• Journal of Periodontal and Implant Science
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• v.27 no.1
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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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• v.27 no.1
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• pp.45-59
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• 1997

Platelet-derived growth factor(PDGF) has been shown to play an important role in periodontal regeneration. The purpose of the present study was to examine the distribution of PDGF in experimentally created periodontal intrabony defects after flap surgery with various bone graft materials. Six healthy mongrel dogs were used in this study. Three-wall bony defects were created in maxillary and mandibular premolars, inflammation induced by wire ligation and injection of impression material into the defects. Eight weeks later, the experimental lesions thus obtained were treated by plain flap surgery(control group), flap surgery plus autogenous bone graft(autogenous bone group), flap surgery plus Biocoral graft(Biocoral group), or flap surgery plus bioglass graft(bioglass group), which were randomly assigned to the defects. After 4, H, and 12 weeks postoperatively, 2 dogs were sacrificed at each time and 1he specimens were taken for histological examinations and immunohistochemical examinations for PDGF. In the control defects the amount of new bone formation was minimal. In the autogenous bone and Biocoral group new bone was deposited around implanted particles and the amount of new bone was increased with time. A large number of bioglass particles exibited a central excabation and bone formation could be observed in the central excabation as well as around the particles. The expression of PDGF was low in the control group. The expression of PDGF in Biocoral group was increased at 1, H week, but decreased at 12 week. The increased PDGF expression in autogenous bone and bioglass group was maintained to the end of the experiment.

• Journal of Periodontal and Implant Science
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• v.41 no.3
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• pp.117-122
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• 2011

Purpose: The purpose of the present randomized controlled clinical study was to evaluate the short-term outcomes of micro-current electrical neuromuscular stimulation (MENS) as an adjunct method to nonsurgical periodontal therapy. Methods: Twenty patients with moderate to severe chronic periodontitis were recruited into the study and randomly treated with either nonsurgical periodontal therapy followed by 5 MENS treatments with a micro current device or by nonsurgical periodontal therapy alone. Periodontal parameters were measured at baseline and 6 weeks following therapy, and included the plaque index, bleeding on probing, probing depth, and clinical attachment level (CAL). Results: All measured values were reduced at the time of re-evaluation. The amount of inflammation was significantly reduced in both the test (P=0.002) and control group (P=0.015). The test group demonstrated a significant CAL gain at 6 weeks following therapy, including non-molar (P=0.009) and molar teeth (P=0.028). In comparison with the control group, the test group showed statistically significant differences in the CAL on both molar (P=0.027) and non-molar teeth (P=0.031). Conclusions: In conclusion, the short-term results of the study indicate that MENS could be a suitable adjunctive method in the treatment of chronic periodontitis.

• Journal of Periodontal and Implant Science
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• v.41 no.3
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• pp.109-116
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• 2011

Purpose: The purpose of this study was to compare and quantify the expression of C-reactive protein (CRP), matrix metalloproteinase (MMP)-14, and tissue inhibitor of metalioproteinases (TIMP)-2 in gingival tissues of patients with chronic periodontitis accompanied with inflammatory reaction related to alveolar bone resorption with or without type 2 diabetes mellitus (DM). Methods: Twelve patients with type 2 DM and chronic periodontitis (group 3), twelve patients with chronic periodontitis (group 2), and twelve healthy individuals (group 1) were included in the study. Gingival tissue biopsies were collected from each patient and from healthy individuals at the time of periodontal surgery (including surgical crown lengthening) or tooth extraction. The concentrations of cytokines were determined by a western blot analysis. Results: The expression levels of CRP and MMP-14 increased in group 2 and 3, and they were highest in group 3. The expressions of TIMP-2 also increased in group 2 and 3. Conclusions: This study demonstrated that the expression levels of CRP, MMP-14, and TIMP-2 might be inflammatory markers in periodontal inflamed tissue. It can be assumed that CRP, MMP-14, and TIMP-2 may be partly involved in the progression of periodontal inflammation associated to type 2 DM.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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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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• v.31 no.3
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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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• v.32 no.1
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• pp.161-172
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• 2002

The present study evaluated the effects of guided tissue regeneration using xenograft material(deproteinated bovine bone powder), with and without biodegradable membrane in beagle dogs. Contralateral fenestration defects (6 ${\times}$ 4mm) were created 4 mm apical to the buccal alveolar crest of maxillary premolar teeth in 5 beagle dogs. Deproteinated bovine bone powders were implanted into fenestration defect and one randomly covered biodegradable membrane (experimental group). Biodegradable membrane was used to provide GTR. Tissue blocks including defects with soft tissues which were harvested following four & eight weeks healing interval, prepared for histo-phathologic analysis. The results of this study were as follows. 1. In control group, at 4 weeks after surgery, new bony trabecular contacted with interstitial tissue and osteocytes like cell were arranged in new bony trabecule. Bony lamellation was not observed. 2. In control gruop, at 8 weeks after surgery, scar-like interstitial tissue was filled defect and bony trabecule form lamellation. New bony trabecular was contacted with interstitial tissue but defect was not filled yet. 3. In experimental group, at 4 weeks after surgery, new bony trabecular partially recovered around damaged bone. But new bony trabecular was observed as irregularity and lower density. 4. In experimental group, at 8 weeks after surgery, lamella bone trabecular developed around bone cavity and damaged tissue was replaced with dense interstitial tissue. In conclusion, new bone formation regenerated more in experimental than control groups and there was seen observe more regular bony trabecular in experimental than control groups at 4 weeks after surgery. In control group, at 8 weeks after surgery, the defects was filled with scar-like interstitial tissue but, in experimental group, the defects was connected with new bone. Therefore xenograft material had osteoconduction but could not fill the defects. We thought that the effective regeneration of periodontal tissue, could be achieved using GTR with biodegradable membrane.

• Journal of Periodontal and Implant Science
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• v.28 no.2
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• pp.377-388
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• 1998

This double-blind controlled clinical and microbiological study was carried out to determine the effects of mouthwash preparation containing the mixture of herbal extract on developing plaque and gingivitis in the experimental gingivitis model. Following a 2-week normalization period, 34 dental students were distributed randomly into 1 of 3 treatment groups. They rinsed, under supervision, two times daily for 3 weeks with either normal saline(CT), 0.1% chlorhexidine(CH), or the mixture of herbal extract (HT), but refrained from any oral hygiene measures. The Plaque Index(PlI), the Gingival Index(GI), and the amount of Gingival Crevicular Fluid(GCF) were measured at week 0,1,2, and 3 of the experimental period, while the assessment of total wet weight of plaque and the phase contrast microscopic examination of plaque were performed at the end of experimental period(3 weeks). Subjects using mouthrinse preparation containing the mixture of herbal extract demonstrated negligible, if any, changes in the accumulation and microbial composition of plaque compared to those using normal saline, while the reduction of gingival inflammation by this mixture was highly significant and comparable to that of chlorhexidine. The results of this study indicate that the preparation containing the mixture of herbal extract do not provide any antiplaque benefits but is very effective in inhibiting the development of and in reducing existing experimental gingivitis when used as mouthrinse. Further research is needed to determine whether a significant reduction of gingival inflammation without a concomitant decrease in plaque accumulation is of clinical importance.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.265-272
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• 2006

Dental plaque, a biofilm consisting of more than 500 different bacterial species, is an etiological agent of human periodontal disease, It is therefore important to characterize interactions among periodontopathic microorganisms in order to understand the microbial pathogenesis of periodontal disease. Previous data have suggested a synergistic effect of tow major periodontal pathogens Porphyromonas gingivalis and Tannerella forsythia in the periodontal lesion. In the present study, to better understand interaction between P. gingivalis and T. forsythia, the coaggregation activity between these bacteria was characterized. The coaggregation activity was observed by a direct visual assay by mixing equal amount (1 ${\times}$ $10^9$)of T. forsythia and P. gingivaJis cells. It was found that the first aggregates began to appear after 5-10 min, and that the large aggregates completely settled within 1 h. Electron and epifluorescence microscopic studies confirmed cell-cell contact between two bacteria. The heat treatment of P. gingivalis completely blocked the activity, suggesting an involvement of a heat-labile component of P. gingivalis in the interaction. On the other hand, heat treatment of T. forsythia significantly increased the coaggregation activity; the aggregates began to appear immediately. The coaggregation activity was inhibited by addition of protease, however carbohydrates did not inhibit the activity, suggesting that coaggregation is a protein-protein interaction. The results of this study suggest that coaggregation between P. gingivalis and T. forsythia is a result of cell-cell physical contact, and that coaggregation is mediated by a heat-labile component of P. gingivalis and T. forsythia component that can be activated on heat treatment.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.97-112
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• 2006

유리 라디칼과 활성 산소종, 산화방지제 간의 불균형이 염증성 구강내 질환의 발생과 진행에 있어 중요한 역할을 한다는 주장이 제기되었고 최근에는 만성 염증성 치주질환에서도 산화에 의한 소실이 관찰되었다. 다양한 내적인 항산화 방어 기전 중 superoxide dismutase 가 $O_2$를 $H_2O_2$로 효과적으로 전환시킴으로써 활성산소종에 대한 일차적인 방어를 맡고 있다. 현재까지 인간에서 발견된 superoxide dismutase 는 cytoplasmic copper-zinc SOD와 mitochondrial manganase SOD, extracellular SOD의 3가지 아형이다. 이번 연구는 만성 치주질환을 가전 환자의 치주조직에서 효소 항산화제인 SOD의 발현정도를 알아봄으로써 질환조직 내의 산화자극 정도를 평가해 보고자하였다. 전남대학교 치주과에 내원한 33명의 만성 치주질환자와 20명 의 임상적으로 건강한 대상으로부터 조직을 얻어 Cu/Zn-SOD와 Mn-SOD, EC-SOD를 이용한 면역조직화학 염색을 시행하였다. 임상적 소견과 조직학적 소견이 일치하지 않아 조직학적 소견을 기준으로 건강한 조직, 경도, 중등도, 중도 치주질환 조직으로 그룹을 나누고 완전한 상피와 결합조직을 가진 27개의 표본에 대한 분석을 시행하였다. 치주질환 조직에서 건강한 조직에 비해 Cu/Zn-SOD가 상피의 기저층과 상피에 근접한 결합조직에서 발현되고 Mn-SOD는 염증이 증가함에 따라 크게 상피의 과립증과 각화층, 그리고 상피에 근접한 결합조직에서 발현됨으로써 활성산소종이 치주조직 파괴에 관여한다는 것을 알 수 있었다. 세 아형 모두 혈관주위에서 발현되었고 특히 EC-SOD는 작은 모세혈관주위에서만 발현되었으나 염증에 의해 혈관벽이 두꺼워지고 혈관 수가 증가한 곳에서 뚜렷하게 염색되었다. 이번 연구는 염증성 치주조직내 증가된 SOD의 활성이 치주질환자의 산화자극 정도와 관련되어 있음을 시사하였다.