• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.597-606
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• 2008

Resorption of alveolar bone in periodontitis is due to excessive differentiation and activation of osteoclasts. Bacterial antigens causing periodontitis activates CD4 T cells, which leads to expressing RANK ligand (RANKL) on CD4 T cells. RANKL binds RANK on preosteoclasts or osteoclasts, and enhances the differentiation preosteoclasts into osteoclasts and the activation of mature osteoclasts. CD137, one of TNF receptor (TNFR) family, expressed on activated T cells binds with CD137 ligand (CD137L) on antigen presenting cells. Cross-linking of CD137 by CD137L acts as T cell co-stimulatory signals and, therefore, enhances the activation of T cell. In this study, I elucidated the biological responses of CD137L on (pre)osteoclasts and RANKL on T cells in the context of in vivo interaction between T cells and osteoclasts. RAW264.7, murine monocytic cells, constitutively express CD137L. Ligation of CD137L with anti-CD137L mAb inhibited RANKL-induced osteoclast formation in a dosedependent manner. Bone marrow cells are expressed CD137L by the treatment with M-CSF. Cross-linking of CD137L abolished M-CSF/ RANKL-evoked the formation of multi-nucleated osteoclasts. Both mouse CD4 and CD8 T cells are expressed RANKL following their activation. Ligation of RANKL with OPG, the decoy receptor for RANKL, inhibited both CD4 and CD8 T cell proliferation. These effects were attributed to RANKL-induced apoptosis. These data indicate that CD137L and RANKL on osteoclasts and T cells, respectively provide them with inhibitory signal.

• Journal of Periodontal and Implant Science
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• v.31 no.1
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• pp.179-193
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• 2001

previous studies have demonstrated an increase in bone mass and density with use of bisphosphonate in osteoporosis. This agent acts as an inhibitor of osteoclastic activity and results in increase of net osteoblastic activity. The purpose of the present study was to examine the effect of the bisphosphonate on osteoblastic activity of the human periodontal ligament cells in vitro. Periodontal ligament cells were primarily obtained from extracted healthy third molars. Cells of 4th to 6th passage were cultured in Dulbecco's modified Eagle's medium containing alendronate sodium or etidronate disodium at the concentration of $10^{-12}{\sim}10^{-6}mol/L$ in 5% $Co_2$ incubator at $37^{\circ}C$. Cell count and MTT assay for cellular activity were done at 2 to 7 days of culture. Alkaline phosphatase activity at 4 to 7 days of culture and formation of mineralized nodules at 28 days of culture with addition of $50{\mu}g/m{\ell}$ ascorbic acid, 10 nM${\beta}-glycerophosphate$, $10^{-7}M$ dexamethasone were evaluated. 1. Alendronate sodium Compared to the control, the proliferation of periodontal ligament cells was generally increased and the cellular activity was maintained at 2 days of culture and generally decreased at 7 days of culture. Alkaline phosphatase activity of periodontal ligament cells was inceased and the formation of mineralized nodules by periodontal ligament cells was enhanced compared to the control. 2. Etidronate disodium The proliferation of periodontal ligament cells was increased at 2 days of culture and decreased or maintained at 7 days of culture. Compared to the control, the cellular activity of periodontal ligament cells was generally decreased. Alkaline phosphatase activity of peridontal ligament cells was increased and the formation of mineralized nodules by periodontal ligament cells was enhanced compared to the control. These results suggest that alendronate sodium and etidronate disodium may have a potential effect on osteoblastic lineage of periodontal ligament cells, distinct from their inhibitory action on osteoclasts and could contribute to enhance periodontal regeneration and alveolar bone regeneration.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.129-136
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• 1991

The fibrin sealant was first designed as an alternative to surgical suture for the purpose of surface-to-surface union especially in parenchymal organs like the liver, spleen and kidney. The clinical application of currently used fibrin sealant was first introduced in 1972. The fibrin sealant consists of principal two components; lyophilized human fibrinogen and bovine thrombin. The fibrinogen component also contains coagulation factor XIII. A solution of aprotinin, an inhibitor of fibrinolysis is used to dissolve the fibrinogen and to provide the first component, and a solution of calcium chloride is also used to provide the second component. From July to December in 1990, during 6 months, we used fibrin sealant in the 28 patients of 33 various cases, in the following ways; supportive application of fibrin sealant after free autogenouse nerve graft for the repair of inferior alveolar nerve, facial nerve or accessory nerve, treament of hemangioma or lymphangioma to thrombosize and lead to the tumor shrinking, skin grafting to stimulate the adhesion and tissue repair, bone grafting in the patients of cleft alveolus, mandibular reconstruction or orthognathic surgery to facilitate the knitting of bone chips, tissue adhesion after tumor resection, radical neck dissection or flap reconstructions, and supportive adhesion of external auditory cannal after TMJ surgery via postauricular approach. No adverse effects were observed, none of the patients developed hepatitis or other blood transmitted disease, and the wound healing were acceptable.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.293-304
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• 2011

The purpose of this study was to investigate the displacement and pattern of stress distribution on periodontal ligaments of maxillary first and second molar, and on orthodontic mini-implant (OMI) surface, according to three different insertion angles to the bone surface of OMI using Dragon helix appliance, which is a newly introduced scissors-bite correcting appliance. OMI were placed between second premolar and first molar with three different insertion angles (45, 60, 90 degrees). Displacement and maximum stress distribution area (MSDA) were analyzed by finite element analysis. When the insertion angle to the alveolar bone surface was 90 degrees, maxillary first and second molar both exhibited MSDA at the palatal root apex. Maxillary first molar did not show any significant displacement, while the second molar exhibited intrusive and palatal displacement. On the OMI, as the insertion angle decreased, the MSDA shifted towards the tip, and the amount of displacement had increased. When the OMI was inserted at a 90 degree angle, anchor loss was minimized and scissors-bite correcting effect was maximized.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.3
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• pp.191-197
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• 2012

Esthetics is important in restoring maxillary anterior area. Alveolar bone resorption and loss of interdental papilla may be minimized by immediate implantation. Previous studies showed successful results with the immediate implantation in healthy extraction socket, while many of these studies objected the immediate implantation into extraction sites with periapical lesions. Recent studies, however, reported successful results of the immediate implantation into extraction sites with periapical lesions with careful debridement of extraction sockets and general medication of antibiotics prior to implantation. A 73-year-old female visited the department of Prosthodontics in ${\bigcirc}{\bigcirc}$ University Dental Hospital with the chief complaint of fallen post-core and crown on left maxillary incisor. Although the incisor was with vertical root fracture and periapical lesion, the immediate implantation following the extraction of tooth was planned. Thorough socket debridement, irrigation with chlorhexidine, and tetracycline soaking were followed by immediate implantation. The general medication of antibiotics (Moxicle Tab.$^{(R)}$, 375 mg) was prescribed before and after the surgery. Immediate provisional restoration was delivered two days after the surgery, and the definitive metal-ceramic restoration was placed about six months later after reproducing the emergence profile from the provisional restoration. This case presents satisfying result esthetically and functionally upto two years after the placement of prosthesis with the harmonious gingival line and no loss of marginal bone.

• Journal of Periodontal and Implant Science
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• v.49 no.6
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• pp.355-365
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• 2019

Purpose: The modified minimally invasive surgical technique (M-MIST) has been successfully employed to achieve periodontal regeneration. Platelet-rich fibrin (PRF) is known to enhance wound healing through the release of growth factors. This study aimed to observe the outcomes of periodontal surgery when M-MIST was used with or without PRF for the treatment of isolated intrabony defects. Methods: This randomized clinical trial was conducted on 36 systemically healthy patients, who had chronic periodontitis associated with a single-site buccal probing pocket depth (PPD) and clinical attachment level of ≥5 mm. Patients were randomly divided into 2 groups: the test group treated with M-MIST and PRF, and the control group treated with M-MIST alone. The primary periodontal parameters analyzed were PPD, relative attachment level (RAL), and relative gingival margin level. The radiographic parameters analyzed were change in alveolar crest position (C-ACP), linear bone growth (LBG), and percentage bone fill (%BF). Patients were followed up to 6 months post-surgery. Results: Intragroup comparisons at 3 and 6 months showed consistently significant improvements in PPD and RAL in both the groups. In intergroup comparisons, the improvement in PPD reduction, gain in RAL, and the level of the gingival margin was similar in both groups at 3 and 6 months of follow-up. Furthermore, an intergroup comparison of radiographic parameters also demonstrated similar improvements in C-ACP, LBG, and %BF at 6 months of follow-up. Conclusions: M-MIST with or without PRF yielded comparable periodontal tissue healing in terms of improvements in periodontal and radiographic parameters. Further investigation is required to confirm the beneficial effects of PRF with M-MIST.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.262-269
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• 2011

Ameloblastic fibroma is rare true benign mixed odontogenic tumor. Most of these tumors occur in the posterior region of the mandible under 20 years of age. It develops generally associated with unerupted tooth and grows slowly on the surface of alveolar bone, therefore interferes normal tooth eruption. These lesions rarely showing a little bony expansion, are usually asymptomatic and are discovered incidentally on routine dental exam. It is similar to amleoblastic fibroodontoma and ameloblastic fibrodentinoma clinically and roentgenographically but represents no dental hard tissue formation histologically. Enucleation and curettage of surrounding bone are generally recommended options for treatment. Even though there are some reports of recurrence and malignant transformation and more aggressive treatment options like block resection are suggested sometimes, but in most cases, recurrence is unusual because it is well encapsulated and easily separated from adjucent bony socket. In these cases, we did conservative treatment such as enucleation and curettage to the patients who were visited for ameloblastic fibroma associated with delayed eruption of lower first molar. After regular check-ups, we found relatively natural eruption process of combined teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.3
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• pp.522-528
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• 2006

When tooth is displaced within the alveolar bone, it could apply pressure and rupture the apical vessels. Pulpal reaction in such case is affected by the stage of root formation, amount of intrusion and pulpal infection. Determining the need of pulp treatment depends on the pulp vitality. Therefore, periodic vitality tests, coronal color changes and radiographic root resorption signs should be observed through periodic post-trauma follow-up. Pulp necrosis, pulp canal obliteration, external root resorption, root ankylosis and marginal bone loss could result from periodontal injuries. Negative sign changes from positive signs of vitality tests suggest pulp necrosis. In this case, pulp treatment should be held before root resorption occurs. By comparing the following two cases, complications of intrusion and factors producing them could be confirmed, thus we propose to report these two cases.

• Journal of Periodontal and Implant Science
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• v.50 no.4
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• pp.238-250
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• 2020

Purpose: This study aimed to evaluate the biocompatibility and the mechanical properties of ultraviolet (UV) cross-linked and biphasic calcium phosphate (BCP)-added collagen membranes and to compare the clinical results of ridge preservation to those obtained using chemically cross-linked collagen membranes. Methods: The study comprised an in vitro test and a clinical trial for membrane evaluation. BCP-added collagen membranes with UV cross-linking were prepared. In the in vitro test, scanning electron microscopy, a collagenase assay, and a tensile strength test were performed. The clinical trial involved 14 patients undergoing a ridge preservation procedure. All participants were randomly divided into the test group, which received UV cross-linked membranes (n=7), and the control group, which received chemically cross-linked membranes (n=7). BCP bone substitutes were used for both the test group and the control group. Cone-beam computed tomography (CBCT) scans were performed and alginate impressions were taken 1 week and 3 months after surgery. The casts were scanned via an optical scanner to measure the volumetric changes. The results were analyzed using the nonparametric Mann-Whitney U test. Results: The fastest degradation rate was found in the collagen membranes without the addition of BCP. The highest enzyme resistance and the highest tensile strength were found when the collagen-to-BCP ratio was 1:1. There was no significant difference in dimensional changes in the 3-dimensional modeling or CBCT scans between the test and control groups in the clinical trial (P>0.05). Conclusions: The addition of BCP and UV cross-linking improved the biocompatibility and the mechanical strength of the membranes. Within the limits of the clinical trial, the sites grafted using BCP in combination with UV cross-linked and BCP-added collagen membranes (test group) did not show any statistically significant difference in terms of dimensional change compared with the control group.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.2
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• pp.106-113
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• 2011

The object of this clinical study was to evaluate the short-term outcome of modified resin-bonded fixed partial dentures which utilizes the original tooth undercuts and different path of insertion of components. Materials and methods: 71 units of modified RBFPDs that were used in 21 patients at the Department of Prosthodontics, College of Dentistry, Yonsei University were evaluated. The follow-up period was up to 25 months, the mean being 7 months. Survival rate, mobility, percussion, probing depth, bleeding on probing, plaque index was recorded and radiographs were taken to monitor alveolar bone loss. Results & Conclusion: Within the limits of this short term retrospective study, it was concluded that: 1. No mechanical failure such as debonding or fracture of the framework was found during the follow-up period. 2. The periodontal apparatus was stable and no clinical change was observed after prosthetic treatment. 3. No significant marginal bone loss was found in the radiographic evaluation.