• Journal of Periodontal and Implant Science
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• v.24 no.3
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• pp.618-632
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• 1994

The ultimate goal of periodontal therapy is promoting the regeneration of lost periodontal tissue. The purpose of this study is to evaluate the effect of treatment using decalcified freeze dried bone allograft as a bone graft material. 47 intrabony defects from 27 patients with clinical diagnosis of chronic periodontitis were selected among those 24 defects were treated via flap operation only and designated as the control group, the other 23 defects were treated with decalcified freeze dired bone allografting via flap operation and designated as the experimental group. Clinical parameters including probing depth, loss of attachment, probing bone level and gingival recession have been recorded at 6th months, and the significance of the changes has been analyzed. The results are as follows : 1. Probing depths were reduced significantly in both control group($2.75{\pm}0.99mm$) and experimental group($3.69{\pm}0.97mm$) postoperatively(p<0.01). Experimental group showed significantly higher decrease compared to the control group(p]0.01). 2. Loss of attachment showed statistically significant decrease in both control group($1.77{\pm}1.08mm$) and experimental group postoperatively($2.70{\pm}1.55mm$). Experimental group showed significantly higher decrease compared to the control group(p]0.05). 3. Probing bone levels were reduced with statistically significance in both control group($1.08{\pm}0.97mm$) and experimental group($4.00{\pm}1.41mm$) postoperatively(p<0.01). Experimental group showed significantly higher decrease compared to the control group(p<0.01). 4. Gingival recession showed statistically significant increase in the control group($1.21{\pm}0.72mm$) and experimental group($1.00{\pm}1.09mm$) postoperatively(p<0.01). There was no statistical significance between the control group and the experimental group. On the basis of these results, treatment using allogenic decalcified freeze dried bone is effective in reducing probing depth, loss of attachment and probing bone level. Therefore allogenic decalcified freeze dried bone is an effective bone graft material in periodontal regeneration.

• 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 Periodontal and Implant Science
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• v.42 no.1
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• pp.13-19
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• 2012

Purpose: The aim of this study was to examine whether a previous peri-implantitis site can affect osseointegration, by comparing implant placement at a site where peri-implantitis was present and at a normal bone site. A second aim of this study was to identify the tissue and bone reaction after treating the contaminated implant surface to determine the optimal treatment for peri-implant diseases. Methods: A peri-implant mucositis model for dogs was prepared to determine the optimal treatment option for peri-implant mucositis or peri-implantitis. The implants were inserted partially to a length of 6 mm. The upper 4 mm part of the dental implants was exposed to the oral environment. Simple exposure for 2 weeks contaminated the implant surface. After 2 weeks, the implants were divided into three groups: untreated, swabbed with saline, and swabbed with $H_2O_2$. Three implants from each group were placed to the full length in the same spot. The other three implants were placed fully into newly prepared bone. After eight weeks of healing, the animals were sacrificed. Ground sections, representing the mid-buccal-lingual plane, were prepared for histological analysis. The analysis was evaluated clinically and histometrically. Results: The untreated implants and $H_2O_2$-swabbed implants showed gingival inflammation. Only the saline-swabbed implant group showed re-osseointegration and no gingival inflammation. There was no difference in regeneration height or bone-to-implant contact between in situ implant placement and implant placement in the new bone site. Conclusions: It can be concluded that cleaning with saline may be effective in implant decontamination. After implant surface decontamination, implant installation in a previous peri-implant diseased site may not interfere with osseointegration.

• Journal of Oral Medicine and Pain
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• v.35 no.2
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• pp.119-122
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• 2010

Carbondioxide($CO_2$) laser is one of the most widely employed lasers in oral soft tissue surgery because of its excellent affinity for water based soft tissues. It has some inherent advantages such as hemostasis, less postoperative swelling, reduction of bacterial population at surgical site, less need for suturing, less scarring, and less postoperative pain compared to conventional surgical therapies including the use of scalpel, diathermy, cryotherapy and electrosurgery. A 30-years-old male was presented with gingival swelling. Clinical examination revealed a well?defined pedunculated fibrotic mass on the buccal gingiva near right maxillary 1st molar. In radiographic examination, no remarkable abnormality was seen. Excisional biopsy was performed with $CO_2$ laser (continuous wave mode, 4.0W). Histological diagnosis was "Irritation fibroma". $CO_2$ laser has advantages those are suitable for surgical treatment of intraoral lesion. If appropriate training and experience are provided, the dentist would be able to manage intraoral lesions more efficiently and successfully with the use of the $CO_2$ laser.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.76-92
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• 1997

Porpilyromonas endodontalis is specifically involved in endodontic infections. The bacterium can be isolated almost exclusively only from infected rool canals. P. gingivalis also has been implicated in endodontic infection. Pathogemcity of P. gingival is is attributed to a variety of virulence factors, especially proteases, produced by the bacterium. Importance of P. endodontalis in endodontic infection has been revealed. However, the pathogenic property of P. endodontalis has not been extensively studied. The present study was undertaken to characterize the proteolytic activity of P. endodontalis and compare the activity with that of P. gingivalis which has the most potent and diverse proteases among oral bacteria. For this purpose, culture supematants(SUP) and cell extracts(CE) were obtained from these two bacteria and were subjected to zymography using 15% polyacrylamide gel copolymerized with gelatin, type I, IV collagens or albumin. Hydrolysis of the collagens was further investigated by the cleavage assay using native type I and IV collagens in solution-phase. The results were as follows: 1. P. endodontalis apparently has a proteolytic activity that is comparable with that of P. gingivalis. 2. SUP and CE obtained from P. endodontalis and P. gingival is showed the strongest activity for gelatin, followed by type I and IV collagens, and albumin. 3. In the zymography, no noticeable difference in proteolytic activity for gelatin and albumin between the SUP and CE was observed, but in the cleavage assay using native collagens, the SUP showed a stronger collagenolytic activity than the CE. 4. The gelatinolytic activity of both the SUP and CE from these two bacteria was diminished in the presence of $CaCl_2$ or reducing agents such as ${\beta}$-mercaptoethanol and dithiothreitol(DTT). 5. Type I(calf skin and human placenta) collagenolytic activity of P. endodontalis and P. gingivalis was reduced by DTT but not affected by $CaCl_2$. The inhibitory effect of DTT, however, was reduced to some extent by $CaCl_2$. 6. Type IV collagenolytic activity of these two bacteria was not affected by $CaCl_2$ but increased to some extent in association with the reducing agents. 7. Hydrolysis of albumin by P. endodontalis and P. gingivalis was demonstrated only in the presence of the reducing agents. The overall results indicate that with respect to proteolytic activity, P. endodontalis appears to be as potent as P. gingivalis, or maybe more, and its proteolytic characteristic is similar to that of P. gingivalis. This suggests that P. endodontalis has so potent proteolytic activity that can participate by itself in endodontic infections and apical periodontitis, causing tissue destruction.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.213-224
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• 2002

The ultimate goal of periodontal disease therapy is to promote the regeneration of lost periodontal tissue, there have been many attempts to develop a method to achieve this goal, but none of them was completely successful. The purpose of this study was to compare the effects of treatment using BBP(R) with control treated by only modified Widman flap. 22 intrabony defects from 12 patients with chronic periodontitis were used for this study, 10 sites of them were treated with BBP(R) as experimental group and 12 site were treated by only modified Widman flap as control group. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded at 6 months later, and the significance of the changes was statistically analyzed. The results are as follows : 1. Probing depth of control(${\triangle}2.7{\pm}1.3mm$) and experimental group(${\triangle}3.6{\pm}1.8mm$) weres reduced with statistically significance(P<0.05), but this changes were not different between the two experiment, control group with statistically significance. 2. Gingival recession showed statistically significant increase in control group(${\triangle}2.1{\pm}1.2mm$)(P<0.05), but not in experimental group(${\triangle}0.5{\pm}0.7mm$), and this changes were different between the two experiment, control group with statistically significance(P<0.05). 3. Bone probing depth showed statistically significant decrease in experimental group(${\triangle}2.9{\pm}1.0mm$)(P<0.05), but not in control group(${\triangle}1.1{\pm}1.4mm$), and this changes were different between the two experiment, control group with statistically significance(P<0.05). 4. Loss of attachment showed statistically significant decrease in experimental group(${\triangle}3.1{\pm}1.7mm$), but not in control group(${\triangle}0.6{\pm}1.2mm$), and this changes were different between the two experiment, control group with statistically significance(P<0.05) On the basis of these results, treatment using BBP(R) improves the probing depth, bone probing depth and loss of attachment in intrabony defects.

• Journal of Periodontal and Implant Science
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• v.30 no.4
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• pp.895-913
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• 2000

It is becoming increasingly clear that human gingival fibroblasts(HGF) may play a role in regulating immune responsiveness in inflammatory periodontal lesions. Stimulation of HGF with locally-secreted T cell cytokine $IFN_{\gamma}$ induces human leukocyte antigen class II(HLA II) expression on HGF, which is one of the characteristic feature of professional antigen presenting cells(pAPC). However, $IFN_{\gamma}$-treated HGF and other nonprofessional antigen presenting cells(npAPC) are known to be ineffective or less effective antigen presenter to resting T cells. This study, therefore, was undertaken in an effort to elucidate the differences in expression of cell surface molecules between npAPC in periodontal tissues, such as HGF and periodontal ligament fibroblasts(PDLF), and pAPC such as monocytes/macrophages. Using flow cytometry, the levels of cell surface expression of HLA-D, ICAM-1, LFA-3, and B7-1, which are involved in antigen presentation, were determined in HGF, PDLF and human myelomonocytic cell line THP-1. $IFN_{\gamma}$ clearly induced HLA-D expression on both of fibroblasts and monocytes dose dependently. However, expression level on monocytes were 4 to 5 times higher than that on fibroblasts, and induction rate was faster in monocytes than in fibroblasts. The levels of ICAM-1 expression on fibroblasts and monocytes were enhanced by $IFN_{\gamma}$ in a dose dependent manner. On the other hand, the expression of LFA-3 molecule, which could be detected in fibroblasts and monocytes without cytokine stimulation, was no more enhanced by addition of $IFN_{\gamma}$. B7-1, important costimulatory molecule in T cell activation and proliferation, was not detected on both of fibroblasts and monocytes even when stimulated with $IFN_{\gamma}$, except on monocytes fully differentiated by pretreatment of PMA and treated by $IFN_{\gamma}$. These results suggest that delayed expression of HLA-D and absence of B7-1 on $IFN_{\gamma}$ - treated fibroblasts may at least in part be involved in the ineffectiveness of fibroblasts as primary APC. And it is postulated that although periodontal fibroblasts may not serve as primary APC in normal periodontium, sustained expression of HLA II on ubiquitous fibroblasts in inflammatory lesions may perpetuate immune responses and produce chronic inflammation and tissue injury.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.573-580
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• 2004

The Palatal masticatory mucosa was widely used as a donor site in periodontal and implant surgery. but there were relatively few studies investigating the thickness of the palatal mucosa in dentate subjects. The purpose of this study was to study the thickness of palatal masticatory mucosa in korean subjects by direct clinical technique. Forty systemically and periodontally healthy subjects(20 males:20 females) participated in this study. A bone sounding method using a periodontal probe with minimal anesthesia and a prepared clear acrylic stent was utilized to assess the thickness of palatal mucosa at 24 measurement points defined according to the gingival margin and mid palatal suture. The results are as follows; 1. Mean thickness of palatal masticatory mucosa was $3.5{\pm}0.4mm$. and no gender differences were identified in the thickness of palatal masticatory mucosa. 2. The thickness of palatal masticatory mucosa increased from canine to second molar area(with the exception of the first molar area). canine and first molar areas were significantly thinner than other areas(P<0.05). 3. The thickness of palatal masticatory mucosa significantly increased in the sites farther from the gingival margin towarding the mid-palate(P<0.05). The results suggest that within the limits of the present study, premolar area appears to be the most appropriate donor site for soft tissue grafting procedures.

• The korean journal of orthodontics
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• v.36 no.4
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• pp.251-262
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• 2006

Objective: The purpose of this study was to compare the bacterial flora at the peri-implant sulcus of the orthodontic mini-implant placed in the alveolar mucosa with the bacterial flora at the adjacent healthy gingival sulcus. Methods: Two plaque samples from 7 patients were collected by inserting paper points into the sulcus between the mini-implant and ligature wire connected to the mini-implant head and inflamed alveolar mucosa, and from the gingival sulcus of a healthy tooth adjacent to the mini-implant. Results: Using 16S rDNA clone library, the 24 kinds of bacteria including Haemophilus aphrophilus, Sphingomonas species, Capnocytophaga species, Prevotella melaninogenica, Lachnospiraceae species, Porphyromonas species, Neisseria flava were identified only from the sulcus around the mini-implant. These bacteria constituted only 9.2% of total clones, and the bacteria identified from both the sulcus around mini-implants and the gingival sulcus constituted 80.4% of total clones. Of these bacteria, clones of Prevotella species, Atopobium rimae, Veillonella species, Streptococcus intermedius/constellatus, Streptococcus salivarius were more frequently isolated from the peri-implant sulcus. Conclusion: This study suggests that a broad epidemiological study is needed to find causative bacteria which induce inflammation from the peri-implant sulcus.

• Korean Journal of Plant Resources
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• v.35 no.5
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• pp.565-573
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• 2022

Gingival inflammation is one of the main causes that can be related to various periodontal diseases. Human gingival fibroblast (HGF) is the major constituent in periodontal connective tissue and secretes various inflammatory mediators, such as nitric oxide (NO) and prostaglandin E₂ (PGE₂), upon lipopolysaccharide stimulation. This study is aimed at investigating the anti-inflammatory and antioxidative activities of Lotus Root extract (LRE) in Porphyromonas gingivalis derived lipopolysaccharide (LPS-PG)-stimulated HGF-1 cells. The concentration of NO and PGE₂, as well as their responsible enzymes, inducible NO synthase (iNOS), and cyclooxygenase-2 (COX-2), was analyzed by Griess reaction, ELISA, and western blot analysis. LPS-PG sharply elevated the production and protein expression of inflammatory mediators, which were significantly attenuated by LRE treatment in a dose-dependent manner. LRE treatment also suppressed activation of Toll-like receptor 4 (TLR4)/myeloid differentiation primary response gene 88 (MyD88) and nuclear factor-κB (NF-κB) in LPS-PG-stimulated HGF-1 cells. In addition, one of phase II enzyme, NAD(P)H quinone dehydrogenase (NQO)-1, and its transcription factor, Nuclear factor erythroid 2-related factor 2 (Nrf2), were significantly induced by LRE treatment. Consequently, these results suggest that LRE ameliorates LPS-PG-induced inflammatory responses by attenuating TLR4/MyD88-mediated NF-κB, and activating NQO-1/Nrf2 antioxidant response element signaling pathways in HGF-1 cells.