단백질 전달 영역 융합-Bone Morphogenetic Protein-2가 백서 두개골 결손부에서 골 조직 재생에 미치는 효과

엄유정,조규성,김종관,최성호,채중규,김창성,Um, Yoo-Jung,Cho, Kyoo-Sung,Kim, Chong-Kwan,Choi, Seong-Ho,Chai, Jung-Kiu,Kim, Chang-Sung 대한치주과학회 2008 Journal of Periodontal & Implant Science Vol.38 No.2

Purpose: Recombining bone morphogenetic protein (BMP) is usually acquiredfrom high level animals. Though this method is effective, its high cost limits its use. The purpose of this study was to evaluate the effect of bone morphogenetic protein-2 with protein transduction domain (BMP-2/PTD;TATBMP-2) on bone regeneration. Rat calvarial defect model and osteoblastic differentiation model using MC3T3 cell were used for the purpose of the study. Materials and Methods: MC3T3 cells were cultured until they reached a confluence stage. The cells were treated with 0, 0.1, 1, 10, 100, 500 ng/ml of BMP-2/PTD for 21 days and at the end of the treatment, osteoblastic differentiation was evaluated usingvon Kossa staining. An 8mm, calvarial, critical-size osteotomy defect was created in each of 48 male Spraque-Dawley rats (weight $250{\sim}300\;g$). Three groups of 16 animals each received either BMP-2/PTD (0.05mg/ml) in a collagen carrier, collagen only, or negative surgical control. And each group was divided into 2 and 8 weeks healing intervals. The groups were evaluated by histologic analysis(8 animals/group/healing intervals) Result: In osteoblastic differentiation evaluation test, a stimulatory effect of BMP-2/PTD was observed in 10ng/ml of BMP-2/PTD with no observation of dose-dependent manner. The BMP-2/PTD group showed enhanced local bone formation in the rat calvarial defect at 2 weeks. New bone was observed at the defect margin and central area of the defect. However, new bone formation was observed only in 50% of animals used for 2weeks. In addition, there was no new bone formation observed at 8 weeks. Conclusion: The results of the present study indicated that BMP-2/PTD(TATBMP-2) have an positive effect on the bone formation in vitro and in vivo. However, further study should be conducted for the reproducibility of the outcomes.

토끼 두개골에서 새로 개발된 biphasic calcium phosphate의 골형성 효과 : A pilot study

엄유정,홍지연,김성태,이용호,박상현,박준효,조규성,김종관,최성호,Um, Yoo-Jung,Hong, Ji-Yeon,Kim, Sung-Tae,Lee, Yong-Ho,Park, Sang-Hyun,Park, Sun-Hyo,Cho, Kyoo-Sung,Chai, Jung-Kiu,Kim, Chong-Kwan,Choi, Seong-Ho 대한치주과학회 2008 Journal of Periodontal & Implant Science Vol.38 No.2

Purpose: Biphasic calcium phosphates have been of great interest recently. Mixing adequate ratios of hydroxyapatite(HA) and beta-tricalcium phosphate($\beta$-TCP) allowed to control the resorption rate without distorting its osteoconductive property. This study evaluated the bone formation effect of newly developed biphasic calcium phosphate(BCP) in calvarial defect of rabbits. Materials and Methods: 6 male New Zealand rabbits were used. Four defects with 8mm in diameter were created on each animal. BCP with HA/$\beta$-TCP ratio of 7:3 and particle size of $0.5{\sim}1.0\;mm$ was used as the test group and bovine bone with $0.25{\sim}1.0\;mm$ particle size, as the control group. Both test and control group materials were randomly implanted in the calvarial defects and were covered witha polymer membrane. The animals were sacrificed after 12, 24, and 48 weeks of implantation under general euthanasia. Resin blocks were obtained and were stained by masson's trichrome for histological observation. Results: Overall results were uneventful without any defect exposure or inflammation. The amount of new bone formation and bone maturity increased with increase in healing period at both groups. New bone in test group was mostly formed along the material particle surrounded by osteoblasts, and observation of osteoblastic stream was also present. Bone maturity increased as it was closer to thedefect margins. Under the same healing period, the test group showed more bone formation than the control group with more stable bovine bone particles remaining even after 48 weeks, whereas considerable resorption took place in BCP. Almost total defect closure was observed in test group with new bone formation in the central part of the defect. However, limited new bone formation was observed in the control group. Conclusion: Within the limits of the study, the present study reveals the newly developed BCP to be a good osteoconductive material. However, further studies are needed to be conducted in a different study model with a larger sample size.

Human immunodeficiency virus 감염과 치주 질환의 상관관계, 진단 및 처치에 관한 문헌 고찰

박정철(Jung-Chul Park),엄유정(Yoo-Jung Um),정의원(Ui-Won Jung),김창성(Chang-Sung Kim),조규성(Kyoo-Sung Cho),채중규(Jung-Kiu Chai),김종관(Chong-Kwan Kim),최성호(Seong-Ho Choi) 대한치과의사협회 2009 대한치과의사협회지 Vol.47 No.8

Purpose: Infection with HIV-1 virus has become a critical worldwide public health problem. The oral complications of HIV infection with its progression of Impairment of the host response to combat infection present unique challenges to the periodontists. Material and Methods : Medline research was carried out to find relationship of the progression of HIV infection to the occurrence of oral lesions including the HIV-related periodontal diseases. Results; The linear gingival erythema, necrotizing ulcerative periodontitis, necrotizing ulcerative gingivitis and oral candidiasis are common lesions in HIV-infected individuals. The linear gingival erythema and necrotizing ulcerative periodontitis lesions in HIV-infected subjects were found to have a similar microbiological profile. There are several general considerations in the periodontal management of the HIV-infected patient with or without periodontal disease. The altered immunity and host response in patients with HIV infection may also affect the incidence and severity of other common forms of periodontal disease not associated with HIV infection. Conclusion: Periodontal diseases in HIV-infected individuals present unique challenges in diagnosis, monitoring, treatment and maintenance. Therefore exact HIV staging, geographic location, antiviral and antimicrobial therapies and oral habits should be taken into consideration when treating HIV-infected patients.

조절되는 당뇨환자에게 식립된 치과 임플란트의 생존율에 대한 후향적 연구

김영희,엄유정,정의원,김창성,조규성,최성호,Kim, Young-Hee,Um, Yoo-Jung,Jung, Ui-Won,Kim, Chang-Sung,Cho, Kyu-Sung,Choi, Seong-Ho 대한치주과학회 2009 Journal of Periodontal & Implant Science Vol.39 No.3

Purpose: The aim of the present study was to analyze 7-year cumulative survival rate (CSR, %) of dental implants in the controlled diabetic patients and to evaluate the influence of the position, diameter and length of fixture, bone quality, age, gender and the method of maxillary sinus elevation on the survival rate. Methods: The data of 342 placed implants in the 104 diabetic patients collected between 1995 and 2007 at the Department of Periodontology in Yonsei University Hospital were analyzed. Results: Seven-year CSR of the 342 dental implants in the 104 controlled diabetic patients was 96.5%. The survival rates of the placed implants according the position have no statistically significant difference. The survival rates according to the length or diameter of the fixtures have no statistically significant difference. The survival rates according to the bone quality were 100% (Type I), 97.1% (Type II), 97.7% (Type III) and 85.7%(Type IV). The difference between the survival rate of Type I, II and III and that of Type IV was statistically significant. The survival rates according to patient gender were 96.8% (male), 95.5% (female). The survival rates according to patient age were 100% (${\leq}59$), 93.8% (${\geq}60$). The survival rates according to the method of sinus elevation in the maxillary posterior area were 96.8% (without sinus elevation), 92.9% (lateral approach) and 89.8% (crestal approach). Conclusions: Dental implants can be used successfully in the controlled diabetic patients. In case of upper posterior region which has poor bone density and older patients, the implant treatment should be more properly planed, executed, and followed-up.

골다공증환자에서 임프란트의 생존율에 대한 후향적 연구

이근,엄유정,정의원,김창성,최성호,조규성,채중규,Lee, Geun,Um, Yoo-Jung,Jung, Ui-Won,Kim, Chang-Sung,Choi, Seong-Ho,Cho, Kyoo-Sung,Chai, Jung-Kiu 대한치주과학회 2009 Journal of Periodontal & Implant Science Vol.39 No.4

Purpose: The presented study aims to evaluate the effects of osteoporosis on dental implants by analyzing a 12-year cumulative survival rate of implants placed in patients with osteoporosis. Methods: 37 patients with history of osteoporosis were selected from a pool of dental implant patients treated at the Department of Periodontology in Yonsei University Hospital between 1993 and 2007. The cumulative survival rate is quantified using data collected from 164 placed implants in the selected 37 patients. Results: 3 out of the 164 implants failed and the cumulative survival rate was observed at 95.1%. The survival rates of the implants according to patients' age were 97.41% (<60) and 100% ($60\leq$). The lower survival rate was directly proportional to younger age, and this relationship is statistically significant (P<0.05). The survival rates of implants according to diagnostic criteria were 95.45% (osteopenia) and 98.59% (osteoporosis; 2 out of 142 implants placed in osteoporosis patients failed). The difference in the two survival rates is statistically significant (P<0.05). The survival rates according to the region of implants do not have statistically significant difference. The survival rates according to the different length and diameter of the implants do not have statistically significant difference. The survival rates of implants accompanied and not accompanied by bone augmentation were 92.11% and 100%, respectively. The difference in the two survival rates is statistically significant (P<0.05). The survival rates of implants placed in patients with and without history of medication for osteoporosis treatment are 96.67% and 99.04%, respectively. The difference in the two survival rates is statistically significant (P<0.05). Conclusions: A high cumulative survival rate of dental implants, similar to one found in non-osteoporosis patients, is observed in osteoporosis patients, indicating the possibility that placing dental implants on patients with osteoporosis can be considered with high treatment predictability.

치과 진료실에서의 신속 구강 점막 도말 HIV 항체 검사에 대한 태도 및 지식에 관한 연구

박정철(Jung-Chul Park),김용태(Yong-Tae Kim),정임희(Im-Hee Jung),엄유정(Yoo-Jung Um),정의원(Ui-Won Jung),김창성(Chang-Sung Kim),조규성(Kyoo-Sung Cho),채중규(Jung-Kiu Chai),김종관(Chong-Kwan Kim),최성호(Seong-Ho Choi) 대한치과의사협회 2009 대한치과의사협회지 Vol.47 No.5

Purpose: The aim of this study was to evaluate the patient’s and dentist’s perspective and knowledge on rapid human immunodeficiency virus screening test in dental setting. Material and Methods: In March 2009, 100 patients and 100 dentists at College of Dentistry, Yonsei University were provided an attitude assessment survey. Results: Results were analyzed for acceptance of testing and potential barriers. 94% of patients agreed to take a rapid HIV screening test and 77% of dentists were willing to provide the test to their patients. Also the current knowledge state of patients and dentists on HIV infection was not accurate as expected. Conclusion: Overall, dental clinic patients widely accepted the offer of rapid oral HIV screening. Rapid HIV screening test in the dental setting can be an important option to increase the number of individuals who know their HIV status.

비스테로이드성 항염진통제의 투여시기가 구강외과 술 후 통증에 미치는 효과에 대한 연구

정영수,김문기,엄유정,박형식,이의웅,강정완,Jung, Young-Soo,Kim, Moon-Key,Um, Yoo-Jung,Park, Hyung-Sik,Lee, Eui-Wung,Kang, Jeong-Wan 대한치과마취과학회 2004 Journal of Dental Anesthesia and Pain Medicine Vol.4 No.2

Background: Many studies on efficacy of preemptive analgesia have been processed in different ways. But the value of preemptive analgesia is still controversial. The goal of this study was to compare analgesic effect of an NSAID according to three different administration times for oral surgical pain. Patients and Methods: Using a randomized, parallel-group, single-center, and active-controlled test design, this study was conducted to healthy 80 patients undergoing a surgical removal of an impacted mandibular third molar requiring bone removal. The oral NSAID was first administered 1 hour preoperatively, or 1 hour postoperatively, or no scheduled administration in pre or postsurgery. Whenever patients felt at least moderate pain (score ${\ge}$ 5 on a 10-point scale) after surgery, they were instructed to take the same drug. Pain intensities and times to the first and second onset of postoperative pain from end of surgery were assessed for 24 hours. Results: Of the enrolled eighty subjects in this study, 25 patients were assigned to preemptive, 26 to post-treatment and 29 to no treatment group. The demographic distribution and duration of surgery in the three groups were statistically similar. The mean time to first onset of postoperative pain was significantly prolonged in post-treatment group (277.2 minutes, p < 0.05) compared to preemptive (158.4 minutes) and no treatment group (196.5 minutes). The mean time to second onset of postoperative pain was not significantly different among the three groups. No significant statistical difference was found among the mean pain intensities at the first and second onset of postoperative pain in the three groups. Conclusions: In this small selected group of subjects and limited study design, the analgesic effects of NSAID administered preoperatively were no longer effective for postoperative pain. The results in this population imply that scheduled postoperative analgesics before pain development are adequate for postoperative analgesia without preoperative administration.

Original Article 1 - 합성골 이식재인 Osteon$^{(R)}$을 이용한 상악동 거상술-임상적, 방사선 계측학적 연구

차재국,정의원,김민수,엄유정,김창성,조규성,최성호,정성민,Cha, Jae-Kook,Jung, Ui-Won,Kim, Min-Soo,Um, Yoo-Jung,Kim, Chang-Sung,Cho, Kyoo-Sung,Choi, Seong-Ho,Chung, Sung-Min 대한치과의사협회 2010 대한치과의사협회지 Vol.48 No.1

Purpose: The aim of this study was to evaluate 1 year cumulative survival rate of implants placed on augmented sinus using Osteon$^{(R)}$, bone graft material and to assess height of the grafted material radiographically. Material and Methods: 10 maxillary sinuses were augmented in 10 patients and 25 implant fixtures were installed simultaneously or after 6 months healing period. The height of the sinus graft material was measured using panoramic images immediately after augmentation and up to 19 months subsequently. Changes in the height of the sinus graft material were calculated with respect to implant length and original sinus wall height. Results: The cumulative survival rate was 100% in all 25 implants. Additionally, normal healing process without any complication was observed in all patients. The mean crown/Implant ratio was 1.25. The mean marginal bone loss was 0.95mm and the mean resorption rate of Osteon$^{(R)}$ was 0.05mm/month. The fastest resorption site of Osteon$^{(R)}$ is the first molar area. The grafted material was well maintained in sinus and decreased slightly over 1 year. Conclusion: In conclusion, It can be suggested that Osteon$^{(R)}$ may have predictable result when it was used as a grafting material for sinus floor augmentation.

토끼 두개골 결손부에서 블록형과 분말형 hydroxyapatite의 골전도 효과

구순자,손주연,임현창,엄유정,정의원,김창성,이용근,최성호,Gu, Sun-Ja,Sohn, Joo-Yeon,Lim, Hyun-Chang,Um, Yoo-Jung,Jung, Ui-Won,Kim, Chang-Sung,Lee, Yong-Keun,Choi, Seong-Ho 대한치주과학회 2009 Journal of Periodontal & Implant Science Vol.39 No.3

Purpose: The purpose of this study was to evaluate the bone regeneration of particulated hydroxyapatite(HA) and block type of hydroxyapatite graft in rabbit calvarial defects. Methods: An 8 mm calvarial circular defects were created in sixteen young adult New Zealand white male rabbits (weight $3.0{\sim}3.5kg$). Each defects were filled with Bio-Oss, particulated HA and block type HA. Sham surgery control defects were filled with blood clots. The specimens were harvested at 4 weeks and 8 weeks for histologic and histomorphometric evaluation. Results: Histomorphometric analysis demonstrated statistical differences in defect closure, new bone formation, and bone density of the four groups. Block type of HA group showed increased bone formation and bone density at 4 weeks and 8 weeks compared with Bio-Oss group or sham surgery control group(p<0.05). Conclusions: Block type of HA is an effective material for osteoconduction in rabbit calvarial defects, which may acts as a guide in use of these products in human application.

Influence of the Sonic Power Toothbrush on Reduction of Gingival inflammation and on the Amount of interleukin-6, Prevotella intermedia and Actinobacillus actinomycetemcomitans in Periodontal Pocket

홍지연,채경준,정성원,엄유정,최성호,김종관,Hong, Ji-Youn,Chae, Gyung-Joon,Jung, Sung-Won,Um, Yoo-Jung,Choi, Seong-Ho,Kim, Chong-Kwan The Korean Academy of Periodontoloy 2007 Journal of Periodontal & Implant Science Vol.37 No.2

세균성 치태는 치은의 염증과 치주 조직 파괴를 동반하는 치주염의 주요한 인자로서 치주 조직 건강을 유지하기 위하여 적절한 치태 조절이 필요하다. 본 논문의 목적은 12주 동안 만성 초기 및 중등도 치주염 환자에서 치은염에 대한 임상 지수의 감소, interleukin-6 (IL-6) 농도와 치주질환 원인균인 Prevotella intermedia (P. intermedia), Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans)에 대한 소니케어 전동 칫솔의 효과를 일반 칫솔과 비교해 보고자 하는 데 있다. 총 82명의 환자를 선택하였으며, 30명은 일반 칫솔, 52명은 소니케어 전동 칫솔 군으로 분류하여 칫솔질 교육을 실시하였다. 전악을 전치부와 구치부로 나누어 초진, 1, 4, 12주에서의 치태, 치은 지수 및 탐침 시 출혈 여부를 조사하였으며, 가장 깊은 치주낭 탐침을 보이는 치아 3개를 선택하여 탐침 깊이와 부착 정도를 측정하였고, 선택된 치아에서 초진, 1, 12주에 채취된 샘플을 통해 치은열구액 내의 IL-6 농도와 P. intermedia, A. actinomycetemcomitans의 CT값을 추가적으로 조사하여 다음과 같은 결과를 얻었다. 1 소니케어 전동 칫솔과 일반 칫솔군 모두 치은 염증을 나타내는 임상 지수 (치태지수, 치은지수, 탐침 시 출혈)는 12주 기간 동안 유의한 감소 (p<0.05)를 보였으나, 전동 칫솔 군에서 통계학적으로 더욱 유의하게 (p<0.05) 나타났다. 2. 전치부를 제외한 구치부 치아에서 소니케어 전동 칫솔군은 12주 기간 동안 탐침 시 출혈의 감소가 통계학적으로 유의하게 (p<0.05) 나타났다. 3. 가장 깊은 치주낭 탐침 깊이를 보이는 3개의 선택된 치아에서 치주낭 탐침 깊이와 부착 정도는 두 군 모두 초진에 비해 유의한 감소 (p<0.05)를 보였다. 퍼센트 변화 비교에서 치주낭 탐침 깊이는 소니케어 전동 칫솔군이 $18.47{\pm}10.05%$, 일반 칫솔군이 $14.19{\pm}8.16%$로, 부착 정도는 소니케어 전동 칫솔군이 $24.26{\pm}12.51%$, 일반 칫솔군이 $15.65{\pm}9.92%$로 각각 나타났으나, 군 간 통계적 유의차는 보이지 않았다. 4. 치은열구액의 IL-6 농도는 두 군 모두 12주 기간 동안 통계적으로 유의한 감소 (p<0.05)를 나타내었다. 퍼센트 변화 비교에서 전동 칫솔군은 51%, 일반 칫솔군은 37%로 각각 나타났으나, 군 간 통계적 유의차는 보이지 않았다. 5. Prevotella intermedia, Actinobacillus actinomycetemcomitans의 관찰에서 두 군 모두 유의한 차이는 없었다. 위 결과를 통해 본 연구에서는 소니케어 전동 칫솔의 사용이 일반 칫솔에 비하여 만성 초기 및 중등도 치주염 환자에서 치태의 제거, 치은 염증 및 임상 지수의 감소에 유의한 효과가 있으며 IL-6의 감소 경향에도 효과가 있음을 관찰하였다.