• 제목/요약/키워드: Periodontal Pockets

검색결과 64건 처리시간 0.022초

Minocycline 국소 약물 방출 제제의 치주질환 치료 효과 (Effects of locally-delivered minocycline hcl on controlled periodontal disease)

  • 정미현;권영혁;허익;이만섭;박준봉
    • Journal of Periodontal and Implant Science
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    • 제28권1호
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    • pp.37-56
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    • 1998
  • The purpose of this study was to evaluate the clinical and microbiological outcomes following the use of 30% minocycline-loaded polycaprolacton film and 2% minocycline-loaded gel that was applied locally into pockets combined with scaling and root planing. 25 human subjects who were non-pregnant, non-lactating, aged 20-50 and diagnosed as moderate to advanced adult periodontitis were enrolled. Subjects were excluded if they had a history of severe acute or chronic systemic disease, if they required antibiotic prophylaxis for dental treatment for any reason, or if they reported a history suggestive of hypersensitivity reactions to minocycline or tetracycline. 4quadrants that had several teeth with a 5-8mm probing pocket depth and radiographic evidence of alveolar bone loss for each patient were selected and divided into test sites and control sites according to the split-mouth design. Scaling and root planing was done for each site at baseline(0week). Test sites received the minocycline gel and strip and control sites had saline irrigation. The patients received both treatments simyltaneously. Subgingival irrigation of sterile saline was applied to the control sites for approximately 30 seconds. Minocycline strip and gel was applied into the periodontal pocket at 1, 2, 3, 4 weeks each after scaling and root planing in the test sites. The clinical and microbiological measurements were made at baseline and at the follow-up visits 6, 10, 14, 20 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth and Periocheck test was significantly reduced and the relative proportions of spirochetes and motile rods were significantly reduced and the proportion of cocci was correspondingly increased, in locally delivered minocycline strip group compared to saline irrigation group. 2. In locally delivered minocycline gel group, The effect was the same with minocycline strip group as compared with saline irrigation therapy. 3. There was no significant differences between minocycline strip group and minocycline gelgroup. In conclusion, minocycline HCl local drug delivery combined with scaling and root planing may provide added improvement of clinical and microbiological responses by inhibiting bacterial recolonization of treated sites. It is suggested that the local administration of minocycline-HCl in the periodontal pocket is effective when combined with subgingival mechanical debridement.

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염증성 치은에 대한 Nd:YAG laser 조사효과에 관한 임상적 연구 (A clinical study of the effect of Nd:YAG laser irradiation on inflamed gingiva)

  • 조형수;김현섭;임기정;김병옥;한경윤
    • Journal of Periodontal and Implant Science
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    • 제26권2호
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    • pp.531-541
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    • 1996
  • Periodontal disease is characterized by destruction of supporting tissues caused by invasion of plaque bacteria and defense mechanism of host. Many dentists are very interested in laser therapy on various intraoral soft tissue lesions including inflammatory periodontal pocket. In order to determine the therapeutic effect of intrapocket irradiation of a pulsed- Nd : YAG laser on the inflammatory periodontal pockets, bilateral 60 teeth with 4-6mm in probing pocket depth and gingival inflammation were selected and evaluated by sulcus bleeding index(SBI), and plaque index(pI) for baseline record. Intrapocket irradiation($300{\mu}m$ fiber optic, I.5W power, for 2 min.) of a pulsed-Nd : YAG laser(EL.EN.EN060, Italy) was applied on half of them. As the control group, the same procedure except power-off was repeated on the contralateral 30 teeth. At 1-, 2-, 3-, and 4-week after intrapocket manipulation, every tooth was reevaluated by the same clinical indices. And the difference between the lased group and control group was statistically analyzed by paired t-test and Chi-square test in Microstat program. Following results were obtained: 1. Until I-week and 2-week after intrapocket manipulation, SBI was lowered in both lased group and control group, compared to baseline SBI, but from 3-week after, the recovering tendency toward baseline was noted, and at only 2-week after, the number of teeth showing lowered SBI was significantly more in lased group than in control group(p<0.05). 2. PI of both lased group and control group was lowered through whole experimental period from I-week to 4-week after, compared to baseline PI(p<0.05), but there was no significant difference between lased group and control group(p>0.1). The results suggest that intrapocket irradiation of a pulsed-Nd:YAG laser may lead somewhat remission of gingival inflammation, but for more favorable therapeutic result the thorough root planing should be necessarily accompanied with gingival curettage.

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단순만성치주염환자와 2형 당뇨환자의 만성치주염에서 Matrix metalloproteinase-1의 발현양상 (Expression of Matrix metalloproteinase-1 between Simple Chronic Periodontitis and Type 2 Diabetes associated Chronic Periodontitis on Protein level)

  • 이재목
    • Journal of Periodontal and Implant Science
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    • 제35권3호
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    • pp.649-659
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    • 2005
  • 본 연구의 목적은 전신적으로 건강한 치주질환자를 대조군으로 하여 제 2형 당뇨병을 동반한 치주질환자의 치은조직에서 MMP-1의 발현양상을 관찰, 비교하는 것으로 당뇨병을 동반한 경우 MMP-1의 발현양상이 변화되는지의 여부를 연구하였다. 경북대학교 병원 치주과에 내원한 환자 중 검사 및 수술에 동의한 환자로 전선 질환이 없고 부착 소설이 없거나 안정되어 있으며 치은 염증 소견이 없는 환자를 정상조직군, 임상적 치주낭 깊이가 5 mm 이상이고 방사선 사진상 치조골 소실이 분명한 환자를 만성 치주염 환자군, 심각한 전신적 합병증, 감염등의 위험요인이 없고 2형 당뇨병으로 진단받은 환자로서 만성 치주염으로 진단된 환지군 각 8명을 대상으로 하였다. 만성 치주염 환자와 당뇨병을 가진 만성 치주염 환자에서 치은 염증 소견을 보이는 치은조직을 채득하고 액화질소에 넣어 급속 동결고정시킨 후 MMP-1의 발현 양상을 western blot analysis를 통해 관찰하였고, densitometer를 이용하여 상대적 발현을 정량, 각 조직의 ${\beta}-actin$을 이용하여 표준화하여 각 군의 평균치를 비교하였다. 각 군 간의 차이를 one way ANOVA test로 분석하였다. 모든 군에서 분자량 53 kDa의 MMP-1에 상응하는 띠가 나타났으며 정량결과 전신적으로 건강한 치주염 환자군에서 MMP-1의 발현이 당뇨병을 동반한 치주염 환자군과 정상조직군의 치은조직에서보다 높게 나타났으나 통계적으로 유의한 차이는 나타나지 않았다. 치은염증의 존재시 MMP-1의 발현이 다소 증가됨을 관찰하였으나 통계적으로 유의한 수준은 아니였으며, 당뇨병을 동반한 치주염 환자군에서 전신적으보 건강한 치주염 환자군에서 보다 MMP-1의 발현이 감소되는 경향을 보였다.

2형 당뇨병환자의 만성 치주염 치은조직에서 골흡수 인자의 발현 양상 비교 (The Gingival Tissue Levels of Bone Resorptive Mediators in Human Chronic Periodontitis with Type 2 Diabetes Mellitus)

  • 김미정;류상호;박진우;서조영;이재목
    • Journal of Periodontal and Implant Science
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    • 제37권4호
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    • pp.743-753
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    • 2007
  • Purpose: The purposes of this study were to compare and quantify the expression of MMP-3, $PGE_2$ and IL-6 in the gingival tissues of patients with $type_2$ diabetes mellitus and healthy adults with chronic periodontitis. Material and methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was devided into three groups. Group 1(n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2(n=8) is inflamed gingiva from patients with chronic periodontitis. Group 3(n=8) is inflamed gingiva from patients with chronic periodontitis associated with type 2 DM. Tissue samples were prepared and analyzed by Westernblotting. The quantification of MMP-3, $PGE_2$ and IL-6 were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. Results: 1. The expression levels of MMP-3 were shown highest in group 3 compared to group 1 and 2, and It showed increasing tendency in group 2 and 3. 2. The expressions of $PGE_2$ and IL-6 were shown increasing tendency in group 2 and 3, and It was highest in group 3. 3. As expressions of MMP-3 were increased, $PGE_2$ and IL-6 expressions showed increasing tendency in group 3 than group1 and 2, although there were no proportional relationship. Conclusion: This study demonstrated that the expression levels of MMP-3, $PGE_2$ and IL-6 will be inflammatory markers of periodonta linflamed tissue and DM. It can be assumed that MMP-3 affect to expressions of $PGE_2$ and IL-6 in progression of periodontal inflammation with alveolar bone resorption to type 2 DM.

만성 치주염 환자에서 2형 당뇨병이 $PGE_2$, MMP-14 및 TIMP의 발현양상에 미치는 영향 (The Influence of Diabetes on of $PGE_2$, MMP-14 and TIMP Expressions in Human Chronic Periodontitis)

  • 김선우;박진우;서조영;이재목
    • Journal of Periodontal and Implant Science
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    • 제37권4호
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    • pp.755-766
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    • 2007
  • Purpose: The purposes of this study were to compare and quantify the expression of $PGE_2$, MMP-14 and TIMP-1 in the gingival tissues of patients with type 2 diabetes mellitus and healthy adults of chronic periodontitis with alveolar bone resorption. Material and methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was devided into three groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2 (n=8) is inflammed gingiva from patients of chronic periodontitis with alveolar bone resorption. Group 3(n=8) is inflammed gingiva from patients of chronic periodontitis with alveolar bone resorption associated with type 2 diabetes. Tissue samples were prepared and analyzed by Western blotting. The quantification of $PGE_2$ MMP-14 and TIMP-1 were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. Results: The expressions of MMP-14 and TIMP-1 were showed increasing tendency in group 2 & 3 compared to group 1. The expressions of $PGE_2$, MMP-14 were showed increasing tendency in group 3 compared to group 1 and group 2. According to MMP-14 levels were increasing, $PGE_2$ showed increasing tendency in group 3, and although $PGE_2$, MMP-14 levels were increasing, TIMP-1 levels were similar expressed comparing to group 2. Conclusion: In conclusion, this study demonstrated that the expression levels of MMP-14 and TIMP-1 had increasing tendency in inflammed tissue. It can be assumed that $PGE_2$ and MMP-14 may be partly involved in alveolar bone resorptive process and the progression of periodontal inflammation associated to type 2 DM.

설태의 형광특성 - 설태 형광현상의 발현기전 소개 및 제안 - (Fluorescence of Tongue Coat - Mechanism of Tongue Coat Fluorescence and Suggestions on Development of Digital Tongue Diagnosis System -)

  • 김지혜;남동현
    • 대한한의진단학회지
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    • 제15권1호
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    • pp.47-54
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    • 2011
  • In traditional Korean medicine, inspection of the tongue is an important method of making medical diagnoses and determining prognosis. We surveyed the fluorescence characteristics of the tongue coat in the ultraviolet light. The tongue coat comprises micro-organisms, blood metabolites, leukocytes from periodontal pockets, large amounts of desquamated epithelial cells released from the oral mucosa and different nutrients. In the ultraviolet light tissues of the oral cavity generally emit weak red or green fluorescence, which is not easily seen by the human eye, but is readily detected. This fluorescence has been proved to be due to the production of porphyrins by oral micro-organisms. While the composition of motile micro-organisms on the dorsum of the tongue is not constant, variations also occur persistingly in the fluorescence characteristics of the tongue coat. But because live bacteria contain a variety of intracellular biomolecules that have specific excitation and emission wavelength spectra characterizing their intrinsic fluorescence, the tongue coat emits fluorescence. the tongue itself, on the other hand, emits very weak or not fluorescence. In conclusion, we suggests that the uncoated tongue area be eliminated from the coated tongue area with the difference between the fluorescence characteristics of the tongue and that of the tongue coat.

Human Peripheral Polymorphonuclear Leukocyte에 대한 Proinflammatory Cytokinessl의 작용 (EFFECTS OF PROINFLAMMATORY CYTOKINES ON THE HUMAN PERIPHERAL POLYMORPHONUCLEAR LEUKOCYTES)

  • 송요한;외귀옥;이인규;소서영;문대희;이인우;김형섭
    • Journal of Periodontal and Implant Science
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    • 제25권2호
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    • pp.267-278
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    • 1995
  • Human polymorphonuclear leukocytes(PMN) are the most numerous host cell in periodontal pockets and their presumed role is to form a protective barrier between the bacteria and periodontal tissues. Microbial component LPS activates macrophages to produce $IL-1{\beta}$, $MIP-1{\alpha}$, $-1{\beta}$, $TNF-{\alpha}$ and IL-6, etc. These cytokines have autocrine function to the macrophages, and paracrine function to other cell such as PMN and affect them to produce some biological functions. In the present study, human PMN were tested for the expression of $IL-1{\beta}$ and $MIP-1{\alpha}$ mRNA. Also we performed the receptor binding assay and in vitro assay for the antimicrobial action of HL-60 cell to determine whether HL-60 can replace the peripheral PMN in analyzing the biological functions. PMN were stimulated with $IL-1{\beta}$, TPA, $MIP-1{\alpha}$, LPS, IL-2 and total cytoplasmic RNA were extracted for the northern blot analysis. In order to determine the induction kinetics of $IL-1{\beta}$ or $MIP-1{\alpha}$ mRNA expression, cells were stimulated for 0,1,2,3 hours. We found peak expression of $IL-1{\beta}$ mRNA after 1hr of induction with $IL-1{\beta}$, LPS and after 2hr of induction with TPA. $MIP-l{\alpha}$ also induced but a scarce $IL-l{\beta}$ message from PMN. In contrast to the $IL-l{\beta}$ mRNA expression, $MIP-1{\alpha}$ were not induced from PMN in any culture conditions. Receptors for $MIP-1{\alpha}$ were identified on dibutyryl cyclic AMP(dbcAMP)-treated HL-60 as well as peripheral PMN. dbcAMP treatment significantly enhanced antimicrobial action of undifferentiated HL-60 cell. MIP-1 further increased enhancing effect of dbcAMP. $IL-1{\beta}$, to a lesser extent, also increased dbcAMP-induced enhancing effect of antimicrobial action of HL-60 cell.

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단순 만성 치주염 환자 및 2형 당뇨병환자의 만성치주염 치은조직에서 IL-6, elastase 및 ${\alpha}_1-PI$의 발현 양상 비교 (The comparison of IL-6, elastase and ${\alpha}1-PI$ expressions in human chronic periodontitis with type 2 diabetes mellitus)

  • 박재완;이재목
    • Journal of Periodontal and Implant Science
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    • 제37권sup2호
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    • pp.325-338
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    • 2007
  • 본 실험에서는 제2형 당뇨병 환자와 비당뇨 환자들에서 만성 치주염 부위의치은 및 건강한 치은에서 염증 매개체 중 하나인 IL-6, elastase 및 ${\alpha}_1-PI$의 발현에 대해 상호 비교 분석함으로서 염증, 혈당이 미치는 영향을 밝히고 제 2형 당뇨병 환자에서 심한 치주조직 파괴의 기전을 연구하고자 하였다. 경북대학교병원 치주과 내원환자 중 제2형 당뇨병 환자와 비당뇨 환자들 및 치주질환이 없는 건강인 대조군을 대상으로 여러 가지 환자요소, 임상 치주상태를 기록하고, 전신적으로 건강한 환자의 건강한 부위(n=8, Group 1), 전신적으로 건강한 환자의 만성 치주염 부위(n=8, Group 2), 제2형 당뇨병 환자의 만성 치주염 부위 (n=8, Group 3)에서 각각 변연치은을 채득하고 액화질소에 급속 동결하였다. Western blotting을 이용하여 각 조직내 IL-6, elastase 및 ${\alpha}_1-PI$의 발현을 관찰, densitometer를 이용하여 상대적 발현을 정량, 각 조직의 ${\beta}-actin$을 이용하여 표준화하여 실험군과 대조군들의 평균치를 비교하여 다음과 같은 결과를 얻었다. 1. IL-6의 발현은 2군과 3군에서 증가되는 경향을 보였으며 3군에서 가장 높게 나타났다. 2. Elastase의 발현도 2군과 3군에서 증가양상을 보였으며, 3군에서 가장 높게 나타났다. 3. ${\alpha}_1-PI$의 발현정도는 1군에 비해 3군에서 증가되는 경향을 보였다. 4. ${\alpha}_1-PI/elastase$ 비율은 1군에 비해 2군과 3군에서 감소되었으며, 특히 3군에서 가장 감소되었다. 5. 3군에서 IL-6 발현이 증가됨에 따라 Elastase 발현이 증가되는 경향을 보였으나, IL-6와 Elastase 수치가 증가함에도 불가하고 ${\alpha}_1-PI$ 수치는 1군에 비해 약간 증가되는 경향을 보였다. 결론적으로 IL-6와 elastase는 만성 치주염과 제2형 당뇨병 환자의 만성 치주염 부위에서 염증상태에 따른 지표로 응용할 수 있으리라 생각되며, ${\alpha}_1-PI/elastase$ 비율 또한 2형 당뇨환자의 만성치주염 부위에서 중요한 측정인자가 될 수 있으리라 생각된다.

흡수성 차폐막을 이용한 조직유도재생술의 임상적 효과 (Clinical comparison of resorbable and nonresorbable Barrier in guided tissue regeneration of human intrabony defects)

  • 허인식;권영혁;이만섭;박준봉;허익
    • Journal of Periodontal and Implant Science
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    • 제29권1호
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    • pp.193-207
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    • 1999
  • The purpose of this study was to compare the clinical results of guided tissue regeneration(GTR) using a resorbable barrier manufactured from an copolymer of polylactic acid (PLA) and polylaetic-glycolic acid(PLGA) with those of nonresorbable ePTFE barrier. Thirty two patients(25 to 59 years old) with one radiographically evident intrabony lesion of probing depth ${\geq}$6mm participated in a 6-month controlled clinical trial. The subjects were randomly divided into three independent groups. The first group(n=8) received a ePTFE barrier. The second group (n=12) received a resorbable PLA/PLGA barrier. The third group (n=12) received a resorbable PLA/PLGA barrier combined with an alloplastic bone graft. Plaque index (PI), gingival index(GI), probing depth(PD), gingival recession, clinical attachment level(CAL), and tooth mobility were recorded prior to surgery and at 3, 6 months postsurgery, Statistical tests used to analyze these data included independent t-test, paired t-test, one-way ANOVA. The results were as follows : 1. Probing depth was significantly reduced in all groups at 3, 6 months postsurgery and there were not significant differences between groups. 2. Clinical attachment level was significantly increased in all groups at 3, 6 months postsurgery and there were not significant differences between groups. 3. There were not significant differences in probing depth, clinical attachment level, gingival recession, tooth mobility between second group (PLA/PLGA barrier) and third group (PLA/PLGA barrier combined with alloplastic bone graft) 4. Tooth mobility was not significantly increased in all groups at 3, 6 months postsurgery and there were not significant differences between groups. In conclusion, PLA/PLGA resorbable barrier has similar clinical potential to eP'IFE barrier in GTR procedure of intrabony pockets under the present protocol.

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다발성 연조직 종괴를 동반한 급성 림프구성 백혈병의 증례 보고 (Case report of acute lymphoblastic leukemia with multiple soft tissue mass)

  • 장정용;허경회;이원진;허민석;이삼선;최순철
    • Imaging Science in Dentistry
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    • 제35권2호
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    • pp.111-114
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    • 2005
  • A 15-year-old patient, who had been diagnosed and treated as Burkitt cell type acute lymphoblastic leukemia (ALL-L3) already, visited our department. He complained of gingival enlargement and loosening teeth 1 month ago. The clinical examination revealed anterior open bite, gingival enlargement, and nontender swelling particularly in molar regions of both jaws. Deep periodontal pockets and severe mobility was shown on most of the teeth. The panoramic radiographs showed severe bone destruction and extrusion of the molars. The contrast enhanced CT showed multiple enhanced mass and bone marrow obliteration in both jaws. Chemotherapy was done and the swelling was subsided at 1 month later. In conclusion, radiologic findings of leukemia with soft tissue mass, known as chloroma or granulocytic sarcoma, mimic those of lymphoma, so blood test may be needed for the final diagnosis.

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