치관 확장술을 통한 변형된 수동적 맹출의 치료

Purpose: Passive eruption is characterized by the apical shift of the dentogingival junction. As this occurs, the length of the clinical crown increases as the epithelial attachment migrates apically. Altered passive eruption occurs when the margin of gingiva is malpositioned incisally on the anatomic crown in adulthood and results in excessive gingiva. The purpose of this article is to evaluate esthetic results of crown lengthening procedure in altered passive eruption.s. Materials and Methods: Three patients who complained "My front teeth look too short" were included. Bone sounding with periodontal probe revealed that alveolar bone crest was close to CEJ. Based on the diagnostic information, a diagnosis of altered passive eruption was made. They were performed apically positioned flap procedure with osseous resection. Results: Six months later, all patients achieved favorable esthetic results and gingival margins were healthy and stable. Conclusion: When the diagnostic procedures reveal alveolar bone crest levels approximating the CEJ, apically positioned flap procedure with osseous resection is indicated

임산부의 치주질환 활성도와 조산과의 상관관계에 관한 연구

Purpose We designed this study for the purpose of determining the relationship between periodontal disease activity and PLBW, using the evaluation of probing pocket depth, loss of attachment, gingival index, gingival crevicular fluid amount and subgingival microflora. Methods A total of 100 volunteer mothers(mean age 30.44) at the Department of Obstetrics and Gynecology Seoul National University Hospital were selected for this study.Pregnancy outcomes were categorized into cases and controls in two ways. our definition was based on the following; Group 1 : Any PLBW cases Vs. All NBW controls Group 2 : PLBW cases Vs. NBW controls A periodontal exam was performed on the Ramfjord( #16, 21, 24, 36, 41, 44) teeth and Clinical evaluation consisted of probing pocket depth, loss of attachment, gingival index and gingival crevicular fluid amount. Subgingival plaque samples were collected by three sterile #35 paper points. The total number of anaerobic colonies and aerobic bacteria were enumerated after incubation. Antisera to P. gingivalis, P. intermedia, A. actinomycetemcomitans were produced in white rabbits with live whole cells suspensions. The specific fluorescent bacteria obtained by immunofluorescence and total cell counts obtained by dark-field microscopy were counted on four fields. The percent of each specific microorganism in the total cell count was determined. Results Any PLBW and PLBW cases showed significantly greater probing depth and attachment loss than all NBW and NBW controls. Cases group had significantly increased anaerobic bacterial counts compared with control group and no differences in the other microbes. This study confirmed that periodontal disease is a statistically significant risk factor for PLBW by investigating clinical parameters and subgingival plaque analysis.이 연구는 1996년도 서울대학교 병원지정연구비 지원에 의한 결과입니다

비외과적 치주치료 : 기계적 치료

1987년에 Lindhe와 Nyman은 적극적인 치주치료의 목적을 첫째, 치주조직 내에 존재하는 염증병소의 제거, 둘째, 치주낭 깊이의 감소, 마지막으로 부착 수준의 증가의 세 가지로 정리하였다. 치주질환은 치태에 의해 유발되는 일종의 감염이므로, 기계적으로 혹은 화학적인 방법으로 치은염과 치주염의 일차적인 원인이 되는 치태를 제거하거나 최소화하는 접근으로 치료하게 된다. 기계적인 치료는 철저하게 치근면의 치태나 endotoxin, 치석 또는 치태가 저류할 만한 인자들을 hand instrument로 제거하거나 초음파 치석제거기로 제거하는 과정을 포함한다. 이러한 기계적인 치주치료의 최종 목표는 건강한 부착이 일어날 수 있는 치근 표면을 형성하는 데에 있다. 이 글은 비외과적 치주치료 중에서도 기계적인 치주치료에 초점을 맞춰 서술하였다

Calcium carbonate 및 자가골 이식술을 동반한 조직유도재생술후 생검을 통한 재생골의 조직학적 관찰

For histologic observation of the regenerated bone following guided tissue regeneration (GTR) using ePTFE membranes with calcium carbonate implant and autogenous bone graft, biopsies were collected from 2 patients during 5-year-postoperative surgical reentry. In both combined cases with guided tissue regeneration in conjunction with calcium carbonate implant and autogenous bone graft, significant bone fill and gain in probing attachment level was observed. In histologic examination, specimen in GTR case with calcium carbonate grafting was composed of a dense bone containing vascular channel with lamellar structure and viable bone cells in lacunae, however considerable calcium carbonate particles remained unresorbed and isolated from regenerated bone by the dense cellular and fibrous connective tissue. No formative cells could be seen in contact with remained calcium carbonate particles. In GTR case with autogenous bone grafting, specimen show was composed of a dense lamellar bone containing vascular channel, which showed normal alveolar bone architectures. The present observation indicate that guided tissue regeneration in conjunction with grafting, especially autogenous bone graft, has highly osteogenic potential, however resorbable calcium carbonate granules were not completely resorbed at 5 year postimplantation

Poly(alpha-hydroxy acids) 제제 생분해성 차폐막의 치주조직 재생유도 능력에 관한 조직학적 장기 관찰

The recent trend of research and development on guided tissue regeneration focuses on the biodegradable membranes, which eliminate the need for subsequent surgical removal. They have demonstrated significant and equivalent clinical improvements to the ePTFE membranes. This study evaluate guided tissue regeneration wound healing in surgically induced intrabony periodontal defects following surgical treatment with a synthetic biodegradable membranes, made from a copolymer of glycolide and lactide, in 8 beagle dogs. After full thickeness flap reflection, exposed buccal bone of maxillary and mandibular canine and premolar was removed surgically mesiodistally and occlusoapically at in size for preparation of periodontal defects. In experimental sites a customized barrier was formed and fitted to cover the defect. Flap was replaced slightly coronal to CEJ and sutured. Plaque control program was initiated and maintained until completion of the study. In 4, 8, 16 and 24 weeks after surgery, the animals were sacrificed and then undecalcified specimens were prepared for histologic evaluation. Histologic examination indicated significant periodontal regeneration characterized by new connective tissue attachment, cementum formation and bone formation. These membranes showed good biocompatibility throughout experiodontal period. The barriers had been completely resorbed with no apparent adverse effect on periodontal wound healing at 24 weeks. These results implicated that present synthetic biodegradable membrane facilitated guided tissue regeneration in periodontal defect.이 연구는 1996년도 서울대학교병원 임상공동연구비(1-96-75)의 지원에 의해 이루어졌습니다

옥수수 불검화 추출물과 후박 추출물 혼합물의 치주질환 원인균에 대한 항균작용 및 치은섬유아세포 활성도에 미치는 영향

Zea Mays L. has been known to be effective for improving tissue health and Magnoliae cortex to have effective antibacterial and antimicrobial activity against pathogenic microbes. The purpose of this study was to examine the antimicrobial effects of Zea Mays L. and Magnoliae cortex extract mixtures on periodontal pathogens(Prevotella intermedia, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Streptococcus mutans )and to examine the effects on human gingival fibroblast cellular activity. Zea Mays L. and Magnoliae cortex extracts and their mixtures were prepared with various mixing ratios (0.5:1, 1:1, 1.5:1, 2:1). These extracts were loaded to periodontal pathogen cultured petri dish for antimicrobial test and also loaded to cultured human gingival fibroblast for cellular activity test. Each test was repeated 3 times and data were analyzed by one-way ANOVA with 95% confidence level. Mixture of these two extracts showed greater amount of inhibition area on periodontal pathogen and more improved gingival fibroblast activity as Zea Mays L. ratio reduced. So, mixture ratio 0.5:1 (Zea Mays L. : Magnoliae cortex) group showed statistical significance in antimicrobial activity and cellular activity among various mixtures(p < 0.05). In conclusion, 0.5:1 (Zea Mays L. : Magnoliae cortex) mixture possessed best gingival fibroblast cellular activity and antimicrobial activity toward periodontal pathogens.이 연구는 1996년도 서울대학교병원 지정연구비 지원에 의한 결과입니다

흡연이 흡수성차폐막을 이용한 조직유도재생술의 치유에 미치는 영향

This study compared the short-term(4 months) clinical results of regenerative therapy with bioabsorbable membranes() and bone allograft for the treatment of periodontal(intrabony and furcation) defects in smokers and nonsmokers.(16 smokers) 32 subjects with 92 defects participated in the study(46 in smokers and 46 in non-smokers). This study also evaluated a bioresorbable barrier with and without decalcified freeze-dried bone allograft(DFDBA). The 92 periodontal defects were randomly treated with either the resorbable barrier alone or resorbable barrier in combination with DFDBA following thorough defect debridement and root preparation with tetracycline. Each patient received both types of treatment modalities. Clinical examinations(probing depth, gingival recession, clinical attachment level, plaque index and gingival index) were carried out immediately before and 4 months after surgery. Significant(p<0.001) gains in mean attachment level were observed for both smokers(2.93mm) and non-smokers(3.30mm) but there were not significant difference between two groups. Similarly, significant reductions in mean probing depthshowed for smokers(4.52mm) and non-smokers(4.26mm). However, when comparing gingival recession, smokers were found to exhibit significantly poorer treatment results(1.59mm vs 0.96mm, p<0.05). Using the split-mouth-design, no statistically significant difference between the two modalities could be detected with regard to pocket depth reduction, gingival recession, or attachment gain. These results illustrate that the attachment gain is better in the non-smoker and the best in the non-smoker with the combination therapy of resorbable barrier and DFDBA than with resorbable barrier alone but smoking had no significant effect on clinical treatment outcome, even though smokers show more significant gingival recession. In addition, both treatments, either resorbable barrier plus DFDBA or resorbable barrier alone, promoted significant resolution of periodontal defects but the addition of DFDBA with a bioabsorbable membrane appears to add no extra benefit to the only membrane treatment

Influence of platform switching on crestal bone resorption

Purpose: Numerous studies have shown that crestal bone resorption around the implant was related to the location of the implant abutment junction(IAJ). Recently it was hypothesized that platform switching termed the inward horizontal repositioning of the IAJ might limit bone resorption around the implants. The purpose of this clinical study was to evaluate the effect of platform switching on crestal bone resorption. Materials and Methods: The crestal bone loss of 65 external hex implants in 26 patients were radiographically measured at crown placement and follow-up examinations. 23 standard implants(non-platform switching group, NP) were connected with the matching abutments and 42 wide implants(platform switching group, PS) were connected with the 1 mm smaller diameter abutments. Results: There was significant difference of crestal bone loss between NP group and PS group. For implants in the NP group, mean crestal bone loss was at crown placement and at follow-up. The meal bone loss in PS group was at crown placement and at follow-up. When the crestal bone changes according to placement depths of implants were compared, subcrestal position of IAJ had a significantly less bone loss in PS group, but it was not in NP group. Conclusion: Within the limits of the present study, it was concluded that platform switching technique might decrease crestal bone loss around the implants. Additionally, when the IAJ of implant was placed 1 mm deeper in the alveolar bone, the effect of platform switching on bone loss was enhanced

한국인 치주감염환자에서의 Prevotella intermedia와 Prevotella nigrescens의 발현빈도

Prevotella intermedia has been implicated as a potent pathogen in many kinds of periodontal, pulpal and periapical diseases. However, it has been isolated from periodontally healthy adults and from edentulous children as well. The intraspecies heterogeneity of Prevotella intermedia has been demonstrated in early studies and finally Shah & Gharbia confirmed the existence of 2 DNA homology groups and proposed dividing Prevotella intermedia into 2 species, Prevotella intermedia and Prevotella nigrescens. This study was designed to examine the frequency of Prevotella intermedia and Prevotella nigrescens in diseased periodontal pockets and healthy gingival sulcus of Korean people by PCR based on 16s ribosomal DNA sequence. One hundred adults who had adult periodontitis but not taken any periodontal treatment or antibiotics during previous 6 months and 50 adults who had healthy periodontal tissue were selected for this study. The sulcular fluid was collected into VMGA by sterilized paper point and diluted to 1,000 times in anaerobic chamber. of sample was cultured in for 10 days. Among the bacterial colonies, BPB were selected and cultured in BHI broth and then Prevotella intermedia was identified through Gram staining and biochemical test. Identified Prevotella intermedia was cultured again and centrifuged. DNA was extracted from the pellet using several reagents. PCR was performed by previously designed primer. The results were followed. 1. BPB were isolated from 39 of 100 samples of diseased periodontal pockets(39%). 2. Prevotella intermedia was identified from 24 of 39 BPB samples. 3. Among 24 Prevotella intermedia, 21 were confirmed as Prevotella inter - media(87.5) and 2 were confirmed as Prevotella nigrescens(8.33%). 4. BPB were isolated from 9 of 50 samples of periodontally healthy patients. Among them only two were identified as Prevotella intermedia, that is, one was confirmed as Prevotella intermedia and the other was Prevotella nigrescens.이 연구는 1997년도 서울대학교병원 대형공동연구비 지원에 의한 결과입니다

비외과적 치주치료시 30% Minocycline을 함유한 Polycaprolactone Strip(미노클린 첨부제)의 부가적 효과

이 연구는 1998년도 서울대학교병원임상연구비의 지원에 의한 것입니다