• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.317-333
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• 1996

The main goal of periodontal regeneration is to be achieved by epithelial exclusion, periodontal ligament cell activation or alveolar bone regeneration. The purpose of this study was to investigate on the physico- chemical and biological characteristics of biodegradable chitosan beads. Chitosan beads were fabricated by ionic gelation with sodium tripolyphosphate and they had the size in 300um diameter. As therapeutic agent, flurbiprofen was incorporated into the beads by 10, 20% loading contents. The release of drugs from the chitosan beads was measured in vitro. Also, biological activity tests of flurbiprofen loaded chitosan beads including cytotoxicity test, ihhibition of $IL-1{\beta}$ production, suppression to $PGE_2$ production, collagenase inhibition test, the ability of total protein synthesis, and tissue response were evaluated. The amount of flurbiprofen released from chitosan was 33-50% during 7 days. Minimal cytotoxicity was observed in chitosan beads. Flurbiprofen released from chitosan beads significantly suppressed the $IL-1{\beta}$ production of monocyte, $PGE_2$ production and markedly inhibited collagenase activity. Meanwhile, flurbiprofen released from this system showed increased ability for protein synthesis. Throughout 4 -week implantation period, no significant inflammatory cell infiltrated around chitosan bead and also fibroblast like cell types at the beads - tissue interface were revealed with gradual degradation of implanted chitosan beads. From these results, it was suggested that flurbiprofen loaded chitosan beads can be effectively useful for biocompatible local delivery system in periodontal regeneration.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.152-159
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• 2016

Implant fixed prosthesis for the complete edentulous maxilla provides significant benefits in the aspects of functions and esthetics compared with the conventional denture. Implant supported fixed prosthesis are totally supported by implant, and thus stabilizes the prosthesis to the maximum degree as possible. Also, the improved retention and stability of fixed prosthesis enhance patients' psychological and psychosocial health. This clinical presentation describes a maxillary full arch implant-supported fixed prosthesis in complete maxillary edentulous patient who showed vertical and horizontal alveolar bone resorption in the anterior ridge. To rehabilitate the esthetics and proper lip support, the zirconia framework was fabricated and the pink porcelain was veneered to reproduce the natural gingival tissue. After 9 months of follow up, the restorations were maintained without complications and the patient was satisfied with the restoration both functionally and esthetically.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.757-762
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• 2014

Smoking is recognized as a health problem worldwide and there is an established tobacco epidemic in Saudi Arabia as in many other countries, with tobacco users at increased risk of developing many diseases. This cross sectional study was conducted to assess the prevalence of oral mucosal, potentially malignant or malignant, lesions associated with tobacco use among a stratified cluster sample of adults in Jeddah, Saudi Arabia. A sample size of 599 was collected and each participant underwent clinical conventional oral examination and filled a questionnaire providing information on demographics, tobacco use and other relevant habits. The most common form of tobacco used was cigarette smoking (65.6 %) followed by Shisha or Moasel (38.1%), while chewing tobacco, betel nuts and gat accounted for 21-2%, 7.7%, and 5% respectively. A high prevalence (88.8%) of soft tissue lesions was found among the tobacco users examined, and a wide range of lesions were detected, about 50% having hairy tongue, 36% smoker's melanosis, 28.9% stomatitis nicotina, 27% frictional keratosis, 26.7% fissured tongue, 26% gingival or periodontal inflammation and finally 20% leukodema. Suspicious potentially malignant lesions affected 10.5% of the subjects, most prevalent being keratosis (6.3%), leukoplakia (2.3%), erythroplakia (0.7%), oral submucous fibrosis (0.5%) and lichenoid lesions (0.4%), these being associated with male gender, lower level of education, presence of diabetes and a chewing tobacco habit. It is concluded that smoking was associated with a wide range of oral mucosal lesions, those suspicious for malignancy being linked with chewable forms, indicating serious effects.

• Journal of Periodontal and Implant Science
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• v.27 no.4
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• pp.845-866
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• 1997

Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggests that the application of electrical currents to periodontal defects could promote bone and cementum formation. The purpose of this study was to determine the effect of direct microcurrent to the periodontal regeneration of class III furcation defects in dogs. Class III furcation defects were surgically created on the third and the fourth premolars bilaterally in the mandibles of nine mongrel dogs. Experimental periodontitis were induced by placing small cotton pellets into the created defects for 3 weeks. The experimental sites were divided into three groups according to the treatment modalities: Group I-surgical debridement only; Group II-allogenic demineralized freeze dried bone grafting; Group III-allogenic demineralized freeze dried bone grafting and electrical stimulation. For fluorescence microscopic evaluation, calcein, oxytetracycline HCI and alizarin red were injected 2, 4 and 8 weeksfS days prior to sacrifice) after surgery. The animals were sacrificed in the 1st, 2nd, 4th and 8th week after periodontal surgery and the decalcified and undecalcified specimens were prepared for histological and histometrical examination. After the first and the second weeks, gingival recession was more severe in group I than groups II and III. After the fourth and the eighth weeks, there was no difference in the width of junctional epithelium and connective tissue attachment among the three groups, but the width of connective tissue attachment increased in group II at the eighth week, compared to the fourth week. The amount of bone repair in new attachment was significantly greater in group III, compared to groups I and II. New attachment formation was significantly greater in group III, compared to groups I and group II. These results suggest that electrical stimulation using microcurrent generator could be a useful tool for periodontal regenerative therapy in class III furcation defect.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.29 no.2
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• pp.84-91
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• 2020

Regeneration of interdental papilla damaged by periodontal disease is a very challenging task. So far, many dentists have devised and introduced great surgical methods. Comparing the pros and cons of the methods introduced so far, I came up with the best way to regenerate interdental papilla. Temporarily creating space between narrow interdental papilla, which cannot be solved by periodontal surgery alone, was a great help for connective tissue graft(CTG). The CTG was performed using a microblade, and only one vertical incision was performed off the gingival margin, and the graft was performed by inserting the grafts through here. Along with the orthodontic treatment, the area between the narrow interdental papilla was widened to make it easier for the CTG was carried out. After a period of maintenance, I was able to gather the teeth again with orthodontic force and regenerate the interdental papilla. I named this method ELSA (Enlargement of space-Labial graft-Squeezing-for Augmentation of papilla) technique.

• Journal of Periodontal and Implant Science
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• v.52 no.1
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• pp.28-38
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• 2022

Purpose: Macrophages play crucial roles as early responders to bacterial pathogens and promote/ or impede chronic inflammation in various tissues. Periodontal macrophage-induced pyroptosis results in physiological and pathological inflammatory responses. The transcription factor Dec2 is involved in regulating immune function and inflammatory processes. To characterize the potential unknown role of Dec2 in the innate immune system, we sought to elucidate the mechanism that may alleviate macrophage pyroptosis in periodontal inflammation. Methods: Porphyromonas gingivalis lipopolysaccharide (LPS) was used to induce pyroptosis in RAW 264.7 macrophages. Subsequently, we established an LPS-stimulated Dec2 overexpression cellular model in macrophages. Human chronic periodontitis tissues were employed to evaluate potential changes in inflammatory marker expression and pyroptosis. Finally, the effects of Dec2 deficiency on inflammation and pyroptosis were characterized in a P. gingivalis-treated experimental periodontitis Dec2-knockout mouse model. Results: Macrophages treated with LPS revealed significantly increased messenger RNA expression levels of Dec2 and interleukin (IL)-1β. Dec2 overexpression reduced IL-1β expression in macrophages treated with LPS. Overexpression of Dec2 also repressed the cleavage of gasdermin D (GSDMD), and the expression of caspase-11 was concurrently reduced in macrophages treated with LPS. Human chronic periodontitis tissues showed significantly higher gingival inflammation and pyroptosis-related protein expression than non-periodontitis tissues. In vivo, P. gingivalis-challenged mice exhibited a significant augmentation of F4/80, tumor necrosis factor-α, and IL-1β. Dec2 deficiency markedly induced GSDMD expression in the periodontal ligament of P. gingivalis-challenged mice. Conclusions: Our findings indicate that Dec2 deficiency exacerbated P. gingivalis LPS-induced periodontal inflammation and GSDMD-mediated pyroptosis. Collectively, our results present novel insights into the molecular functions of macrophage pyroptosis and document an unforeseen role of Dec2 in pyroptosis.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.30 no.2
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• pp.91-101
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• 2021

The interdental papilla area is a difficult area for connective tissue graft (CTG) due to its narrow space. So Regeneration of interdental papilla is very challenging work. It is very difficult when the teeth have contact with adjacent teeth, but if there was only 3mm of space between the teeth, CTG was not very difficult. Therefore, through the orthodontic force, a 3mm space between the teeth was intentionally created. The CTG was performed using a microblade, and only one vertical incision was performed off the gingival margin, and the graft was performed by inserting the grafts through here. After a period of maintenance, I was able to gather the teeth again with orthodontic force and regenerate the interdental papilla. I named this technique ELSA Technique (Enlargement of space - Labial graft - Squeezing - for Augmentation of papilla). If interdental papilla is lost due to periodontal disease, ELSA techniques can regenerate interdental papilla very efficiently.

• Journal of Periodontal and Implant Science
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• v.53 no.5
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• pp.376-387
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• 2023

Purpose: Peri-implantitis (PI) is an inflammatory condition associated with the destruction of bone tissue around a dental implant, and diode lasers can be used to treat this disease. In this study, we aimed to evaluate the effectiveness of a 940-nm diode laser for the nonsurgical treatment of PI. Methods: Twenty patients (8 women and 12 men) were enrolled in a split-mouth randomized controlled study. In the control group (CG), mechanical debridement with titanium curettes accompanied by airflow was performed around the implants. The test group (TG) was treated similarly, but with the use of a diode laser. Clinical measurements (plaque index, gingival index [GI], probing pocket depth [PPD], bleeding on probing [BOP], clinical attachment level, and interleukin-1β [IL-1β] in the peri-implant crevicular fluid) were evaluated and recorded at baseline and 3 months. IL-1β levels were determined using the enzyme-linked immunosorbent assay method. Results: The symptoms were alleviated in both groups at 3 months as assessed through clinical measurements. GI, BOP, and PPD were significantly lower in the TG than in the CG (P<0.05). The IL-1β level increased post-treatment in both groups, but this increase was only statistically significant (P<0.05) in the CG. Conclusions: The diode laser enabled improvements in clinical parameters in the periimplant tissue. However, it did not reduce IL-1β levels after treatment. Further studies about the use of diode lasers in the treatment of PI will be necessary to evaluate the effects of diode lasers in PI treatment.

• Journal of Periodontal and Implant Science
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• v.27 no.3
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• pp.621-631
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• 1997

To verify the effect of subgingival calculus on the periodontal tissues in periodontitis and the effectiveness of supragingival scaling to remove the calculus, 30 teeth from healthy group (Probing pocket depth:$PPD{\leq}mm$: HP group), 15 teeth from moderate group ($4{\leq}PD<7mm$:MP group), 30 teeth from advanced group (PPD>7mm: AP group) were selected and supragingival scaling was performed before extraction of all experimental teeth. After careful extraction, the teeth were cleaned with saline and disclosed with toluidine blue and carefully examined the relationship and distance between the calculus attached on the root surface and periodontal tissues. As a result, it was; 1. The calculus was not discovered on the root surface of teeth in HP group, but was in MP and AP group, mostly on interproximal surface and furca area. The shape of the attached calculus was ovoid, trepazoid and polygonal and the calculus was distributed randomly over the root surface. 2. PPD was more than the distance between the gingival margin to the level of attached connective tissue in AP group rather than in HP and MP group. 3. The length of calculus was $2.7mm{\pm}.44mm$ in HP group and $4.1{\pm}.89in$ AP group. 4. The distance between the apical margin of calculus and the level of attached connective tissue was $2.4{\pm}.33mm$ in MP group and $3.4{\pm}.89mm$ in AP group. 5. The length of subgingival calculus was tended to increase in relation to the probing pocket depth. Therefore, it can be concluded, the calculus in periodontal pocket can not be removed completely with supragingival scaling. As the terminal part of calculus was far away with limited distance from the periodontal tissue, it can be said that the calculus was not a direct factor in destroying the periodontal tissue. In this study, the extent of the plaque was not verified but the location of calculus can be used in clinical practice for complete removal of calculus when the distance relation bewteen calculus and plaque will be known.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.237-249
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• 2007

This study was performed to evaluate the effect of membrane exposure on new bone formation when guided bone regeneration with perforated titanium membrane on atrophic alveolar ridge. The present study attempted to establish a GBR model for four adult beagle dog premolar. Intra-marrow penetration defects were created on the alveolar ridge(twelve weeks after extraction) on the mandibular premolar teeth in the beagle dogs. Space providing perforated titanium membrane with various graft material were implanted to provide for GBR. The graft material were demineralized bovine bone(DBB), Irradiated cancellous bone(ICB) and demineralized human bone powder(DFDB). The gingival flap were advanced to cover the membranes and sutured. Seven sites experienced wound failure within 2-3weeks postsurgery resulting in membrane exposure. The animals were euthanized at 4 weeks postsurgery for histologic and histometric analysis. The results of this study were as follows: 1. There was little new bone formation at 4 weeks postsurgery. irrespectively of membrane exposure. 2. There was significant relationship between membrane exposure and bone graft resorption(P<0.05), but no relation between membrane exposure and infiltrated connective tissue. 3. There was much bone graft resorption on DFDB than ICB and DBB. 4. The less exposure was on the perforated titanium membrane, the more dense infiltrated connective tissue was filled under the membrane when grafted with ICB and DBB. but there was no relationship between the rate of membrane exposure and the percentage of infiltrated connective tissue area and no relationship between the percentage of the area in the infiltrated connective tissue and in the residual bone graft. Within the above results, bone formation may be inhibited when membrane was exposed and ICB and DBB were more effective than DFDB as a bone graft material when guided bone regeneration.