• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.4
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• pp.302-309
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• 2002

In order to improve the success rate of implants, various implant designs have been developed. Although there have been enough efforts to handle the surface of the implant with careful choice of material and mechanics so that the bone and the implant can be tightly joined together, they have still failed to play the role of periodontal ligaments of the natural teeth in the past. The role of periodontal ligaments is very important since it can improve the initial stability of implant by absorbing the impacts. The purpose of this study is, thus, to test the possibility of alleviating the impact when the surface of the implant was coated with chitosan, a natural polymer, and making sure that the coated material stayed on. Then, the condition of newly developed bone formation and the degree of inflammation in response was closely observed in the surface level. In the main experiment, Chitosan coated implant ($3.3mm{\times}7mm$) was implanted on both the right and the left side of rabbit's femur. The animals were each sacrificed on the $1^{st}$, $2^{nd}$, $3^{rd}$, $7^{th}$, $14^{th}$, $21^{st}$ and 28th day. The process was observed under an light microscope after the Toluidin Blue staining. From the experiment, it was found that the chitosan was evenly distributed on the surface of the screws, and the implant was adjoined with adjacent bone. There was a sign of inflammation on the $3^{rd}$ day, but on the $14^{th}$ day, the formation of woven bone and newly formed bones were noticed. Also, chitosan filled the gap was formed between the implant and the newly formed bone. The implant, the chitosan and the newly formed bone were forming one unit as a result. Therefore, it was found that chitosan coated implant could absorbe the impact in the initial stage of implant.

• Journal of Periodontal and Implant Science
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• v.24 no.1
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• pp.64-86
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• 1994

The authors have transplanted periodontally involved roots which had been root planed into healthy and periodontally involved extraction sockets, and studied the root resorption patterns as well as its effect on new bone formation and wound healing. Alveolar bone around mandibular premolars of 6 adult dogs has been surgically removed, followed by ligation of orthodontic elastic wires for 8 weeks inducing chronic periodontal disease. After removing the crown portions, roots were extracted, and notches were made on the root surfaces discriminating healthy and periodontally involved areas using burs. Controls and experimental groups were divided as follows. Control I : Transplantation of periodontally involved root into healthy extraction sockets. Control II : Transplantation of periodontally involved root into diseased extraction sockets. Experimental group I : Transplantation of root planed roots into healthy extraction sockets. Experimental group II : Transplantation of root planed roots into diseased extraction sockets. Extraction sockets were sutured after transplantations, completely submerging the roots. Healing progress was histologically observed at 2nd, 8th, 12th, and 20th weeks, and the results were as follows ; 1. No inflammation or infection within the extraction sockets had been observed in all groups throughout the experimental period. 2. Reversal lines were observed at week 2 in all groups, clearly discriminating socket walls and new bone, and numerous blood vessels were observed in the new bone trabeculae. 3. Experimental groups showed markedly less root resorption compared to the controls at week 2, but as time progressed, severe resorptions were present in all groups. 4. Localized areas of new bone ankylosis were observed, and the rest of the areas showed collagen fiber insertion with new bone formation at its periphery. 5. No clear differences were found in healing and alveolar bone regeneration between healthy and diseased extraction sockets. 6. The amount of root resorption and ankylosis had increased up to week 8 and 12, showing ankylosis of new bone and the roots. However, no further increase in ankylosis was observed at week 20. 7. Most of the cementum on healthy roots was directly ankylosed to new bone at week, 2, and were gradually resorbed and replaced by new bone thereafter. These results appear to indicate that root planing may inhibit early root resorption of transplanted roots, but gradual replacement by alveolar bone and collagen fibers eventually occur. Condition of the roots or presence of disease in extraction sockets do not appear to make marked differences in alveolar bone regeneration process.

• Journal of Periodontal and Implant Science
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• v.38 no.sup2
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• pp.317-324
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• 2008

Purpose: Aggregatibacter actinomycetemcomitans was associated with localized aggressive periodontitis, endocarditis, meningitis, and osteomyelitis. The cytolethal distending toxin (CDT) of A. actinomycetemcomitans was considered as a key factor of these diseases is composed of five open reading frames (ORFs). Among of them, An enzymatic subunit of the CDT, CdtB has been known to be internalized into the host cell in order to induce its genotoxic effect. However, CdtB can not be localized in host cytoplasm without the help of a heterodimeric complex consisting of CdtA and CdtC. So, some studies suggested that CdtC functions as a ligand to interact with GM3 ganglioside of host cell surface. The precise role of the CdtC protein in the mechanism of action of the holotoxin is unknown at the present time. The aim of this study was to generate recombinant CdtC proteins expression from A. actinomycetemcomitans, through gene cloning and protein used to investigate the function of Cdt C protein in the bacterial pathogenesis. Materials and Methods: The genomic DNA of A. actinomycetemcomitans Y4 (ATCC29522) was isolated using the genomic DNA extraction kit and used as template to yield cdtC genes by PCR. The amplifed cdtC genes were cloned into T-vector and cloned cdt C gene was then subcloned to pET28a expression vector. The pET28a-cdtC plasmid expressed in BL21 (DE3) Escherichia coli system. Diverse conditons were tested to opitimize the expression and purification of functional CdtC protein in E. coli. Results: In this study we reconstructed CdtC subunit of A. actinomycetemcomitans Y4 and comfirmed the recombinant CdtC expression by SDS-PAGE and Western Blotting. The expression level of the recombinant CdtC was about 2% of total bacterial proteins. Conclusion: The lab condition of procedure for the purification of functionally active recombinant CdtC protein is established. The active recombinant CdtC protein will serve to examine the role of CdtC proteins in the host recognition and enzyme activity of CDT and investigate the pathological process of A. actinomycetemcomitans in periodontal disease.

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.615-630
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• 2002

Various long-term studies have shown that titanium implants as abutments for different types of prostheses have become a predictable adjunct in the treatment of partially or fully edentulous patients. The continuous exposure of dental implants to the oral cavity with all its possible contaminants creates a problem. A lack of attachment, together with or caused by bacterial insult, may lead to peri-implantitis and eventual implant failure. Removal of plaque and calculus deposits from dental titanium implants with procedures and instruments originally made for cleaning natural teeth or roots may cause major alterations of the delicate titanium oxide layer. Therefore, the ultimate goal of a cleaning procedure should be to remove the contaminants and restore the elemental composition of the surface oxide without changing the surface topography and harming the surrounding tissues. Among many chemical and mechanical procedure, air-powder abrasive have been known to be most effective for cleaning and detoxification of implant surface. Most of published studies show that the dental laser may be useful in the treatment of pen-implantitis. $CO_2$ laser and Soft Diode laser were reported to kill bacteria of implant surface. The purpose of this study was to obtain clinical guide by application these laser to implant surface by means of Non-contact Surface profilometer and X-ray photoelectron spectroscopy(XPS) with respect to surface roughness and atomic composition. Experimental rough pure titanium cylinder models were fabricated. All of them was air-powder abraded for 1 minute and they were named control group. And then, the $CO_2$ laser treatment under dry, hydrogen peroxide and wet condition or the Soft Diode laser treatment under Toluidine blue O solution condition was performed on the each of the control models. The results were as follows: 1. Mean Surface roughness(Ra) of all experimental group was decreased than that of control group. But it wasn't statistically significant. 2. XPS analysis showed that in the all experimental group, titanium level were decreased, when compared with control group. 3. XPS analysis showed that the level of oxygen in the experimental group 1, 3($CO_2$ laser treatment under dry and wet condition) and 4(Soft Diode laser was used under toluidine blue O solution) were decreased, when compared with control group. 4. XPS analysis showed that the atomic composition of experimental group 2($CO_2$ laser treatment under hydrogen peroxide) was to be closest to that of control group than the other experimental group. From the result of this study, this may be concluded. Following air-powder abrasive treatment, the $CO_2$ laser in safe d-pulse mode and the Soft Diode laser used with photosensitizer would not change rough titanium surface roughness. Especially, $CO_2$ laser treatment under hydrogen peroxide gave the best results from elemental points of view, and can be used safely to treat peri-implantitis.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.2
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• pp.203-244
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• 1998

The human mandible is always under the condition of loading by the various forces extorted by the attached muscles. The loading is an important condition of the stomatognathic system. This condition is composed of the direction and amount of forces of the masticatory muscles, which are controlled by the neuromuscular system, and always influenced by the movement of both opening and closing. Mandible is a strong foundation for the teeth or various prostheses, nevetheless it is a elastic body which accompanies deformation by the external forces on it. The elastic properties of the mandible is influenced by the various procedures such as conventional restorative treatments, osseointegrated implant treatments, reconstructive surgical procedures and so forth. Among the treatments the osseointegrated implant has no periodontal ligaments, which exist around the natural teeth to allow physiologic mobility in the alveolar socket. And so around the osseointegrated implant, there is almost no damping effect during the transmission of occlusal stress and displacements. If the osseointegrated implants are connected by the superstructure for the stabilization and effective distribution of occlusal stresses, the elastic properties of mandible is restricted according to the extent of 'splinting' by the superstructure and implants. To investigate the change of elastic behaviour of the mandible which has osseointegrated implant prosthesis of various numbers of implant installment and span of superstructre, a three dimensional finite element model was developed and analyzed with conditions mentioned above. The conclusions are as follows : 1. The displacements are primarily developed at the area of muscle attachment and distributed all around the mandible according to the various properties of bone. 2. The segmentation in the superstructure has few influence on the distribution of stress and displacement. 3. In the load case of ICP, the concentration of tensional stress was observed at the anterior portion of the ramus($9.22E+6N/m^2$) and at the lingual portion of the symphysis menti($8.36E+6N/m^2$). 4. In the load case of INC, the concentration of tensional stress was observed at the anterior portion of the ramus($9.90E+6N/m^2$) and the concentration of tensional stress was observed at the lingual portion of the symphysis menti($2.38E+6N/m^2$)). 5. In the load case of UTCP, the relatively high concentration of tensional stress($3.66E+7N/m^2$) was observed at the internal surface of the condylar neck.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.10
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• pp.5020-5028
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• 2013

The purpose of this study is to investigate the effects of awareness of oral health on oral health status and oral health behavior with subjects of students in the middle school which is the important period when lifetime set of teeth is completed with eruption of the second molar tooth and complete set of permanent teeth, and provide the basic data for development of oral health program for adolescents. We examined oral condition and conducted the survey about students' awareness of oral health and behavior in the middle school located in JeonJu. As the results of oral examination, dental caries and malocclusion were higher in female students and periodontal disease was higher in male students (p < 0.038). There was no significant difference in awareness of oral health between male and female students. However, M = 4.08 out of 5 point scale, which was high. For oral health behaviors, female students (M = 4.508) was higher than male students (M = 4.257) in the question of 'I visit the dental office when my gums are bleeding'. Female students (M = 4.547) was higher than male students (M = 4.333) in the question of 'I use the dental floss after brushing my teeth'(p<0.05). Awareness of oral health gave the significant effect on the oral health behavior at 95 % confidence level. Therefore, the education for oral health behavior is required to improve oral health and studies are needed to present the development of program for awareness and knowledge of oral health affecting behavior.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.661-674
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• 2005

The purpose of this study was to quantify and compare the level of MMP-2, MMP-8 in the healthy, inflammed gingival tissue and inflammed gingival tissue associated with type 2 DM. We investigate whether expression of MMP-2, MMP-8 is increased by chronic periodontitis associated with type 2 DM. Gingival tissue samples were obtained during periodontal surgery or tooth extraction. Based on patient's systemic condition & clinical criteria of gingiva, each gingival samples were divided into three groups. Group l(n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from 8 systemically healthy patients. Group 2(n=8) is inflammed gingiva from patients with chronic periodontitis. Group 3(n=8) is inflammed gingiva from type 2 diabetic patients with chronic periodontitis. Tissue samples were prepared and analyzed by Western blotting. The quantification of MMP-2, MMP-8 was performed using a densitometer and statistically analyzed by ANOVA. MMP-2, MMP-8 was expressed in all samples including healthy gingiva and increased in group 3 compared to group 1 and 2, and showed that significant variation was observed between group 1 & 3 in MMP-8 results. In conclusion, this study demonstrated that human gingival tissue with chronic periodontitis associated to type 2 diabetes showed slightly elevated MMP-2, MMP-8 levels compared to healthy gingiva and non-diabetic inflamed gingiva.

• Journal of Periodontal and Implant Science
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• v.33 no.3
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• pp.499-518
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• 2003

The surface characteristics of titanium have been shown to have an important role in contact ossseointegration around the implant. Anodizing at high voltage produces microporous structure and increases thickness of surface titanium dioxide layer. The aim of present study was to analyse the response of rat calvarial osteoblast cell to commercially pure titanium and Ti-6A1-4V anodized in 0.06 mol/l ${\beta}$-glycerophosphate and 0.03 mol/l sodium acetate. In this study, rat calvarial osteoblasts were used to assay for cell viability and cell proliferation on the implant surface at 1,2,4,7 days. 1. Surface roughness was 1.256${\mu}m$ at 200V, and 1.745${\mu}m$ at 300V. 2. The thickness of titanium oxide layer was increased 1 ${\mu}m$ with the increase of 50V. 3. The proliferation rate of osteoblastic cells was increased with the increase of the surface roughness and the thickness of titanium oxide layer. 4. There was no difference in cell viability and cell proliferation between commercially pure titanium and Ti-6A1-4V anodized at the same condition. In conclusion, the titanium surface modified by anodizing was biocompatible, produced enhanced osteoblastic response. The reasons of enhanced osteoblast response might be due to reduced metal ion release by thickened and stabilized titanium dioxide layer and microporous rough structures.

• Journal of Periodontal and Implant Science
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• v.33 no.4
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• pp.651-671
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• 2003

The influence of calcium phosphate (Ca-P) coating on the bone response of titanium implants was investigated two types of titanium implants, i.e. as -machined ,as -machined with Ca-P coating, were prepared. The Ca-P coating produced by OCT Inc technique. These implants were inserted into the left and right femur of beagle dog, After implantation periods of 3 days, 1weeks, weeks, 4weeks, 8weeks, 12weeks. 24weeks, the bone-implant interface was evaluated histologically, histomorphometrically , and removal torque. Histological evaluation revealed no new bone formation around different implant materials after 2weeks of implantation. After 4 weeks, Ca-P coated implants showed a higher amount of bone contact than either of the non coated implants. After 12weeks, bone healing was almost completed. And implant were removed by reverse torque rotation with torque-measuring device. Mean torque values for 4weeks control were 2.375Kgf.cm and experimental were 2.725Kgf.cm. And mean torque values for 8weeks control were 1.25Kgf.cm and experimental were 1.0Kgf.cm On the basis of these findings, we concluded that deposition of a Ca-P coating on an implant has a beneficial effect on the bone response to this implant during the healing phase. Besides implant surface conditions the bone response is also determined by local implant site condition.

• Proceedings of the KAIS Fall Conference
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• 2009.12a
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• pp.946-948
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• 2009

본 연구는 우리나라 청소년의 치주건강상태와 구강건강인식 및 행태간의 연관성을 파악하여 구강건강향상을 위한 방안을 제시하고자 하며, 청소년 치주질환 예방 프로그램의 기초자료를 제공하는데 목적을 두었다. 연구문제의 검증을 위해 2006년도 국민구강건강실태조사의 원시자료를 활용해이중 구강검진과 학생용 면접기록지를 동시에 수행한 만 12~18세의 청소년 총 5,192명을 대상으로 하였다. 분석결과, 청소년의 치주건강상태를 성별, 연령별로 보면, 남자가 여자에 비해, 또한 연령이 많아질수록 치주건강상태가 나쁜 것으로 나타났다(P<.0001). 성별과 연령을 보정한 후 치주건강상태와 구강건강 인식 및 행태와의 관련성을 보면 주관적 구강건강인식이 좋지 않은 청소년이 좋은 청소년에 비해 불건 강한 치주조직군에 속할 가능성이 1.7배 높았고[Odds Ratio(OR)=1.74; p<0.001], 구강건강행태 변수 중 점심식사 후 잇솔질을 하지 않는 청소년은 잇솔질을 하는 청소년에 비해 불건강한 치주조직군에 속할 가능성이 1.6배 높았다(OR=0.1.59; P<0.001). 한편 구강건강행태 변수 중 1일 간식횟수는 치주조직의 건강상태와 통계적으로 유의하였으나, OR 값이 1보다 낮았다[1일 간식횟수가 4회 이상(OR=0.61; P<0.001), 2~3회(OR=0.58;P<0.001), 1회(OR=0.71;P<0.001)]. 끝으로 청소년의 구강건강 행태 변화를 통해 구강건강을 향상시킬 수 있음은 물론 청소년의 치주질환예방 및 관리프로그램 계획시 올바른 구강건강행태를 가지도록 하는 것의 중요성을 암시하고 있다.