• Journal of Periodontal and Implant Science
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• 제29권4호
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• pp.803-823
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• 1999

In order to reveal immunopathogenesis of periodontal tissue destruction, it is important to clarify the molecular mechanism of trafficking and retention of activated leukocytes, including monocytes/macrophages. Gingival fibroblasts may be involved in the regulation of inflammatory cell accumulation in the extravascular periodontal connective tissues via cytokine production and surface expression of adhesion molecules. In this study, it was investigated the molecular basis for the adhesive interactions between monocytes and fibroblasts such as peri-odontal ligament fibroblast(PDLF), human gingival fibroblast(HGF), and human dermal fibroblast(HDF). First, it was examined the evidence whether monocyte-fibroblast cell contact may cause signal transduction in fibroblasts. Being directly in contact with fixed human monocyte cell line THP-1, or U937, upregulation of IL-6 production, $TNF-{\alpha}$ mRNA expression and increased cell proliferation could be seen for fibroblasts. IL-6 production induced by monocyte- fibroblast coculture were further increased when fibroblasts had been pretreated with $IFN-{\gamma}$ or $IL-1{\beta}$ , and monocytes with LPS. Next, it was examined the expression of ICAM-1 which has been known to be involved in accumulation and activation of leukocytes in inflammatory diseases such as periodontitis. ICAM-1 was upregulated up to 10-fold on PDLF, HGF, and HDF by exposure to $IFN-{\gamma}$ or $IL-1{\beta}$. Furthermore, anti-ICAM-1 monoclonal antibody clearly blocked cocultureinduced IL-6 production by fibroblasts, suggesting that $ICAM-1/{\beta}_2$integrin pathway is involved in periodontal fibroblastmonocyte interaction. Overall, these findings provide evidence that periodontal fibroblasts could be involved in the accumulation and retention of monocytes/macrophages in periodontal inflammatory lesion at least in part by ICAM-1 expression. In addition, periodontal fibroblast-monocyte interaction could cause activation signals in fibroblasts intracellularly which result in cytokine production and cell proliferation. Thus, periodontal fibroblasts are speculated to play an important role in immunoregulation and tissue destruction in chronic periodontal diseases by interaction with monocytes/macrophages.

• 구강회복응용과학지
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• 제37권3호
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• pp.130-137
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• 2021

목적: 다양한 봉합술을 통해 임플란트 주변에 최적화된 각화점막을 확보하려는 시도가 진행되었다. 본 연구의 목적은 임플란트 식립 후 2개의 서로 다른 봉합술 시행 후 연조직의 치유 양상을 평가하는 것이다. 연구 재료 및 방법: 15명의 환자에서 18개의 임플란트가 식립되었고 연구에 포함되었다. 부가적인 골이식 없이 단순 임플란트 식립만 진행하였다. 2개의 서로 다른 봉합술을 이용해 paramarginal flap design을 시행한 협측 판막을 임플란트 치유 지대주 하방으로 고정하였다. 디지털 구내 스캐너를 이용하여 초진, 수술 직후, 발사, 3개월 시점에 스캔을 진행하였다. 각 시점에 따른 스캔 데이터를 인접치의 교두, 소와, 치유지대주 등의 여러 점들을 기준으로 초진 데이터와 중첩하였다. 각 시점의 스캔 데이터를 초진 데이터와 subtraction한 다음 임플란트 주위 연조직의 증가량에 해당하는 폐곡면의 부피를 측정하였다. 폐곡면의 부피는 mm³ 단위로 계측하였다. 3개 시점에서 2개의 서로 다른 봉합술에 의한 부피 변화를 비교하기 위해 nonparametric rank-based 분석을 시행하였다. 결과: 양쪽 군 모두 치유는 양호하였다. 양쪽 봉합군은 수술 후 즉시 연조직 부피의 증가를 보여주었다. 3개월에 걸쳐 부피는 시간에 따라 유의성 있게 감소하였다(P < 0.001). Flap folding suture 군의 연조직 부피는 3개월 시점에서 interrupted suture 군보다 더욱 높은 중앙값을 보였으나 통계적 유의성은 없었다(P > 0.05). 결론: 임플란트 시행 시 paramarginal flap 형태로 거상된 판막을 flap folding suture로 고정한 군은 3개월 치유 기간 후 interrupted suture 군보다 더욱 높은 연조직 증강 수치를 보였다. 하지만 좀더 장기적인 관찰 연구가 필요할 것으로 사료된다.

• Journal of Periodontal and Implant Science
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• 제45권2호
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• pp.62-68
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• 2015

Purpose: The goal of this study was to investigate the histomorphometric characteristics of the healing process of microcracks in the cortical bone after the installation of mini-implants (MIs). Methods: Self-drilling MIs were inserted into the tibial diaphysis of twelve adult male New Zealand rabbits. Four MIs per rabbit were placed randomly. The animals were divided into four groups according to the length of the healing period: group A was sacrificed immediately, group B was sacrificed after one week, group C was sacrificed after two weeks, and group D was sacrificed after four weeks. Cortical bone thickness was measured using micro-computed tomography, and histomorphometric analyses of the cumulative length of the microcracks (CLCr) and the total number of microcracks (NCr) were performed using hematoxylin and eosin staining. Results: The microcracks were radially and concentrically aligned in the peri-MI bone. The CLCr decreased significantly one week after the surgery, mainly due to healing of the concentrically aligned microcracks. The CLCr showed another significant decrease from two weeks after the surgery to four weeks after the surgery, mainly reflecting healing of the radially aligned microcracks. A statistically significant decrease in the NCr occurred as the microcracks healed from zero weeks to two weeks. However, no significant difference in the NCr was found between groups C and D. Conclusions: In order to improve the primary stability of MIs, delayed loading and a healing period of a certain length are recommended to ensure the optimal healing of microcracks and bone remodeling.

• 대한구순구개열학회지
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• 제15권2호
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• pp.69-82
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• 2012

Our Team Approach consists of following five stages; (1) Peri-natal care until lip repair After ultrasound diagnosis, some obstetricians recommend the mother with CL/P fetus to undergo prenatal counseling in our CLP clinic. On the day the CL/P baby was born, our oral surgeon, nurse, and pedodontist visit the maternity clinic, and take counseling and take impression for a feeding plate. The cheiloplasty is performed in three months old. (2) From lip repair to palatal repair At one year of age, Otorhinolaryngologist checks middle-ear disease. Palatoplasty is carried out at 1.5 - 2 years old. (3) In deciduous and early mixed dentitions Speech is the most important issue in social life for the CL/P subjects, therefore the training of velopharyngeal function is essential. Orthodontist monitors dentofacial development from 5 years of age. In the case of severe maxillary under-growth or severe collapse, maxillary protractor or lateral expansion is indicative, respectively. In early mixed dentition, upper central incisor on the cleft area erupts with some torsion, and then the traumatic occlusion with tooth torsion must be corrected. (4) In mixed dentition Right before the eruption of upper canines, secondary bone grafting is performed. One year prior to the operation, maxillary fan-type expansion is carried out to correct the collapse of maxillary segments. Following the surgical operation, the erupted canine will be moved into the transplanted bone to avoid alveolar resorption. (5) In permanent dentition Final tooth alignment is carried out after eruption of second molars. Some cases may require orthognathic surgery after physical maturation. Prosthetic oral rehabilitation including the dental-implant is carried out after age eighteen.

• Journal of Periodontal and Implant Science
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• 제48권1호
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• pp.22-33
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• 2018

Purpose: The purpose of this study was to evaluate the efficacy of the modified plaque score (MPS) for assessing the oral hygiene status of periodontitis patients. Methods: A total of 116 patients were included in this study. After evaluation of the $L{\ddot{o}}e$ and Silness gingival index (GI), Silness and $L{\ddot{o}}e$ plaque index (PlI), O'Leary plaque control record (PCR), and MPS, patients were randomly assigned to either a conventional tooth brushing instruction (C-TBI) group (n=56) or a professional intraoral tooth brushing instruction (P-TBI) group (n=60). The MPS and clinical parameters were re-evaluated after scaling and a series of root planing. The convergent validity of MPS with the PlI and PCR was assessed. The measurement time for MPS and PCR was compared according to the proficiency of the examiner. Results: After root planing, the GI, PlI, PCR, and MPS improved from their respective baseline values in both groups. Three different plaque indices including the MPS, showed significant differences between the C-TBI group and the P-TBI group after root planing. The MPS showed significant concurrence with the PCR and PlI. The mean time for PCR measurement was $2.76{\pm}0.71$ times longer than that for MPS measurement after 2 weeks of training. Conclusions: MPS seems to be a practical plaque scoring system compared with the PlI and PCR. These findings suggest that repetitive plaque control combined with an easily applicable plaque index (MPS) may facilitate more effective oral hygiene education and improved periodontal health.

• Journal of Microbiology and Biotechnology
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• 제32권4호
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• pp.522-530
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• 2022

In this study we aimed to develop novel ZnO-NP/chitosan/β-glycerophosphate (ZnO-NP/CS/β-GP) antibacterial hydrogels for biomedical applications. According to the mass fraction ratio of ZnO-NPs to chitosan, mixtures of 1, 3, and 5% ZnO-NPs/CS/β-GP were prepared. Using the test-tube inversion method, scanning electron microscopy and Fourier-transform infrared spectroscopy, the influence of ZnO-NPs on gelation time, chemical composition, and cross-sectional microstructures were evaluated. Adding ZnO-NPs significantly improved the hydrogel's antibacterial activity as determined by bacteriostatic zone and colony counting. The hydrogel's bacteriostatic mechanism was investigated using live/dead fluorescent staining and scanning electron microscopy. In addition, crystal violet staining and MTT assay demonstrated that ZnO-NPs/CS/β-GP exhibited good antibacterial activity in inhibiting the formation of biofilms and eradicating existing biofilms. CCK-8 and live/dead cell staining methods revealed that the cell viability of gingival fibroblasts (L929) cocultured with hydrogel in each group was above 90% after 24, 48, and 72 h. These results suggest that ZnO-NPs improve the temperature sensitivity and bacteriostatic performance of chitosan/β-glycerophosphate (CS/β-GP), which could be injected into the periodontal pocket in solution form and quickly transformed into hydrogel adhesion on the gingiva, allowing for a straightforward and convenient procedure. In conclusion, ZnO-NP/CS/β-GP thermosensitive hydrogels could be expected to be utilized as adjuvant drugs for clinical prevention and treatment of peri-implant inflammation.

• Clinics in Shoulder and Elbow
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• 제24권4호
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• pp.245-252
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• 2021

Background: In patients with total elbow arthroplasty (TEA), the soft-tissue around the elbow can be vulnerable to soft-tissue complications. This study aims to assess the outcomes after soft-tissue reconstruction following TEA. Methods: We retrospectively included nine adult patients who underwent soft-tissue reconstruction following TEA. Demographic data and disease characteristics were collected through medical chart reviews. Additionally, we contacted all four patients that were alive at the time of the study by phone to assess any current elbow complications. Local tissue rearrangement was used for soft-tissue reconstruction in six patients, and a pedicle flap was used in three patients. The median follow-up period was 1.3 years (range, 6 months-14.7 years). Results: Seven patients (78%) underwent reoperation. Four patients (44%) had a reoperation for soft-tissue complications, including dehiscence or nonhealing of infected wounds. Five patients (56%) had a reoperation for implant-related complications, including three infections and two peri-prosthetic fractures. At the final follow-ups, six patients (67%) achieved successful wound healing and two patients had continued wound healing issues, while two patients had an antibiotic spacer in situ and one patient underwent an above-the-elbow amputation. Conclusions: This study reports a complication rate of 78% for soft-tissue reconstructions after TEA. Successful soft-tissue healing was achieved in 67% of patients, but at the cost of multiple surgeries. Early definitive soft-tissue reconstruction could prove to be preferable to minor interventions such as irrigation, debridement, and local tissue advancement, or smaller soft-tissue reconstructions using local tissue rearrangement or a pedicled flap at a later stage.

• 대한치과교정학회지
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• 제39권4호
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• pp.203-212
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• 2009

골밀도가 높고 두꺼운 피질골에 마이크로임플란트를 self-drilling 방식으로 식립하는 경우 과도한 수준의 골부하 (bone loading)가 발생할 위험이 있으며 이는 인접골의 정상적인 골개형(bone remodeling)에 장애를 초래할 수 있다. 이에, 본 연구에서는 유한요소해석으로 두께 1.0 mm의 피질골에 Absoanchor SH1312-7 마이크로임플란트((주)덴토스, 대구, 대한민국)가 self-drilling 방식으로 식립되는 과정(10회전, 식립깊이 5 mm)을 모사(simulation)하였으며 식립 단계별로 피질골에 발생되는 스트레인을 조사하였다. 식립중 마이크로임플란트 첨부의 절삭연(cutting flute)에 의한 골삭제로 생기는 나사길(threaded groove)의 치수를 얻기 위하여 가토 경골에 마이크로임플란트를 식립/제거한 후 Micro CT (Explore Locus RS, GE Healthcare, Ontario, Canada)를 이용하여 기하형상을 측정하였으며 이를 치밀골의 유한요소모델에 반영하였다. 해석결과, 치밀골에 발생되는 스트레인은 임플란트 식립깊이에 따라 증가하였고, 초기단계에서 나사산에 인접한 골에 국한되던 과부하 부위(스트레인이 4,000${\mu}$-strain을 상회하는 영역)가 식립깊이 증가에 따라 인접골 전체, 즉 나사산 인접부는 물론 골(valley) 부위에 접하는 모든 영역으로 확장되었다. 본 연구를 통해, self-drilling 방식으로 마이크로임플란트를 식립할 때 치밀골에 발생하는 스트레인 크기는 생리적인 골개형을 저해할 수 있는 수준임을 확인할 수 있었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권4호
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• pp.301-307
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• 2004

The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

• 대한치과보철학회지
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• 제46권1호
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• pp.31-41
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• 2008

현대 치의학에서 임플랜트가 상실치 수복에 가장 효과적인 대안으로 여겨지면서, 임플랜트의 골유착을 보다 쉽게 얻기 위한 여러 연구들이 진행되고 있다. 이에 임플랜트의 형태 및 표면 처리법 등에 많은 진보가 이루어졌으며, 최근에는 임플랜트 주위골의 치유율을 높이고 골밀도를 증가시키는 약제의 개발도 보고되어, Pleurotus eryngii Quel와 Eleu- therococcus senticosus가 주성분인 $OPB-K^{(R)}$는 조골세포의 증식과 활성을 자극하고 파골세포의 생성과 활성을 억제하는 것으로 알려져 있다. 이에 본 연구에서는 특수 제작한 임플랜트를, 골다공증 유도를 위해 난소절제술을 시행한 백서 36 마리의 경골에 식립한 후 $OPB-K^{(R)}$ (Post-$Plant^{TM}$ Calcium, Oscotech, Korea)를 투여한 군을 실험군, 투여하지 않은 군을 대조군으로 2주, 4주, 6주에 $Periotest^{(R)}$, 골밀도 측정 및 조직학적 검사 등을 이용하여 골유착 정도를 비교분석하여 다음과 같은 결론을 얻었다. 1. $Periotest^{(R)}$ 측정 결과 시간이 경과함에 따라 실험군, 대조군 모두 수치가 낮아지며, 2주에서는 각 군간에 유의한 차이가 없었으나, 4 주, 6주에서는 각 군간에 유의한 차이가 관찰되었다(p<0.05). 2. 골밀도 측정결과, 난소절제에 따른 결과로 시간이 경과함에 따라 실험군, 대조군 모두 골밀도가 감소하는 경향을 나타내었으며, 2주와 4주에서는 각 군간에 유의한 차이가 없었으나, 6주에서는 각 군간에 유의한 차이가 관찰되었다(p<0.05). 3. 조직학적 검사결과 시간이 경과할수록 실험군이 대조군에 비해 골유착면에서 더 나은 소견을 보였다. 이상의 결과로 볼 때 $OPB-K^{(R)}$를 투여한 군이 대조군에 비해 임플랜트 주위 골밀도와 임플랜트 안정성면에서 더 나은 결과를 보였고 통계적으로 유의한 차이가 있었다. 임상적으로 임플랜트 식립 후 $OPB-K^{(R)}$를 환자에게 장기간 투여하는 것이 성공적인 임플랜트 시술에 좋으리라 사료된다.