• Journal of dental hygiene science
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• v.15 no.6
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• pp.703-711
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• 2015

The high dental treatment cost has been considered as one of the major reasons for inappropriate dental treatment in Korea. The aim of this study was to investigate the opinions of expansion of National Health Insurance (NHI) in dental treatment fields not covered with NHI and buying private dental insurance. This survey was carried out targeting 266 adults from their 30s to 50s with convenience sampling. The higher orders in stress of dental treatment cost were orthodontic treatment, dental implant, prosthodontic treatment, and caries treatment not covered with NHI. The higher orders in needs of expansion of NHI were caries treatment not covered with NHI, prosthodontic treatment, and orthodontic treatment. The agreement percentages with age restriction in NHI were scaling 57.1%, denture 23.3%, implant 14.3%, respectively. The subjective oral health had impact on the stress of dental treamtent cost and expansion on NHI. Although only 8.3% subjects had private dental insurance, 68.4% of the subjects had positive opinions buying private dental insurance. The correlation coefficients between stress of dental treatment cost and buying private dental insurance were implant 0.408, caries treatment not covered with NHI 0.404, denture 0.394, crown and bridge 0.375, and orthodontic treatment 0.313. Expansion of NHI in dental treatment and development of private dental insurance was suggested to treat dental disease in appropriate time.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.271-278
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• 2012

Purpose: Recently implant surgical guides were used for accurate and atraumatic operation. In this study, the accuracy of two different types of surgical guides, positioning device fabricated and stereolithography fabricated surgical guides, were evaluated in four different types of tooth loss models. Materials and methods: Surgical guides were fabricated with stereolithography and positioning device respectively. Implants were placed on 40 models using the two different types of surgical guides. The fitness of the surgical guides was evaluated by measuring the gap between the surgical guide and the model. The accuracy of surgical guide was evaluated on a pre- and post-surgical CT image fusion. Results: The gap between the surgical guide and the model was $1.4{\pm}0.3mm$ and $0.4{\pm}0.3mm$ for the stereolithography and positioning device surgical guide, respectively. The stereolithography showed mesiodistal angular deviation of $3.9{\pm}1.6^{\circ}$, buccolingual angular deviation of $2.7{\pm}1.5^{\circ}$ and vertical deviation of $1.9{\pm}0.9mm$, whereas the positioning device showed mesiodistal angular deviation of $0.7{\pm}0.3^{\circ}$, buccolingual angular deviation of $0.3{\pm}0.2^{\circ}$ and vertical deviation of $0.4{\pm}0.2mm$. The differences were statistically significant between the two groups (P<.05). Conclusion: The laboratory fabricated surgical guides using a positioning device allow implant placement more accurately than the stereolithography surgical guides in dental clinic.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.321-339
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• 1994

The cytokines released by osteoblasts induce bone resorption via the differentiation of osteoclast precursors. In this process, $interleukin-1{\beta}$($IL-1{\beta}$)-induced bone resorption is mediated by granulocyte macrophage-colony stimulation factor(GM-CSF), interleukin-6 (IL-6), and tumor necrosis factor ${\alpha}$($TNF-{\alpha}$) released from osteoblasts. Since these cytokines (GM-CSF, IL-6, $TNF-{\alpha}$) are produced by not only osteoblasts but also monocytes, and interleukin-10(I1-10) inhibits the secretion of these cytokines from monocytes, it may be speculated that IL 10 could modulate the production of GM-CSF, IL-6, and $TNF-{\alpha}$ by osteoblasts, then control $IL-1{\beta}-induced$ bone resorption. Therefore, the aims of the present study were to examine the effects of IL-10 on bone resorption. The sixten or seventeen-day pregnant ICR mice were injected with $^{45}Ca$ and sacrificed one day after injection. Then fetal mouse calvaria prelabeled with $^{45}Ca$ were dissected out. In order to confirm the degree of bone resorption, mouse calvaria were treated with Lipopolysaccharide(LPS), $TNF-{\alpha}$, $IL-1{\alpha}$, IL-8, $IL-1{\beta}$, and $IL-1{\alpha}$, Then, IL-10 and $interferon-{\gamma}$ ($IFN-{\gamma}$) were added to calvarial medium, in an attempt to evaluate the effect of $IL-1{\beta}-induced$ bone resorption. In addition, osteoclasts formation in bone marrow cell cultures, and the concentration of IL-6, $TNF-{\alpha}$, and GM-CSF produced from mouse calvarial cells were investigated in response to $IL-1{\beta}$ alone and simultaneously adding f $IL-1{\beta}$ and IL-10. The degree of bone resorption was expressed as the ratio of $^{45}Ca$ release(the treated/the control). The osteoclasts in bone marrow cultures were indentified by tartrate resistant acid phosphatase(TRAP) stain and the concentration of the cytokines was quantified using enzyme linked immunosorbent method. As results of these studies, bone resorption was induced by LPS(1 ng/ml ; the ratio of $^{45}Ca$ release, $1.14{\pm}0.07$). Also $IL-1{\beta}$(1 ng/ml), $IL-1{\alpha}$(1 ng/ml), and $TNF-{\alpha}$(1 ng/ml) resulted in bone resorption(the rations of $^{45}Ca$ release, $1.61{\pm}0.26$, $1.77{\pm}0.03$, $1.20{\pm}0.15$ respectively), but IL-8 did not(the ratio of $^{45}Ca$ release, $0.93{\pm}0.21$). The ratios of $^{45}Ca$ release in response to IL-10(400 ng/ml) and $IFN-{\gamma}$(100 ng/ml) were $1.24{\pm}0.12$ and $1.08{\pm}0.04$ respectively, hence these cytokines inhibited $IL-1{\beta}$(1 ng/ml)-induced bone resorption(the ratio of $^{45}Ca$ release $1.65{\pm}0.24$). While $IL-1{\beta}$(1 ng/ml) increased the number of TRAP positive multinulcleated cells in bone marrow cultures($20{\pm}11$), simultaneously adding $IL-1{\beta}$(1 ng/ml) and IL-10(400 ng/ml) decreased the number of these cells($2{\pm}2$). Nevertheless, IL-10(400 ng/ml) did not affect the IL-6, GM-CSF, and $TNF-{\alpha}$ secretion from $IL-1{\beta}$(1 ng/ml)-activated mouse calvarial cells. From the above results, it may be suggested that IL-10 inhibites $IL-1{\beta}-induced$ osteoclast differntiation and bone resorption. However, the inhibitory effect of IL-10 on the osteoclast formation seems to be mediated not by the reduction of IL-6, GM-CSF, and $TNF-{\alpha}$ production, but by other mechanisms.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.4
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• pp.430-435
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• 2000

Cleft lip and palate is one of the congenital anomalies which need comprehensive and multidisciplinary treatment plan because 1) oral cavity is an important organ with masticatory function as a start of digestive tract, 2) anatomic symmetry and balance is esthetically important in midfacial area, and 3) it is also important to prevent psycho-social problems by adequate restoration of normal facial appearance. There are many different protocols in the treatment of cleft lip and palate, but our department has adopted and modified the $Z{\"{u}}rich$ protocol, as published in the Journal of Korean Cleft Lip and Palate Association in 1998. The first challenge is feeding. Type of feeding aid ranges from simple obturators to active orthopedic appliances. In our department we use passive-type plate made up of soft and hard acrylic resin which permits normal maxillary growth. We use Millard's method to restore normal appearance and function of unilateral complete cleft lip. In consideration of both maxillary growth and phonetic problems, we first close soft palate at 18 months of age and delay the hard palate palatoplasty until 4 to 5 years of age. When soft palate is closed, posterior third of the hard palate is intentionally not denuded to allow normal maxillary growth. In hard palate palatoplasty the mucoperiosteum of affected site is not mobilized to permit residual growth of the maxilla. We have treated a patient with unilateral complete cleft lip and palate by Ajou protocol, which is a kind of modified $Z{\"{u}}rich$ protocol. It is as follows: Infantile orthopedics with passive-type plate such as Hotz plate, cheiloplasty with Millard's rotation-advancement flap, and two stage palatoplasty. It is followed by orthodontic treatment and secondary osteoplasty to augment cleft alveolus, orthognathic surgery, and finally rehabilitation with conventional prosthodontic treatment or implant installation. The result was good up to now, but we are later to investigate the final result with longitudinal follow-up study according to master plan by Ajou protocol.

• Journal of Periodontal and Implant Science
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• v.48 no.4
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• pp.224-235
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• 2018

Purpose: The purpose of this study was to evaluate the effects of platelet-rich plasma (PRP) on periodontal healing of replanted root surfaces in dogs histologically and histomorphometrically. Methods: A total of 36 roots of mandibular incisors and premolars from 6 mongrel dogs were used. The roots were randomly divided into 3 groups: 1) a positive control group (n=12), in which the periodontal ligament (PDL) and cementum were retained and the roots were soaked in saline; 2) a negative control group (n=12), in which the PDL and cementum were removed and the roots were soaked in saline; and 3) an experimental group (n=12), in which the PDL and cementum were removed and the roots were soaked in PRP. After soaking the root surfaces, the extracted roots were replanted into the extraction sockets. The roots were covered using a coronally repositioned flap Results: Histologically, irregular-thickness PDL-like and cementum-like tissues were observed in the 4-week experimental group and the positive control group. PDL-like tissue and cementum-like tissue with a more uniform thickness were observed at 8 weeks. In the negative control group, PDL-like tissue and cementum-like tissue were rarely found, and root resorption and ankylosis were observed. In the cross-sectional histomorphometric analysis, the experimental group demonstrated a higher rate of formation of cementum-like tissue and a lower tooth ankylosis rate than the positive and negative control groups at 4 and 8 weeks. Although there was a significant difference in the tooth ankylosis rate and the formation of cementum-like tissue across the 3 groups (P<0.05), no statistical significance was observed between any pair of groups (P>0.017). Conclusions: Applying PRP to root surfaces during tooth replantation in dogs can reduce tooth ankylosis and increase PDL-like and cementum-like tissue formation.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.103-115
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• 1999

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. Various periodontal procedures have been used throughout the years in an attempt to reestablish attachment of periodontal tissues to root surfaces affected by periodontitis. Flap debridement surgery has been demonstrated to be a successful procedure in gaining the probing attachment level and reducing probing depth. A tendency towards impaired wound healing following periodontal procedures in smokers has been clinically documented. But, previous clinical studies on healing response in smokers are based on a retrospective design. The purpose of this study was to evaluate the treatment outcome following flap debridement surgery in smokers compared to nonsmokers. 25 patients with moderate to advanced periodontitis were included for study. Among these patients, 13 patients were smokers, and 12 patients were nonsmokers. Mucoperiosteal flap was raised with the sulcular incision. No antibiotic treatment was administered postsurgery. The patients was recalled at monthly intervals during a period of 6 months following the surgery. The patients were received supragingival scaling and oral hygiene reinforcement. All the recordings, including modified O' Leary plaque control record, bleeding on probing, probing pocket depth, probing attachment level,were recorded, presurgery and 6 months postsurgery. The changes of all the recordings at 6 months after flap debridement surgery revealed the following results: 1. PI on all the dentitions and surgical sites showed no statistical significance between smokers and nonsmokers at presurgery. But, smokers demonstrated a significantly lower % of PI than nonsmokers at 6 months postsurgery. 2. Smokers demonstrated a greater % of BOP sites than nonsmokers on the surgical sites and all the dentitions, presurgery and 6 months postsurgery. But, there was no statistical significance between two groups. 3. Smokers exhibited significantly less reduction of probing depth in the 3 mm or less probing pocket depth(PPD) group, 6mm or more PPD group and total PPD group when compared to nonsmokers at 6 months postsurgery. 4. Smokers exhibited significantly less gain of probing attachment level(PAL) in the 3mm or less PPD group, 6 mm or more PPD group and total PPD group when compared to nonsmokers at 6 months postsurgery.

• The korean journal of orthodontics
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• v.35 no.1 s.108
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• pp.35-42
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• 2005

There is lack of data for the amount of vertical bone in the midpalatal region for miniscrew implantation. The purpose of this study was to measure the structure of the midpalatal suture area using CT image and V-works 4.0 program (Cybermed Inc, Seoul, Korea). CT images of 14 male and 14 female adults were reconstructed. In detail, it was 1) to measure the length of maxilla on the midsagittal plane 2) to measure vertical bone height in the midpalatal area 3) to establish the zone of safety for miniscrew implantation. The following results were obtained. The mean length of ANS-PNS was 51.08mm in males and 47.34mm in females. There was a statistically significant difference between males and females (p<0.05). The vertical bone height of the midpalatal suture area was above 0mm except for 6mm posterior from the central Point of ANS-PNS in males The zone of safety was located 19.43mm posterior from the ANS in males while it was 17.62mm in females along the palatal plane. These results support that the safety zone of the midpalatal area is suitable for screw implantation. Midpalatal miniscrew implantation is a powerful tool in modern orthodontics Through many applications. it can expand the modern orthodontic field.

• Journal of Periodontal and Implant Science
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• v.30 no.3
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• pp.539-555
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• 2000

Recently, it was reported that enamel matrix derivative may be beneficial in periodontal regeneration procedures in expectation of promoting new bone and cementum formation. The aim of present study was to evaluate the effect of enamel matrix derivative($Emdogain^?$)and Caso4 sulfate paste in 1-wall intrabony defects in beagle dogs. Surgically created 1-wall intrabony defects were randomly assigned to receive root debridement alone or $Emdogain^{(R)}$ or $Emdogain^{(R)}$ and Caso4. Clinical defect size was 4 X 4mm. The control group was treated with root debridement alone,and Experimental group I was treated with enamel matrix derivative application, and Experimental group II was treated with enamel matrix derivative and Caso4 sulfate paste application,. The healing processes were histologically and histometrically observed after 8 weeks and the results were as follows: 1. The length of junctional epithelium was $0.41{\pm}0.01mm$ in the control group, $0.42{\pm}0.08mm$in the experimental group I and $0.50{\pm}0.13mm$in the experimental group II. 2. The connective tissue adhesion was $0.28{\pm}0.02mm$ in the control group, $0.13{\pm}0.08mm$ in the experimental group I and $0.19{\pm}0.02mm$ in the experimental group II. 3. The new cementum formation was $3.80{\pm}0.06mm$ in the control group, $4.12{\pm}0.43mm$ in the experimental group I and $4.34{\pm}0.71mm$ in the experimental group II. 4. The new bone formation was $1.43{\pm}0.03mm$ in the control group, $1.53{\pm}0.47mm$ in the experimental group I and $2.25{\pm}1.35mm$ in the experimental group II. Although there was limitation to present study, the use of enamel matrix derivative in the treatment of periodontal 1-wall intrabony defect enhanced new cementum and bone formation. Caso4 sulfate paste will be the candidate for carriers to deliver enamel matrix derivative, and so enhance the regenerative potency of enamel matrix derivative.

• Journal of Periodontal and Implant Science
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• v.29 no.2
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• pp.371-387
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• 1999

The present study was performed to assess and compare the clinical and microbiological effects following local application of 2% minocycline gel or 0.1% chlorhexidine subgingival irrigation to augment scaling and root planing in patients with moderate to advanced chronic adult periodontitis. 32 healthy patients with moderate to advanced chronic adult periodontitis were enrolled in the study. In each patient, the quadrants that had 2 or more teeth with $5{\sim}8mm$ probing pocket depth and radiographic evidence of alveolar bone loss were selected and divided into test side and control side according to the split-mouth design. All patients received standardized oral hygiene instructions at the beginning of the study and all remaining teeth received scaling and root planing until 0 week. The 2% minocycline gel was applied to periodontal pocket at 0, 1, 2, 3 week in the test side. The 0.1% chlorhexidine solution and the normal saline were irrigated subgingivally for about 30 seconds in the positive control side and negative control side respectively. The clinical and microbiological analysis carried out at 0, 4, 8, and 12 weeks . The results of this study were as follows; 1. In saline irrigation group, there was no adjunctive effects in probing pocket depth reduction, sulcular bleeding index and no significant changes in relative proportions of subgingival bacteria. 2. The chlorhexidine irrigation as an adjunct to scaling and root planing results in reduction in the plaque index and sulcular bleeding index, but there was not statistically significant. The relative proportion of spirochetes was significantly reduced, but the proportion of motile rods was no significant reduction. 3. The minocycline gel delivered subgingivally as an adjunct to scaling and root planing provide significant benefit in reducing probing depths and sulcular bleeding index compared to saline and chlorhexidine irrigation groups. 4. The relative proportions of spirochetes and motile rods were significantly reduced and the proportions of cocci and non-motile bacteria were correspondingly increased in the minocycline gel group. In conclusion, minocycline gel delivered subgingivally as an adjunct to scaling and root planing induces clinical and microbial responses more favorable for periodontal health than saline and chlorhexidine subgingival irrigation.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.415-428
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• 2002

Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.