• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.143-160
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• 1996

The purpose of this study was to evaluate the response in aspect of attachment and growth rate of osteoblasts and growth rate of osteoblasts and human gingival fibroblasts to the commercially pure titanium(CP titanium)and titanium alloy(Ti-6AI-4V) that are used widely as implant materials, and to obtain the basic information to ideal implant materials. In the studly, commercially pure titanium in first test group, titanium alloy(Ti-6AI-4V) in second test group, cobalt-chrome-molybdenum alloy(Co-Cr-Mo alloy) in positive control group, and tissue culture polystyrene plate in negative control group were used. The results of this study were as follows. 1. Bone marrow cells cultured on CP titanium and Ti-6Al-4V showed significantly greater attachment and growth rate(p(0.05) compared to Co-Cr-Mo alloy in each time. 2. There were no significant differences(p>0.05) in attachment and growth rate of bone marrow cells cultured on CP titanium and Ti-6AI-4V or tissue culture plate. 3. Most bone marrow cells cultured on CP titanium, Ti-6Al-4V and tissue culture plate were attached well to each substratum in first 2days, and then, grew at higher growth rate. On the other hand, some cells cultured on Co-Cr-Mo alloy failed to attach in first 2 days, and then, attached cells grew at lower growth rate than other groups. 4. Attachment and growth rates of gingival fibroblasts cultured on CP titanium and Ti-6Al-4V showed no significant differences(p>0.05) compared to Co-Cr-Mo alloy in 2 days, but significantly greater increase(p<0.05) in 5 and 9 days. 5. There were no significantly differences(p>0.05) between growth rates on gingival fibroblasts cultured on CP titanium, Ti-6Al-4V and tissue culture plate in 2 and 5days, but a significant lower growth rate(p<0.05) on CP titanium and Ti-6Al-4V versus tissue culture plate. 6. Some gingival fibroblasts cultured on all specimen groups failed to attach, but attached cells grew well, especially on CP titanium, Ti-GAl-4V and tissue culture plate. 7. There were no significant differences(P>0.05) between growth rates of both bone marrow cells and gingival fibroblasts cultured on CP titanium and Ti-6AI-4V. As a result of this study, both commercially pure titanium and Ti-6AI-4V showed excellent biocompatibility and there was no significant difference in the cellular response to the both metals. Bone marrow cells cultured on each substratum showed significantly greater growth rate and responded sensitively to cytotoxic effects of metal surfaces compared to gingival fibroblasts. Considering cell response to the substrate, it was likely that the composition itself of titanium metals have no significant effect on the biocompatibility. Further study need to be done to evaluate the influence of surface characteristics on cellular responses.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.591-596
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• 2005

Amlodipine, nifedipine, and felodipine are calcium channel blocking agents, which are cause of unwanted gingival overgrowth around natural teeth. Many studies has been performed about this unwanted effects. However, the exact etiology remains uncertain.Few reports and investigations can be found in the literature on drug-induced gingival overgrowth around dental implants. The present case reports that amlodipine-induced gingival overgrowth occurred in peri-implant sites, confirms clinical and histological features in hyperplastic peri-implant tissues. Clinical and histological features of amlodipine-induced gingival overgrowth around dental implants were similar to that of tissue around natural teeth.

• Journal of Periodontal and Implant Science
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• v.24 no.3
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• pp.607-617
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• 1994

To determine the effect of tenascin on forming periodontal pocket and pseudopocket, the ginival tissues were surgically obtained from the patients with adult periodontitis(10) and non-inflammatory phenytoin-associated gingival hyperplasia(5). The excised tissue specimens were fixed in neutral formalin for $6{\sim}24$ hours, embedded with paraffin, sectioned at 4-6m in thickness, mounted on glass slides coated with 3-aminopropyltriethoxysilane(Sigma Chemical Co., St. Louis, MO, U.SA.) and immunohistochemically processed by Avidin-Biotin peroxidase complex method for the localization of tenascin, using monoclonal mouse anti-human tenascin antiboday(Chemicon-International Inc., Temecula, CA, U.S.A., 1: 5,000) as the primary antibody. Regardless of periodontal pocket and pseudopocket, tenascin was localized along the connective tissue subjacent to basement membrane of gingival epithelium, and strong positive reactivity was obviously noted in the papillary projections of gingival connective tissue. The results suggest that tenascin may affect the development of papillary projections and the proliferation of epithelial cells.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.296-302
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• 2011

Idiopathic gingival fibromatosisrarely occurs, but frequently recurred after surgical removal. It usually occurs in generalized symmetrical pattern but sometimes in localized unilateral pattern. The localized pattern usually affects the maxillary molar and tuberosity area. This disease usually causes tooth migration, malocclusion, and problems in eating, speech, and esthetics. A boy showed dense gingival fibromatosis localized at primary maxillary right lateral incisor area at the age of 5 years, and his maxillary right lateral incisor become severely displaced at the age of 9 years. He had no medical and hereditary factors relevant to the gingival fibromatosis. However, the dense fibrous tissue was dominant in his labial gingiva of maxillary right incisors. In order to realign the displaced incisors by orthodontic treatment, the dense fibrous tissue covered the defect space between the central incisor and the displaced lateral incisor was surgically removed. The removed specimen was examined by simple immunohistochemical(IHC) array method. IHC array showed increased expression of CTGF, HSP-70, MMP-1, PCNA, CMG2, and TNF-${\alpha}$ in keratinocytes, fibroblasts, endothelial cells, and macrophages of gingival fibromatosis tissue. Therefore, it was suggested that the gingival fibromatosis be caused by the concomitant overexpression of CTGF, HSP-70, MMP-1, PCNA, CMG2, and TNF-${\alpha}$, and resulted in the fibroepithelial proliferation and the inflammatory reaction of gingival tissue.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.21-30
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• 2005

Matrix metalloproteinases (MMPs) are a family of host-derived proteolytic enzymes and implicated in the remodeling and degradation of extracellular matrix under both physiological and pathological conditions. Connective tissue degradation in periodontal diseases is thought to be due to excessive MMP activities over their specific inhibitors. The effects of lipopolysaccharide (LPS) from Prevotella intermedia, one of the major putative pathogens of periodontitis, on the expression of mRNA for MMPs and tissue inhibitors of metalloproteinases (TIMPs) in human gingival and periodontal ligament fibroblasts were examined by reverse transcriptase-polymerase chain reaction (RT-PCR). The expression of mRNAs encoding MMP-1, -2, -3, -10, and -14 was increased in human gingival fibroblasts treated with p. intermedia LPS, whereas MMP-11 and TIMP-2 mRNA expression was decreased in these cells stimulated with LPS. P. intermedia LPS increased the MMP-1, -2, -10, -11, and -14 mRNA expression and decreased TIMP-1 and -2 mRNA expression in human periodontal ligament fibroblasts. These findings imply that P. intermedia LPS may play an important role in the connective tissue degradation in periodontitis.

• 대한치주과학회:학술대회논문집
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• 2003.11a
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• pp.53-54
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• 2003

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.989-1002
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• 1996

The purpose of this study was to determine the effect of a pulsed Nd:YAG laser irradiation on human gingival tissues. The patients, who were planned to be treated by clinical crown lengthening procedure and gingivectomy, were selected. All the patients received oral hygiene instruction, scaling and root planing at preoperation. The crest of gingival tissue on upper and lower anterior teeth was irradiated by a pulsed Nd:YAG laser(El. EN. EN060, Italy) with a fiber optic of 300 m in contact mode for 20 seconds. Gingival tissues were divided into 4 groups according to the laser power of 1.0W(10Hz, 100mJ), 2.0W(20Hz, 100mJ), 3.0W(30Hz, 100mJ) and 4.0W(40Hz, 100mJ). Immediately after the laser irradiation, the specimens were excised, fixed 10% neutral formalin, sectioned $4-6{\mu}m$ thick, stained by Hematoxylin-Eosin and Periodic Acid Schiff stain and observed under light microscope. The removed tissue depth and the coagulated layer depth due to a laser irradiation by a laser irradiation were measured on the microphotographs. The difference of measurements according to the different laser power was statistical1y analyzed by Kruskal Wallis Test with SAS program. The results were as follows : 1. In histologic findings of irradiated gingival tissues; a. In the irradiated gingival specimen with 1.0W laser power, some vesicles were observed in limited superficial layer of gingival epithelium. b. In the irradiated gingival specimen with 2.0W and 3.0W laser power, the epithelium was almost removed except for the traces of viable basal cell remnants at ret peg, and coagulation necrosis related with the thermal effect of laser was noted. c. In the irradiated gingival specimen with 4.0W laser power, complete removal of epithelium, partial removal of underlying connective tissue, and the coagulation necrosis of subjacent gingival tissue were shown. 2. The removed tissue depth was deeper in the irradiated specimens with higher power. There was a statistical significance in the difference of removed tissue depth between 1.0W group ($44.54{\pm}6.99um$) and 3.0W group ($99.75{\pm}6.64{\mu}m$), and between 1.0W group($44.54{\pm}6.99{\mu}m$) and 4.0W group($111.36{\pm}4.50{\mu}m$), and between 2.0W group($98.01{\pm}4.53{\mu}m$) and 4.0W group($111.36{\pm}4.50{\mu}m$)(P<0.05). 3. The coagulated layer depth was deeper in the irradiated specimens with higher power. There was a statistical significance in the difference of coagulated layer depth between 1.0W group($31.82{\pm}8.99{\mu}m$) and 3.0W group($55.99{\pm}20.94{\mu}m$), and between 1.0W group($31.82{\pm}8.99{\mu}m$) and 4.0W group($83.68{\pm}10.34{\mu}m$)(P<0.05). From this study, the results demonstrated that the effects of a pulsed Nd:YAG laser irradiation on gingival tissues seemed to depend on the laser power and that the irradiation with high power could be harmful to adjacent healthy tissue.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.26 no.1
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• pp.4-16
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• 2017

In dental esthetics, soft tissue plays an important part, probably very large portion of it. A clear understanding of the periodontal tissues and its management around teeth and implants help us to develop concepts for a modern dental treatment that addresses the needs of demanding patients in regard of esthetics and durability. When we talk about esthetic, we can say that one of the most important element is a harmonization with gingiva (soft tissue) called 'Pink Esthetic' As for the pink esthetics, gingival line(contour) takes most of the influence on esthetic result; it consists of labial gingival level, interproximal papilla height, and a line that connects them. In the gingival recession, labial gingival level and gingival contour move to the apical portion, and the root area is exposed. It leads to the unesthetic result. Root coverage technique is classically used to treat gingival recession (marginal tissue recession) of natural teeth. It is an essential technique on periodontal plastic surgery part. It is also a very useful technique to recover soft tissue problems in implant dentistry. So, root coverage technique must be mastered for a good implant esthetic result. The general overview of root coverage procedures will be discussed with step by step explanation to get more esthetic result.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.26-31
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• 2011

Purpose: Chronic inflammatory gingival lesions occur as pyogenic granulomas or non-specific chronic suppurative lesions. Methods: Of the 59 chronic inflammatory gingival lesions examined, plasma cell granuloma (n=14), which showed an intense antibody-mediated immune reaction with the increased infiltration of plasma cells, was observed as a pseudotumor-like gingival overgrowth and myofibroblastic or fibrohistiocytitc proliferation of stromal cells with a heavy collection of plasma cells. The levels of CD3, CD20, CD31, CD68, RANKL, cathepsin G, cathepsin K, lysozyme, TNF${\alpha}$, MMP-2, and MMP-9 in the 14 cases of gingival plasma cell granuloma with immunohistochemical detection were measured to determine the pathogenetic progresses of the plasma cell granuloma compared to the common pyogenic granuloma (n=45) in the gingiva. Results: The gingival lesions of the plasma cell granuloma could be divided into three histological types, plasma cell predominant type (PPT, n=8), mixed inflammatory cell type (MICT, n=2), and sclerosed fibrosis type (SFT, n=4). The PPT showed a condensed infiltration of plasma cells into the perivascular spaces of the granulomatous lesion with frequent formation of Russel's body in their cytoplasm. The MICT showed the concomitant infiltration of many macrophages together with plasma cells, resulting in the diffuse destruction of stromal fibrous tissue. The SFT showed granulomatous lesions replaced gradually by thick collagenous fibrous tissue, resembling an inflammatory pseudotumor. The SFT expressed strongly the lymphocytic markers, CD3 and CD20, and the macrophage/monocyte markers, CD31 and CD68, but showed reduced expression of common inflammatory markers, TNF${\alpha}$, cathepsin G, lysozyme, MMP-2, and MMP-9, as well as the reduced expression of osteoclastogenic markers, RANKL and cathepsin K. Conclusion: These results suggest that a gingival plasma cell granuloma shows variable gene expression for cell-mediated immunity and stromal tissue degeneration, undergoing sclerotic fibrosis with a persistent inflammatory reaction.

• Journal of Periodontal and Implant Science
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• v.48 no.6
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• pp.395-404
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• 2018

Purpose: The purpose of this study was to propose a technique for periodontal biotype modification through thickening of the entire facial aspect using a volume-stable collagen matrix and autogenous subepithelial connective tissue graft (CTG) for the treatment of gingival recession. Methods: Four systemically healthy patients showing Miller class I or class II gingival recession in the mandibular incisor area were included in this study. Full-mouth scaling and root planing procedures were performed at least 4 weeks prior to periodontal plastic surgery. A split-thickness flap with a horizontal intrasulcular incision and 2 vertical incisions was used in cases 1-3, and the modified tunnel technique was used in case 4 for coronal advancement of the mucogingival complex. After the exposed root surfaces were debrided thoroughly, double-layered volume-stable collagen matrix was placed on the apical part of the recession and a subepithelial CTG harvested from the palatal area was placed on the coronal part. The amount of root coverage at 3 months postoperatively was evaluated in cases 1-3, and facio-lingual volumetric changes were analyzed in cases 1 and 2. Results: Healing was uneventful in all 4 cases and complete root coverage was shown in cases 1-3. In case 4, reduction of gingival recession was observed at 3 months after surgery. In cases 1 and 2, a comparison of stereolithographic files from the preoperative and postoperative time points demonstrated that the entire facio-lingual volume had increased. Conclusions: The surgical technique suggested herein, using a volume-stable collagen matrix and autogenous subepithelial CTG, may be an effective method for periodontal biotype modification through thickening of the entire facial aspect for the treatment of gingival recession.