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Purpose This study was designed to investigate the maintenance of teeth and implants in patients with viral liver disease. Materials and methods 316 patients without any significant systemic disease were selected as a control group. Liver disease group was consisted of 230 patients. Necessary data were collected using clinical records and panoramic radiographs. Then, the patients were subdivided into 2 groups based on the type of active dental therapy received before maintenance period (Pre-Tx). Analysis for finding statistically significant difference was performed based on the need for re-treatment of active dental therapy (Re-Tx) and change in the number of teeth (N-teeth) and implants (N-implants). Results Comparing to control group, the patients with liver disease showed higher value on N-teeth, N-implants, and Re-Tx. Statistically significant differences were found on N-teeth (P=.000) and Re-Tx (P=.000) in patients with non-surgical Pre-Tx. Analysis based on severity of liver disease showed that N-teeth and Re-Tx were directly related to severity of liver disease regardless of received type of Pre-Tx. Significant differences were found on N-teeth (P=.003) and Re-Tx (P=.044) in patients with non-surgical Pre-Tx. Conclusion In this study, it was concluded that liver disease might influence the loss of teeth and cause the relapse of dental disease during maintenance period in patients. A significant positive relationship between tooth and implant loss and severity of liver disease seems to exist.

Although increasing evidence indicates that serotonin (SER; 5-hydroxytrypamine [5-HT]) is involved in the regulation of bone metabolism, conflicting data exist regarding whether SER promotes or inhibits osteoblast differentiation and bone formation. Regeneration of functional bone is required for proper osseointegration of dental implants. Noticeably, the use of selective SER reuptake inhibitors was recently associated with the failure of osseointegrated dental implants. The present study examines the direct role of peripheral SER on the regulation of bone regeneration.The effect of SER on osteoblast differentiation and bone regeneration was examined using rat calvarial cell cultures in vitro and a rat critical-sized calvarial defect model in vivo.Rat calvarial cells expressed SER receptors Htr1 (5-HT1) and Htr2 (5-HT2), which are known to transmit signals in bone cells. In vitro, SER significantly reduced osteogenic differentiation and mineralization of rat calvarial cells with concomitant reduction of osteoblast marker genes including alkaline phosphatase (Alpl), osterix (Sp7), and osteocalcin (Bglap). Histologic and radiologic analyses using the rat critical-sized calvarial defect model revealed that the existence of SER significantly inhibited β-phase tricalcium phosphate-induced bone regeneration.Results suggest that SER in the local bone microenvironment might play a negative role in osteoblast differentiation and bone formation in rats.

Statement of the Problem There is a reported gap between the relative satisfaction of the clinician and patient after a root coverage procedure. In addition, there may also be a disparity between objective esthetic evaluation tools and subjective satisfaction. Methods This study included 58 sites in 31 patients who had undergone root coverage procedures. The percentage of root coverage and the root coverage esthetic score system were used as objective measurements. A questionnaire with a five-point ordinal scale was used for subjective evaluation. Initial recession depth and width, Miller classification, tissue biotype, treatment procedures, and follow-up periods were considered as associated factors. Results After a period of at least 6 months from the procedure, the patient-perceived outcome showed a better match with the root coverage esthetic scoring system than the percentage of root coverage alone. A lower value for objective outcome was obtained for a deeper gingival recession and higher Miller class, but the subjective outcome displayed a steady trend. All four esthetic results were at their lowest after an epithelialized free soft tissue graft. Conclusion An esthetic outcome according to patient satisfaction was not always consistent with that determined by professional scoring. In addition, partial root coverage may be viewed as a positive outcome by patients and clinicians in cases of deep gingival recession and high Miller class. Clinical Significance This study evaluates the esthetic outcome of root coverage procedures using an objective method, including the percentage of root coverage, root coverage esthetic scoring system, and subjective assessment by patient and clinician-based questionnaires. The results will be helpful for the understanding of the differences that exist in esthetic satisfaction.

Periodontitis is a very prevalent disease. Therefore, biomarkers for the early and standard diagnoses of periodontitis are urgently needed. TACE is a membrane-bound metalloprotease. Although a recent study suggested that TACE levels in GCF are elevated during periodontal disease, the levels of TACE in GCF at different stages of chronic periodontitis have not been determined. Here, we analyzed the protein levels of TACE in GCF from periodontal disease subjects and confirmed that the protein levels of TACE were higher in the moderate periodontitis groups. TACE is known to be a NF-κB ligand that stimulates RANKL secretion in osteoblasts. To understand the effects of TACE on RANKL and OPG in osteoblasts, we treated MG63 cells with TACE. We observed an increase in RANKL protein expression but a decrease in OPG protein expression. Our data suggest that TACE can induce RANKL expression and promote osteoclastogenesis, thus worsening the outcome of periodontitis. [BMB reports 2011; 44(7): 473-477]

Purpose To evaluate the effect of periodontal and prosthodontic therapy on glycated hemoglobin A(HbA1c) level in patients with diabetes. Materials and methods This is a retrospective study of 70 patients suffering from diabetes who visited the Kyungpook National University Hospital between January 2016 and May 2018. Patients underwent medical evaluation for their routine check-up, which includes laboratory test for HbA1c levels. Among the 70 patients, 35 patients also visited Kyungpook National University Dental Hospital during the same period to receive periodontal and prosthodontic therapy, while the other 35 patients did not receive such therapy. The HbA1c levels were compared before and after periodontal and prosthodontic therapy. Comparisons between groups and within groups were performed using independent t-test. Results The HbA1c levels in the group who have received periodontal and prosthodontic therapy decreased from 7.2 to 6.7 (P=.001). The HbA1c levels in the control group decreased from 7.2 to 7.1 (P=.580). The difference in changes between the two patient groups was statistically significant (P=.011). Conclusion Periodontal and prosthodontic therapy can be effective on glycemic control in patients with diabetes.

The regional distribution and relative frequency of neurohormonal peptides-producing cells were demonstrated in the gut of the stomachless teleost, Zacco platypus (Temminck et Schegel), using 10 types of specific antisera raised against mammalian regulatory peptides. The gut of Z. platypus was divided into five portions from proximal to distal (segment I-V). Most of immunoreactive cells in the epithelial lining portion, between epithelial cells, were generally spherical or spindle shape having long cytoplasmic process that was reached via the lumen while cells round in shape were found in the basal portions of epithelial lining occasionally. Serotonin-, somatostatin-, glucagon-, cholecystokinin (CCK)-8 and pancreatic polypeptide (PP)-immunoreactive cells were observed in this study. However, no chromogranin A-, secretin-, vasoactive intestinal peptide (VIP)-, substance P- and bombesin-immunoreactive cells were found. Serotonin-immunoreactive cells were demonstrated throughout the entire gut tract and occurred more frequently than other cells. Somatostatin-immunoreactive cells were restricted to proximal segments of the gut (segment I-III) with rare frequencies, and glucagon-immunoreactive cells were demonstrated in the proximal segments of the gut (segment I, II) with moderate to few occurrences. CCK-8-immunoreactive cells were found throughout the whole intestinal tract except for most proximal segment (segment I) with moderate to few frequencies and PP-immunoreactive cells were demonstrated in the proximal to middle segments, segment I-III, with a few, rare and rare frequencies, respectively.

The regional distribution and relative frequency of neurohormonal peptides-producing cells were demonstrated in the gastrointestinal (GI) tract of the Korean aucha perch Coreoperca herzi, using 10 types of specific antisera raised against mammalian regulatory peptides. The GI tract was divided into four portions: stomach, gastro-intestinal junction, and small and large intestine. Most of the immunoreactive (IR) cells were in the mucosal epithelium and they were generally spindle shaped with a long cytoplasmic process. In addition, ovoid cells were found in the gastric regions. Serotonin-, somatostatin-, glucagon-, cholecystokinin-8 (CCK-8)- and pancreatic polypeptide (PP)-IR cells were observed with various relative frequencies. No chromogranin A-, secretin-, vasoactive intestinal peptide-, substance P- or bombesin-IR cells, however, were found. Serotonin-IR cells occurred throughout the GI tract and were the most numerous. Somatostatin-IR cells were restricted to the stomach and gastro-intestinal junction in numerous and moderate frequencies, respectively, but small numbers of glucagon-IR cells were restricted to the small intestine. Numerous CCK-8-IR cells were found in the small intestine but variable numbers of PP-IR cells occurred throughout the GI tract except for the large intestine. In general the distribution and relative frequency of these IR cells correspond well to previous reports in teleosts but there are some difference in this species.

The purposes of this study were to compare patient expectation before periodontal surgical treatment with their level of satisfaction afterward on the basis of a self-reported questionnaire, and to analyze the relationship between various satisfaction factors and periodontal surgical treatment.Information was obtained from 33 patients initially diagnosed with chronic periodontitis. The survey was completed twice by each patient, once before and once after modified Widman flap surgery.The satisfaction scores of items related to patient expectation of treatment outcome decreased significantly following surgery. The patients also expressed great dissatisfaction with items regarding disease prevention such as "desire for knowledge of periodontal disease prevention" and "desire for knowledge of recurrence control methods." However, some items such as "dental pain during treatment," "dental fear of treatment," and "cost of treatment" increased significantly after treatment. The total mean score of general satisfaction before treatment was 2.65, decreasing to 2.60 after treatment.Among the 5 subscales, any increase in patient satisfaction related to the treatment factors is difficult to achieve, but we should be able to raise the satisfaction level of our patients through improvement of the preventive measure factors.

The purpose of this study was to quantify the expressions of XO and MDA in the gingival tissues of the chronic periodontitis patients associated with HTN. Xanthine oxidase (XO) generates reactive oxygen species. Malondialdehyde (MDA) is one of many low molecular weight end-products of LPO and is the most often measured as an index of peroxidation. Depending on the patient"s systemic condition and clinical criteria of gingiva, each gingival sample was divided into three groups. Group 1 is clinically healthy gingiva. Group 2 is inflamed gingiva from patients with chronic periodontitis. Group 3 is inflamed gingiva from patients with chronic periodontitis associated with HTN. The expression levels of XO increased in order of group 1, group 2 and group 3, and significantly increased in group 3 as compared to group 1. The expression levels of MDA increased in order of group 1, group 2 and group 3. MDA expression was significantly higher in group 2 than in group 1, and the quantitative analysis of MDA level was significantly higher in group 3 than in group 1. In conclusion, this study demonstrated that the expression levels of XO and MDA might be inflammatory and bone resorption marker in periodontal inflammed tissue. It is assumed that hypertension may be associated with the progression of periodontal inflammation and alveolar bone resorption.

Purpose This study aimed to evaluate the effects of a cetylpyridinium chloride (CPC) and tranexamic acid (TXA) mouth rinse on patients with gingivitis. Methods This randomized, placebo-controlled, double-blind, parallel-group, clinical trial included 45 healthy adults with gingivitis, who were randomized into 2 groups. The experimental group used a 0.05% CPC and 0.05% TXA mouth rinse, and the control group used a placebo mouth rinse. The following clinical indices were assessed at baseline, at 3 weeks, and at 6 weeks: the Turesky-Quigley-Hein plaque index (QHI), the Löe-Silness gingival index (GI), and bleeding on marginal probing (BOMP). The subjects used the mouth rinse during the experimental period for 20 seconds, 4–5 times daily (10 mL each time). Results There were no significant differences in the clinical indices between the groups at baseline. In the experimental group (CPC+TXA), a statistically significant improvement was evident in the QHI, GI, and BOMP at 3 and 6 weeks. These results were similar to those observed in the control group at 3 and 6 weeks, although the change in BOMP was not statistically significant in that group. At 6 weeks, the experimental group had a significantly lower mean score for the QHI than the control group. Conclusions This study demonstrated that a CPC and TXA mouth rinse exhibited significant antiplaque and anti-gingivitis efficacy, and had a positive effect on bleeding control when used daily for 6 weeks., Graphical Abstract

Purpose: The purpose of this study was to analyze the expression of inducible nitric oxide synthases (iNOS), tissue inhibitors of metalloproteinase (TIMP)-3, and TIMP-4 in the gingival tissues of periodontal patients with or without type 2 diabetes mellitus (DM). Methods: Depending on the patient’s systemic condition and clinical criteria of the gingiva, each gingival sample was classi fied into one of three groups. Sixteen clinically, systemically healthy patients (group 1), 16 periodontal patients (group 2), and 16 periodontal patients with DM (group 3) were included. Tissue samples in each group were collected, prepared, and analyzed by western blotting. Quantification of the relative amount of TIMP-3, TIMP-4, and iNOS was performed. Results: The expression levels of iNOS and TIMP-3 both increased in group 1, group 2, and group 3 in increasing order, and were significantly higher in both group 2 and group 3 as compared to group 1 (P < 0.05). The expression levels of TIMP-4 increased in the same order, but significantly increased in group 2 as compared to group 1, in group 3 as compared to group 1, and group 3 as compared to group 2 (P < 0.05). Conclusions: This study demonstrated that iNOS, TIMP-3, and TIMP-4 might be involved in the progression of periodontal inflammation associated with type 2 DM. It is thought that further study of these factors can be applied practically for the diagnosis and control of periodontitis in diabetics.

The aim of this study was to evaluate and compare the radiographic results of bone-added osteotome sinus floor elevation (BAOSFE) and lateral approach sinus floor elevation techniques.The 43 patients who had undergone implant procedure with either BAOSFE or lateral approach method on their maxillary molar edentulous area were included. Their dental records were confirmative and the radiographic-changes using orthopantomographs were consistently checked up during 2 years after the procedure (immediately after procedure and 6 months, 12 months, and 24 months after implant placement).The radiographic evaluation after 2 years of implantation with sinus elevation showed the significant amount of bone formation (6.75 mm for BAOSFE and 11.36 mm for lateral approach method). Largest amount of grafted height loss occurred during the first 6 months (62.8% of total amount of bone loss), but the resorption was minimal (1.35 mm for BAOSFE and 1.36 mm for lateral approach method) for overall 24 months.Long-term stability of graft height was achieved using both BAOSFE and lateral approach sinus floor elevation. Overall, graft height decreased gradually during 2 years after procedures, but the changes were minimal.

Summary The distributions and frequencies of some endocrine cells in the eight portions of the gastrointestinal (GI) tract – fundus, pylorus, duodenum, jejunum, ileum, cecum, colon and rectum of the nude mouse, Balb/c-nu/nu were studied with immunohistochemical method using six types of anti-sera against serotonin, gastrin, cholecystokinin (CCK)-8, somatostatin, glucagon and human pancreatic polypeptide (hPP). All of six types of immunoreactive (IR) cells were identified. Most of IR cells in the intestinal portion were generally spherical or spindle in shape (open type cell) while cells showing round in shape (close type cell) were found in the intestinal gland and stomach regions occasionally. Their relative frequencies were varied according to each portion of GI tract. Serotonin-IR cells were detected throughout the whole GI tract and they showed the highest frequency in the pylorus. Gastrin-IR cells were restricted to the pylorus and duodenum with numerous and a few frequencies, respectively. CCK-8-IR cells were also restricted to the pylorus, duodenum and jejunum with numerous, a few and rare frequencies, respectively. Somatostatin-IR cells were demonstrated throughout the whole GI tract except for the colon and rectum, and they showed the highest frequency in the fundus. In addition, glucagon- and hPP-IR cells were restricted to the fundus and rectum, respectively with a few frequencies. In conclusion, the general distribution patterns and relative frequency of GI endocrine cells of the nude mouse, Balb/c-nu/nu was similar to that of other strains of mice. However, some strain and/or species-dependent unique distributions and frequencies of endocrine cells were also observed especially for somatostatin- and hPP-IR cells.

Summary The distributions and frequencies of some endocrine cells in the eight portions of the gastrointestinal tract (GIT) of BALB/c mouse were studied. Endocrine cells were stained using immunohistochemical method with seven types of antisera against bovine chromogranin (BCG), serotonin, gastrin, cholecystokinin (CCK)-8, somatostatin, glucagon and human pancreatic polypeptide (HPP), and the regional distributions and their relative frequencies were observed in the eight portions of the GIT of BALB/c mice. All seven types of immunoreactive (IR) cells were identified. Most of the IR cells in the intestinal portion were generally spherical or spindle in shape (open type cell) while round-shaped cells (closed type cell) were found in the intestinal gland and stomach regions occasionally. Their relative frequencies varied according to each portion of the GIT. BCG-IR cells were observed throughout the whole GIT except for the rectum and they were most predominant in the pylorus. Serotonin-IR cells were detected throughout the whole GIT and they showed the highest frequency in the fundus. Gastrin- and CCK-IR cells were restricted to the pylorus and duodenum with a majority in the pylorus and rare or a few frequencies in the duodenum. Compared with other mammals, somatostatin-IR cells were restricted to the fundus and pylorus with a few frequencies, respectively. In addition, glucagon- and HPP-IR cells were restricted to the fundus and duodenum, respectively, with relative low frequencies. Some species-dependent unique distributions and frequencies of endocrine cells were observed in the GIT of BALB/c mouse compared with other rodents.

The regional distributions and relative frequencies of some gastrointestinal endocrine cells in the eight portions (fundus, pylorus, duodenum, jejunum, ileum, cecum, colon and rectum) of the gastrointestinal tract of C57BL/6 mouse was studied with immunohistochemical method using seven types of specific anti-sera against chromogranin A (CGA), serotonin, somatostatin, human pancreatic polypeptide (HPP), glucagon, gastrin and cholecystokinin (CCK)-8. In this study, all these seven types of immunoreactive (IR) cells were identified. Most of these IR cells in the intestinal portion were generally spherical or spindle in shape (open-type cell) while cells showing round in shape (closed-type cell) were found in the intestinal gland and stomach regions occasionally. Their relative frequencies were varied according to each portion of gastrointestinal tract. CGA-IR cells were demonstrated throughout the whole gastrointestinal tract and they showed most predominant in the pylorus and duodenum. Serotonin-IR cells were detected throughout whole gastrointestinal tract and they showed highest frequency in the stomach and colon. Somatostatin-IR cells were demonstrated throughout whole gastrointestinal tract except for large intestine and showed highest frequency in the fundus. HPP-IR cells were found in the fundus with rare frequency. Peculiarly, glucagon-IR cells were restricted to the fundus, ileum and colon with a few frequencies. Gastrin-IR cells were restricted to the pylorus with numerous frequency and CCK-8-IR cells were observed in the pylorus, duodenum and jejunum with numerous and/or a few frequencies, respectively. In conclusion, some peculiar distributional patterns of gastrointestinal endocrine cells were found in C57BL/6 mouse.

The regional distributions and relative frequencies of some gastrointestinal endocrine cells in the eight portions (fundus, pylorus, duodenum, jejunum, ileum, caecum, colon and rectum) of the gastrointestinal tract of SKH-1 hairless mice were investigated using immunohistochemical methods and seven types of specific antisera against somatostatin, serotonin, glucagon, cholecystokinin (CCK)-8, secretin, pancreatic polypeptide (PP) and gastrin. In this study, somatostatin-, serotonin-, glucagon-, CCK-8-, secretin- and gastrin-immunoreactive (IR) cells were identified. Most of these IR cells in the intestinal portion were generally spherical or spindle-shaped (open-type cell) while cells that were round in shape (close-type cell) were occasionally found in the stomach regions. Their relative frequencies were varied according to each portion of gastrointestinal tract. Somatostatin-IR cells were found throughout the gastrointestinal tract except for the large intestine. Serotonin-IR cells were detected throughout the whole gastrointestinal tract and were the most predominant endocrine cell types in this species of mouse. Glucagon-IR cells were restricted to the fundus, occurring rarely. CCK-8-IR cells were observed in the pylorus, duodenum and jejunum with frequencies that were numerous, moderate and few, respectively. Peculiarly, secretin-IR cells were demonstrated in the whole intestinal tract with either few or rare frequencies. Gastrin-IR cells were restricted to the pylorus and were numerous. However, no PP-IR cells were found in this study. In conclusion, some peculiar distributional patterns of gastrointestinal endocrine cells were found in SKH-1 hairless mouse.

Purpose The purpose of the current study was to examine the effect of dexamethasone (Dex) at various concentrations on the apoptosis and mineralization of human periodontal ligament (hPDL) cells. Methods hPDL cells were obtained from the mid-third of premolars extracted for orthodontic reasons, and a primary culture of hPDL cells was prepared using an explant technique. Groups of cells were divided according to the concentration of Dex (0, 1, 10, 100, and 1,000 nM). A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was performed for evaluation of cellular viability, and alkaline phosphatase activity was examined for osteogenic differentiation of hPDL cells. Alizarin Red S staining was performed for observation of mineralization, and real-time polymerase chain reaction was performed for the evaluation of related genes. Results Increasing the Dex concentration was found to reduce cellular viability, with an increase in alkaline phosphatase activity and mineralization. Within the range of Dex concentrations tested in this study, 100 nM of Dex was found to promote the most vigorous differentiation and mineralization of hPDL cells. Dex-induced osteogenic differentiation and mineralization was accompanied by an increase in the level of osteogenic and apoptosis-related genes and a reduction in the level of antiapoptotic genes. The decrease in hPDL cellular viability by glucocorticoid may be explained in part by the increased prevalence of cell apoptosis, as demonstrated by BAX expression and decreased expression of the antiapoptotic gene, Bcl-2. Conclusions An increase in hPDL cell differentiation rather than cellular viability at an early stage is likely to be a key factor in glucocorticoid induced mineralization. In addition, apoptosis might play an important role in Dex-induced tissue regeneration; however, further study is needed for investigation of the precise mechanism.

Purpose Periodontal ligament (PDL) cell differentiation into osteoblasts is important in bone formation. Bone formation is a complex biological process and involves several tightly regulated gene expression patterns of bone-related proteins. The expression patterns of bone related proteins are regulated in a temporal manner both in vivo and in vitro. The aim of this study was to observe the gene expression profile in PDL cell proliferation, differentiation, and mineralization in vitro. Methods PDL cells were grown until confluence, which were then designated as day 0, and nodule formation was induced by the addition of 50 µg/mL ascorbic acid, 10 mM β-glycerophosphate, and 100 nM dexamethasone to the medium. The dishes were stained with Alizarin Red S on days 1, 7, 14, and 21. Real-time polymerase chain reaction was performed for the detection of various genes on days 0, 1, 7, 14, and 21. Results On day 0 with a confluent monolayer, in the active proliferative stage, c-myc gene expression was observed at its maximal level. On day 7 with a multilayer, alkaline phosphatase, bone morphogenetic protein (BMP)-2, and BMP-4 gene expression had increased and this was followed by maximal expression of osteocalcin on day 14 with the initiation of nodule mineralization. In relationship to apoptosis, c-fos gene expression peaked on day 21 and was characterized by the post-mineralization stage. Here, various genes were regulated in a temporal manner during PDL fibroblast proliferation, extracellular matrix maturation, and mineralization. The gene expression pattern was similar. Conclusions We can speculate that the gene expression pattern occurs during PDL cell proliferation, differentiation, and mineralization. On the basis of these results, it might be possible to understand the various factors that influence PDL cell proliferation, extracellular matrix maturation, and mineralization with regard to gene expression patterns.

1Periodontology and 2 Oral Biochemistry, Kyungpook National University School of Dentistry, Daegu, Korea Purpose: The purpose of this study was to compare and quantify the expression of C-reactive protein (CRP), matrix metalloproteinase (MMP)-14, and tissue inhibitor of metalloproteinases (TIMP)-2 in gingival tissues of patients with chronic periodontitis accompanied with inflammatory reaction related to alveolar bone resorption with or without type 2 diabetes mellitus (DM). Methods: Twelve patients with type 2 DM and chronic periodontitis (group 3), twelve patients with chronic periodontitis (group 2), and twelve healthy individuals (group 1) were included in the study. Gingival tissue biopsies were collected from each patient and from healthy individuals at the time of periodontal surgery (including surgical crown lengthening) or tooth extraction. The concentrations of cytokines were determined by a western blot analysis. Results: The expression levels of CRP and MMP-14 increased in group 2 and 3, and they were highest in group 3. The expressions of TIMP-2 also increased in group 2 and 3. Conclusions: This study demonstrated that the expression levels of CRP, MMP-14, and TIMP-2 might be inflammatory markers in periodontal inflamed tissue. It can be assumed that CRP, MMP-14, and TIMP-2 may be partly involved in the progression of periodontal inflammation associated to type 2 DM.

Purpose Under different culture conditions, periodontal ligament (PDL) stem cells are capable of differentiating into cementoblast-like cells, adipocytes, and collagen-forming cells. Several previous studies reported that because of the stem cells in the PDL, the PDL have a regenerative capacity which, when appropriately triggered, participates in restoring connective tissues and mineralized tissues. Therefore, this study analyzed the genes involved in mineralization during differentiation of human PDL (hPDL) cells, and searched for candidate genes possibly associated with the mineralization of hPDL cells. Methods To analyze the gene expression pattern of hPDL cells during differentiation, the hPDL cells were cultured in two conditions, with or without osteogenic cocktails (β-glycerophosphate, ascorbic acid and dexamethasone), and a DNA microarray analysis of the cells cultured on days 7 and 14 was performed. Reverse transcription-polymerase chain reaction was performed to validate the DNA microarray data. Results The up-regulated genes on day 7 by hPDL cells cultured in osteogenic medium were thought to be associated with calcium/iron/metal ion binding or homeostasis (PDE1A, HFE and PCDH9) and cell viability (PCDH9), and the down-regulated genes were thought to be associated with proliferation (PHGDH and PSAT1). Also, the up-regulated genes on day 14 by hPDL cells cultured in osteogenic medium were thought to be associated with apoptosis, angiogenesis (ANGPTL4 and FOXO1A), and adipogenesis (ANGPTL4 and SEC14L2), and the down-regulated genes were thought to be associated with cell migration (SLC16A4). Conclusions This study suggests that when appropriately triggered, the stem cells in the hPDL differentiate into osteoblasts/cementoblasts, and the genes related to calcium binding (PDE1A and PCDH9), which were strongly expressed at the stage of matrix maturation, may be associated with differentiation of the hPDL cells into osteoblasts/cementoblasts.

Purpose: The purpose of this study was to observe and quantify the expression of interleukin-4 (IL-4), interferon-g (IFN-g), and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) in the gingival tissue of patients with type 2 diabetes mellitus (DM) and healthy adults with chronic periodontitis. Methods: Twelve patients with type 2 DM and chronic periodontitis (Group 3), twelve patients with chronic periodontitis (Group 2), and twelve healthy individuals (Group 1) were included in the study. Clinical criteria of gingival (sulcus bleeding index value, probing depths) and radiographic evidences of bone resorption were divided into three groups. The concentrations of cytokines were determined by a western blot analysis and compared using one-way ANOVA followed by Tukey’s test. Results: The expression levels of IFN-g and TIMP-2 showed an increasing tendency in Groups 2 and 3 when compared to Group 1. On the other hand, the expression of IL-4 was highest in Group 1. Conclusions: The findings suggest that IFN- g and TIMP-2 may be involved in the periodontal inflammation associated with type 2 DM. IL-4 may be involved in the retrogression of the periodontal inflammation associated with type 2 DM.

Purpose: The purpose of this study was to quantify and compare the expressions of CRP and M-CSF in the gingival tis- sues of the patients with chronic periodontitis associated to hypertension. Methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. Clinically healthy gingival tissue samples from systemically healthy 12 patients were categorized as group 1 (n=12). Inflammatory gingival tissue sam- ples from patients with chronic periodontitis were categorized as group 2 (n=12). Inflammatory gingival tissue samples from patients with chronic periodontitis associated with hypertension were categorized as group 3 (n=12). Tissue samples were prepared and analyzed by Western blotting. The quantification of CRP and M-CSF were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. Results: There were significant differences between group 1 and group 2 and between group 1 and group 3 in both CRP and M-CSF. The differences between group 2 and group 3 were not statistically significant in both proteins. However, the expression levels of CRP and M-CSF in hypertensive inflammatory gingiva showed increased tendency compared to non-hypertensive inflammatory gingiva. Conclusions: It is suggested that CRP and M-CSF might be used as inflammatory and bone resorption markers in perio- dontal diseased tissue. It is assumed that hypertension may be associated with the progression of periodontal inflammation and alveolar bone resorption. (J Korean Acad Periodontol 2009;39:391-398)

Purpose: The purposes of this study were to compare and quantify the expression of Stromelysin-1 and MT-MMP-1 in the gingival tissues of patients with type 2 diabetes mellitus(DM) and healthy adults with chronic periodontitis. Materials and Methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was devided into three groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2 (n=8) is inflammed gingiva from patients with chronic periodontitis. Group 3 (n=8) is inflammed gingiva from patients with chronic periodontitis associated with type 2 DM. Tissue samples were prepared and analyzed by Western blotting. The quantification of Stromelysin-1 and MT-MMP-1 were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. Results: In the analysis of expression levels, Stromelysin-1 and MT-MMP-1 expressions were similar in group 1 and 2. Stromelysin-1 and MT-MMP-1 expressions was more increased in group 3 than group 1, 2. The difference between group 3 and group 1, 2 was statistically significant. Also, in the interrelationship of Stromelysin-1 and MT-MMP-1 expressions, expressions of Stromelysin-1 and MT-MMP-1 showed increasing tendency in chronic periodontitis associated with type 2 DM and it seems that the MT-MMP-1 expressions were increasing in proportion to Stromelysin-1 expressions. Conclusion: It is suggested that Stromelysin-1 and MT-MMP-1 may be partly involved in the progression of periodontal inflammation associated with type 2 DM, as related to a metabolism of other factors, such as AGE, plasmin and other inflammatory mediators. Therefore, the expression levels of Stromelysin-1 and MT-MMP-1 can be inflammatory markers of periodontal inflammed tissue with type 2 DM. (J Korean Acad Periodontol 2008;38:629-638)

Diabetes mellitus is an important risk factor of periodontal diseases. It is one of the main contributing factors for periodontal disease and also limiting factor for periodontal treatments such as implant therapy. Although diabetes itself does not cause periodontitis, periodontal disease progresses more rapidly and leads to more tooth losses in patients with poorly controlled blood glucose. Severe periodontitis has been associated with an increased risk of poor glycemic control and, in turn untreated advanced periodontal disease can deteriorate the metabolic control of diabetes. Various pathogenetic factors have been suggested to explain the increased prevalence and severity of periodontitis in diabetes.1) Reduced polymorphonuclear leukocyte(PMN) function has been found in patients with diabetes. This impairment of function was noted in assays of PMN chemotaxis, adherence and phagocytosis. Studies of PMN defects suggest that this dysfunction could lead to impaired host resistance to infection. Gingival fibroblasts from diabetic patients synthesize less collagen compared to non-diabetic subjects. In addition to decreased collagen production, crevicular fluid collagenolytic activity also was increased in diabetic patients. This increased crevicular fluid collagenase activity appears to be primarily of neutrophil origin. Non-enzymatic glycosylation process results in increased cross-linking between collagen molecules. This cross-linking of collagen significantly contributes to reduced solubility and de

Chronic periodontitis is an inflammatory disease that results in the destruction of the tooth-supporting tissues, that is, the gingiva, periodontal ligament, root cementum, and alveolar bone. Chronic periodontitis is strongly associated with the presence of cytokines, such as IL-1α and β. Indeed many cell types in the periodontium have the capacity to produce these compounds. The cytokine IL-1 is now fully characterized polypeptide with multiple overlapping biological activities and act as early mediator of inflammation and immunities. IL-1 has been shown to have a dual function in collagen digestion. It inhibits the intracelluar phagocytic pathway, but at the same time, it strongly promotes extracelluar digestion by inducing the release of collagenolytic enzymes like collagenase. Matrix metalloproteinase(MMP) and matrix-degrading serine proteinases were shown to participate in the breakdown of extracelluar matrix in disease processes as diverse as rheumatoid arthritis, atherosclerotic plaques and cancer metastasis. In the oral environment, MMPs take part in developmental events involving teeth and salivary glands and in collagen turn over, besides playing an important role in pathologic processes such as periodontal tissue destruction, oral lichen planus, dysplasia, squamous cell carcinoma, bone and cartilage degradation and root caries. It is now recognized that during active periodontitis, degradation of gingival tissue (mainly collagen) is due in part to matrix metalloproteinases (MMPs)

Diabetes mellitus(DM) is disease resulted from insufficiency of insulin production or from reduction of tissue response to circulating insulin and symptoms such as organ system damage, immune imparement can expressed by hyperglycemia. Especially, type 2 diabetes mellitus is related with latter reason and predominant to adult patient and occupies 90% of overall DM.1) From 1960s, there has been discussions between diabetes mellitus and degree of periodontitis. Many studies reported diabetes mellitus increases the susceptibility to oral infection including periodontitis. Although DM itself doesn't cause periodontitis, periodontal disease progresses more rapidly and leads to more tooth losses in patients with poorly controlled blood glucose 1-3) . In chronic hyperglycemia, advanced glycation end-products(AGEs) is produced and this material induce secretion of pro-inflammatory cytokine such as Interleukin-1, Tumor Necrosis Factor-α by binding to macrophage and blood vessel endothelial cells 4-6) . And it is assumed that increased infection susceptibility by declined function of polymorphonuclear leukocyte (PMNL), reduction of collagen production by fibroblast, periodontal ligament cell, blood vessel disorder, change of sulcular fluid and subgingival microorganism, hereditary tendency contribute to the disease. Nelson et al. 7) reported that type 2 diabetes mellitus patient shows 2.6 times higher incidence of periodontitis than normal person and Papupanou et al. 8) reported that diabetes mellitus increases risk of periodontitis twice, regardless of local contributing factor such as calculus. And inversely, a few studies reported insulin

Bisphosphonates는 파골세포에 의한 골흡수를 방지하는 물질로 알려져 있으며 임상에서 널리 쓰이고 있다. 그 중 Alendronate는 Aminobisphosphonates의 한 종류로 non-aminobisphosphonates인 etidronate보다 100-1000배 더 강한 효과를 보이는 것으로 알려져 있다. 본 실험의 목적은 백서두개골 결손부의 골재생을 실험모델로 하여 alendronate의 국소투여 효과를 알아보는 것으로 액체의 흡수성과 골전도성이 우수한 것으로 알려진 collagen membrane을 사용하여 결손부 양측에 alendronate와 physiologic saline을 각각 적용하여 1주, 2주, 4주의 조직학적 치유양상, 파골세포활성도, 경도를 평가하였다. 조직학적 치유양상은 1주째 collagen membrane에 의한 염증성 침윤이 나타났으며 2주째부터 골성회복이 관찰되었고 4주째 완전한 골성회복을 보여 각주별 실험군, 대조군 공히 유사한 양상을 보였고 실험에 사용한 $200{\mu}g$ 의 용량은 조직학적으로 관찰할만한 골재생의 향상을 위해서는 부족한 용량으로 사료되는 바이다. TRAP(+) cell은 1주째 대조군에 비해 실험군에서 유의하게 적은 수를 보였으며(p 【The present study aimed to examine the effects of topical application of alendronate with a collagen membrane on the healing of the calvarial defect in rats, which has a good experimental design for the healing of tissue destruction, To study the effect of alendronate on bone healing, the collagen membrane containing $200{\mu}g$ alendronate was inserted in the defects of the right side and collagen membrane treated with physiologic saline was inserted in the defects of the left side. After 1, 2 and 4 weeks, observation of histologic feature after H&E staining, cell counting after TRAP staining, and hardness measurement(Knoop) were performed. In histologic finding, similar features were shown for both test and control groups each week. In cell counting only the 1 week test groups showed significant reduction of TRAP(+)cells than control groups(p】