치근이개부 수평결손시 조직재생에 관여하는 전구세포의 면역세포화학적 연구

허익,권영혁,Herr, Yeek,Kwon, Young-Hyuk 대한치주과학회 1995 Journal of Periodontal & Implant Science Vol.25 No.2

The origin of fibroblasts, their proliferative activity and roles in the early stages of periodontal regeneration were investigated in order to better understand the periodontal healing process in furcation defects of the beagle dog after guided tissue regeneration. Newly divided cells were identified and quantitated by immunolocalization of bromodeoxyuridine (BrdU) injected 1 hour prior to sacrificing the animals. The results were as follows :1. During periodontal healing in horizontal furcation defect, three different stages, namely the granulation tissue, connective tissue, and bone formation stages, were identified on the basis of major types of cells and tissue. 2. In the early stages of periodontal regeneration, both the remaining periodontal ligament and alveolar bone compartment were the major sources. 3. The majority of BrdU-labeled fibroblasts were located at the following areas ; 1) the coronal zone of the defect in case of the connective tissue fanned on the root surface. 2) the area within an 400 ${\mu}m$ distance from the remaining bone level in case of the periodontal ligament. 3) the area within an 100 ${\mu}m$ distance from the bone surface in case of areas of active bone formation.4. The highly proliferative fibroblasts adjacent to bone surface played a major role in the formation of osteoblast precursor cells, whereas both paravascular and endosteal cells played a minor role in new bone formation, In conclusion, it was suggested that the fibroblasts in the remaining periodontal ligament and bone will play a major role in periodontal regeneration, whereas both paravascular and endosteal cells will play a minor role in new bone formation.

한국인 상악 제1대구치 치근의 면적 및 해부학적 구조에 관한 연구;치주질환의 병인론과 치료에 있어서 임상적 중요성

허익,권영혁,이만섭,Herr, Yeek,Kwon, Young-Hyuk,Lee, Man-Sup 대한치주과학회 1989 Journal of Periodontal & Implant Science Vol.19 No.2

유지치주치료기간과 치은연하세균 출현율의 관계

김진철,허익,권영혁,박준봉,정종혁,Kim, Jin-Cheol,Herr, Yeek,Kwon, Young-Hyuk,Park, Joon-Bong,Chung, Jong-Hyuk 대한치주과학회 2005 Journal of Periodontal & Implant Science Vol.35 No.1

This study was performed to evaluate the relation between the interval of supportive periodontal therapy and the prevalence of the subgingival microflora. The subgingival plaques from 108 patients were used in the study. Control group were the patients with no periodontal treatment and test groups were assigned into 3 groups according to the period of recall check: group 1; 1-2 months, group 2; 3-4 months, group 3; 6months or more. The polymerase chain reaction (PCR) used for direct identification of periodontal pathogens (P. gingivalis, T. forsythensis, T. denticola) in subgingival plaque. The results of this study were as follows. 1. The prevalence of P. gingivalis, T. forsythensis, T. denticola in control group were 100%, 87%, 90%. 2. In clinical parameters such as plaque index, gingival index, bleeding on probing, control group was not significant different with group 1 but Significant different with group 2, group 3. 3. In group 1, the majority of P. gingivalis had type II fimA. 4. When group 3 were compared with group 1, the prevalence of P. gingivalis increased. But the prevalence of P. gingivalis with type II fimA, which have the virulence factor, decreased. 5. We were unable to find the correlation between P. gingivalis with type IV fimA and periodontal disease. 6. The prevalence of T. forsythensis, T. denticola in test group were 85%, 93% or more. From the above results, we were able to find the relation between the interval of supportive periodontal therapy and the prevalence of the subgingival microflora and the need of the strict supportive periodontal therapy to prevent recurrence of periodontal disease, because there were high prevalence of periodontal pathogens.

방사선 조사 망상골이 외방형 골형성에 미치는 영향

정미현,허익,권영혁,박준봉,정종혁,Chung, Mi-Hyun,Herr, Yeek,Kwon, Young-Hyuk,Park, Joon-Bong,Chung, Jong-Hyuk 대한치주과학회 2007 Journal of Periodontal & Implant Science Vol.37 No.4

The purpose of this study was to evaluate exophytically vertical bone formation in residual ridge of the beagle dog by the concept of guided bone regeneration with a titanium reinforced e-PTFE membrane combined with irradiated cancellous human bone. Twelve male beagle dogs(mean age 1.5 years and mean weight 12kg) were used for this study. The alveolar ridges after extraction of all mandibular premolars were surgically and horizontally removed. At 8 weeks after extractions, full-thickness flap was reflected and cortical bone was removed with round bur and copious irrigation. Rectangular parallelepiped(10mm in length, 5mm in width, and 4mm in height) bended with titanium-reinforced e-PTFE(TR e-PTFE) membrane was placed on the decorticated alveolar ridge, fixed with metal pins and covered with full-thickness flap and assigned as a control group. Test groups ere treated with TR e-PTFE membrane filled with irradiated cancellous human bone. Of twelve beagle dogs, four control dogs and four test dogs without membrane exposure to oral cavity were sacrificed at 8 and 16 weeks respectively. The surgical sites were dissected out, fixed in 4% buffered formaldehyde, dyed using a Villanueva staining technique, and processed for embedding in plastic resin. The cutting and grinding methods were routinely processed for histologic and histomophometric analyis of exophytic bone formation as well as statistical analysis. The results of this study were as follows: 1. Exophytic bone formation in the both of experimental groups was increased respectively after surgery from 23.40% at 8 weeks to 46.26% at 16 weeks in the control groups, from 40.23% at 8 weeks to 47.11% at 16 weeks in the test groups(p<0.05). 2. At 8 weeks after surgery, exophytic bone formation was made 40.23% in the test groups and 33.40% in the control groups. Exophytic bone formation was significantly made in the test group more than in the control group. At 16 weeks after surgery, exophytic bone formation was made 44.11% in the test groups and 46.26% in the control groups. Exophytic bone formation was made in the test groups more than in the control groups, but there was no statistically significant differences. 3. The membrane was fixed with metal pins to closely contact it to the bone surface. So, collapse and deviation of the membrane could be prevented and in growth of connective tissue also could be blocked from the periphery of the membrane. On the basis of these findings, wee suggest that intraoral experimental model for exophytic bone formation may be effective to evaluate the effect of bone graft material. And it indicates that combined use of membrane and ICB graft material is more effective than use of membrane only for exophytic bone formation.

치은 퇴축 화복을 위한 상피하 결합조직 이식을 동반하는 다양한 치근피개술에 대한 임상적 평가

김성원,허익,권영혁,박준봉,정종혁,신승일,Kim, Seong-Won,Herr, Yeek,Kwon, Young-Hyuk,Park, Joon-Bong,Chung, Jong-Hyuk,Shin, Seung-Il 대한치주과학회 2008 Journal of Periodontal & Implant Science Vol.38 No.4

Purpose: The subepithelial connective tissue graft(SCTG) has been proven to be a highly predictable treatment modality for coverage of gingival recession. This case report was performed to evaluate the effect of various root coverage procedures using SCTG on gingival recession. Materials and Methods: Three patients presents with Miller's class I recession defect on the maxillary canine. Each other SCTG(coronally advanced flap, Bruno's Tech., envelope Tech.) were performed for root coverage. Clinical parameters assessed included recession depth, recession width, and keratinized gingival width. Measurements were taken at baseline and 2 months and follow up end. Results: The average of root coverage was 4 mm(100% of the pre-operative recession depth) at the 2, 5 months examination. The average increase of keratinized tissue between the baseline and the 2 months amounted to 3.2mm. Conclusion: Within the above results, various root coverage using SCTG is an effective procedure to Miller's class I recession defect and patient could be satisfied aesthetic requirement.

동결건조골이 재생공간 유지 및 골재생에 미치는 영향

홍소미,허익,권영혁,박준봉,Hong, So-mi,Herr, Yeek,Kwon, Young-Hyuk,Park, Joon-Bong 대한치주과학회 2004 Journal of Periodontal & Implant Science Vol.34 No.1

This study was performed to evaluate the effect of freeze-dried bone graft on space-making capacity and bone formation in the procedure of guided bone regeneration with titanium reinforced ePTFE membrane. After decortication in the calvaria, GBR procedure was performed on 8 rabbits with titanium reinforced ePTFE membrane filled with human FDBA(Rocky Mountain Tissue Bank,Aurora Co., USA). Decortication was performed to induce the effect of bone forming factor from bone marrow. The animals were sacrificed at 2 weeks, 4 weeks, 8 weeks and 12 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis. πle results of this study were as follows: 1. Titanium reinforced-ePTFE membrane was biocompatable and capable of maintaining the space-making. 2. FDBA particle was surrounded with connective tissues but there was no evidence on new bone formation. 3. FDBA particle resorbed continuously but it remained until 12weeks after the surgery. Within the above results, TR-ePTFE membrane could be used effectively for Guided bone regeneration but It was assumed that FDBA does not appear to contribute to bone formation.

혈소판유래성장인자와 상피성장인자가 치주인대세포와 골수세포의 성상에 미치는 영향

조병도,허익,박준봉,권영혁,이만섭,Cho, Byeong-Do,Herr, Yeek,Park, Joon-Bong,Kwon, Young-Hyuk,Lee, Man-Sup 대한치주과학회 1996 Journal of Periodontal & Implant Science Vol.26 No.2

This study was performed to evaluate the effects of platelet-derived growth factor (PDGF) and epidermal growth factor (EGF) on the characteristics of beagle dog's periodontal ligament (BPD) cells and bone marrow (BBM) cells which have the important role on the early stage of periodontal tissue regeneration in vitro. In control group, the cells ($1.5{\times}10^5$cells/ml) were cultured alone with Dulbecco's Modified Eagle's Medium contained with 10% fetal bovine serum, $50{\mu]g/ml$ ascorbic acid, and 10mM/ml ${\beta}-glycerophosphate$. In experimental groups, growth factors, PDGF or EGF(10ng/ml), were added into the above culture condition. And then each group was characterized by examining the cell proliferation rate, amount of total protein synthesis, alkaline phosphatase activity at 1, 5, 9, 13, 17th day after seeding of cells into the culture wells. The results were as follows: 1. Both BPD and BBM cells in PDGF-treated group proliferated more rapidly than non-treated cells. This finding also was observed in EGF-treated group but it was not as prominent as that of PDGF-treated group. The proliferation rates of both cells showed the time-dependent pattern during experimental periods in all three groups. 2. Amount of total protein synthesis was more increased in PDGF-treated group than in control group. But no significant difference between EGF-treated group and control group was observed throughout experimental periods even though the tendency of amount of protein synthesis was time-dependent pattern. 3. Alkaline phosphatase activity also more increased in PDGF-treated group than control group. But slight decrease tendency was seen in both cells of EGF-treated group. From the above results, PDGF appeared to enhance the proliferation and cellular activities including amount of total protein synthesis and alkaline phosphatase activity of BPD and BBM cell, but EGF did not show notable effects. The optimal application of these growth factors was thought to be useful as the adjunctive means in periodontal regeneration procedures.

배양골세포 이식이 치조골재생에 미치는 영향

정순준,허익,박준봉,이만섭,권영혁,Jeong, Soon-Joon,Herr, Yeek,Park, Joon-Bong,Lee, Man-Sup,Kwon, Young-Hyuk 대한치주과학회 1996 Journal of Periodontal & Implant Science Vol.26 No.1

This study was performed to estimate the effects of cultured bone cell inoculated on porous type hydroxyaptite for the regeneration of the artificial alveolar bone defect. In this experiment 3 beagle dogs were used, and each of them were divided into right and left mandible. Every surgical intervention were performed under the general anesthesia by using with intravenous injection of Pentobarbital sodium(30mg/Kg). To reduce the gingival bleeding during surgery, operative site was injected with Lidocaine hydrochloride(l:80,000 Epinephrine) as local anesthesia. After surgery experimental animal were feeded with soft dietl Mighty dog, Frisies Co., U.S.A.) for 1 weeks to avoid irritaion to soft tissue by food. 2 months before surgery both side of mandibular 1st premolar were extracted and bone chips from mandibular body were obtained from all animals. Bone cells were cultured from bone chips obtained from mandible with Dulbecco's Modified Essential Medium contained with 10% Fetal Bovine Serum under the conventional conditions. Porous type hydroxyapatite were immerse into the high concentrated cell suspension solution, and put 4 hours for attachin the cells on the surface of hydroxyapatite. Graft material were inserted on the artificial bone defect after 3 days of culture. Before insertion of cellinoculated graft material, scanning electronic microscopic observation were performed to confirm the attachment and spreading of cell on the hydroxyapatite surface. 3 artificial bone defects were made with bone trephine drill on the both side of mandible of the experimental animal. First defect was designed without insertion of graft material as negative control, second was filled with porous replamineform hydroxyapatite inoculated with cultured bone marrow cells as expermiental site, and third was filled with graft materials only as positive control. The size of every artificial bone defect was 3mm in diameter and 3mm in depth. After the every surgical intervention of animals, oral hygiene program were performed with 1.0% chlorhexidine digluconate. All of the animals were sacrificed at 2, 4, 6 weeks after surgery. For obtaining histological section, tissus were fixed in 10% Buffered formalin and decalcified with Planko - Rycho Solution for 72hr. Tissue embeding was performed in paraffin and cut parallel to the surface of mandibular body. Section in 8um thickness of tissue was done and stained with Hematoxylin - Eosin. All the specimens were observed under the light microscopy. The following results were obtained : 1. In the case of control site which has no graft material, less inflammatory cell infiltration and rapid new bone forming tendency were revealed compared with experimental groups. But bone surface were observed depression pattern on defect area because of soft tissue invasion into the artificial bone defect during the experimental period. 2. In the porous hydroxyapatite only group, inflammatory cell infiltration was prominet and dense connective tissue were encapsulated around grafted materials. osteoblastic activity in the early stage after surgery was low to compared with grafted with bone cells. 3. In the case of porous hydroxyapatite inoculated with bone cell, less inflammatory cell infiltration and rapid new bone formation activity was revealed than hydroxyapatite only group. Active new bone formation were observed in the early stage of control group. 4. The origin of new bone forming was revealed not from the center of defected area but from the surface of preexisting bony wall on every specimen. 5. In this experiment, osteoclastic cell was not found around grafted materials, and fibrovascular invasion into regions with no noticeable foreign body reaction. Conclusively, the cultured bone cell inoculated onto the porous hydroxyapatite may have an important role of regeneration of artificial bone defects of alveolar bone.

산화 티타늄 블라스팅 임프란트 표면구조에 대한 염산 테트라싸이클린의 영향

이정민,허익,권영혁,박준봉,정종혁,허성주,Lee, Jung-Min,Herr, Yeek,Kwon, Young-Hyuk,Park, Joon-Bong,Chung, Jong-Hyuk,Heo, Seong-Joo 대한치주과학회 2007 Journal of Periodontal & Implant Science Vol.37 No.3

The present study was performed to evaluate the surface roughness and effect of Tetracycline-HCI on the change of implant surface microstructure according to application time. Ti$O_2$ surface Implant was utilized. Implant surface was rubbed with 50mg/ml Tetracycline-HCI solution for 0.5min, 1min, 1.5min, 2min, 2.5min and 3min respectively in the Tetracycline-HCI group. Then, specimens were measured surface roughness and processed for scanning electron microscopic observation. The results of this study were as follows. 1. Ti$O_2$ blast implant surface showed increased surface roughness 1.5 minute after treatment with Tetracycline-HCI. But, there were not significant differences in saline group after treatment. 2. Tetracycline-HCI group showed changed surface micro-morphology in SEM after 1.5 minute. There were not significant differences in saline group after treatment. 3. Between Tetracycline-HCI group and saline group, there were difference in surface roughness change and SEM micro-morphology. Tetracycline-HCI have influence on Ti$O_2$ blast implant surface. In conclusion, the detoxification with 50mg/ml Tetracycline-HCI must be applied respectively with different time according to various implant surfaces.

천공형 티타늄 막의 조기 노출이 수직 골 형성에 미치는 영향

김은정,허익,권영혁,박준봉,정종혁,Kim, Eun-Jung,Herr, Yeek,Kwon, Young-Hyuk,Park, Joon-Bong,Chung, Jong-Hyuk 대한치주과학회 2007 Journal of Periodontal & Implant Science Vol.37 No.2

This study was performed to evaluate the effect of membrane exposure on new bone formation when guided bone regeneration with perforated titanium membrane on atrophic alveolar ridge. The present study attempted to establish a GBR model for four adult beagle dog premolar. Intra-marrow penetration defects were created on the alveolar ridge(twelve weeks after extraction) on the mandibular premolar teeth in the beagle dogs. Space providing perforated titanium membrane with various graft material were implanted to provide for GBR. The graft material were demineralized bovine bone(DBB), Irradiated cancellous bone(ICB) and demineralized human bone powder(DFDB). The gingival flap were advanced to cover the membranes and sutured. Seven sites experienced wound failure within 2-3weeks postsurgery resulting in membrane exposure. The animals were euthanized at 4 weeks postsurgery for histologic and histometric analysis. The results of this study were as follows: 1. There was little new bone formation at 4 weeks postsurgery. irrespectively of membrane exposure. 2. There was significant relationship between membrane exposure and bone graft resorption(P<0.05), but no relation between membrane exposure and infiltrated connective tissue. 3. There was much bone graft resorption on DFDB than ICB and DBB. 4. The less exposure was on the perforated titanium membrane, the more dense infiltrated connective tissue was filled under the membrane when grafted with ICB and DBB. but there was no relationship between the rate of membrane exposure and the percentage of infiltrated connective tissue area and no relationship between the percentage of the area in the infiltrated connective tissue and in the residual bone graft. Within the above results, bone formation may be inhibited when membrane was exposed and ICB and DBB were more effective than DFDB as a bone graft material when guided bone regeneration.