shown that the system released effective antibiotic concentration during the 7 days' period. This clinical trial was to compare the efficacy of a minocycline film(poly-caprolactone+polyglycol+10% minocycline) insertion plus supragingival scaling(MS) or subgingival scaling & root planing(MSRP) with the scaling(S) or subgingival scaling & root planing alone(SRP), at improving the periodontal condition in RPP. Fifteen patients were examined for plaque accumulation, gingival inflammation, probing depth and attachment loss at baseline, then 1, 2, 4 and 8 weeks after 4 treatment regimens were randomly undergone in 4 comparable sites(PD>5mm, LA>3mm) in each subject. Results revealed statistically significant treatement effect with a reduction in a probing depth in SRP(2.0mm), MS(1.8mm), and MSRP(2.1mm). There was no significant reduction in the supragingival scaling alone group(0.6mm). Similarly, attachment levels were significantly improved in the SRP(1.5mm), MS(2.0mm) and MSRP(2.0mm) groups. Net % BOP reduction at 8 week compared to baseline was 6.7% (S), 26.7% (MS), 26.7% (SRP), and 33.3% (MSRP). MSRP produced the greatest improvement in BOP at 8 week. This data suggests that a subgingival minocycline delivery system as a adjunct to scaling alone or scaling & root planing may produce significant clinical benefits over scaling alone in rapidly progressive periodontitis patients.

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EFFECTS OF MINOCYCLINE-LOADED POLYCAPROLACTONE FILM ON RAPIDLY PROGRESSIVE PERIODONTITIS (급속진행형 치주염에서 국소약물 송달제제의 효과에 관한 연구)

  • Park, Gwi-Woon;Kim, Young-Wook;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
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    • v.23 no.3
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    • pp.411-421
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    • 1993
  • The purpose of this study was to assess the effect of polycaprolactone strip with minocycline on the periodontal pocket in humans and the various clinical parameters in rapidly progressive periodontitis. Nine patients with rapidly progressive periodontitis were selected for the study. They had not taken antibiotics for 6 months and had no history of dental treatment for 6 months before the study. They were in good general health. By the split-mouth method, patients received a supragingival scaling, experimental group (9sites) were subjected to subgingival placement of polycaprolactone strips(1 strip) containg 30% minocyclne and control group (9 site) were subjected to subgingival placement of not polycaprolactone strips(1 strip) containing 30 A Minocycline. Strips were replaced with freshly filled ones at 1 week and 2 week. All strips were removed from pockets at 3 week Clinical examination (plaque index, gingival index, probing pocket depth) and distribution on the bacteria morphology of subgingival plaque were monitored on baseline (0 week), 1, week, 2 week, 4 week and 8 week. The result were as follows : 1. Plaque index in experimental group was not significantly reduced during all weeks(P<0.05), but slightly reduced at 2, 4 and 8 weeks and that in control group was not significantly reduced during monitoring period. 2. Probing pocket depth was significantly reduced at 2, 4 and 8 weeks(P<0.05) in experimental group, but that in control group was not siginificantly changed during monitoring period. 3. Gingival index was significantly improved at 2, 4 and 8 weeks(P<0.05) in experimental group but that in control group was not significantly changed. 4. Percentage of cocci was significantly increased at 2, 4 and 8 weeks in experimental group but that in control group was not significantly changed. 5. Percentage of non-motile rods in both group were not significantly changed when compared with those of baseline(0 week) (P<0.05). 6. Percentage of motile rods was siginificantly reduced at 1, 2 and 4 weeks in experimental group (p<0.05) but that in control group was not significantly changed. 7. Percentage of spirochetes was siginificantly reduced during all weeks(P<0.05) but that in control group was not significantly changed. The result showed that polycaprolactone containing 30% minocycline effect the clinical index and bacterial morphotype.

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