• Journal of Periodontal and Implant Science
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• 제27권1호
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• pp.19-43
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• 1997

The barrier membranes for GTR procedure could be affected bY bacterial contamination after exposure to oral environment. This study was done to evaluate whether the tetracycline impregnated barrier membranes could inhibit bacterial attachment and penetration into membranes. The resorbable membrane(polylactic and polyglycolide copolymer, $Resolute^{(R)}$, W.L Gore and Associates, Inc..USA) and the non-resorbable membrane(e-PTFE; Gore-TexTM, W.L. Gore & Associates, Inc.,USA) were cut into 4mm discs and trated with 5% tridodecylmethylammonium chloride solution in ethanol and dried in air. The membranes were immersed in tetracycline(TC) solution (100mg/ml, pH 8.0) and dried. To the maxillary canine-premolar region in six periodontally healthy volunteers, removable acrylic devices were inserted, on which 8 cylindrical chambers were glued with TC impregnated and non-impregnated discs, the membrane discs were examined for bacterial attachment and penetration, and structural changes under SEM and LM. From the 1st day to the 7th day, membranes showed bacterial plaque formation composed of cocci and rods. Thereafter, filamentous bacteria appeared and the plaque thickness increased. The TC impregnated e-PTFE membranes showed less bacterial attachment and delayed in bacterial plaque maturation than non-treated membranes. As for bacterial penetration, the TC impregnated e-PTFE membranes showed superficial invasion and infrequent presence of bacteria in unexposed inner surface at the 4th week. while the non-treated e-PTFE membranes showed deep bacterial invasion at the 2nd week and frequent presence of internal bacteria at the 4th week. The resorbable membranes started to be resorbed at the 2nd week and were perforated at the 4th week, regardless of TC treatment. In conclusion, bacterial plaque formation and penetration was efficiently delayed in TC impregnated e-PTFE membranes, whereas resorbable membranes were similar in bacterial invasion due to membrane degradation and perforation, regardless of TC treatment.

• Journal of Periodontal and Implant Science
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• 제27권1호
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• pp.249-262
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• 1997

The present study investigates the effects of calcium sulfate graft on the periodontal healing in intrabony periodontal defects of dogs. Following the general anesthesia with 30mg/kg pentobarbital injected intravenously, the first premolar was extracted and full-thickness periodontal flap was elevated from the second premolar to the fourth premolar. The portion of premolars coronal to the alveolar crest was removed and mesial and distal roots were separated. Exposed root canals were sealed with Caviton and covered completely with flaps sutured. Following the healing period of 12 weeks, the surgical sited were uncovered and $4{\times}4mm$ intrabony defects were surgically created. Those defects with calcium sulfate graft following the root planing was designated as the test sites and those with flap surgery-only were designated as control sites. The animals were sacrificed after 8 weeks and the healing was histologically analyzed. The results were as follows. 1. No foreign body reaction or inflammation were observed in either groups. Calcium sulfate was completely resorbed in the test sites. 2. New cementum was observed coronal to the notch in both groups. Connective tissue fibers were oriented parallel to the root surface in the controls. Connective tissues were formed in large amount in the sites. 3. Test sites showed marked amount of new bone formation while the control sites showed minimal bone gain. 4. Root resorption was observed in coronal portions of th control Sites. The results suggest that calcium sulfate is a biocompatible graft material with a potential for new bone and cementum formation.

• Journal of Periodontal and Implant Science
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• 제41권4호
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• pp.192-200
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• 2011

Purpose: The aim of this study is to compare the gene expression profile in mesenchymal stem cells derived from dental tissues and bone marrow for characterization of dental stem cells. Methods: We employed GeneChip analysis to the expression levels of approximately 32,321 kinds of transcripts in 5 samples of bone-marrow-derived mesenchymal stem cells (BMSCs) (n=1), periodontal ligament stem cells (PDLSCs) (n=2), and dental pulp stem cells (DPSCs) (n=2). Each cell was sorted by a FACS Vantage Sorter using immunocytochemical staining of the early mesenchymal stem cell surface marker STRO-1 before the microarray analysis. Results: We identified 379 up-regulated and 133 down-regulated transcripts in BMSCs, 68 up-regulated and 64 down-regulated transcripts in PDLSCs, and 218 up-regulated and 231 down-regulated transcripts in DPSCs. In addition, anatomical structure development and anatomical structure morphogenesis gene ontology (GO) terms were over-represented in all three different mesenchymal stem cells and GO terms related to blood vessels, and neurons were over-represented only in DPSCs. Conclusions: This study demonstrated the genome-wide gene expression patterns of STRO-$1^+$ mesenchymal stem cells derived from dental tissues and bone marrow. The differences among the expression profiles of BMSCs, PDLSCs, and DPSCs were shown, and 999 candidate genes were found to be definitely up- or down-regulated. In addition, GOstat analyses of regulated gene products provided over-represented GO classes. These data provide a first step for discovering molecules key to the characteristics of dental stem cells.

• Journal of Periodontal and Implant Science
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• 제38권sup2호
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• pp.273-298
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• 2008

Purpose: The aim of this review is to introduce a novel bone-graft material for hard-tissue regeneration based on the calcium phosphate glass(CPG). Materials and Methods: CPG was synthesized by melting and subsequent quenching process in the system of CaO-$CaF_2-P_2O_5$-MgO-ZnO having a much lower Ca/P ratio than that of conventional calcium phosphates such as HA or TCP. The biodegradability and bioactivity were performed. Effects on the proliferation, calcification and mineralization of osteoblast-like cells were examined in vitro. Influence in new bone and cementum formations was investigated in vivo using calvarial defects of Sprague-Dawley rats as well as 1-wall intrabony defect of beagle dogs. The application to the tissue-engineered macroporous scaffold and in vitro and in vivo tests was explored. Results: The extent of dissolution decreased with increasing Ca/P ratio. Exposure to either simulated body fluid or fetal bovine serum caused precipitation on the surface. The calcification and mineralization of osteoblast-like cells were enhanced by CPG. CPG promoted new bone and cementum formation in the calvarial defect of Sprague-Dawley rats after 8 weeks. The macroporous scaffolds can be fabricated with $500{\sim}800{\mu}m$ of pore size and a three-dimensionally interconnected open pore system. The stem cells were seeded continuously proliferated in CPG scaffold. Extracellular matrix and the osteocalcin were observed at the $2^{nd}$ days and $4^{th}$ week. A significant difference in new bone and cementum formations was observed in vivo (p<0.05). Conclusion: The novel calcium phosphate glass may play an integral role as potential biomaterial for regeneration of new bone and cementum.

• Journal of Periodontal and Implant Science
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• 제36권1호
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• pp.69-84
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• 2006

Reports on the comparison of clinical effect between non-surgical and surgical therapy, and the change of the clinical parameters during maintenance phase have been rarely presented in Korea. This study was to observe the clinical changes during maintenance phase of 6 months in patients with chronic periodontitis treated by non-surgical or surgical therapy in Department of Periodontics, Chonnam National University Hospital. Among the systemically healthy and non-smoking patients with moderate to severe chronic periodontitis, twenty eight patients (mean age: 47.5 years) treated by non-surgical therapy (scaling and root planning) and nineteen patients (mean age: 47.3 years) treated by surgical therapy (flap surgery) were included in this study. The periodontal supportive therapy including recall check and oral hygiene reinforcement was started as maintenance phase since 1 month of healing after treatment. Probing depth, gingival recession. clinical attachment level and tooth mobility were recorded at initial, baseline and 1, 2, 3 and 6 month of maintenance phase. The clinical parameters were compared between the non-surgical and surgical therapies using Student t-test and repeated measure ANOVA by initial probing depth and surfaces. Surgical therapy resulted in greater change in clinical parameters than non-surgical therapy. During the maintenance phase of 6 months, the clinical effects after treatment had been changed in different pattern according to initial probing depth and tooth surface. During maintenance phase, probing depth increased more and gingival recession increased less after surgical therapy, compared to non-surgical therapy. The sites of initial probing depth less than 3 mm lost more clinical attachment level, and the sites of initial probing depth more than 7 mm gained clinical attachment level during maintenance phase after non-surgical therapy, compared to surgical therapy. Non-surgical therapy resulted in greater reduction of tooth mobility than surgical therapy during maintenance phase. These results indicate that the clinical effects of non-surgical or surgical therapy may be different and may change during the maintenance phase.

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.113-127
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• 2002

The purpose of this study is to evaluate histologically the tissue response and resorption of various nonresorbable and resorbable suture materials used for periodontal surgery, using a subcutaneous model on the dorsal surface of the rat. In this study, 10 Sprague-Dawley male rats (mean BW 150gm) were used and the commercially available materials included polyglactin 910, pain gut, nylon, e-PTFE. Animals were sacrificed at 3 days, 1, 2 and 4 weeks after implantation of various nonresorbable and resorbable suture materials. Specimens were prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows: 1. Resorption : The resorption of plain gut was showed at 1 week after implantation, was lost their structure and almost resorbed at 4 weeks. The resorption of polyglactin 910 was started at 2 weeks and slowly absorbed untill 4 weeks. 2. Tissue response : Plain gut showed persistent and severe inflammatory reactions from 3 days to 4 weeks. Polyglactin 910, e-PTFE and nylon showed mild inflammatory reactions. Suture material should be biocompatible and be able to be functioned until tissue tensile strength reaches maximum level. In this study, polyglactin 910, nylon and e-PTFE are considered to be proper suture materials for periodontal surgery.

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.61-68
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• 2002

The objective of this study was to determine the incidence and distribution of root fusion as well as its sexlinkage in maxillary and mandibular molars. One hundred fifty patients who had eight maxillary and mandibular molars (third molars excluded) were consecutively selected for the study subjects. The subjects provided a total of 1200 molars, i.e., 600 maxillary and 600 mandibular molars. A decision about root fusion was made on the radiographic examination. If a molar had one root and/or roots fused at any part in the root surface, it was considered as having root fusion. The results showed that : (1) 14.1 % of the maxillary molars and 5.8 % of the mandibular molars had a fused root, (2) the prevalence of root fusion in the male was 33 % and 56.4 % in the female, (3) 60 % in the male and 48.8 % in the female had bilaterally paired root fusion, (4) the root fusion was most frequently observed in the maxillary second molar position, but none in the mandibular first position in this study. Within limitations of this study, it can be concluded that, in management of molars with a furcation problem, treatment options such as hemisection and root amputation should be chosen after careful evaluation of root fusion. Further studies are needed to investigate a possible relationship between root fusion and periodontal disease progression.

• Journal of Periodontal and Implant Science
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• 제31권3호
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• pp.531-542
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• 2001

Periodontal debridement is most important procedure in periodontal treatment, because periodontal disease is the biofilm infection. The use of ultrasonic instrument has many clinical advantages compared to classical hand instrument. The introduction of newly developed ultrasonic scaler tips made the use of ultrasonic scaler popular. However the study of tooth substance removal according to the working parameters of ultrasonic scaler with newly developed tips is not sufficient. The purpose of this study is to evaluate the effects of working parameters of piezoelectric ultrasonic scaler with curette tip on casting gold removal. The working parameters was standardized by the sledge device which controls lateral force(0.5 N, 1.0 N, 2.0 N) and power setting was adjusted 2, 4, 8 in P mode and S mode and instrumentation time was 5 seconds. The defect depth and width were measured with profile meter and defect surface was examined by SME. The depth of defect was significantly large in S mode( $39.58{\pm}19.35{\mu}m$) compared to P mode( $8.37{\pm}6.98{\mu}m$). There was significant decrease of depth of defect between 1.0N($32.87{\pm}27.18{\mu}m$) and 2.0N( $14.86{\pm}15.04{\mu}m$). The area of defect was also significantly large in S mode($4482.42{\pm}3551.71{\mu}m^2$) compared to P mode( $922.06{\pm}960.32{\mu}m^2$). There was significant decrease of area of defect between 1.0N($3889.12{\pm}3936.00{\mu}m$) and 2.0N( $974.66{\pm}986.01{\mu}m$). The change of mode did not effect on the width of the defect. The change of power setting did not effect on the depth, width, and area of defect. In spite of limitation of this study it could be concluded that the use of piezoelectric ultrasonic scaler with curette tip on S mode could make significant tooth substance loss.

• Journal of Periodontal and Implant Science
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• 제30권4호
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• pp.815-821
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• 2000

The purpose of this study was to evaluate the influence of accessibility to dental cervices of maxillary molars upon plaque control level of these areas. Fifthy-seven dental students with healthy gingiae participated in this study. Maxillary dental casts were fabricated for each participants. Using the casts, cervical accessibility was measured at the mid-palatal point of maxillary first and second molars. Cervical accessibility was defined as the perpendicular distance from the entrance of gingival sulcus to the imaginary line between the most protruded points of palatal gingiva and tooth surface, and classified into degree I(${\leq}0.5mm$), II($>0.5mm,\;{\leq}1.0mm$), III($>1.0mm,\;{\leq}1.5mm$), and IV(>1.5mm). Plaque score was recorded as the distance from crest of gingival margin to the most coronal extent of plaque. Measurements of plaque score were repeated 3 times at 1-week intervals. After the baseline measurements, the participants began to use unitufted brushes on randomly assigned right or left side. Two weeks later, a session of plaque score records identical to the baseline measurements was started. The maxillary second molars showed higher cervical accessibility than the first molars(p<0.01), but the plaque scores of maxillary second molars were also higher than those of first molars(p<0.01). For the maxillary first molars, correlation between accessibility and plaque score was statistically significant, but such correlation was not found for the second molars. Use of unitufted brushes decreased the plaque score(p<0.01). Correlation between accessibility and the degree of plaque score improvement was not found. These findings suggest that cervical accessibility may influence the amount of plaque, and use of adjunctive oral hygiene devices may be helpful in maintaining optimal oral hygiene level at the areas of low cervical accessib ility.

• Journal of Periodontal and Implant Science
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• 제23권3호
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• pp.422-441
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• 1993

The purpose of this study was to compare effects of the bioceramics on healing processes of the alveolar bone defects in dogs. Five adult dogs aged 1 to 2 years were used in this study. Experimental alveolar bone defects were created surgically with a #1/2 round bur at the furcation area of the buccal surface of the mandibular 3rd, 4th premolars and 1st molar. Fifteen experimental alveolar bone defects were devided into three groups according to the type of graft materials. The groups were as follows : 1) flap operation with dense hydroxyapatite( DHA group ) 2) flap operation with porous hydroxyapatite( PHA group ) 3) flap operation with natural coral ( NC group ) At 1, 2, 4, 6, and 12 weeks, dogs were serially sacrificed and specimens were prepared with Hematoxylin-Eosin stain and Mallory stain for light microscopic evaluation. The results of this study were as follows : 1. In every group, inflammatory cell infiltrations were seen at 1st weeks due to surgical trauma, however inflammatory response owing to graft materials were not seen. 2. In every group, the appearance of connective tissue around graft materials was loosely formed at the initial stages, however the connective tissue was densely formed at 2 weeks. 3. The presence of osteocytes were observed at 2 weeks in the natural coral group, however the osteocytes were appeared at 6weeks in the dense hydroxyapatite group. 4. A new bone was formed from the base and walls of the defect and gradually expanded toward the graft materials. 5. A resorption of the natural coral occurred irregularly at the periphery of the material, therefore the size and shape of the natural coral were reduced at 6 weeks. 6. At 12 weeks, the porous hydroxyapatite and natural coral were surrounded by newly formed bone most completely, however dense hydroxyapatite was surrounded by newly formed bone in part.