The 102nd Annual Meeting of the American Academy of
Periodontology in collaboration with
the Japanese Society of Periodontology and Japanese
Academy of Clinical Periodontology

Abstracts of JSP/JACP Poster Session

September 10-13, 2016
San Diego Convention Center, San Diego, CA, USA
The Japanese Society of Periodontology
The Japanese Academy of Clinical Periodontology

第102回アメリカ歯周病学会共催
日本歯周病学会・日本臨床歯周病学会2016年大会
The 102nd Annual Meeting of the American Academy of
Periodontology in collaboration with the Japanese Society of
Periodontology and Japanese Academy of Clinical Periodontology

JSP/JACP ポスターセッション抄録集

一般演題（基礎研究，臨床研究），症例報告，歯科衛生士演題

Abstracts of JSP/JACP Poster Session
General (Basic Research, Clinical Research), Case Report, Dental Hygiene

会期：2016年 9 月10日～ 9 月13日
会場：サンディエゴ・コンベンションセンター

September 10-13, 2016
San Diego Convention Center, San Diego, CA, USA

第102回アメリカ歯周病学会共催日本歯周病学会・
日本臨床歯周病学会2016年大会
JSP/JACP ポスター発表・若手研究者支援
協賛企業
アサヒプリテック株式会社
有限会社エルバ
長田電機工業株式会社
株式会社ガイドデント
クインテッセンス出版株式会社
株式会社松風ストローマン・ジャパン株式会社
スリーエム ジャパン株式会社 ヘルスケアカンパニー
大信貿易株式会社
デンツプライ三金株式会社
株式会社ナルコーム
株式会社白鵬
ライオン歯科材株式会社

（50音順）

General（Basic Research）

1

GB-01

Bone regeneration using adipose-derived stem cells and platelet-rich plasma
Satoshi Tajima*1,2, Morikuni Tobita1, Hiroshi Mizuno1

1

Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan2
Department of Dental and Oral Surgery, AOI Universal Hospital, Kanagawa, Japan

Background and objective: A key goal for successful bone regeneration is to bridge a bone defect using healing proceduresthat are stable and durable. Adipose-derived stem cells（ASCs）with/without several scaffolds can differentiate into
osteogenic cells. Meanwhile, platelet-rich plasma（PRP）is an interesting biological means to repair tissue by inducing
chemotactic, proliferative, and anabolic cellular responses.
Materials and Methods: This study evaluated bone regeneration using a combination of ASCs and PRP in a rat calvarial
defect model. ASCs were isolated from inguinal fat pads of F344 inbred rats, while PRP was prepared from these rats. ASCs
were cultured in control medium supplemented with 10% fetal bovine serum or 5% PRP in vitro. After 1 week, levels of
growth factors including insulin-like growth factor-1, transforming growth factor-β1, hepatocyte growth factor, andvascular endothelial growth factor in the culture supernatant were measured by enzyme-linked immunosorbent assays.
Moreover, the ASC/PRP admixture was transplanted into the rat calvarial defect. Micro-computed tomography, histological,
and immunohistochemical（osteopontin and osteocalcin）analyses were performed at 4 and 8 weeks after transplantation.
Results: The in vitro study showed that the levels of growth factors secreted by ASCs were signiﬁcantly increased by theaddition of PRP. Transplantation of the ASC/PRP admixture had dramatic effects on bone regeneration overtime incomparison with rats that received other transplants. Furthermore, some ASCs directly differentiated into osteogenic cells invivo.
Conclusion: These ﬁndings suggest that the combination of ASCs and PRP has augmentative effects on bone regeneration.
The ASC/PRP admixture may be a promising source for the clinical treatment of cranial defects.

GB-02

Low-level blue laser irradiation enhances osteoblast proliferation and differentiation

Risako Mikami*1, Akira Aoki1, Koji Mizutani1, Yukihiko Tamura2, Kazuhiro Aoki2, Yuichi Izumi1
1

Department of Periodontology, 2Department of Bio-Matrix（Pharmacology）, Graduate School of Medical and
Dental Sciences, Tokyo Medical and Dental University（TMDU）

Background and objective: Low-level laser irradiation（LLLI）has various biostimulation effects such as promotion ofwound healing and bone regeneration. However, there are few studies which examined the effects of LLLI with a blue laser.
The purpose of this study was to investigate the effects of a high-frequency ultra-short pulsed blue laser on osteoblasts.
Materials and Methods: Osteoblast cell lines（MC3T3-E1 and ST2, Riken Bioresource Center）and mouse primaryosteoblasts were cultured in a 96-well plate with osteoinducing medium, and were irradiated for 1 minute with a highfrequency ultra-short pulsed blue laser（405 nm, pulse width 3 ps, Spectra-Physics）at 0（control), 31.3, 93.8, 156.3 mW/
cm2 in a single session. During 7 days of cell culture after LLLI, cell proliferation assay（Cell Counting Kit-8, Dojindo）
and alkaline phosphatase（ALP）activity assay were performed to determine the optimum power for irradiation. Then,mRNA expression of osteoblast differentiation markers such as Runx2, Osterix（Osx）, Alkaline phosphatase（Alp）,
Osteopontin（Opn）and Osteocalcin（Ocn）were measured by real-time PCR.
Results: LLLI with the blue laser signiﬁcantly and dose-dependently enhanced cell proliferation and signiﬁcantly increased
ALP activity of MC3T3-E1, ST2 and primary osteoblasts compared with control（p<0.05）. The highest ALP activity wasobserved at 93.8 mW/cm2. mRNA expression of Osx, Runx2, Alp and Opn was signiﬁcantly increased following LLLI at
93.8 mW/cm2 compared with control on 3 to 7 days after LLLI.
Conclusion: The results suggest that LLLI with a high-frequency ultra-short pulsed blue laser enhances osteoblast
proliferation and differentiation in vitro.

JSP/JACP Poster Session AAP2016

2

GB-03

Resorption of deproteized cancellous bovine bone（DPBB）by osteoclasts
Masayuki Narukawa＊1,2, Hiroshi Arai2, Hirotada Otsuka2, Nobuaki Yanagisawa2,
Masanori Nakamura2

1

Narukawa Dental Clinic, 2Department of Oral Anatomy and Developmental Biology, Showa University School of
Dentistry

Background and objective: DPBB has been reported as non-absorbed bone ﬁlling material. Hydroxyapatite（HA）in bone
is calcium-deficient and carbonate-rich apatite. Our previous study indicated that chemically equivalent HA was notresorbed by osteoclasts while octacalcium converted into calcium-deﬁcient and carbonate-rich apatite（ODA）, resorbed byosteoclasts. In this study, we analyzed the chemical composition of DPBB and compared the tissue reactions around DPBB
and ODA after the implantation into mouse bone marrow.
Materials and Methods: X-ray diffraction analysis（XDA）and Fourier transform infrared spectroscopy（FTIS）wereperformed to analyze the chemical composition of DPBB. DPBB and ODA were implanted into the bone marrow of mouse
tibiae and examined by micro-CT, histological and ultrastructural methods.
Results: XDA and FTIS showed that DPBB was carbonate-rich apatite. Micro-CT analysis indicated the massive boneformation on DPBB and ODA at 2 weeks after the implantation. The volume of the bone was gradually decreased to 12
weeks after the implantation. Histological examination indicated many columnar osteoblasts were aligned along the newly
formed bone surface at 2 weeks after the implantation. Tartrate-resistant acid phosphatase（TRAP）-positive multinucleatedcells were also detected on the surface of newly formed bone. At 12 weeks, most of bone on the materials was disappeared
and TRAP-positive multinucleated cells were directly attached to implanted DPBB and ODA. Ultrastructural examination
showed that these multinuclear cells had well developed rufﬂed border and attached directly DPBB and ODA by clear zone.
Conclusion: In this study, we clearly indicated that DPBB was the absorbed bone ﬁlling material.

GB-04

Porphyromonas gingivalis induced periodontitis exacerbates NASH progression in rat
Ryutaro Kuraji＊1, Hiroshi Ito1, Miyako Fujita1, Hitomi Ishiguro1,
Shuichi Hashimoto2, Yukihiro Numabe1
1

Department of Periodontology, School of Life Dentistry at Tokyo, Nippon Dental University,
2
Nippon Dental University, Tokyo, Japan

Background and objective: In recent years, epidemiological and animal studies have reported that Porphyromonas gingivalis（P.gingivalis）, known as periodontopathic bacteria, is closely related to non-alcoholic steatohepatitis（NASH）. However,previous studies could not demonstrate a direct relationship between periodontitis, P.gingivalis infection, and NASH. The
purpose of the present study was to examine the impact of P.gingivalis-associated periodontitis on the onset and progressionof NASH.
Materials and Methods: Male Wistar rats were fed a high-fat diet（HFD）for 12 weeks in order to induce fatty liver.
Furthermore, test animals were given a P.gingivalis slurry around the silk sutures ligating the maxillary ﬁrst molar tooth inorder to induce experimental periodontitis after 4 weeks（HFD-feeding and P.gingivalis-infection group; HFD/P.g-group）.
Controls were given slurry without P.gingivalis after ligation using the same protocol（HFD/cont-group）.
Results: Signiﬁcant increases in alveolar bone resorption and inﬂammation in periodontal tissue around the molar tooth in
the HFD/P.g-group were observed when compared with the HFD/cont-group. Moreover, histological images showing
NASH characterized by perivenular lipid deposition including big fatty drops, ballooning degeneration, and focal necrosis
with inflammatory cells were confirmed in the liver of rats in the HFD/P.g-group. Significant increases of alanine
aminotransaminase（ALT）, aspartate aminotransferase（AST）and C-reactive protein（CRP）levels were observed in the
HFD/ P.g-group. Furthermore, endotoxin levels in serum in the HFD/P.g-group were signiﬁcantly higher than those in the
HFD/cont-group.
Conclusion: The present study demonstrated that experimental periodontitis induced by P.gingivalis led to the onset andprogression of NASH in rats with fatty liver.

JSP/JACP Poster Session AAP2016

3

GB-05

Inhibition of periodontal tissue-related transcription factors induces differentiation of chondrocyte
Hideki Takai＊1,2, Yorimasa Ogata1,2
1Department of Periodontology and 2Research Institute of Oral Science, Nihon University School of Dentistry at
MatsudoBackground and objective: Periodontal tissue is consisted by gingiva, periodontal ligament, cementum and alveolar bone.
Stem cells present in periodontal ligament can undergo differentiation into osteoblasts, chondrocytes, myoblasts andadipocyte. Moreover, speciﬁc transcription factors（TFs）are need for differentiation of stem cells into different nature ofcells. Therefore, it has been suggested that the target cells could induce different nature cells by controlling the expression oftranscription factors. In this study, we investigated the speciﬁc TFs in periodontal tissues.
Materials and Methods: Human gingival ﬁbroblasts（HGF）and human periodontal ligament cells（HPDL）were culturedby D-MEM, and osteoblast-like Saos2 cells were cultured by α-MEM supplemented with 10% FCS. HPDL weretransfected by siRNA which targeted TFs expressed in periodontal tissue cells. After 72 h transfection, cells were harvested,
and real-time PCR and Western blot were performed to investigate the mRNA and protein levels of TFs expressed inmesenchymal cells.
Results: Runx2, Runx3 and Sox5（osteogenic and chondrogenic TFs）mRNAs are expressed much more in Saos2 cells
compared with HGF and HPDL. Whereas, Twist2, KLF12 and Pax9 mRNA are expressed much more by HGF and HPDL
compared to Saos2 cells. When we inhibited three kinds of TFs（Twist2, KLF12 and Pax9）in HPDL, Sox5 mRNA andprotein levels were increased in HPDL.
Conclusion: These results suggest that KLF12, Twist2 and Pax9 are crucial TFs to maintain the character of periodontal
tissue cells compared to osteoblast-like cells. Furthermore, periodontal ligament cells could differentiate into chondrocytes
by inhibiting KLF12, Twist2 and Pax9.

GB-06

Bactericidal effects of 310 nm ultraviolet light-emitting-diode irradiation on oral bacteria
Ayuko Takada＊1,2, Kenji Matsushita2, Satoru Horioka3,Yasushi Furuichi1,Yasunori Sumi4

1

Division of Periodontology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health
Sciences University of Hokkaido, 2Department of Oral Disease Research, National Center for Geriatrics andGerontology, 3NIIKISO CO., LTD, 4Department of Center for Development of Advanced Medicine for Dental
Diseases, National Center for Geriatrics and Gerontology

Background and objective: Ultraviolet light is used for phototherapy in dermatology, and UVB（around 310 nm）is
effective for treatment of psoriasis and atopic dermatitis. In addition, it is known that UVC（around 265 nm）has abactericidal effect, but little is known about the bactericidal effect of UVB. Here, we examined the bactericidal effects of
UVB-LED irradiation on oral bacteria to explore the possibility of using a 310 nm UVB-LED irradiation device fortreatment of oral infectious diseases.
Materials and Methods: We prepared a UVB（310nm）LED device for intra-oral use to examine bactericidal effects on
Streptococcus mutans, Streptococcus sauguinis, Porpyromonas gingivalis, and Fusobacterium nucleatum and also to
examine the cytotoxicity to a human oral epithelial cell line（Ca9-22）. We also examined the production of NO and H2O2
from Ca9-22 cells after irradiation with UVB-LED.
Results: Irradiation with 310 nm UVB-LED at 105 mJ/cm2 showed 30-50% bactericidal activity to oral bacteria, though
17.1 mJ/cm2 irradiation with 265 nm UVC-LED completely killed the bacteria. Ca9-22 cells were strongly injured byirradiation of 265 nm UVC-LED but were not harm by irradiation of 310 nm UVB-LED. NO and H2O2 were produced by
Ca9-22 cells with irradiation of 310 nm UVB-LED. P. gingivalis was killed by applying small amounts of those ROS in
culture, but other bacteria showed low sensitivity to them.
Conclusion: Narrowband UVB-LED irradiation exhibited a weak bactericidal effect on oral bacteria but showed low
toxicity to gingival epithelial cells. Its irradiation also induces the production of ROS and may enhance bactericidal activity
to anaerobic oral bacteria.

JSP/JACP Poster Session AAP2016

4

GB-07

Inﬂuence of horizontal load application on microgaps between ﬁxture-abutment interfaces

Ayako Yasui＊, Junichi Tatsumi, Kohei Hayashi, Makiko Ishii, Akitoshi Nakajima, Kwon Haesang,
Kazuhiro Yatabe, Kitetsu Shin
Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of
Dentistry
Background and objective: Marginal sealing properties of the ﬁxture-abutment interface（FAI）may be adversely affectedby horizontal load application. Inadequate marginal sealing at the FAI allows pathogenic bacterial invasion, which is themain cause of peri-implantitis. This study compared the adverse effects of horizontal load application in several types of
implants with a conical abutment.
Materials and Methods: Several implants（Ti-6Al-4V Aadva（Group A）, pure titanium Aadva（Group B）, Ankylos（Group C）, NobelActive（Group D）, and Osseospeed（Group E））were inserted into a jig and abutments were ﬁxed witha screw at torques recommended by the manufacturers. After applying a horizontal load（23-225 N）against the abutment,
the size of the gap at the FAI was measured using scanning electron microscopy（SEM）. Furthermore, the diameter（Xaxis;axis parallel to the horizontal load, Y axis;axis vertical to the horizontal load）of each implant platform was measured
using a high-precision non-contact depth measuring microscope to determine the permanent deformation before and after
horizontal load application.
Results: Microgaps at the FAI were signiﬁcantly wider in pure titanium implants than the Ti-6Al-4V implant（p<0.05）.
Permanent deformation before and after horizontal load application was greater in pure titanium implants than the alloy
implant. The mean FAI distance changed in all groups when ≥114 N horizontal load was applied. Moreover, at ≥225 N,
signiﬁcant differences were observed among Group A,C, D, E and Group B.
Conclusion: These ﬁndings suggest that bacterial invasion through FAI may occur under a horizontal load application of ≥114 N.

GB-08

Histological analysis of implantation to augmented bone using “Casing Method”
Wataru Ono＊1, Makoto Ogiso1, Kiichi Maruyama1, Seiji Mineno2, Yuichi Izumi1

1

Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental
University, 2Shinsei-kai, Medical Corporation

Background and objective: To place the implants to the severely resorbed alveolar ridge, establishing a great-sized ridge
augmentation technique is important;furthermore, confirming that the integration between the augmented bone and theimplant is done similarly as with the original bone, is also essential. In this study, the great amount of bone has been
augmented to the dog's alveolar ridge, using “Casing Method ”1）which we have previously reported; the implant was placedon the border of the original and the regenerated bone, and compared how the implant is integrated with each bone.
Materials and Methods: The mixture of 150-500µm hydroxyapatite（APACERAM-G®）and β-tricalcium phosphate（Osferion60®）granules impregnated into the suspension of autologous super ﬁne bone powder and plasma was ﬁlled in apolyethylene terephthalate-made case, ﬁxed to buccal side of the alveolar ridge. Sixteen weeks later, the case was removed,
and the implant（diameter:4.6mm, length:8.0mm, Eight-Lobe®）was placed at the border of the original and the augmented
bone. Collecting the samples 2-16 weeks after the implantation, the bone surrounding the implant was analyzed
histologically.
Results: We were able to conﬁrm the good bone formation in the augmented area. New bone was ﬁlled in the space between
the implant and the augmented bone. What's more, the bone-implant contact was higher with the augmented bone area thanwith the original bone area.
Conclusion: It was suggested that it is positively effective to implant to the augmented bone using “Casing Method ”.
1）M.Ogiso et al. ,In Trans.8th World Biomaterials Congress, 2008, No.1988.

JSP/JACP Poster Session AAP2016

5

GB-09

The histological analysis of great-sized ridge augmentation applying the “Casing Method”
Kiichi Maruyama＊1, Makoto Ogiso1, Wataru Ono1, Seiji Mineno2, Yuichi Izumi1

1

Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental
University, 2Shinsei-kai, Medical Corporation

Background and objective: To place dental implants to the severely resorbed alveolar ridge, establishing a great-sized ridge
augmentation technique is important. We have reported that the mixture of hydroxyapatite（HA）granule and the microsized autogenous bone covered by the polyethylene terephthalate（PET）-made case resulted in ectopic bone formation, andbone formation ﬁtting the shape of the case on the bone surface（Casing Method）.1）This study aimed at evaluating whether
Casing Method brings a great-sized ridge augmentation.
Materials and Methods: The mixture of the same amount of 150-500µm HA（APACERAM-G®）and β-tricalciumphosphate（β-TCP）（Osferion60®）granules impregnated into the suspension of autogenous super ﬁne bone powder and plasma（boneconcentration:approximately 1/100V%）was ﬁlled in 0.8mm thick PET-made case（thickness:6mm, height:10mm, mesialdistal length:20mm, with φ0.5mm nutrient foramens placed every 2mm）
, ﬁxed on buccal side of the alveolar ridge. Collecting
the samples 4,8,16 weeks after the operation, the tissues were analyzed histologically.
Results: Despite individual difference, new bone formation has started in about a half of the case area in four weeks, and thecalciﬁed bone around the granule became thick and were interconnected within eight weeks. In sixteen weeks, a part of thetrabeculae became thicker and the bone marrow were widened. Also, the density of the granule inside the case wasdecreasing, and the reduction of β-TCP was obvious.
Conclusion: It was suggested that Casing Method has an ability of bringing a great-sized ridge augmentation.
1）M. Ogiso, et al., In Trans.8th World Biomaterials Congress, 2008, No.1988.

GB-10

Availability of in vitro-cultured immunosuppressive macrophages for periodontitis treatment
Naoki Takizawa＊1, Seiko Kyakumoto2, Naoyuki Chosa2, Daisuke Sasaki1, Keita Suzuki1,
Akira Ishisaki2, Takashi Yaegashi1
1Division of Periodontology, Department of Conservative Dentistry, School of Dentistry, Iwate Medical
University, 2Division of Cellular Biosignal Sciences, Department of Biochemistry, Iwate Medical University
Background and Aims: The availability of immunosupressive macrophages for the therapy of inﬂammatory/autoimmune
deseases has been shown in recent years. We have established a bone marrow-derived messenchymal stem cell（MSC）
culture system in which MSCs and blood cells proliferate together. We found that the blood cells were differentiated toCD206-positive immunosuppressive macrophages（M2-macrophages）during the co-culture with MSCs. In this study, weinvestigated how these cells interact with each other in the primary co-culture and the resulting M2-macrophage
polarization occurs.
Materials and Methods: MSCs and blood cells were separated by using Lineage（Lin）-Cell Depletion Kit from td-Tomato
mouse bone marrow cells, and the separated cells were examined for growth, differentiation and markers expression.
Moreover, two separated cells were reconstitutively co-cultured cell contact-dependent- and independently, and determined
for M2-macrophage polarization.
Results: The growth of blood cells（Lin+）was sustained by a soluble factor secreted from MSCs（Lin-）into the culture
medium. Flow cytometry revealed that 70-80% of Lin+ cells were CD206（M2-marker）-positive, indicating that Lin+
cells were already polarized to M2-macrophages. The reconstitutive co-culture experiment of Lin+ and Lin- revealed thatthe mRNA expression levels of CD206 and the immunosuppressive cytokine IL10 and IL10 secretion level were higher in
Lin+ cells adhered directly with Lin− than those cultured non-adherently.
Conclusion: It is suggested that our co-culture system seems to be beneﬁcial as a supplier of a number of immunosuppressive
macrophages, which are clinically applicable to regenerating or restoring the injured tissues with high efficiency andimproving inﬂammatory diseases such as periodontitis.

JSP/JACP Poster Session AAP2016

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GB-11

rhFGF-2/gelatin-βTCP in the treatment of gingival recessions in dogs

Ammar Shujaa Addin＊1, Tatsuya Akizuki1, 2, Shu Hoshi1, Takanori Matsuura1, Takahiro Ikawa1,
Kiichi Maruyama1, Wataru Ono1, Shunsuke Fukuba1, Yuichi Izumi1
1

Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental
University, Tokyo, Japan 2Division of Periodontology, Department of Oral Function and Restoration, Graduate
School of Dental Science, Kanagawa Dental University, Kanagawa, Japan
Background and objective: Connective tissue graft and coronally advanced ﬂap result mainly in periodontal repair througha long junctional epithelium and connective tissue adhesion when utilized to treat gingival recessions. Tissue engineering
using recombinant growth factor technology may provide a new paradigm in root coverage. In this study we investigated theeffect of recombinant human fibroblast growth factor-2（rhFGF-2）combined with gelatin incorporating βTCP
（gelatin-βTCP sponge）on root coverage in dogs.
Materials and Methods: This study was approved by the institutional animal care and use committee of Tokyo Medical and
Dental University（0160319 A）. In six adult beagle dogs, artiﬁcial gingival recession defects were created bilaterally in the
maxillary canines. The defects were randomly assigned to the test（rhFGF-2/gelatin-βTCP）or the control group（gelatin-βTCP）. Width of keratinized gingiva（wKG）was measured at baseline right after surgery and before sacriﬁce（8weeks）. Biopsy specimens were obtained and subjected to micro-CT and histological evaluation.
Results: Clinically healing was uneventful and complete root coverage was achieved in both the test and control groups.
There was no statistical significant difference in wKG between the test and control sites. The new bone volume wassigniﬁcantly greater at the test sites than control sites. Histologically the scaffolds were completely resorbed with no signs ofinﬂammation in both groups. Histomorphometrically, the test group attained more new bone and periodontal attachment
than the control group.
Conclusion: The combined use of rhFGF-2 and gelatin-βTCP sponge enhances more formation of new bone and cementum
than the scaffold alone in artiﬁcially created gingival recession defects in beagle dogs.
GB-12

Bone Metabolic Microarray Analysis of Ligature-Induced-Periodontitis in Streptozotocin-Induced
Diabetic Mice
Shogo Maekawa＊, Sayaka Katagiri, Yasuo Takeuchi, Rina Komazaki, Anri Ohtsu,
Sayuri Udagawa, Yuichi Izumi
Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental
University, Tokyo, Japan
Background and objective: Many epidemiological studies have reported the progression of periodontitis in patients withdiabetes;however, the associated mechanism remains unclear. We comprehensively investigated how diabetes affect theperiodontal tissue and alveolar bone loss using a ligature-induced-periodontitis model in streptozotocin-induced diabetic（STZ）mice.
Materials and Methods: Diabetes was induced by intraperitoneal injection with streptozotocin in 6-week-old C57/BL6J
male mice. A silk ligature was tied around the maxillary left second molar in 9-week-old wild type（WT）and STZ mice.
Bone loss was evaluated at 3 and 7 days after ligation. mRNA expressions in the gingiva between the two groups was
examined by DNA microarray and quantitative PCR（qPCR）. Tartrate-resistant acid phosphatase（TRAP）and alkaline
phosphatase（ALP）staining of the periodontal tissue was performed for evaluation of osteoclasts and osteoblasts inhistological analysis.
Results: In the ligated gingiva, TNF-α mRNA expression was up-regulated at 1 day post-ligation in STZ mice but not in
WT mice. At 3 days post-ligation, alveolar bone loss was observed only in STZ mice. More severe alveolar bone loss wasobserved in STZ mice at 7 days post-ligation compared to WT mice. Bone metabolic analysis using DNA microarrayshowed significant downregulation in the mRNA expression of glioma-associated oncogene homologue 1（Gli1）andcollagen type VI alpha 1（Col6a1）at the gingiva of the ligated sites in STZ mice. Histological analysis showed increased
number of TRAP-positive multinucleated cells at the ligated sites in STZ mice.
Conclusion: Alveolar bone loss could occur at an early phase under diabetic condition.

JSP/JACP Poster Session AAP2016

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GB-13

Functional keystone species enable discrimination of peri-implantitis and periodontitis

Takahiko Shiba＊1, Takayasu Watanabe2, Tatsuro Koyanagi1, Noriko Maruyama1, Yasuo Takeuchi1,
Fumito Maruyama3, Yuichi Izumi1, Ichiro Nakagawa3
1

Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental
University, 2Laboratory of Food-borne Pathogenic Microbiology, Research Center for Food Safety, Graduate
School of Agricultural and Life Sciences, The University of Tokyo, 3Department of Microbiology, Graduate Schoolof Medicine, Kyoto University
Background and objective: Periodontitis and peri-implantitis are polymicrobial diseases with similar symptoms and occur inoral cavities. The effectiveness of clinical treatments for peri-implantitis is often unsatisfactory, even when using a treatment
strategy similar to that used for periodontal disease. One possible reason for the failure might be the dissimilarity of
microbial species that serve as etiological agents in each disease. Here, we performed metatranscriptomic analysis to dissect
the microbiological similarities and dissimilarities related to the disease etiologies of both diseases.
Materials and Methods: Twelve subjects at the Tokyo Medical and Dental University Hospital（2012-2013）were recruited
to analyze microbiota in subgingival plaque samples of one peri-implantitis and one periodontitis site.
Results: Both diseases were dissimilar in terms of 16S rRNA-based taxonomic profiles. Although disease-specificfunctional gene such as phage-related virulence factors were detected, no signiﬁcant difference in mRNA abundance wasobserved for any gene between both diseases suggesting the functional composition including metabolic pathways weresimilar. However, the dissimilarities between the diseases were in not only network structures of co-occurrence patterns oftaxonomic mRNA proﬁles but also the functional keystone species, which are of signiﬁcantly higher mRNA（functional
genes）than 16S rRNA（viable bacteria）in abundance.
Conclusion: Our approaches provide way to determine the potential causative agents of diseases in microbiota. Our ﬁndings
lead to develop new clinical treatment approaches speciﬁc to peri-implantitis or periodontitis. Furthermore, the approaches
can be used to clarify the etiologies of other polymicrobial diseases.
GB-14

Effect of intermittent administration of parathyroid hormone in rat cranial bone defects
Mao Mizuno＊, Hirotsugu Morinaga, Keisuke Mukai, Keiichi Kanayama, Toshiaki Shibutani
Department of Periodontology, Division of Oral Infections and Health Science, Asahi University School of
Dentistry, Gifu, Japan

Background and objective: Intermittent administration of parathyroid hormone（PTH）increases bone mass for thetreatment of osteoporosis. This study was to evaluate the local intermittent administration of PTH for bone regeneration in
rat cranial bone defects.
Materials and Methods: Eight-week-old male Wistar rats were divided into four groups . Two groups（PTH-3 and PTH-1
groups）underwent creation of two cranial bone defects using a trephine bur（ø 4.3 mm）. These groups received PTH at
14.1µg/kg in absorbable collagen sponge placed in bone defects. The collagen group received saline at 14.1µg/kg inabsorbable collagen sponge in bone defects. The control group underwent sham-surgery. After surgery, the PTH-3 group
received subcutaneous injection of PTH（14.1µg/kg）twice at the experimental sites. The PTH-1 group was administeredsaline twice. The collagen group subcutaneously was used saline. The control group was injected subcutaneous with saline.
All animals were sacriﬁced 21 days after surgery. BMC/TV at the experimental sites was evaluated using µ-CT. Tissue
sections were stained with HE . Anti-ALP antibody was used for immunohistochemical staining.
Results: BMC/TV was signiﬁcantly higher in the PTH-3 group and PTH-1 group than in collagen group. Ratio of new bone
area to defect area was signiﬁcantly higher in PTH-3 than in controls. ALP-positive area was more widely distributed in
new bone in PTH-3 than in PTH-1, collagen and controls.
Conclusion: These ﬁndings suggest that local intermittent administration of PTH enhanced bone regeneration in rat cranialbone defects. Local intermittent administration of PTH may be effective for periodontal regeneration.

JSP/JACP Poster Session AAP2016

8

GB-15

Comprehensive analysis of gene expression in the junctional epithelium from bioengineered tooth
Tatsuaki Seki＊1, Ryo Aizawa1, Junichi Tanaka2, Sara Himuro1, Mayu Kato1, Kenji Mishima2,
Matsuo Yamamoto1
1

Department of Periodontology, Showa University School of Dentistry, 2Division of Pathology Department of Oral
Diagnostic Sciences, Showa University School of Dentistry

Background and objective: Periodontal disease caused by bacterial infection shows symptom of inflammation in the
periodontal tissue including junctional epithelium（JE）. It has been reported that JE has several unique features to prevent
bacterial infection. However, those molecular mechanisms have remained to be completely elucidated. We can isolate JE
cells expressed green ﬂuorescent protein（GFP）by using a bioengineered tooth technique in mice. The aim of this study
was to perform a comprehensive analysis of gene expression in JE using a bioengineered tooth germ method.
Materials and Methods: Bioengineered tooth germs, which consisted of GFP-transgenic mouse-derived epithelial cells andnormal mouse-derived mesenchymal cells, were cultured for 4 days. They were transplanted into alveolar bone in normal
mice. GFP-positive JE cells around erupted bioengineered teeth were isolated by ﬂow cytometry and analyzed by RNA
sequencing and real-time PCR.
Results: The expression of secretory leukocyte protease inhibitor（Slpi）and keratin 17（Krt17）were increased in JE cells
compared with palatal gingival epithelial cells. Furthermore, immunohistochemical analysis indicated that Slpi protein ishighly expressed in JE cells. Also, the expression of anti-oxidative stress response genes were increased in JE cells.
Conclusion: We determined that Slpi is characteristically expressed in JE cells. Gene expression patterns of JE cells frombioengineered tooth germs showed similar results as our previous reports. These results indicate that JE cells have antioxidative stress potential.

GB-16

Elucidation of the adhesion domain of Porphyromonas gingivalis Hgp44 for Treponema denticola
Kouki Yoshikawa＊1, Koki Ota1,2, Kentaro Imamura1, Daichi Kita1, Keiko Yamashita1,
Kazuyuki Ishihara2,3, Atsushi Saito1,2
1

Department of Periodontology, Tokyo Dental College, 2Oral Health Science Center, Tokyo Dental College,3
Department of Microbiology, Tokyo Dental College

Background and objective: Coaggregation between the two major periodontal pathogens, Porphyromonas gingivalis andTreponema denticola, is important in the bioﬁlm formation and pathogenicity. It has been shown that the gingipain adhesion/
hemagglutinin domain of P. gingivalis（Hgp44）is involved in its coaggregation with T. denticola.
The purpose of this study is to elucidate the adhesion domain of P. gingivalis Hgp44 for T. denticola.
Materials and Methods: The Hgp44 sequence encoding amino acid residues 720 to 1136 of Hgp44, which was C-terminal
hemagglutinin/adhesion domain of P. gingivalis ATCC 33277, were amplified by PCR. The amplification genes wereinserted in expression vector and the recombinant proteins（r-Hgp44）were induced. SDS-PAGE and Western blotting
using anti-P. gingivalis antibody were used to conﬁrm the production. Enzyme-linked immunosorbent assay（ELISA）wasused to evaluate the adhesion to T. denticola ATCC 35405.
Results: The productions of r-Hgp44（residues 720-1136）and the variant（residues 720-1032; r-Hgp44 1）wereconfirmed by SDS-PAGE and Western blotting. Compared with control, a significantly greater level of T. denticola
adherence was observed with r-Hgp44 and r-Hgp441 . However, no signiﬁcant difference in the adherence was observed
between r-Hgp44 and r-Hgp441.
Conclusion: It was suggested that P. gingivalis Hgp44 domain responsible for adhesion to T. denticola resides in residues
720 to 1032. Further clariﬁcation of the speciﬁc Hgp44 domain is underway. Inhibition of such domain may prove to be anovel strategy to control periodontitis.

JSP/JACP Poster Session AAP2016

9

GB-17

Effects of vitamin B-complex supplementation on bone regeneration in rat

Mayuko Takano＊1, Saeka Mochizuki1, Naoyuki Sugano1,3, Shinya Iguchi2, Daigo Suzuki2,
Yasumasa Ozawa2, Yoshihiro Sawamoto1, Hiroaki Yagi1, Naoto Yoshinuma1,3, Shuichi Sato1,3
1

Department of Periodontology, Nihon University School of Dentistry, 2Nihon University Graduate School of
Dentistry, 3Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
Background and objective: Among the nutrients necessary for normal physiological functions, vitamin B6, vitamin B12, andfolic acid play important roles in the immune response and wound healing, although the underlying mechanisms are unclear.
This study examined the effect of vitamin B-complex supplementation on bone regeneration in non-critical-sized rat
calvarial bone defects.
Materials and Methods: We used 4-week-old male Wistar rats（n=10）in this study. The drinking water of the rats in theexperimental group contained 1 g/L vitamin B6, 1.25 mg/L vitamin B12, and 62.5 mg/L folic acid. Non-critical-sizedcalvarial bone（defectsidiameter 2.7 mm）were trephined into the dorsal parietal bone on both sides of the midsagittal
suture. Using in vivo micro focus computed tomography（micro-CT）and tissue sectioning, we evaluated boneregeneration. Micro-CT imaging was performed every week for 6weeks after surgery. The defect sites were removed alongwith surrounding bone and soft tissues and stained with hematoxylin-eosin.
Results: Histomorphometric and histological analysis showed that the amount of bone augmentation was significantly
increased in the group supplemented with B-complex vitamins compared to controls at 6 weeks. Moreover, histologicalanalyses revealed that the group that received vitamin B-complex supplementation showed more osteoblast-like cells than
did controls.
Conclusion: These results obtained from micro-CT and histological analysis showed that vitamin B complex
supplementation accelerated bone regeneration in non-critical-sized bone defects. This effect might be beneficial inperiodontal therapy, particularly in regeneration of bone lost to periodontal disease. Further studies are required to clarify themechanism underlying these supplementation effects.
GB-18

Use of BMSCs prevents alveolar bone resorption on experimental periodontitis
Shinya Iguchi＊1, Eisuke Kawano1, Daigo Suzuki1, Niina Tsurumachi2, Mikihito Kajiya3,
Taku Toriumi4,5,Keitaro Isokawa4,5, Yoshinori Arai6, Takeshi Fukuda7, Yoshiaki Fujisaki7,
Naoyuki Sugano7,8, Shuichi Sato7,8, Masaki Honda9

1

Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, 2Department of Orthodontics,
Nihon University School of Dentistry, 3Department of Periodontal Medicine, Applied life Sciences, Institute of
Biomedical & Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University,
4
Department of Anatomy, Nihon University School of Dentistry, 5Division of Functional Morphology, Dental
Research Center, Nihon University School of Dentistry, 6Nihon University School of Dentistry, 7Department of
Periodontology, Nihon University School of Dentistry, 8Division of Advanced Dental Treatment, Dental ResearchCenter, Nihon University School of Dentistry, 9Department of Oral Anatomy, Aichi-Gakuin University School of
Dentistry

Background and objective: Mesenchymal stem cells are known to exert potent immunosuppression and anti-inﬂammatory
effects. There is growing interest in their use for immunotherapy for controlling inﬂammation. In this study, we examine
whether the transplantation of bone marrow stromal cells（BMSCs）would prevents alveolar bone resorption on
experimental periodontitis in mice.
Materials and Methods: Bone resorption was induced by using the 5-0 silk around the maxillary second molar. The BMSCs,
including mesenchymal stem cells were isolated from the femurs and tibiae of 8-week-old C57BL/6 mice. BMSCs（1×10⁶ cells in 5µL）were administered to gingiva around the ligatured maxillary right second molar using needle. At 5 days
after cell administration, we evaluated the bone resorption levels around second molar by micro CT and histologicalexamination.
Results: Micro-CT analysis showed that mice from the untreated group had significant bone loss compared to the celladministration group. Histologically, severe inﬂammation was shown in untreated mice, while inﬂammatory inﬁltration andbone resorption appeared suppressed in mouse periodontal tissue injected with BMSCs.
Conclusion: The ﬁndings in this in vivo study suggested that the local administration of BMSCs is an effective approach as atreatment for periodontitis.
JSP/JACP Poster Session AAP2016

10

GB-19

Dedifferentiated fat cells for tissue engineering in rat periodontal defects
Daigo Suzuki＊1, Shinya Iguchi1, Eisuke Kawano1, Niina Tsurumachi2, Taku Toriumi3,4,
Keitaro Isokawa3,4, Yoshinori Arai5, Akihiko Sakai6,7, Ooshio Kaori6,7, Naoyuki Sugano6,7,
Shuichi Sato6,7, Masaki Honda8

1

Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, 2Department of Orthodontics,
Nihon University School of Dentistry, 3Department of Anatomy, Nihon University School of Dentistry, 4Division of
Functional Morphology, Dental Research Center, Nihon University School of Dentistry, 5Nihon University Schoolof Dentistry, 6Department of Periodontology, Nihon University School of Dentistry, 7Advanced Dental Treatment,
Dental Research Center, Nihon University School of Dentistry, 8Department of Oral Anatomy, Aichi-Gakuin
University School of Dentistry
Background and objective: Lipid droplet-free fibroblast-like cells, known as dedifferentiated fat（DFAT）cells, can begenerated from mature adipocytes. DFAT cells can restore their proliferation activity and differentiate into various cell types
under appropriate conditions in culture. The objective of this study was to assess the regenerative potential of DFAT cells
combined with a solid scaffold in periodontal tissue regeneration.
Materials and Methods: Preparation of DFAT cells from mature adipocytes was conducted with a previously-reported
modiﬁed method（Matsumoto et al., 116 2008）. The PLGA-based solid scaffolds（LA:GA = 75:25, Mw. 25 kDa;PLGAscaffold, GC Dental Product Co. Ltd., Japan）, with a porosity of 80%, were used DFAT cells were seeded onto PLGA
scaffolds（DFAT/PLGA）, and the scaffolds without cells were served as control（empty PLGA）. Three-wall bone defects
were created bilaterally at the mesial side of ﬁrst molars of rats maxilla. DFAT/PLGA or empty PLGA were placed in thedefects. Imaging of micro-computed tomography（CT）was performed every week for 4 weeks, and then, decalciﬁed andprocessed for histomorphometrical observation.
Results: Micro-CT analysis showed signiﬁcantly higher bone growth in DFAT/PLGA groups compared with controls at 4
weeks after surgery. Histomorphometry demonstrated thicker cementum and periodontal ligament in DFAT/PLGA groups
compared with controls.
Conclusion: These findings suggest that the in vivo graft of DFAT cells combined with PLGA scaffolds is effective inpromoting the tissue regeneration in periodontal bone defects.
GB-20

Fundamental research on the mechanism underlying corniﬁcation in oral mucosa

Seiichi Arita＊1, Hiroshi Murakami1, Mitsutoki Hatta2, Yasunori Yoshinaga1, Jun Yamazaki2,
Ryuji Sakagami1
1

Section of Periodontology, Department of Odontology, Fukuoka Dental College 2Section of Cellular and Molecular
Regulation, Department of Physiological Science and Molecular Biology, Fukuoka Dental College

Background and objective: The corniﬁcation of gingival epithelia is essential for maintaining its barrier function and healthy
periodontal homeostasis. Filaggrin, an intermediate ﬁlament-associated protein, is known to contribute to epidermal barrier
function and degraded into the small molecules called natural moisturizing factors during the cornification process.
However, filaggrin expression pattern and its role in the oral epithelial cornification are still elusive. In this study, we
examined the expression of ﬁlaggrin and its degradation products in the stratiﬁed squamous epithelium of skin and oral
mucosa.
Materials and Methods: The skin, palate and buccal mucosa were taken from a rat. Tissue sections were subjected toimmunoﬂuorescence using anti-ﬁlaggrin antiserum, and anti-peptidyl arginine deiminase（PAD）1 and anti-citrullinatedprotein antibodies. Protein extracts were subjected to western blot analysis.
Results: Immunoﬂuorescence showed that ﬁlaggrin is highly expressed from the granular layer to the lower corniﬁed layerof skin. In the oral mucosa, ﬁlaggrin was detected in the keratohyalin granule-like structures of the granular layer. PAD1 andcitrullinated protein were highly expressed in the lower corniﬁed layer of skin, but not in the oral mucosa. Western blotting
showed that the ﬁlaggrin monomer is degraded in skin but not the oral mucosa.
Conclusion: Our ﬁndings suggest that the different patterns of ﬁlaggrin degradation observed here may be due to differences
in PAD1-mediated ﬁlaggrin citrullination in the skin and oral mucosa.

JSP/JACP Poster Session AAP2016

11

GB-21

LIPUS inhibits LPS-induced IL-1α mediated NF-κB activations via AT1-PLCβ pathway

Mayu Nagao＊1, Natsuko Tanabe2,3, Soichiro Manaka4, Hisashi Ujiie4, Shigeki Oka4, Masako Naito3,5,
Naoto Suzuki2,3, Masao Maeno3,6, Shuichi Sato4,7
1

Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, 2Department of Biochemistry,
Nihon University School of Dentistry, 3Division of Functional Morphology, Dental Research Center, Nihon
University School of Dentistry, 4Department of Periodontology, Nihon University School of Dentistry, 5Departmentof Anatomy Nihon University School of Dentistry, 6Department of Oral Health Sciences Nihon University Schoolof Dentistry, 7Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of
Dentistry
Background and objective: Periodontal disease destroys alveolar bone, is stimulated by lipopolysaccharide（LPS）-induced
inflammatory cytokine IL-1α. Low-intensity pulsed ultrasound（LIPUS）is used for bone healing in orthopedics anddental treatments. Previous reports have shown that mechanical stimulation by LIPUS inhibits inﬂammatory chemokinesthat are activated in response to LPS（Nakao et al., Bone 2014）. However, the mechanism underlying the effects of LIPUS
on LPS-induced inﬂammatory cytokine has not been elucidated. We aimed to investigate the role of LIPUS on LPS-induced
IL-1α production including its signaling pathway.
Materials and Methods: MC3T3-E1 cells were plated on a 6-well plate, incubated in the presence or absence of competitive
LPS, and then stimulated with LIPUS for 30 min using OSTEOTRON D2. To clarify the role of LIPUS-effect, we
determined the expression of IL-1α stimulated with LIPUS and treated with angiotensin receptor type 1（AT1）antagonist
Losartan. The expression of IL-1α and AT1 receptor was determined using real-time PCR or ELISA. The nuclear
translocation of NF-κB was examined by ﬂuorescent immunostaining.
Results: LIPUS inhibited mRNA and protein expression of LPS-induced IL-1α. LIPUS reduced the nuclear translocation of
NF-κB. Losartan and si RNA silencing AT1 cells blocked all the stimulatory effects of LIPUS on production NF-κB
translocation. Furthermore, PLCβ inhibitor U73122 recovered NF-κB translocation.
Conclusion: These result suggest that LIPUS inhibits IL-1α-mediated the activation of NF-κB induced by LPS inosteoblasts via AT1-PLCβ pathway. This is the first demonstration of the molecular mechanism underlying the positiveeffect of LIPUS on periodontitis which involved IL-1α.
GB-22

Invasion mechanism of ʻred complex speciesʼ across gingival epithelial barrier

Shinpei Takahashi＊1, Taichi Ishikawa2, Yu Shimoyama2, Daisuke Sasaki1, Shigenobu Kimura2,
Takashi Yaegashi1
1Division of Periodontology, 2Division of Molecular Microbiology, Iwate Medical University, Morioka, Japan

Background and objective: It was demonstrated that periodontopathic bacteria including ʻred complex speciesʼ can invade
into the apical gingiva of periodontitis patients. The precise invasion mechanism, however, remains to be elucidated. In thisstudy using the quantitation assays of bacteria and FITC-dextran, we assessed the invasion mechanism of ʻred complex
speciesʼ across gingival epithelial barrier through two putative routes（transcellular and paracellular routes）.
Materials and Methods: After preculture of a human gingival epithelial cell line（Ca9-22）on 3-µm-pore-size ﬁlters ofTranswell culture insert, bacterial suspensions of freshly harvested ʻred complex speciesʼ（Porphyromonas gingivalis
ATCC33277, Treponema denticola ATCC33520 and Tannerella forsythia ATCC43037）were added to the uppercompartment on the layered cells in an antibiotic-free media. At appropriate times after incubation, the translocated bacteria
across epithelial cells in the lower compartment were quantified by real-time quantitative PCR（q-PCR）. Then, thedisruption of cell-cell junctions in Ca9-22 was examined by the translocation of FITC-dextran. The invaded and persisted
bacteria within Ca9-22 were also assessed by q-PCR.
Results: The quantitation assays of bacteria and FITC-dextran indicated that P. gingivalis could invade signiﬁcantly acrossgingival epithelial barrier at 6 hours of incubation through both transcellular and paracellular routes. T. forsythia could also
possess the invasive ability, although T. forsythia utilized only transcellular route. In contrast, T. denticola could scarcely
invade across gingival epithelial barrier.
Conclusion: Among ʻred complex speciesʼ, P. gingivalis and T. forsythia, but not T. denticola, could invade signiﬁcantly
across gingival epithelial barrier, whereas the translocation route may differ between the organisms.

JSP/JACP Poster Session AAP2016

12

GB-23

Effect of cavitating jet for cleaning bioﬁlm from implant ﬁxture
Junki Yamada＊1, Takashi Takiguchi1, Akihiro Saito1, Hibiki Odanaka1, Hitoshi Soyama2,
Matsuo Yamamoto1

1

Department of Periodontology, Showa University School of Dentistry, 2Department of Nanomechanics Tohoku
University

Background and objective: Although some cleaning devices have been developed, more effective methods are desired toremove bioﬁlm from implant surface. The aim of the present study was to demonstrate the effectiveness of the cavitating jetin removing bioﬁlms from rough surface of screw type implant.
Materials and Methods: The optimal nozzle dimensions and injection conditions were identified by cavitation impact
measurements. Plaque biofilm was formed on the fixtures mounted on custom-made stents intraorally for 72h in fourvolunteers. The stained ﬁxtures were assigned to different experimental groups. One comparison was performed between thecavitating jet and the water jet at 60 seconds. Additional comparisons were conducted among the time course experiments at
30, 60, and 180 seconds. After injection, the residual plaque bioﬁlm（RPB）area was measured using digital microscope.
Results: The total RPB of the cavitating jet was signiﬁcantly lower than that of the water jet. The total RPB areas of thecavitating jet at 30 seconds, at 60 seconds and at 180 seconds were signiﬁcantly lower than the initial plaque bioﬁlm. A
signiﬁcant decrease was detected between 60 seconds and 180 seconds. The RPB on the dedendum sector was signiﬁcantly
lower than that on the addendum sector at 60 seconds and 180 seconds.
Conclusion: This study demonstrated that cavitating jet could be one of the effective methods for removal of bioﬁlm fromscrew type implant.

GB-24

P2X7 receptor mediates collagen synthesis induced by LIPUS

Soichiro Manaka＊, Natsuko Tanabe, Mayu Nagao, Masako Naito, Kenji Sugai, Noboru Shiomi,
Naoto Suzuki, Shuichi Sato
Nihon University School of Dentistry
Background and objective: In orthopedics, low-intensity pulsed ultrasound（LIPUS）is commonly used for the treatment
or diagnosis of fracture. In addition, LIPUS is also used to enhance the alveolar bone regeneration after the placement of
implants. Adenosine triphosphate（ATP）is a key regulator of osteoblast response to mechanical stimuli. Furthermore, theATP receptor of P2X7 is related to the skeletal remodeling by mechanotransduction. Type I collagen（Col1）is one of the
major protein constituents of the bone ECM; it also functions as a scaffold for the nucleation of hydroxyapatite crystals
during the calciﬁcation. However, the interaction between LIPUS-induced ATP and P2X7 receptor during collagen synthesis
is poorly understood. In this study, we investigated the role of P2X7 receptor in LIPUS induced osteogenesis during collagensynthesis.
Materials and Methods: MC3T3-E1 cells were plated on a 6 well plate, incubated in the presence or absence of competitive
P2X7 antagonist A438079, and subsequently stimulated with LIPUS for 30 min/day using OSTEOTRON D2. In addition,these cells transfected with P2X7 shRNA were also incubated and stimulated with LIPUS under the same condition. The
expression of Col1, matrix metalloproteinase（MMP）, and tissue inhibitor of metalloproteinase（TIMP）was determinedusing real-time PCR.
Results: LIPUS induced the gene expression of Col1, whereas it reduced MMP-1, 3, and 13. However, LIPUS didnʼt affectthe expression of TIMPs.
Conclusion: These results suggest that LIPUS promotes osteogenesis through the P2X7 receptors in osteoblasts during
collagen synthesis.

JSP/JACP Poster Session AAP2016

13

GB-25

Bone augmentation using bone graft material derived from a rat GBA model

Katsuyoshi Tsunori＊2,3, Akira Hasuike2,3, Yutaka Yamada2,3, Tatsuya Kubota1, Yasumasa Ozawa1,
Harumi Masuda2, Yuichi Mizumura2, Shuichi Sato2,3
1

Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, 2Department of eriodontology,
Nihon University School of Dentistry, 3Division of Advanced Dental Treatment, Dental Research Center, Nihon
University School of Dentistry, Tokyo, Japan

Background and objective: Autogenous bone grafts are ideal, but the quantity of bone collected can limit the ability toperform effective bone augmentation. This study evaluated the effects of newly augmented tissue derived from a rat guided
bone augmentation（GBA）model as bone graft material.
Materials and Methods: Thirty 8-week-old male Fischer rats were used. In an initial operation, a standardized plastic cap
was put in place, and bone augmentation was performed. In a second operation 12 weeks later, a 5-mm-diameter bone
defect was formed in the right parietal bone as the recipient site. The plastic cap was removed. In the experimental group,
the recipient site was ﬁlled with newly augmented bone tissue as autotransplant bone. The recipient site was not ﬁlled in thenegative control group. In the positive controls, a sham operation was performed using autogenous bone from the leftparietal bone to ﬁll the bone defect. Repeated micro-computed tomography（CT）imaging was performed from 1 to 12
weeks after the second surgery. The defect sites were removed along with the surrounding bone and soft tissues, stained withhematoxylin and eosin.
Results: More bone regeneration was observed in the experimental and positive control groups than in the negative control
group using micro-CT. Histologically, more osteoblast-like cells were observed around the bony rim in the experimental
and positive control groups than in the negative control group.
Conclusion: The newly augmented tissue derived from a rat GBA model was an effective bone graft material.

GB-26

Porphyromonas gingivalis LPS induced the production of Angiopoietin-like protein2 in gingival
epithelial cellTasuku Ohno＊1, Genta Yamamoto1, Eisaku Nishida1, Jun-ichiro Hayashi1, Hisashi Goto1,
Makio Mogi2, Akio Mitani1
1

Department of Periodontology, School of Dentistry, Aichi Gakuin University , 2Department of Medicinal
Biochemistry, School of Pharmacy, Aichi Gakuin University

Background and objective: Angiopoietin-like protein2（ANGPTL2）plays pivotal roles in various inﬂammatory diseases
such as vascular inﬂammation, obesity, insulin resistance, cancer and rheumatoid arthritis. However, there is no report about
the association with periodontal disease. The aim of present study is to investigate the role of ANGPTL2 in human gingival
epithelial cells.
Materials and Methods: We obtained gingival crevicular ﬂuid（GCF）samples from patients with chronic periodontitis andhealthy and then determined ANGPTL2 protein production. Human gingival epithelial cells（Ca9-22 cells）were
stimulated with Porphyromonas gingivalis LPS and recombinant human ANGPTL2. Expression levels of ANGPTL2 andvarious inﬂammatory cytokines were detected by respectively enzyme-linked immunosorbent assay（ELISA）, western blot
（WB）and quantitative polymerase chain reaction（qPCR）.
Results: We found that the production of ANGPTL2 was increased in GCF from patients with chronic periodontitis
compared with it from healthy. The stimulation of P.gingivalis LPS clearly increased the mRNA expression and protein
production of ANGPTL2 in Ca9-22 cells. Inﬂammatory cytokines production was increased by addition of recombinanthuman ANGPTL2 in Ca9-22 cells.
Conclusion: It is suggested that ANGPTL2 is increased by P.gingivalis LPS stimulation in human gingival epithelial cells
and might associate with chronic inﬂammatory disease like periodontal disease.

JSP/JACP Poster Session AAP2016

14

GB-27

LNGFR+THY-1+ neural crest like cells have potential of mesenchymal stem cells
Takehito Ouchi＊, Satoru Morikawa, Taneaki Nakagawa
Department of Dentistry and Oral Surgery, Keio University School of Medicine

Background and objective: Periodontal tissues originate from cranial neural crest derived mesenchyme. Recent reports haveshown that mesenchymal stem cells（MSCs）are efficient for periodontal tissues regeneration. MSCs are classically
identiﬁed by adherent culture and multipotent differentiation. The drawback leads contamination of other lineages cells. Our
purpose of this study is to generate puriﬁed-human MSCs, which are developmentally derived from cranial neural crest
cells for periodontal regeneration.
Materials and Methods: Human induced pluripotent stem（iPS）cells were induced into cranial neural crest like cells（NCLCs）. To confirm the existence of highly potent purified-human MSCs that expressed LNGFR and THY-1, we
analyzed cell surface markers using flow cytometry. Sorted LNGFR+THY-1+ cells were analyzed for their potentials as
MSCs.
Results: Induced LNGFR+THY-1+ cells from human iPS cells, have potentials of mobilization and self-renewal. And, theyexpressed neural crest markers, Nestin, Sox10, AP2α, and HNK-1. Therefore, we designated those cells as LNGFR+THY-1+
neural crest like cells（LT-NCLCs）. LT-NCLCs vigorously survived, and had multipotent differentiation into mesenchymal
and neural crest lineages.
Conclusion: To advance human periodontal stem cell research, additional clariﬁcation is needed. Previously, we reported
highly potent puriﬁed human MSCs that express LNGFR and THY-1. Here, we demonstrate a method, which provides asimple way to generate a large amount of developmentally selected MSCs that express LNGFR and THY-1. They will bepromising candidates for periodontal regenerative medicine.

GB-28

Effect of osteoporosis on bone augmentation in ovariectomized rat calvarium

Tatsuya Kubota＊1, Katsuyoshi Tsunori2, Yasumasa Ozawa1Takanobu Yamamoto1, Naoya Tsukune1,
Akira Hasuike2, Sanae Ezawa2, Kenji Tanaka2, Yoshinori Arai4, Shuichi Sato2, 3
1

Division of Applied Oral Sciences, Nihon University Graduate School of Dentistry, 2Department of eriodontology,
Nihon University School of Dentistry, 3Division of Advanced Dental Treatment, Dental Research Center, Nihon
University School of Dentistry, 4Nihon University School of Dentistry, Tokyo, Japan

Background and objective: An ovariectomized（OVX）rat model is used to mimic osteoporosis in postmenopausal women.
This study investigated the effect of osteoporosis on augmented bone using a rat calvarial model.
Materials and Methods: The study divided 12 6-week-old female Wistar rats into two groups. OVX surgery（experimentalgroup）or a sham operation（control group）was performed in the 6-week-old rats. The rats were bred at 8 weeks. In eachrat, the calvarial bone was exposed and a circular groove was made on each side of the midline using a trephine drill with an
inner diameter of 5 mm. Five small holes were drilled with a No.2 round burr to induce bleeding within each circle. A
cylindrical plastic cap was placed over the grooves on both sides of the midline. The day of surgery was designated day 0.
Repeated micro-computed tomography（CT）imaging was performed 1 to 12 weeks after surgery. Micro-CT andhistological sections were used to measure the amount of bone augmentation within the plastic caps.
Results: Analysis of the micro-CT images indicated that the radiopaque contrast increased in both the OVX and control
groups from 2 to 12 weeks after surgery. The difference was signiﬁcant at 8 and 12 weeks.
Conclusion: The OVX rat model showed inhibited bone augmentation using a rat calvarial model, as conﬁrmed by microCT and tissue sections. Therefore, osteoporosis may inhibit bone augmentation.

JSP/JACP Poster Session AAP2016

15

GB-29

Apical bud transplantation model of rodent teeth for studying epithelial-mesenchymal transition
Ryuji Sakagami＊1, Naoki Maruo1, Yasunori Yoshinaga1, Kazuhiko Okamura2, Yoshihiko Sawa3
1

Section of Periodontology, Department of Odontology, Fukuoka Dental College, 2Section of Pathology, Departmentof Morphological Biology, Fukuoka Dental College, 3Section of Functional Structure, Department ofMorphological Biology, Fukuoka Dental College

Background and objective: Rodent mandibular incisors grow throughout the lifetime of the animal. The labial and lingualsides of an incisor are regarded as analogs of the crown and root of human teeth, respectively. This report presents a noveltransplantation technique of the apical bud tissue of rodent mandibular incisors for establishing a model for investigating thecementoblasts/cementocytes formation through epithelial-mesenchymal transition.
Materials and Methods: Mandibular incisal apical end tissue with green fluorescent protein from transgenic mouse wastransplanted to wild type mice. The cryosections were prepared without decalciﬁcation process and the development of thetransplanted cells were immunohistologically observed at 2,4, and 12 weeks after the transplantation. Podoplanin was used
for investigating the characteristics of the transplanted and migrating cells.
Results: Results indicate that the green ﬂuorescent apical end tissue replaced the original tissue, and cells from the apicalbud differentiated and extended toward the incisal edge direction. The immunostaining with podoplanin also showed that thecharacteristics of the transplanted tissue were identical to those of the original. The green ﬂuorescent cells were only foundin the labial side up to 4 weeks. After 12 weeks, however, they were also found in the lingual side. The green ﬂuorescentcementocyte-like cells were found in the cementum close to the dentin surface.
Conclusion: This study indicated that some of the cells from apical bud became the cementocyte-like cells in the cementumof rodent incisors. Epitheial-origin cells in the apical bud might have become cementoblast/cementocyte-like cells throughepithelial-mesenchymal transition.

GB-30

Effects of hyperglycaemia in human periodontal ligament stem cells
Makoto Umeda＊, Hirohito Kato, Yoichiro Taguchi, Isao Yamawaki, Nobuhiro Yamauchi,
Masahiro Noguchi
Department of Periodontology, Osaka Dental University, Osaka, Japan

Background and objective: Diabetes mellitus is a major risk factor for periodontal disease and affects various cellularfunctions. Periodontal ligament stem cells（PDLSCs）play an important role in periodontal tissue regeneration. However,
the effect of hyperglycaemia on PDLSCs is unclear. The aim of this study was to investigate whether hyperglycaemia affects
periodontal tissue regeneration using human PDLSCs and high glucose medium as a model of diabetes.
Materials and Methods: PDLSCs were obtained from healthy adult human mandibular third molars. Cell proliferation andosteoblastic differentiation were investigated by culturing PDLSCs in media supplemented with four different glucose
concentrations representative of normal patients（5.5 mM;control）, postprandial or controlled-diabetes patients（8.0 mM）,
and high values similar to those seen in uncontrolled diabetic patients（12.0 and 24.0 mM）. We then examined themolecular effects of hyperglycemia on PDLSC physiology with a focus on the nuclear factor-kappa B（NF-κB）signaling
pathway. We also investigated the involvement of NF-κB in PDLSCs under hyperglycemic conditions with a specific
NF-κB inhibitor.
Results: High glucose levels inhibited the PDLSC proliferation and differentiation into osteoblasts. Treatment with a NF-κB
inhibitor rescued the defects in cell proliferation and osteoblastic differentiation caused by the high glucose culture
environment.
Conclusion: The results of this study demonstrated that hyperglycemia inhibits human PDLSC proliferation and osteoblastic
differentiation.

JSP/JACP Poster Session AAP2016

16

GB-31

IL-15 and RANKL play a synergistically important role in osteoclastogenesis

Iichiro Okabe＊1, Takeshi Kikuchi1, Makio Mogi2, Makoto Aino1, Yosuke Kamiya1, Takeki Fujimura1,
Hisashi Goto1, Kosuke Okada1, Yuzo Ohno3, Toshihide Noguchi1, Akio Mitani1
1

Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2Department of Medicinal
Biochemistry, School of Pharmacy, Aichi Gakuin University, 3Aichi Gakuin University Dental Hospital

Background and objective: Interleukin-15（IL-15）, a cytokine secreted by several cell types, has important physiologicalroles in the activity, proliferation, and viability of immune cells. IL-15 has both chemoattractant and proinflammatory
properties and may promote bone destruction. A previous study has shown that IL-15 alone has no effect on
osteoclastogenesis. Therefore, the current study addressed the synergistic effect of IL-15 on osteoclast formation using
RAW264.7（RAW）cells by co-stimulation with receptor activator of NF-κB ligand（RANKL）that has an important rolein osteoclastogenesis involving the pathogenesis of rheumatoid arthritis（RA）and periodontal disease（PD）.
Materials and Methods: Murine macrophage RAW264.7 cells were used for all experiment. Cells were stimulated with 25
ng/ml soluble recombinant RANKL and/or 100 ng/ml soluble recombinant IL-15.
Results: IL-15 synergistically increased the number of RANKL-induced TRAP-positive multinucleated cells.
It also synergistically increased the mRNA and protein production of osteoclast's speciﬁc markers.
We also found that the ERK signaling pathway is a critical regulator of IL-15/RANKL-mediated osteoclastogenesis.
Conclusion: The IL-15 and RANKLʼs synergistic role has been suggested to play an important role in disease with aninﬂammatory bone resorption such as RA and PD.

GB-32

Attachment of human gingival epithelial cell on titanium and zirconia

Takuya Hama＊1, Hirotsugu Morinaga1, Tadashi Yasuda1, Yasuaki Hotta2, Yukimichi Tamaki3,
Toshiaki Shibutani1
1Asahi University School of Dentistry Department of Periodontology,2Asahi University School of Dentistry Central
Research Institute of Oral Science,3Asahi University School of Dentistry Department of Dental Materials

Background and objective: Zirconia has attracted attention as a substitute material for titanium in implant treatments. In suchcases, conferring protection at the junction of the implant body and the epithelium is important. The objective of the present
study is to examine the state of adhesion between epithelial precursor cells and zirconia. After epithelial precursor cells were
cultured on zirconia and titanium disks, we sequentially observed changes in cell morphology due to attachment under ascanning electron microscope.
Materials and Methods: The present study employs three materials in total:two zirconia disks and a titanium disk. Surface
roughness and wettability were measured for all samples. Human gingival epithelial progenitor cells were obtained from
CELLnTEC, which were later passaged three times and seeded onto the disks. After incubation periods of 1, 12, 24, and 48
h in the culture medium in an incubator, they were washed with water and dehydrated for fixation. Subsequently, thesamples were freeze-dried, and the adherent cells on the disk were coated and examined using a scanning electron
microscope.
Results: The measurement of surface wettability showed that the contact angle of zirconia disk was smaller than that oftitanium disk. The examination under a scanning electron microscope revealed that cells were capable of attaching,extending, and proliferating over time on both titanium and zirconia disks. The composition ratio of cell morphology
changed over time.
Conclusion: It was suggested that human gingival epithelial progenitor cells adhere to the zirconia and titanium disks asepithelial cells.

JSP/JACP Poster Session AAP2016

17

GB-33

Inﬂammatory cytokines regulate human amelotin gene transcription

Mizuho Yamazaki＊1, Yasunobu Iwai1, Keisuke Noda1, Sari Matsui1, Ayako Kato1, Hideki Takai1, 2,
Yohei Nakayama1, 2, Yorimasa Ogata1, 2
1

Department of Periodontology and 2Research Institute of Oral Science, Nihon University School of Dentistry at
Matsudo, Chiba, Japan

Background and objective: Amelotin（AMTN）is a secreted enamel matrix protein that is localized in the basal lamina of
maturation stage ameloblasts and junctional epithelium. To elucidate the transcriptional regulation of human AMTN gene ininflamed gingiva, we have analyzed the effects of inflammatory cytokines on the expression of AMTN gene in Ca9-22
human gingival epithelial-like cells.
Materials and Methods: Total RNA, total and nuclear proteins were extracted from Ca9-22 cells after stimulation by TNF-α（10 ng/ml）or IL-1β（1ng/ml）. Real-time PCR, Western blotting, luciferase assays using constructs ligated with various
length of human AMTN gene promoter and gel mobility shift assays were performed.
Results: TNF-α and IL-1β increased AMTN mRNA and protein levels at 6 h and reached maximal at 12h. TNF-α induced
luciferase activities of -211 and -353AMTN constructs, and IL-1β increased luciferase activities of -211, -353 and-501AMTN constructs. Induction of luciferase activities by TNF-α and IL-1β were partially inhibited in the −353AMTN
construct which included mutations in C/EBP（1）, C/EBP（2）and YY1 elements. Transcriptional activities induced by
TNF-α- and IL-1β were inhibited by tyrosine kinase, ERK1/2 and PI3-kinase inhibitors. Gel shift assays showed that
TNF-α and IL-1β increased nuclear proteins binding to C/EBP（2）and YY1 elements.
Conclusion: These results demonstrate that TNF-α and IL-1β induce AMTN gene transcription via tyrosine kinase, ERK1/2
and PI3-kinase pathways in human gingival epithelial cells by targeting the C/EBP（1）, C/EBP（2）and YY1 elements in
the human AMTN gene promoter.

GB-34

Study on regeneration of periodontal tissue microvasculature using dedifferentiated fat cells
Yutaka Shimizu＊1, Atsushi Toyama2, Kosuke Maruyama3, Soh Sato3,4

1

Comprehensive Dental Care, The Nippon Dental University Niigata Hospital, 2Periodontology, The Nippon Dental
University Graduate School of Life Dentistry at Niigata, 3Department of Periodontology, The Nippon Dental
University School of Life Dentistry at Niigata, 4Division of Cell Regeneration and Transplantation, Advanced
Research Center, The Nippon Dental University

Background and objective: Human dedifferentiated fat cells（HDFATs）may be a new cell type suitable for regenerative
therapies. The aim of this study is to assess the potential of HDFATs for vascular regeneration of periodontal tissue. To dothis, HDFATs and human gingival endothelial cells（HGECs）were cocultivated, and vascular regeneration was examinedin vitro.
Materials and Methods: HDFATs were isolated from subcutaneous adipose tissue, and HGECs were isolated from gingival
cells using anti-cluster of differentiation 31 antibody-coated magnetic beads. HDFATs were cocultured with HGECs inmicrovascular endothelial cell growth medium-2（EGM-2MV）for 7 days. Expression of endothelial cell（EC）markers,
the formation of capillary-like tubes, and the expression of pericyte markers were determined.
Results: HDFATs, cultured in EGM-2MV or cocultured with HGECs, expressed EC markers. HDFATs in both conditions
initiated tube formation within 5 hours of seeding and formed extensive capillary-like structures within 12 hours. These
structures disintegrated within 24 hours when cells were cultured in EGM-2MV alone, whereas cocultured HDFATs
maintained tubes for >24 hours. Cocultured HDFATs significantly increased expression of pericyte markers, a cell typeassociated with microvasculature.
Conclusion: HDFATs possess the ability to express EC markers, and coculture with HGECs promotes differentiation into
pericytes involved in the maturation and stabilization of the microvasculature.

JSP/JACP Poster Session AAP2016

18

GB-35

Effect of high-glucose conditions on human periodontal ligament endothelial cells
Kosuke Maruyama＊1, Soh Sato1, 2

1

Department of Periodontology, The Nippon Dental University School of Life Dentistry, 2Division of Cell
Regeneration and Transplantation, Advanced Research Center, The Nippon Dental University School of Life
Dentistry at Niigata, Niigata, Japan
Background and objective: Endothelial cells participate in key aspects of vascular biology, such as maintenance of capillarypermeability and regulation of inﬂammation. According to previous reports, endothelial cells have revealed highly speciﬁccharacteristics depending on the organs and tissues. In particular periodontal endothelial cells have a higher permeability
than vascular endothelial cells of other types of tissue. Periodontal disease is not only a chronic disease in oral but also affectthe entire body. Diabetes and periodontal disease are closely related, with periodontal disease even been referred to as thesixth complication of disease. However, no reports have investigated the pathophysiology of microvascular in periodontal
tissue once diabetes has developed. Therefore, the aim of the present study is to investigate changes in the properties ofhuman periodontal endothelial cells（HPDLECs）that were cultured under high-glucose conditions.
Materials and Methods: We isolated human periodontal ligament cells from extracted teeth（males:3, females:5, age:18-56
years）. We isolated HPDLECs from human periodontal ligament cells. HPDLECs were cultured under high-glucose（5.5mM, 11.0mM, 22.0mM）and investigated proliferation, apoptosis, tube formation and the expression of cell adhesion
molecules.
Results: HPDLECs stimulated with high glucose concentration exhibited suppression of cell proliferation and an increased
percentage of apoptosis-positive cells. The expression levels cell adhesion molecules increased
Conclusion: Thus, the results of this study demonstrate that diabetes exacerbates periodontal disease.

GB-36

LPS reduced nicotine-mediated IL-8 secretion

Mariko Ohtsu＊1, Masatake Asano2,3, Kou Tsunoda1, Ryosuke Koshi4,5, Masahiro Eda4, Shinji Arai4,
Shuichi Sato4,5
1

Divisionof Applied Oral Sciences, Nihon University Graduate School of Dentistry, 2Department of Pathology,
Nihon University School of Dentistry, 3Division of Immunology and Pathobiology, Dental Research Center, Nihon
University School of Dentistry, 4Department of Periodontology, Nihon University School of Dentistry, 5Division ofAdvanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
Background and objective: Cigarette smoking is an important environmental risk factor for the development of periodontal
disease. In an attempt to verify the role of nicotine on development of periodontitis, OSCC was cultured with
P.gingivalis-derived LPS in the presence or absence of nicotine. Contrary to our expectation, LPS reduced nicotinemediated IL-8 secretion. The aim of the present study was to elucidate the mechanisms underlying this phenomenon.
Materials and Methods: Ca9-22 was used for the experiments. Cells were stimulated by nicotine with or without P.
gingivalis-derived LPS for 48 h. The culture supernatants were harvested and subjected to IL-8 ELISA. For acetylcholine（ACh）production, cells were cultured with PBS for 10, 30 and 60 min and ACh concentration was measured by ELISA.
Results: Ca9-22 was cultured with or without nicotine and LPS for 48 h. Nicotine-mediated IL-8 secretion was reduced
signiﬁcantly by LPS. To elucidate the mechanisms of LPS-mediated IL-8 reduction, Ca9-22 was cultured in the presence orabsence of LPS and ACh concentration was measured. In the absence of LPS, ACh was accumulated in the culture
supernatant in a time-dependent manner. In contrast, LPS reduced ACh accumulation. Reduction of nicotine-mediated IL-8
secretion by LPS might be attributed to LPS-mediated ACh inhibition.
Conclusion: The results indicated the constitutive production of ACh by Ca9-22. Although further experiments should be
required, LPS might inﬂuence nicotine-mediated IL-8 secretion by reducing ACh production.

JSP/JACP Poster Session AAP2016

19

GB-37

Osteogenic effects of high glucose concentration on nano-modiﬁed titanium surface
Yoichiro Taguchi＊1, Isao Yamawaki1, Satoshi Komasa2, Hirohito Kato1, Akio Tanaka3,
Makoto Umeda1

1

Department of Periodontology, 2Department of Removable Prosthodontics and occlusion, 3Department of Oral
Pathology, Osaka Dental University

Background and objective: A lot of cases of an peri-implantitis have been reported, However, it is also fact that many
diabetic patients have the implant prostheses in recent years. The purpose of this study was to determine the effect of glucose
concentrations on the osteogenic differentiation of bone marrow mesenchymal stem cells（BMMSCs）on a nanonetworkmodiﬁed titanium surface.
Materials and Methods: Titanium disks treated with 10 M NaOH solution and untreated control disks were incubated with
BMMSCs and then exposed to high glucose concentrations（5.5, 8, 12 or 24mM）. The effects of the modiﬁed nanonetwork
structure on osteogenic differentiation of BMMSCs were evaluated at four different glucose concentrations.
Results: High glucose levels inhibited the osteogenic differentiation of BMMSCs. The amounts of osteocalcin production
and calcium extraction after 3 or 4 weeks culture in 24 mM medium was higher than in physiological medium, but those in 8
and 12mM medium were lower. The Ca extraction crystal is reduced by the rise of the glucose concentration, and it isthought that it inﬂuences the calciﬁed condition.
Conclusion: These results suggests that hyperglycemia due to diabetes inﬂuence calciﬁcation and hard tissue formation of
BMMSCs that play an important role to the periodontal tissue regeneration on the nano-modiﬁed titanium surface.

JSP/JACP Poster Session AAP2016

General（Clinical Research）

21

GC-01

Platelet-rich ﬁbrin with beta-tricalcium phosphate for treatment of periodontal defects
Kazuhiro Okuda＊1, Yu Nakajima1, Tomoyuki Kawase2, Mito Kobayashi1, Mana Kamiya1,
Makoto Horimizu1, Larry F. Wolff 3, Hiromasa Yoshie1

1

Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of
Medical and Dental Sciences, 2Division of Dental Pharmacology, Department of Tissue Regeneration andReconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan 3Division of
Periodontology, Department of Developmental and Surgical Sciences, University of Minnesota School of Dentistry, USA
Background and objective: It has been reported that platelet-rich ﬁbrin（PRF）membranes contain numerous platelets andangiogenic growth factors. These findings suggested that PRF membranes exhibit the characteristics of a promisingtherapeutic grafting material for the treatment of periodontal osseous defects.
Materials and Methods: To prepare the PRF, blood samples were collected from peripheral blood of patients, andcentrifuged by a Medifuge system. After eliminating the red thrombus, the resulting PRF preparations were compressed by a
PRF compression device, which resulted in a PRF membrane suitable for use in grafting. Thirteen interproximal infrabony
osseous defects in 13 healthy, non-smoking subjects diagnosed with chronic periodontitis were included in this study. The
periodontal surgery exposed the osseous defects, and allowed access for debridement and root planing. The beta-tricalcium
phosphate（TCP）was placed into the osseous defects, and then they were covered with a PRF membrane before suturing.
Clinical and radiographic measurements were determined at baseline and at the 3, 6, and 12-month post-surgery.
Results: When compared to baseline, the 12-month results demonstrated the treatment procedures resulted in statisticallysigniﬁcant favorable changes in probing depth（7.9±1.6 mm versus 3.1± 0.3 mm;P<0.01）, clinical attachment level gain
（9.5±1.9 mm versus 6.6±1.3 mm; P<0.01）and radiographic infrabony defect depth decrease（5.1±1.9 mm versus 1.9±1.0mm;P<0.01）.
Conclusion: The present study demonstrated that grafting using a combination of a PRF membrane and beta-TCP was
successful in the treatment of human infrabony periodontal defects.
GC-02

GTR using Xenogeneic Bone-Mineral with Collagen Membrane: A Multicenter Study

Daisuke Irokawa＊1, Nobuki Okubo1, Takahisa Fujita1, Yoshihito Ishii1, Masahiko Nikaido1, 2,
Hiroyasu Shimizu3, Nobuyuki Konobu4, Tokuo Matsui5, Hiroaki Goto1, Takahiro Takeuchi1,
Atsushi Saito1
1

Department of Periodontology, Tokyo Dental College, 2Nikaido Dental Clinic, 3Shimizu Dental Clinic, 4KNB
Dental Ofﬁce, 5Kiwakai Ginza Dental Clinic

Background and objective: This multicenter prospective clinical study aimed to evaluate the outcome of GTR using adeproteinized bovine bone mineral（DBBM）in combination with a collagen barrier（CB）in the treatment of intrabony
defects.
Materials and Methods: Patients with chronic periodontitis who have completed initial periodontal therapy were recruited in
5 centers in Japan. Participants had at least one 2- or 3-wall intrabony defect of ≥3 mm. Surgical procedures included accessfor debridement using the modiﬁed or simpliﬁed papilla preservation ﬂap. Defects were ﬁlled with DBBM and covered with
CB. Periodontal parameters were re-evaluated at 6 months after surgery.
Results: Thirty-six patients were enrolled and completed the study（mean age 53.6 years old, 18 females and 18 males）. At
baseline, mean clinical attachment level（CAL）of the treated site was 8.08±1.58 mm and mean probing depth（PD）was
7.47±1.29 mm. Intrabony component of the defect, measured during surgery, was 4.96±1.83 mm. Throughout the study,
none of the participants underwent any adverse event. At 6 months after surgery, the mean gain in CAL（primary
outcome）was 3.42±1.87 mm. Signiﬁcant improvements were also noted in the secondary outcomes such as PD, Gingival
Index and tooth mobility. A signiﬁcant positive correlation was found between CAL gain and baseline CAL value.
Conclusion: This study showed non-inferiority of the GTR with DBBM and CB when compared with already publishedliterature data. Clinical evidence after 6 months supported the effectiveness of the combination therapy in the treatment of
intrabony defects.

JSP/JACP Poster Session AAP2016

22

GC-03

Biological effects of a-PDT and LDDS in chronic periodontitis

Takahiro Hokari＊1, Toshiya Morozumi1, Yasutaka Komatsu1, Toshiaki Yoshino1,3, Taro Shimizu1,2,Maki Tanaka3, Yoshie Tanaka3, Takehiko Kubota1, Hiromasa Yoshie1
1

Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of
Medical and Dental Sciences,2Oral Implant Clinic, Niigata University Medical and Dental Hospital,3Seikeikai
Hospital, Seikeikai Group
Background and objective: Antimicrobial photodynamic therapy（a-PDT）is a new treatment method for the removal of
infectious pathogens using a photosensitizer and light of a speciﬁc wavelength. We investigated the microbiological andclinical effect of a-PDT and local drug delivery system（LDDS）in chronic periodontitis patients.
Materials and Methods: Twenty-three patients with chronic periodontitis were randomly assigned to two groups:a-PDT and
LDDS. Subjects were received a-PDT（PeriowaveTM）or LDDS（minocycline）twice in periodontal pockets of 2 selected
teeth. Sampling of subgingibal plaque and gingival crevicular ﬂuid（GCF）, and periodontal examination were performed atbaseline, 1 and 4 weeks after. Periodontopathic bacteria were quantiﬁed using the modiﬁed Invader PLUS assay. Multiplex
Array was performed for inflammatory biomarkers from GCF. The data was calculated by Friedman test and MannWhitneyʼs U test.
Results: Counts of P. gingivalis and T. forsythia, and the ratio of those bacteria（to total bacteria）in the LDDS group weresigniﬁcantly decreased after 1 week compared to the baseline（P<0.05）. GCF levels of IFN-γ, IL-1β in the LDDS groupwere also signiﬁcantly decreased after 1 week（P<0.05）. Signiﬁcant reduction of probing pocket depth, clinical attachmentlevel and bleeding on probing in the both group were indicated after 4 weeks（P<0.05）.
Conclusion: It is suggested that a-PDT and LDDS may have clinical effects in periodontal treatment. In particular, LDDS
may be effective on periodontal pathogen and inﬂammatory markers from GCF.

GC-04

Expression of neprilysin in periodontitis-affected gingival tissues

Arata Nezu＊1, Takehiko Kubota1,2, Satoshi Maruyama3, Masaki Nagata4, Makoto Horimizu1,2,
Kaname Nouno5, Takahiro Hokari1, Toshiya Morozumi1,2, Takashi Saku3, Hiromasa Yoshie1,2
1Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate school of
Medical and Dental Sciences, 2Division of Periodontology, Niigata University of Medical and Dental Hospital,
3
Division of Oral Pathology, Niigata University Graduate School of Medical and Dental Sciences, 4Division of Oraland Maxillofacial Surgery, Department of Health Science, Niigata Graduate School of Medical and Dental
Sciences, 5Division of Preventive Dentistry, Niigata Graduate School of Medical and Dental Sciences
Background and objective: The pathogenesis between Alzheimer's diseases（AD）and periodontal diseases have somecommon factors including ageing and chronic inﬂammation but still unclear. To explore the pathogenesis of periodontitis, acomprehensive gene expression/transcriptomes in periodontitis-affected gingival tissues found that the AD pathway wassignificantly up-regulated in periodontitis-affected gingival tissues. AD-related genes, Amyloid beta precursor protein（APP）, interleukin-1 beta and compliment 1QA were signiﬁcantly elevated in periodontitis. In the present study, Balance
between APP and a potent amyloid degradation enzyme, neprilysin（NEP）mRNA expression levels, as well as the protein
localisation of APP and NEP were analysed.
Materials and Methods: Eighteen periodontitis-affected and 18 clinically healthy control gingival tissues were taken frompatients with severe chronic periodontitis or with tooth extraction needs. Total RNA was puriﬁed and used for quantitative
reverse transcription real-time polymerase chain reaction（qRT-PCR）. The localisation of APP was analysed byimmunohistochemistry（IHC）.
Results: The genes both APP and NEP were up-regulated in periodontitis-affected gingival tissues. APP-expressing
macrophages and NEP expression in neutrophils and ﬁbroblasts depends on inﬂammatory stages were detected in inﬂamed
gingival tissues by IHC
Conclusion: The up-regulation of APP and NEP mRNA levels in periodontitis-affected gingival tissues compared withhealthy controls was confirmed by qRT-PCR analyses. Thinking that, NEP is one of the primary enzymes degrading
amyloid beta, the increased NEP mRNA in periodontitis may acts as an inhibitor for amyloid beta in gingival tissues,balancing increased APP mRNA. However, NEP has several effects including degradation of vasoactive substances, further
research are needed.
JSP/JACP Poster Session AAP2016

23

GC-05

Combinational perio-regenerative therapy with/without collagen membrane–A split mouth study-

Takehiko Kubota＊1,2, Yasuko Nemoto1,3,4, Kaname Nouno5, Toshiya Morozumi1,2, Arata Nezu1,
Hiromasa Yoshie1,2
1Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate school of
Medical and Dental Sciences, 2Division of Periodontology, Niigata University of Medical and Dental Hospital,
3
Omote-sando Dental Clinic, 4Yamabuki Dental Clinic, 5Division of Preventive Dentistry, Niigata Graduate Schoolof Medical and Dental Sciences
Background and objective: To compare the clinical outcome in the treatment of periodontal intrabony defects using
deproteinised bovine bone mineral（DBBM）, enamel matrix derivative（EMD）, with or without collagen membrane（CM）.
Materials and Methods: Nine informed consented patients with chronic periodontitis were enrolled. Two defects per patientwith probing depth ≥6 mm were assigned to the treatment with either EMD + DBBM + CM（CM site）or EMD + DBBM
（no-CM site）（n=9 vs. 9）. At baseline and after six months, clinical parameters including probing pocket depth（PPD）,
clinical attachment level（CAL）and bleeding on probing（BOP）and the bone ﬁll % measured by corn beam CT（CBCT）
were recorded. Statistical analyses were done with Wilcoxon S.R. test.
Results: Signiﬁcant decrease in PPD, CAL gain, absence of BOP and increased bone ﬁll were observed at six month after
both regenerative combinations（p<0.05）Changes in PPD（p=0.03）and CAL（p=0.02）decrease were significantly
greater in CM sites compared to no-CM sites at six month examination. The other parameters including the bone ﬁll %, nosigniﬁcant differences were observed between two groups.
Conclusion: Within the limitation of the study, combinations of periodontal regenerative therapy using EMD + DBBM +CM or EMD + DBBM for deep periodontal intrabony defects both improved clinical outcomes. Advantages in PPD decrease
and CAL gain were expected with the use of CM. Further analyses assessing individual periodontal biotype, smoking status,
types of defects and longer prognosis are needed and ongoing.
GC-06

Effectiveness of collagen membrane in combinational periodontal regenerative therapy

Yasuko Nemoto＊1,2,3, Takehiko Kubota1,4, Kaname Nouno5, Toshiya Morozumi1,4, Arata Nezu1,
Hiromasa Yoshie1,41Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate school of
Medical and Dental Sciences, 2Omote-sando Dental Ofﬁce, 3Yamabuki Dental Clinic, 4Division of Periodontology,
Niigata University of Medical and Dental Hospital, 5Division of Preventive Dentistry, Niigata Graduate School of
Medical and Dental Sciences
Background and objective: Aim: To examine the clinical benefit in treatment of periodontal intrabony defects using
deproteinised bovine bone mineral（DBBM）, enamel matrix derivative（EMD）, with or without collagen membrane（CM）.
Materials and Methods: Forty informed consented patients with chronic periodontitis were enrolled. An intrabony defect pera patient with probing depth ≥6 mm were assigned to the treatment with either EMD + DBBM + CM（CM）or EMD +DBBM（no-CM）（n=21 vs. 19）. At baseline and after six months, clinical parameters including probing pocket depth（PPD）, clinical attachment level（CAL）, and bleeding on probing（BOP）and the bone ﬁll % measured by corn beam CT
were recorded. Statistical analyses were done with Wilcoxon S.R. test.
Results: Signiﬁcant decrease in PPD, CAL gain, absence of BOP and increased bone ﬁll were observed at six month after
both regenerative combinations（p<0.05）. Changes in PD（p=0.04）and CAL（p=0.02）were signiﬁcantly greater in CM
compared to no-CM at six month, especially in patients with thick periodontal biotype, with smoking habit and withcontained defects. The other parameters including the bone ﬁll %, no signiﬁcant differences were observed.
Conclusion: Within the limitation of the study, combinations of periodontal regenerative therapy using EMD + DBBM +CM or EMD + DBBM for deep periodontal intrabony defects both showed good clinical outcomes. Advantages in PPD
decrease and CAL gain were expected with the use of CM, however longer prognosis needs to be examined.

JSP/JACP Poster Session AAP2016

24

GC-07

A retrospective study on the effects of Konus-telescope dentures for periodontal patients on the
prognosis of abutment teeth
Makiko Ishii＊, Ayako Yasui, Haruki Kodama, Takuya Iwata, Hisayasu Shinya, Takafumi Suzuki,
Hideharu Otsuka, Joichiro Hayashi, Kitetsu Shin
Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of
Dentistry

Background and objective: The use of prosthetics during treatment for oral rehabilitation in patients with advanced
periodontitis is often challenging because of worsening of the crown-to-root ratio due to bone resorption, movement of theremaining teeth, gingival recession and tooth loss. Following treatment, masticatory dysfunction can occur as a result of
secondary occlusal trauma. Konus-telescope dentures, a type of denture with rigid support, have many superior clinicalfeatures;however, very few reports have examined the effect of dentures on prognosis and periodontal tissue surrounding
abutment teeth suffering from periodontitis from the perspective of periodontal disease. Therefore, the usefulness andapplicability of Konus-telescope dentures in periodontal prosthetics must be examined. This study was conducted to
examine the effects of treatment for oral rehabilitation on the prognosis of abutment teeth and their surrounding tissue inpatients with periodontitis using Konus-telescope dentures.
Materials and Methods: Thirty-two dentures and 217 abutment teeth were examined and compared for prosthetic
parameters and periodontal disease parameters during the initial examination, at insertion of dentures and maintenance.
Results: Each periodontal disease parameter showed a signiﬁcant tendency toward improvement while wearing the denturesand during maintenance as compared with the initial examination. The survival rate of abutment teeth during the observation
period was 96.3%.
Conclusion: These results suggest that good periodontal tissue can be maintained over the long-term with Konus-telescope
dentures through continued, regular maintenance even if the amount of supporting tissue has decreased due to chronic
periodontitis and the abutment teeth are difﬁcult to treat with prosthetics.
GC-08

Periodontal evaluation using sIL-6R/calprotectin in GCF during SPT phaseJung-Hwan Lew＊, Koji Naruishi, Yukari Kajiura, Takahisa Ikuta, Yasufumi Nishikawa,
Jun-ichi Kido, Toshihiko Nagata
Department of Periodontology and Endodontology, Institute of Health Biosciences,
Tokushima University Graduate School

Background and objective: Periodontitis is a chronic inﬂammatory disease, and the supportive periodontal therapy（SPT）
is known as an integral part of periodontal treatment. In the present study, we propose a new method for periodontal
evaluation during SPT phase by determining the cut-off values of solble interleukin-6 receptor（sIL-6R）and calprotectinlevels in gingival crevicular ﬂuid
（GCF）.
Materials and Methods: A total of 16 periodontitis patients during SPT phase were selected and GCF samples were collectedfrom each healthy and inﬂamed site of periodontal pockets in the patients. The relationship between periodontal conditionand sIL-6R/calprotectin levels in GCF was investigated in a cross-sectional study. Cut-off values of sIL-6R andcalprotectin levels in GCF to diagnose periodontitis were determined using a receiver operating characteristic（ROC）
curve.
Results: Both sIL-6R and calprotectin levels in GCF were higher in inﬂamed sites than in healthy sites. When the patientswere divided by gingival index（GI）, sIL-6R and calprotectin levels was higher in GI:1 and GL: 2 groups than in GI:0
group. The sIL-6R level was also higher in BOP positive group than in BOP negative group, although calprotectin level
showed no change between BOP positive and negative group. Cut-off values of sIL-6R and calprotectin levels in GCF to
distinguish the presence or absence of periodontal inﬂammation were as follows: sIL-6R: 43.7 pg/ml; calprotectin:193.7 ng/
ml.
Conclusion: Both sIL-6R and calprotectin in GCF may be useful bio-markers to evaluate the progression of periodontitis inpatients during SPT phase.

JSP/JACP Poster Session AAP2016

25

GC-09

Analysis of the relationship between periodontal disease and diabetes mellitus
Nobuo Yoshinari＊1, Yukiko Iwai1, Akira Taguchi2, Yasuaki Ishioka1, Keita Kubokawa1
Keiichi Uchida2

1

Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental
University, 2Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University,
Nagano, Japan
Background and objective: The purpose of this study was to clarify the relationship between the alveolar bone resorption（ABR）rate, a high-sensitivity C-reactive protein（hs-CRP）level and diabetes mellitus（DM）, used as the indexes ofthe severity classiﬁcation of Japanese Society of Periodontology（JSP）. In addition, we investigated whether the ABR rate
and the hs-CRP level could predict DM.
Materials and Methods: A total of 374 patients（253 men and 121 women）, including 50 already diagnosed DM who
visited medical examination center and department of periodontology, Matsumoto Dental University Hospital and underwent
radiography and the examination of he-CRP comprised the participants. Then, each subject was classiﬁed following thedegree of the severity classiﬁcation of JSP. Logistic regression analysis, adjusted for gender, age, body mass index（BMI）,
the number of present teeth, history of smoking was used. In addition, receiver operating characteristic（ROC）curve
analysis was used to clarify whether the presence of DM was accurately identiﬁed using the ABR rate and hs-CRP level.
The Ethics Committee of Matsumoto Dental University reviewed and approved the study protocol（approved number,
No.0151）.
Results: It was found that the factors associated with DM were age, BMI, ABR rate, hs-CRP values, and risk of DM became
higher that the ABR rate, hs-CRP level are expensive. Furthermore, the ABR rate and hs-CRP value is useful as a screening
indicator of DM was found from the ROC analysis.
Conclusion: It is suggested that the radiograph or hs-CRP examination at dental or medical examinations could lead early
detection, early treatment of DM.
GC-10

Repeating subgingival debridement of periodontal pockets by air polishing
Satoshi Sekino＊1, Tomohisa Ogawa2, Etsuko Murakashi1, Hiroshi Ito1, Hitomi Ishiguro1,
Yukihiro Numabe1

1

The Nippon Dental University, School of Life Dentistry, Department of Periodontology, 2 The Nippon Dental
University Hospital, Division of General Dentistry

Background and objective: The purpose of the study was to evaluate clinical effects of repeating subgingival debridement by
air polishing during supportive periodontal therapy.
Materials and Methods: The double blind, randomized controlled trial of 3month duration was conducted on 18 recall
patients previously treated for chronic periodontitis. Three sites with probing pocket depth（PPD）of 4-9mm and bleedingon probing in each patients were randomly assigned to treatment by（1）Repeating glycine-powder/air polishing every 4
weeks（group 1）,（2）glycine-powder/air polishing once at baseline（group 2）, or（3）water irrigation（group 3）.
Clinical parameter was recorded at baseline and 3 month post-treatment.
Results: Group 1 and 2 results in signiﬁcant reduction in BoP, PPD and clinical attachment level at 3 months. There were
statistically signiﬁcant differences in change in PPD between the group 1 and 3 at 3 month examination.
Conclusion: This study revealed significant clinical effects of repeating subgingival air polishing in moderato to deep
pockets in SPT patients.

JSP/JACP Poster Session AAP2016

26

GC-11

Guided Bone Regeneration using Bone Enhancing Cover Screw（BECS）
Mitsuharu Inoko
Inoko Dental Clinic

Background and objective: BECS（Bone Enhancing Cover Screw）system is developed to locate and ﬁx titanium mesh
（Ti-Mesh）ﬁrmly for bone augmentation around Implant. It enables to make easy environment for bone augmentation bysteady bone graft and eliminating micro-movement of Ti-mesh.BECS have several kinds for each purpose. One of them isfor the bone augmentation to 1 mm above the platform of an implant used in simultaneous approach.
Materials and Methods: BECS system is developed to locate and ﬁx Ti-Mesh ﬁrmly for bone augmentation around Implant.
The BECS simultaneously used with the Implant placement has an anchorage at the top of the bone crest where bone isrequired absolutely so that it can help achieve ideal bone augmentation.
Results: Conventional ﬁxation of Ti-mesh was mostly done by mini-screw. Because of the mechanism of ﬁxation by miniscrew, bone substitute material and/or Ti-mesh were easy to expose, and it required much attention to prevent complications.
The GBR for horizontal bone defect of mandible, which has relatively large number of indicated cases, expedient titanium
mesh extension should be avoided because of thin lingual gingiva especially for mandible. In such cases, BECS can achievesafe and ideal vertical bone augmentation, and can avoid dangerous titanium mesh extension to the lingual side because it
does not need to use mini-screw.
Conclusion: BECS enables to make easy environment for bone augmentation by steady bone graft and eliminating micromovement of Ti-mesh.

GC-12

Periodontal tissue regeneration by adipose tissue-derived multi-lineage progenitor celltransplantation

Masahide Takedachi＊1, Keigo Sawada1, Tomoaki Iwayama1, Satomi Yamamoto1, Chiaki Morimoto1,
Asae Hirai1, Chun Man Lee2, Hanayuki Okura3, Akifumi Matsuyama3, Yuko Sano1,
Masahiro Kitamura1, Shinya Murakami1
1

Department of Periodontology, Osaka University Graduate School of Dentistry, 2 Medical Center for Translational
Research, Osaka University Hospital, 3Research on Disease Bioresources, Platform of Therapeutics for Rare
Disease, National Institute of Biomedical Innovation

Background and objective: Several stem and progenitor cells are currently under investigation for their application in cellbased therapy for periodontal tissue regeneration. We have been revealed the efﬁcacy of periodontal tissue regeneration bytransplantation of adipose tissue-derived multi-lineage progenitor cells（ADMPCs）with experimental periodontitis
models on beagle dogs. The objective of this study was to evaluate the efﬁcacy and safety of transplantation of ADMPCs forperiodontal tissue regeneration in a clinical study.
Materials and Methods: Subcutaneous adipose tissue was harvested by liposuction from a couple of patients withperiodontitis who provided written informed consent. ADMPCs were isolated from the tissue and cultured in a cellprocessing isolator. Each patient underwent ﬂap operation during which we transplanted autologous ADMPCs with a ﬁbrin
carrier material（Bolheal ®）to the bone defect. Before and for 36 weeks after transplantation, patients underwent
periodontal tissue inspection, standardized dental radiographic analysis and a variety of clinical examinations.
Results: 36-week follow up indicated that ADMPCs transplantation resulted in reduction of probing pocket depth, clinicalattachment gain and improvement of radiolucency. This therapeutic efﬁciency was observed not only in 2- or 3-walledvertical bone defects but also in more severe periodontal bone defects. No transplantation-related adverse events wereobserved.
Conclusion: These results suggest that ADMPCs transplantation can induce periodontal regeneration. We expect that theaccumulation of this clinical data will provide the accuracy about not only the efﬁcacy and safety but also the indication inthis ongoing clinical study.

JSP/JACP Poster Session AAP2016

27

GC-13

Interleukin（IL）-35 and IL-17 may play important role in periodontitis

Akio Mitani＊1, Kosuke Okada1, Hisashi Goto1, Yosuke Kamiya1, Takeki Fujimura1, Makio Mogi2,
Makoto Aino1, Toshimitsu Hishikawa1, Toshihide Noguchi1, Takeshi Kikuchi1
1

Department of Periodontology, School of Dentistry, and 2Department of Medical Biochemistry, School of
Pharmacy, Aichi Gakuin University

Background and objective: Interleukin（IL）-35 plays an important role in immune regulation through the suppression ofeffector-T cell populations, especially T helper 17（Th17）cells. While IL-17 and Th17 cells are involved in thepathogenesis of periodontitis, the role of IL-35 in periodontal tissues is unclear. We investigated IL-35 and IL-17
expression in gingival crevicular ﬂuid（GCF）and human gingival tissue, and tested the effect of IL-35 on Th17 cells.
Materials and Methods: GCF samples were collected from patients with periodontitis and healthy controls, and wereanalyzed by ELISA for IL-35 and IL-17. Gingival tissue was collected from 10 healthy participants and 10 patients withperiodontitis, and were analyzed by qPCR for EBI3, IL12A, IL27p28 and IL17A. CD4+T cells were sorted by auto-MACS
from a healthy volunteer, and then Th17 cells were induced by cytokines cocktail. Th17 cells were incubated with or without
rIL-35, and analyzed by qPCR for RORA, RORC and IL17A.
Results: IL-35 and IL-17 were signiﬁcantly higher in GCF from patients with periodontitis than healthy participants（p<0.05）. We found a positive correlation between IL-35 and probing pocket depth and clinical attachment level（CAL）, anda positive correlation between IL-17 and CAL. EBI3, IL12A and IL17A mRNA expression levels were signiﬁcantly higher
in inﬂamed gingival tissue than in healthy control tissues（p<0.05）, but IL27p28 was not detected in any sample. RORA
and IL17A mRNA expressions were signiﬁcantly reduced by addition of rIL-35 in T cells（p<0.05）.
Conclusion: IL-35 and IL-17 may play important roles in the pathogenesis of periodontitis.

GC-14

Association of salivary P.gingivalis with serum antioxidants in hyperlipidemia patients

Hiroyuki Watanabe＊1, Toshiyuki Nagasawa2, Shintaro Shimizu1, Yutaka Terada3, Satsuki Kato1,
Yumiko Konishi4, Mari Mori4, Takeo Maida5, Tomofumi Kawakami4, Hajime Ide6, Masahiro Tsuji6,
Yasushi Furuichi1
1

Division of Periodontology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health
Sciences University of Hokkaido, 2Division of Advanced Clinical Education, Department of Integrated Dental
Education, School of Dentistry, Health Sciences University of Hokkaido, 3Division of General Dentistry, University
Hospital, Health Sciences University of Hokkaido, 4Division of General Dental Sciences, Department of Oral
Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, 5Division of Advanced
Prosthodontics, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido,
6
Division of Internal Medicine, Hospital University, Health Sciences University of Hokkaido
Background and objective: Hyperlipidemia and type 2 diabetes mellitus（T2DM）are major risk factors for atherosclerosis.
Oxygen radicals are generated by the inﬂammation, and oxidative stress is known to enhance atherosclerosis. Purpose of thepresent study was to examine the effects of periodontitis on serum antioxidants in hyperlipidemia patients with T2DM.
Materials and Methods: 110 hyperlipidemia patients with（48 patients）or without T2DM were enrolled in the present
study. Periodontal parameters, including probing pocket depth（PPD）and bleeding on probing（BoP）, were examined.
Serum total cholesterol, HDL, neutral fat, super oxide dismutase（SOD）and uric acid were measured. Salivary
periodontopathic bacteria, including Porphyromonas gingivalis（P.gingivalis）and Aggregatibacter actinomycetemcomitans（A.actimomycetemcomitans）, were quantitated using real time PCR. Spearman's rank correlation test was used to evaluate
the relationship between 2 parameters. Logistic regression analysis was performed using uric acid or SOD as a dependent
variable.
Results: Number of P.gingivalis in saliva was positively correlated with SOD, but negatively correlated with uric acid in
hyperlipidemia patients with diabetes. Logistic regression analysis showed that SOD and uric acid had signiﬁcant positive
and negative association with the number of P.gingivalis in T2DM patients, respectively.
Conclusion: Present study suggested that increase of P.gingivalis might enhance the consumption of antioxidants in
hyperlipidemia patients with T2DM.
JSP/JACP Poster Session AAP2016

Case Report

29

R-01

Anti-infective periodontal surgical therapy for peri-implantitis. A 24-month clinical follow-up
Yoshihide Shirai＊1, Tomoo Kono2, Tsurayuki Takahashi2, Hajime Tabata2, Makoto Umeda1, 2
1Osaka Dental University Hospital, Periodontology, 2Department of Periodontology, Osaka Deantal University

Background: The incidence of peri-implantitis has risen with the increasing use of implants. A number of treatments havepreviously been reported for peri-implantitis. This case report describes the basic periodontal surgery for peri-implantitis.
Case: On April 12, 2013, a 67-year-old woman was admitted to Osaka Dental University Hospital with the chief complaintof pus discharge and bleeding around the implant. There were no remarkable findings in her medical history. Upon
admission, the patient exhibited pus discharge, bleeding from the left maxilla molar implant, PD was 9mm, CAL was 9mm.
Furthermore, X-ray indicated about 1/3 bone resorption. The ﬁndings of the initial examination and diagnosis, as well as thesubsequent general periodontal surgery, and the bleeding on probing were fully described to the patient to help her tounderstand the importance of establishment of plaque control.
Clinical Procedures and Outcomes: This case involved basic access ﬂap and debridement（scaling, lubricated mechanicallysurface, irrigated with saline）. The preoperative PD of 9mm was reduced to 3mm during the 24 months after surgery.
Moreover, CAL also improved from 9mm to 4mm. X-Ray at 24 months, compared with the preoperative examination
showed clear improvement in the alveolar bone.
Conclusion: Surgical treatment for one implant improved the outcome for all four alveolar bones. From the above, but thetreatment for peri-implantitis has been tried non-surgical, surgical methods do peri-implantitis, committed to theestablishment of edge on the plaque control modiﬁed sulcus bleeding index（mBI）（-）is believed to be is that a good result
maintenance is obtained.

R-02

A case of severe chronic periodontitis treated by comprehensive therapy including adjunctantimicrobial therapy
Yuichiro Ihara＊1, Akihiko Katayama1,2, Taneaki Nakagawa1

1

Department of Dentistry and Oral Surgery, Keio University School of Medicine, 2Yurakucho Dental Ofﬁce, Tokyo

Background: Scaling and root planing adjunctive with antimicrobial therapy is the basic approach to control the amount of
periodontal pathogens in the oral cavity. Moreover, periodontal surgery and an orthodontic approach are effective treatments
to eliminate deep periodontal pockets and maintain stable periodontal tissue which leads to an improved prognosis for severe
chronic periodontitis.
Case: A 38-year-old female visited in February 2012 with a chief complaint of a loose lower anterior tooth. She hadreceived periodontal treatment, which included #2,15 extraction and #19 root separation in 2005. However, as thecomplaints had not improved, she visited our hospital.
Clinical Procedures and Outcomes: We harvested GCF from #12, which was the deepest pocket at her first visit. The
percentage of P.gingivalis and T. forsythia in the sample were 81% and 8.6%, respectively. Therefore, we performed fullmouth disinfection adjunctive with oral administration of azithromycin（500 mg once a day for 3 days）. P.gingivalis andT.forsythia were not detected at the time of re-evaluation. After initial periodontal therapy, #14 root resection and apically
positioned ﬂap with free gingival graft were performed. Then the patient was treated orthodontically and ﬁnal prosthodontic
therapy was completed.
At 4-years after initial treatment and antimicrobial therapy, no periodontal pathogen was detected, and the shallow
periodontal pocket maintained stable periodontal tissue.
Conclusion: The result suggests that comprehensive treatment, including periodontal surgery and antibicrobial therapy waseffective to maintain good periodontal tissue and save the teeth in the treatment of severe chronic periodontitis.

JSP/JACP Poster Session AAP2016

30

R-03

Treatment of periodontal intrabony defect in the molar region
Takamasa Ohyagi＊
Dental Ohyagi

Aim: This case discusses the treatment of periodontal intrabony defect in the molar region by means of initial preparation,orthodontic treatment and periodontal regeneration..
Patient: A 46-year-old female ﬁrst visited our clinic in October 2010 with periodontal problems. The last time she visited adentist was a decade ago. She smoked 10-15 cigarettes a day but started quitting smoking at the time.
Examination: The percentage of sites with PPD ≥ 4mm was 20.6%. The percentage of BOP was 31.3%. PPD in the molar
region was ≥ 5mm. PPD at the distal of 17 and 26 were 7mm（both with Grade 2 mobility）. 18 was impacted. PPD at themesial of 27 was 8mm（Grade 3 mobility）. 27 was extruded by the presence of 28. Two-three wall intrabony defect was
found at the distal of 36（7mm PPD, Grade 1 mobility）.
Treatment: 1）extracted 18, 27 and 38, 2）initial preparation 3）with emdogain® regenerated one-three wall intrabony
defect（17 distal）, three wall intrabony defect（36 distal）and one wall intrabony defect（26 distal）. 26 was done after
orthodontically moving 28 to the 27 position, 4）Conducted FGG on 17 as the amount of keratinized gingiva wasinsufﬁcient after the surgery and 5）SPT was introduced when the recovery of the tissues was conﬁrmed.
Conclusion: Bone resorption in the molar region was treated effectively by moving 28 forward and creating one wall defectat the distal of 26 before conducting regeneration. SPT is required to maintain a good prognosis.

R-04

Case report: Occlusal reconstruction of missing maxillary molar teeth using implants
Wataru Atsuta＊, Yuka Atsuta
Blossom dental ofﬁce

Background: Cases of missing maxillary teeth due to reduced periodontal support by periodontitis can lead to rapid toothloss. It can become necessary to administer treatments including periodontal therapy and occlusal reconstruction. We reportthat it was possible to obtain a good follow through these treatments.
Case: This 61 year-old man ﬁrst visited in April 2010, with the chief complaint of occlusal pain at the maxillary molar site.
#17 exhibited mobility（+++）, swelling and pus discharge. #26 and #27 exhibited root fracture. It exhibited vertical bone
resorption and gingival recession in the anterior teeth. Medical History:Sinusitis, Non-smoker.
Clinical Procedures and Outcomes: The initial treatment plan included periodontal therapy, #26 and #27 extraction,
followed by medical treatment of the maxillary sinusitis by an otolaryngologist. After healing of the disease, dental implants
were inserted into the maxillary molars missing teeth area with socketlift and GBR. After treatment of the vertical occlusionof the posterior teeth, gingival ﬂap surgery was performed on the maxillary anterior teeth. After conﬁrming stability of theocclusion, it was determined that the ﬁnal prosthesis would include porcelain fused to zirconia crown as the ﬁnal prosthesis.
Conclusion: Up to 2 years 10 months of maintenance follow-up, there has been no problem with the implant site or theanterior bone formation. In this case of maxillary missing teeth by periodontitis, periodontal therapy and implant treatment
appeared to be very effective.

JSP/JACP Poster Session AAP2016

31

R-05

Long-term management of occlusal plane for generalized severe chronic periodontitis patientwith occlusal trauma
Jiro Hirano＊, Tatsuo Hirano, Naomasa Yasuda, Yuichiro Togashi
Hirano Dental Ofﬁce

Background: Here we report a case involving periodontal treatment and occlusal management administered for a patientwith generalized severe chronic periodontitis associated with occlusal trauma.
Case: A 48-year-old woman came to our hospital on May, 1988. During her thirties, she had experienced gingival swelling.
At the age of 40, her right lower gums grew swollen and painful, hampering her ability to chew and eventually prompting
her visit.
Clinical Procedures and Outcomes: The marginal gingiva were red and swollen. Additionally, numerous periodontal pocketsof 4 mm or deeper were observed. Vertical bone loss was observed at the distal of teeth 15, 25, and 34 and at the mesial ofteeth 16 and 26. Furcation involvement was present in the molar region. Movement was noted in the maxillary teeth,
prompting a diagnosis of generalized severe chronic periodontitis associated with occlusal trauma. Malocclusion was Angle
class-II.
Initial preparation was performed to improve her disposition and to stabilize periodontal tissue. After re-examination,
periodontal surgery was performed. To change the tooth axis to a normal direction, increase arch length, and enhanceocclusal support,MTM was applied, followed by periodontal surgery, including osteoplasty and rehabilitation of masticatory
functions. Two years and ﬁve months after the ﬁrst visit, the patient was transitioned to supportive periodontal therapy.
Conclusion: After the treatment for severe periodontitis patients depending on individual differences, and to control
inﬂammation are essential for a good outcome over extended periods. In addition to reevaluations of periodontal tissue andmaxillomandibular position, appropriate management involves measures monitoring of the occlusal plane and the verticaldimension.

R-06

Regenerative procedures for root canal perforations and bone resorption
Kotaro Tsuchida＊
Tsuchida Dental Ofﬁce

Background and objective: Perforation, which is one of the possible consequences of root canal treatment, may result inbacterial leakage from the root canal, which can lead to alveolar bone destruction and make it difﬁcult to preserve the tooth.
Recently, a mineral trioxide aggregate（MTA）has been used for the treatment of perforations that occur during or after
endodontic therapy, and excellent outcomes have been observed in clinical settings. However, in the case of a perforation on
the labial side of the anterior tooth, the repair using MTA may not be successful in maintaining the esthetic cervical line dueto the severity of the bone defect. I report here on both the regenerative procedures for the treatment of bone resorption
associated with a perforation on the labial side of the maxillary anterior teeth and the therapeutic course.
Materials and Methods: A 37-year-old female. There were two perforations and signiﬁcant bone resorption on the labial
side the tooth. An MTA（Pro root®）was used for perforation repair, and Xenograft（Bio-oss®）and resorbable membrane（Bio-guide®）were used for the regenerative procedures.
Results: After 6 years, the inﬂammation is controlled. There are no gingival recession and esthetic problems.
According to the CBCT, taken ﬁve years after these procedures, the regenerative procedures in the labial side maintained the
newly formed bone.
Conclusion: This case suggests that biocompatibility between the MTA and newly formed bone after regenerative
procedures is excellent.

JSP/JACP Poster Session AAP2016

32

R-07

One-stage full-mouth disinfection for patients with severe intellectual disability
Jin Sekino＊1, Rikako Ishii1, Atsushi Saito2

1

Tokyo Metropolitan Center for Oral Health of Persons with Disabilities, 2Department of Periodontology, Tokyo
Dental College

Background and objective: It is difﬁcult to manage periodontitis in intellectually disabled person, because of limited abilityof self-care and maladaptation to dental treatment. Currently, methods of effective periodontal treatment for the disabled has
not been established in Japan. We report a case of intensive non-surgical periodontal treatment and thorough supportive
periodontal therapy（SPT）implemented for patients with severe intellectual disability.
Materials and methods: Patients were siblings with severe intellectual disability;a 28-year-old female and a 24-year-old
male. They were not able to perform self-care. Because of severe maladaptive behavior toward dental treatment, nontraumatic physical restraint was necessary. They exhibited poor plaque control and severe gingival inflammation. The
clinical diagnosis was generalized aggressive periodontitis. We performed one-stage full-mouth disinfection（Os-FMD）
in combination with antimicrobial therapy using azithromycin, under general anesthesia. After the treatment, they wereplaced under monthly SPT, which included behavior modiﬁcation.
Results: Although tooth brushing instruction was also given to their mother, their level of plaque control showed no
improvement. Systemic azithromycin was administered two days before Os-FMD. After Os-FMD their periodontal
conditions showed improvement and they have been well maintained for two years.
Conclusion: We have demonstrated that Os-FMD combination with antimicrobial therapy is effective in managing theperiodontal condition of individuals with intellectual disability and compromised oral hygiene. Careful SPT with shortintervals to supplement the home care is essential in order to maintain a good periodontal condition for the disabled.

R-08

Interdisciplinary dental treatment of aggressive periodontitis after oral antimicrobial therapy
Masaru Shimizu＊
Alpha dental clinic, Hiroshima Japan

Background and objective: This case report shows the effectiveness of interdisciplinary dental treatment, involving
antimicrobial therapy, periodontal regenerative therapy, implant placement and orthodontic therapy, on aggressive
periodontitis patient.
Case: Age: 33 year old female, non-smoker, healthy
Chief complaint:difﬁculty of mastication
First visit: September 2009
Dental history: the patient has tooth mobility with occlusal pain from 20 year old.
Family history: Grandmother had periodontitis
Periodontal pocket depth was from 3 to 12 mm, BOP was 80%, Mobility of molar was second or third degree
Diagnosis: Aggressive periodontitis with secondary occlusal trauma
Clinical Procedures and Outcomes:① Full mouth disinfection in conjunction with systemically administered Azithromycin（FMD）② Periodontal regenerative therapy③ Implant placement（#16,26）④ Orthodontic therapy⑤ Building shortened dental arch
Conclusion: The keys in this case are FMD with Azithromycin , qualitative control of bacteria in periodontal pockets,
implant placement as an anchor, regenerative therapy, obtain thick and ﬂat alveolar bone , and continuous follow up.

JSP/JACP Poster Session AAP2016

33

R-09

A Case Report of Chronic Periodontitis with Diabetes Treated by Regenerative Therapy
Fumi Seshima＊1, Hiroyuki Asai2, Junichi Takahashi3, Atsushi Saito1

1

Department of Periodontology, Tokyo Dental College, 2Asai Dental Clinic, 3Shiodome Takahashi Dental Clinic

Background and objective: Periodontal disease has been recognized as the sixth complication of diabetes mellitus. Studies
have shown that treatment for periodontal disease can improve diabetes, and diabetes treatment improves periodontal
condition. We report a case of generalized chronic periodontitis and type 2 diabetes mellitus requiring periodontal treatment
including regenerative therapy.
Case: The patient was a 66-year-old man who presented with the chief complaint of gingival inﬂammation and mobile teeth
in the molar region. He had been being receiving treatment for type 2 diabetes mellitus since 1999. His glycated hemoglobin（HbA1c）level was 7.8%. An initial examination revealed sites with a probing depth of ≥7 mm in the molar region, andradiography revealed angular bone defects in this area. A clinical diagnosis of generalized chronic periodontitis was madeaccording to the classiﬁcation of the American Academy of Periodontology（1999）.
Clinical Procedures and Outcomes: The patient underwent initial periodontal therapy. An improvement was observed inperiodontal conditions on reevaluation, and his HbA1c level showed a reduction to 6.9%. Periodontal regenerative therapies
with enamel matrix derivative（EMD）were performed in #26 and 27. Autogenous bone graft was applied with EMD in#16. Following another reevaluation, a removable partial denture was fabricated for #47 and the patient placed on supportive
periodontal therapy（SPT）.
Conclusion: The results suggest the potential improvement of HbA1c levels by periodontal therapy, indicating theimportance of collaboration between dentist and physician in managing periodontal and diabetic conditions.

R-10

Multiple procedures（orthodontic treatment, hard and soft tissue management around theimplant）were carried out to improve peri-implant environment: a case report
Takao Kannari＊1, Masahiko Nikaido2
1

Aozora Dental Ofﬁce, 2Nikaido Dental Ofﬁce

Background: This case report describes improvement of the peri-implant environment by localized orthodontic treatment（LOT）, implant with bone augmentation, and free gingival graft（FGG）for a patient with tooth malalignment due to lossof teeth.
Case: This 44-year-old male with moderate periodontitis underwent LOT for mesially inclined #37 after initial preparation
for periodontitis, and implant placement for the lost part of #36 with simultaneous guided bone regeneration（GBR）. Six
months after the placement, FGG was performed to increase the peri-implant keratinized mucosa and cover the root surfaceof the adjacent tooth with gingival recession.
Clinical Procedures and Outcomes: Correction of #37 by LOT secured the space for implant placement to #36, andsimultaneous GBR was performed due to augment a narrow residual ridge. Since keratinized mucosa was insufﬁcient, FGG
was performed to ensure proper oral hygiene. Through these procedures, keratinized mucosa could be obtained around theimplant. After 3.5 years the surgery, no peri-implant inﬂammation is observed, and plaque control remains favorable. In
addition, the adjacent tooth sensitivity was diminished by covering the root surface.
Conclusion: Peri-implantitis is a multi-factorial disease. To prevent this disease, great caution has to be paid to develop thesite adequately with periodontal therapy for residual teeth, orthodontic treatment for alignment and bone augmentation if
they are needed. Also superstructure design is essential.
Although the necessity of peri-implant keratinized mucosa remains controversial, periodontally susceptible patients may
require keratinized mucosa. However, since the treatment is highly invasive, careful consideration should be paid to avoid
overtreatment.

JSP/JACP Poster Session AAP2016

34

R-11

Treatment of a patient with generalized advanced chronic periodontitis utilized periodontal
regenerative therapy and localized orthodontic treatment: 7.5- year follow up
Misa Satomi＊1, Masahiko Nikaido2
1

Paciﬁc Century Place Marunouchi Dental Clinic, 2Nikaido Dental Ofﬁce

Background: We report a case of a patient who presented with advanced periodontitis. #37 had vertical bony defect which
was treated by periodontal regenerative therapy, followed by localized orthodontic treatment（LOT）. After active therapy,
the patient has been placed in supportive periodontal therapy（SPT）for 7.5 years.
Treatment: A 61-year-old male initially visited on February 28, 2006 with the chief complaint of pain on mastication on left
maxillary molars. His medical history revealed unremarkable and he had quitted smoking 12 years ago.
Poor oral hygiene, gingival enlargement and redness were observed throughout the whole mouth with plaque control record（PCR）: 88.0%, bleeding on probing（BOP）: 81.5% and average probing pocket depth（PPD）: 4.2 mm. X-ray ﬁndings
revealed that horizontal bone loss was observed for most of teeth, associated with vertical bone loss for #24, 37 and #38.
Also #37 and 38 were mesially inclined.
Clinical Procedure and Outcomes: 1. Initial preparation（oral hygiene instruction（OHI）, scaling/root planing（Sc/Rp）,
extraction of #17, 24 and 38）, 2. Re-evaluation, 3. Surgical periodontal treatment（open ﬂap debridement（F.op）for #1316 and #25-27, and enamel matrix derivative application a autogenous bone graft for #37）
, 4. Re-evaluation, 5. LOT（upright of #37）
, 6. Implant placement, 7. Re-evaluation, 8. Prosthodontics, 9. SPT（PCR: 8.0%, BOP: 8.0%, average
PPD: 3.0 mm）.
Conclusion: #37 could be successfully treated with periodontal regenerative therapy and LOT. At present, 7.5 years havepassed since the patient has placed in SPT, We will continue to provide SPT to maintain his dentition and an implant.

R-12

Periodontal Treatment in Chronic Periodontitis Involved Occlusal Trauma: A Case Report
Nobuhiko Inagaki＊
Midorigaoka Dental Clinic, Tokyo, Japan

Background and objective: Excessive occlusal force has been known as the factor enhancing the degree of periodontal
destruction of periodontally compromised tooth. Occlusal adjustment as a part of periodontal therapy has been controversial
for years. The purpose of this case report is to demonstrate the effects of occlusal adjustment, associated with periodontal
therapy, on periodontal parameters.
Materials and Methods: A 60-year-old female patient presented with discomfort of #24 and 46. #17 has been extracted 7-8
years ago due to poor prognosis. Class III furcation involvement, mobility class II as well as vertical bone loss wereobserved on multiple teeth. Patient was diagnosed as localized chronic moderate periodontitis.
Results: Following initial therapy, #26 was removed due to poor prognosis, but #27 was preserved and well functioned. The
periodontal regeneration, using Enamel Matrix Derivative（EMD）has been applied to vertical bone loss on the mesial of#36 as well as the root separation was performed for the furcation involvement of #46. #48 was transplanted to maxillary
right partial edentulous area and #35 and 45 were moved orthodontically for occlusal force distribution. A significant
improvement of periodontal condition was achieved after therapy.
Conclusion: This case demonstrated the signiﬁcance of periodontal treatment in conjunction with occlusal adjustment to
reduce the progression of periodontal attachment loss. A success to key to treat chronic periodontitis involved occlusal
trauma, especially for patients with multiple missing teeth was to adjust occlusion to increase the number of tooth supporting
occlusion following inﬂammation control.

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R-13

Generalized severe chronic periodontitis treated with regenerative therapy
Satoru Morikawa＊, Takehito Ouchi, Taneaki Nakagawa
Department of Dentistry and Oral Surgery, Keio University School of Medicine

Background: In persons with type 2 diabetes mellitus, control of generalized severe periodontitis is considered to be more
difﬁcult than that of chronic periodontitis. This is due to the complex etiology of generalized severe periodontitis, which ischaracterized by poor wound healing and increased susceptibility to infection. In this report, regenerative treatment with anenamel matrix derivative and autologous bone graft was used to control generalized severe periodontitis and regenerate lost
periodontal tissues.
Case: The patient presented with generalized severe periodontitis, type 2 diabetes mellitus, high blood pressure andhyperlipidemia. Glycemic control was assessed using glycated hemoglobin（HbA1c）concentrations.
Clinical Procedures and Outcomes: After evaluation, additional diagnostic measures and consultation, an aggressive
treatment regimen was developed to eliminate pathogens, regenerate lost tissues and help maintain oral health. After initialperiodontal therapy, periodontal lesions were treated with regenerative therapy using an enamel matrix derivative andautologous bone graft. Patient response was favorable, marked by an elimination of the multiple osseous defects. This result
was maintained for 2 years.
Conclusion: This case report presents the successful management of a 58-year-old male with type 2 diabetes mellitus andgeneralized severe periodontitis. The treatment approach combined a regenerative technique employing an enamel matrix
derivative with conventional therapies. Through effective maintenance approaches, favourable results have persisted for 2
years.

R-14

Treatment for Moderate chronic periodontitis with occlusal trauma
Yuri Komai＊, Yasunori Yosinaga Ryuji Sakagami
Section of Periodontology, Fukuoka Dental College

Background: Traumatic occlusion is one of the risk factors for the progression of periodontal disease. In this report occlusal
treatments, i.e., occlusal adjustment and instruction to stop bruxism were provided to a moderate periodontitis patient at thetime of the initial treatment. The patient received conventional periodontal treatment including periodontal surgery, andsuccessful results were obtained in this case report.
Case: 39 year old female. Chief complaint of “mobile back teeth”. She came to our clinic because her general dentist pointed
out the progression of periodontitis. Oral hygiene status was good. Moderate swelling and redness of gingiva were noted. In
the upper molar area, more than 6 mm of probing pocket depths were observed. Vertical bone defects were noted in theupper molars and upper incisors.
Diagnosis: Moderate chronic periodontitis;Occlusal traumatism
Clinical Procedures and Outcomes: Occlusal interferences during anterior/lateral jaw movement were adjusted, and fremitus
was removed. After the reevaluation, ﬂap surgery was performed to the area with the pocket depth of more than 5 mm.
Periodontal condition was reevaluated 6 months after the surgery, and it revealed that the mobility of the teeth reduced from
grade 2 to grade 1 by the treatment. It was also conﬁrmed that the periodontal pocket depth became less than 4 mm after thetreatment. The patient was put in the supportive periodontal therapy.
Conclusion: Achievement of good oral hygiene with deﬁnitive occlusal treatment at the time of the initial treatment showed
successful treatment result.

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R-15

Treatment of severe periodontal defects with EMD
Taishi Hirose＊, Makiko Hirose, Tetsushi Hirose
Yokohama Kannai perio-Implant Institute（Yuraku Dental Ofﬁce）

Background and objective: We report regenerative procedure for severe periodontal defects with enamel matrix derivative（EMD）
Materials and Methods: A 38-year old female complained of severe pain of gum on the lower anterior teeth. The patient isin excellent health and reports no history of any systemic disease or any problem, which would preclude dental treatment.
Tooth #5, #12, #21, #28 are missing due to the orthodontic treatment from in the past.Upon perio-examination of the patient,
we formulated a diagnosis of generalized severe periodontitis. Pocket depth ranging from 3 to 9 mm with some gingival
recession.Radiographically, we observed severe horizontal and vertical bone loss around all teeth. After obtaining informed
consent and phase 1 therapy, we began a regimen of regenerative treatment with EMD. Prior to the regenerative treatment,
mobile tooth were splinted.
Results: Pocket depth ranging from 2 to 4 mm with some additional gingival recession. Some clinical attachment gain foundmost of defective sites.
Conclusion: Regenerative therapy with EMD might be an effective treatment for severe periodontal defects.

R-16

A case report of Periodontal Therapy for moderate chronic periodontitis with Occlusal Trauma
Hiroyuki Suzuki＊
Soar-bld. dental clinic

Background: Persistent inflammation, often due to bacteria, destroys periodontal tissue and is accelerated by trauma.
Inﬂammation suppression by plaque control, easy-to-clean periodontal environment, and bite force dispersion maintain andstabilize the periodontal tissue.
Case: A 45-year-old female presenting with a chief complaint of pain in the upper-left teeth was diagnosed with moderatechronic periodontitis with occlusal trauma and underwent periodontal and orthodontic treatment. . At the initial visit, probing
depth was ≧ 6 mm for #16, 17, 26, 27, 36, 37, 46 and 47;tooth mobility was Grade I;and vertical bone resorption reaching
to the root tip and widening of periodontal space were observed by X-ray. Moreover, #36 and #46 had Grade II and GradeIII furcation area lesions, respectively.
Clinical Procedures and Outcomes: Plaque control, scaling and root planing of the entire mouth, and gingival ﬂap operationof #14-17, 25-27 and 35-37 were followed by orthodontic treatment. Apically positioned ﬂap surgery including surgicalprocedure of the bone was conducted for #46.The periodontal tissue was improved by prosthesis of #13-23, 25-27, 35, 36
and 46;therefore, treatment was changed to SPT.
Conclusion: The inflammation was improved by the periodontal treatment, and the anterior guidance was ensured byanterior teeth prosthesis after the orthodontic treatment. Moreover, the bone level was planarized by the root separation of#46, and an easy-to-control oral environment was established. Inflammation control, confirmation of the occlusal
relationship, and continuous SPT should be implemented in the future.

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R-17

Osteonecrosis of the jaw associated with oral bisphosphonate and implant
Eiji Ichimaru＊1, Yoichiro Ogino2, Takuma Nishi1, 3, Kiwako Ogawa1, Kiyoshi Koyano2,
Ryusuke Yamaguchi1

1

Shin-Tosu Periodontal and Implant Dentistry Center, Ichimaru Dental Ofﬁce KURANOUE, Saga/JP, 2Section of
Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu
University, Fukuoka/JP, 3Sakura Dental Ofﬁce, Nagasaki/JP.

Background: Since there are few reports about medication-related osteonecrosis of the jaw（MRONJ）associated with oral
bisphosphonate（BP）and dental implant removal, the non-exposed osteonecrosis（NE-MRONJ）for such a case wasreported.
Case: Clinical procedure and outcomes: An 83-year-old male received twelve implants from 2005 to 2007, including one
at the position of 17 in June 2007, at a private practice in Japan. Installation of the superstructures was completed in March
2008. BP（Fosamac®）had been administrated orally for osteoporosis treatment since November 2006 till July 2011.
Although the implants had functioned uneventfully, the 17-implant observed mobility was removed with small amount ofbony tissue in October 2010. A cavity was observed in the removal site, seven weeks after the loss, with φ1mm of the entrance,
φ3-4mm wide, 10mm deep, and roughness like bone surface inside, without any sensation. Infectious signs, such as
suppuration, were observed 13 weeks after the loss. The cavity had remained with a little change at least for 10 months after
the loss.
The retrospective radiological observation revealed that sequestered dense woven bone expanded from the mesial site of theimplant in Oct 2007 to the all-around in Oct 2010, and that unremodeled bone had been persistent after the implant removal.
We, therefore, diagnosed this case as NE-MRONJ.
Conclusion: Although MRONJ is reported a rare complication with the risk of dose/time dependent, this case reported thateven oral-low-dose administration of BP for the relatively short duration caused NE-MRONJ associated with dental
implant removal.
R-18

A case report of guided bone regeneration therapy for generalized chronic periodontitis
Seiji Ozaki＊
OZAKI DENTAL OFFICE

Background and objective: I present here a comparative report of clinical outcome of guided bone regeneration（GBR）
therapy at 1-and 2-year follow-up points for a patient diagnosed with generalized moderate chronic periodontitis withocclusal trauma. A 53-year-old man came to our hospital on February 21, 2013 presenting with the chief complaints ofgingival swelling, pain, and tooth mobility for tooth 41. Periodontal probing depths were<3 mm（54.8%）, 4-5 mm（22.1%）, and >6 mm（23.1%）. Vertical osseous defects were observed in the areas of teeth 36 and 45. Premature contact
was observed for teeth 27 and 36.
Clinical Procedures: The patient underwent the following course of treatment: 1）basic periodontal therapy; 2）reexamination; 3）GBR therapy（for teeth 36 and 45）using EMDOGAIN® and Bio-Oss®; 4）implant treatment for tooth46; 5）rehabilitation of oral function; 6）re-examination;and 7）SPT
Results: The periodontal tissue of tooth 41, for which the patient had reported the chief complaints were stabilized. GBR
therapy applied to teeth 36 and 45 for vertical osseous defects improved the stability of the corresponding alveolar bone.
Conclusion: Basic periodontal therapy improved the condition of the periodontal tissue, premature contact was eliminated,and occlusal support was established at the right and left molar regions to allow anterior guidance to be achieved, thereby
stabilizing the periodontal tissue throughout the jaw. We believe that the most important factors in this case were thecleaning and occlusal examination and adjustment performed at SPT every 4 months, and maintaining patient motivation to
perform daily home care.

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R-19

Non-surgical management of drug-induced gingival hyperplasia: a case report
Satoshi Ozaki＊
Ozaki Dental Clinic

Case: A 55-year-old woman visited us with the main complaint of gingival swelling and bleeding in July 2011. In 2009, she
had experienced subarachnoid bleeding and had been taking a calcium antagonist（ADALAT）since then. Bleeding on
Probing（+）72%, 4 mm ≥ periodontal pocket（62%）, and significant swelling of gingiva throughout both jaws werenoted.
Moreover, a prosthetic appliance was installed in the maxillary connecting from #17 through to #24. This installation was
suspected as the cause of dislocation of the lower jaw to the left.
Diagnosis: Localized severe chronic periodontitis associated with drug-induced gingival hyperplasia
Treatment strategy: Through basic treatment for the periodontal area including a change of medication, inﬂammation andswelling were expected to be reduced. For the lower jaw, a stabilization splint was implanted to maintain a relaxed position
and to re-constitute articulation at a stable jaw position.
Clinical Procedures and Outcomes: A standard periodontal treatment was provided. As a result, without medication change,
the gingiva contracted with only plaque control, and the periodontal pocket reduced to 3 mm or less throughout the jaw.
Thereafter, the jaw position was evaluated and articulation adjustment was repeated. The jaw position changed and the upper
anterior teeth with fragile periodontal tissue demonstrated signiﬁcant improvement on dental X-ray.
Prosthesis treatment was provided to the entire jaw. Three years after the shift to supportive periodontal therapy, periodontal
tissue was stable.
Conclusion: This case suggested that through extensive plaque control, drug-induced gingival hyperplasia could be
improved without medication change. Moreover, the dislocated jaws might have accelerated the destruction of theperiodontal tissue.

R-20

Esthetic correction of maxillary anterior ridge deformity, caused by failed implant
Katsumi Masuda＊1, Yoshihiro Shibukawa2, Masahiko Nikaido3
1

Fukuoka Dental Clinic, 2Shibukawa Dental Clinic, 3Nikaido Dental Clinic

When peri-implantitis becomes advanced, removal of implants is needed. However, it causes loss of peri-implant tissue.
Especially if this is the case in anterior esthetic zone, it creates major esthetic problem. In this case presentation, a failed
implant in maxillary incisor area was removed and its esthetic and functional problem has been recovered with alveolar
ridge augmentation, utilized connective tissue graft.
Case: Patient:55-year-old female, First visit:June, 2012, Chief complaint:discharge of pus from peri-implant pocket of #21.
Radiographic finding: #21 implant was located far apically from the alveolar ridge with significant resorption of thesurrounding bone.
Diagnosis: #21 Peri-implantitis, generalized moderate chronic periodontitis,
Treatment plan:
1）Initial preparation（OHI, scaling/root-planing）, #21:implant removal, 2）re-evaluation, 3）alveolar ridge
augmentation with connective tissue graft, 4）re-evaluation, 5）occlusal functional recovery treatment, 6）SPT
Clinical procedures and outcome: After initial preparation, we decided to remove #21 implant, caused tremendous amountof loss of tissue in terms of both apico-coronal and labio-palatal dimension（i.e. Seibert Class III）
. We performed a
combination onlay-interpositional graft to recover the ridge both esthetically and functionally. After it was healed, ﬁxed
partial denture has been placed. Three years post-operation, the periodontal tissue has been well maintained.
Conclusion: The implant removal, which had been placed far apically, caused major ridge deformity（Seibert Class III）in
maxillary anterior area. Surgical correction of the Seibert Class III ridge defects is still a clinical challenge, however, wewere able to obtain good result with a single connective tissue graft.

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R-21

Treatment with EMD in conjunction with bovine bone grafts
Yoshihiro Iwano＊1,2, Shuichi Sato2,3

1

Iwano Dental Clinic, 2Department of Periodontology, 3Division of Advanced Dental Treatment, Dental ResearchCenter, Nihon University School of Dentistry

Background: Although several reports have investigated the clinical effectiveness of enamel matrix derivative（EMD）in
conjunction with bone grafts in the treatment of intrabony defects, this is not an established approach. We report 3 cases oflarge intrabony defects that showed good prognosis after treatment with EMD in conjunction with bovine porous bonemineral（BPBM）.
Case: Case 1: A 54-year-old woman received treatment for the medial aspect of #3. Baseline probing depth（PD）was 10mm, attachment loss（AL）was 11 mm, bone defect angle（BDA）was 40°and class Ⅱ furcation involvement was noted.
Case 2: A 47-year-old woman received treatment for the distal aspect of #18. Baseline PD was 12 mm, AL was 12 mm and
BDA was 40°. Case 3: A 47-year-old woman received treatment for the distal aspect of #25. Baseline PD was 7 mm, AL
was 7 mm, and BDA was 45°.
Clinical Procedures and Outcomes: After initial preparation, periodontal regenerative therapy using EMD in conjunction
with BPBM was performed. Case 1: The MMPT incision technique and horizontal cross-mattress sutures and 2 simple
sutures were used. Case 2: Distal wedge lined incision and simple sutures were used. Case 3: The SPPF incision techniqueand modiﬁed vertical mattress sutures were used.
At the time of re-evaluation, PD and CALgain were 4, 3, and 2 mm and 6, 7, and 5 mm, respectively.
Conclusion: The combined use of EMD and BPBM may produce good clinical improvement in the treatment of large
intrabony defects.

R-22

A case of localized severe chronic periodontitis
Shogo Wakamatsu＊
Ogikubo Wakamatsu Dental Clinic

Background: Patients with severe periodontitis often struggle to restore and stabilize their periodontal tissue to a state inwhich management by supportive periodontal therapy（SPT）can be continued. We report a case of a patient with severe
periodontitis in whom periodontal tissue was successfully stabilized .
Case: The patient was a 28-year-old woman with a history of smoking. Her condition was initially diagnosed in February
2010, with chief complaints of gingival swelling and bleeding during brushing. The patient had not visited a dentist in 10
years.
The patient was conﬁrmed to have marked localized progression of periodontal disease. O bservation of a large amount of
subgingival tartar deposits led to a diagnosis of localized severe chronic periodontitis.
Treatment and Results: We ﬁrst waited before performing basic periodontal therapy. A clenching habit was noted at thistime, for which autosuggestion was encouraged as a treatment for para-function. As a result, recovery was seen at sites witha deep probing depth on probing and X-ray examinations. To achieve further recovery, periodontal surgery was performedin the molar region, where probing depths remained. Thereafter, stabilization of periodontal tissue was observed, despite
residual deep probing depths. The patient was subsequently switched to SPT.
Conclusions: The good results in the present case were likely the result of the patientʼs young age, the good responsivenessof the periodontal tissue to removal of bacterial factors and associated improvement in the patientʼs motivation, as well as
the patientʼs cooperation in her treatment.

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R-23

Treatment of periodontal intrabony defects and furcation involvement in molars
Yusuke Okada＊
Nakano Station South Dental Clinic

Objective: This poster discusses a case where intrabony defect and furcation involvement in molars were treated by initial
preparation, root separation, root extraction and periodontal regeneration.
Patient: A 48-year-old male visited our clinic in August 2014 because of pain in the upper left teeth that had been causing
difﬁculty in eating. He smoked 10-15 cigarettes a day and had not been to a dentist for a decade.
Examination: The percentage of sites with PPD ≥ 4mm was 32.1%. The percentage of BOP was 46.9%. Vertical bone
defects on molars were found. The pain was coming from 26 where PPD was 10mm with grade 2 mobility. PPD was 10mm
at the distal of 17 with grade 3 furcation involvement. PPD at the center of 37 was 12mm, with grade 3 furcation
involvement. Both 24 and 25 had 12mm PPD with grade 2 mobility.
Treatment plan: initial prepration with plaque control, root canal treatment, natural shifting of loose teeth, periodontal
surgical treatment, temporary splint, provisional restration, prosthetic treatment and SPTTreatment: Initial preparation including plaque control was performed. The distal root of 17 was extracted. Root separationof 37 was conducted. Two wall bone defect（26 distal and mesial）and one-three wall bone defect（27 mesial）were
regenerated with emdogain®. SPT was introduced when the recovery of the tissues was conﬁrmed.
Conclusion: Bone resorption in molars was conﬁrmed. Periodontal tissues had been recovered by having 27 and 28 naturally
shift and regenerating the defects. SPT is necessary to monitor the prognosis.

R-24

Case report: Extensive severe chronic periodontitis in a diabetes patient
Masayuki Kamada＊1, Yorimasa Ogata2
1

Kamada Dental Clinic, 2Department of Periodontology, Nihon University School of Dentistry at Matsudo

Objective: We report a case of improved periodontal tissues in a diabetic patient with extensive severe chronic periodontitis
through basic periodontal therapy to improve his lifestyle habits.
Materials and Methods: A 54-year-old male patient ﬁrst visited in November 2011.
Chief complaint: Bleeding from the alveolar ridge
History: Diabetes
Dental history: Visited our clinic 10 years ago
Exploratory/test findings: Ten years ago, the patient developed diabetes, which remained untreated until today. His oralcavity was unclean with reddened and swollen gingiva, deep probing depth, and many mobile teeth throughout the jaw.
Dental X-ray showed loss of alveolar crest lamina dura, bone absorption reaching the apex of the tooth root, and verticalbone defects in many teeth. Although no abnormal findings were observed in the temporomandibular joint, flare out ofmaxillary anterior teeth, and minimal intercuspal positioning with the left molar region were conﬁrmed, suggesting difﬁcultywith strong biting.
Diagnosis: Extensive severe chronic periodontitis
Therapeutic plan: 1）basic periodontal treatment, 2）preparation of therapeutic dentures, 3）reevaluation, 4）prosthesis
treatment, 5）reevaluation, 6）supportive periodontal therapy（SPT）
Results: Dental X-ray in SPT showed clear alveolar crest lamina dura, trabecular bone, and no enlarged periodontal
ligament space, suggesting stable periodontal tissues and occlusion. However, HbA1c increased recently from 6.5 to 8.5,
suggesting unstable diabetes and the potential for periodontitis recurrence.
Conclusion: At present the patient visits us once every 4 months for maintenance. In future, the physician should promote
aggressive diabetes treatment, and we will continue to support the patient with plaque control and maintenance of healthy
lifestyle habits.

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R-25

Follow-up of patient with generalized severe chronic periodontitis over a 21-year period
Mitsutaka Funakoshi＊
Funakoshi Dental Ofﬁce

Background: We report herein on a 21-year follow-up of a case of generalized severe chronic periodontitis with furcation
involvement, which was treated with supportive periodontal therapy（SPT）after initial periodontal and prosthetic
therapies.
Case: A 46-year-old woman December 1, 1995 presenting with a complaint of loose back teeth. History of the present
illness:The patient had visited another hospital due to a one-year history of movement in the molar region and was informedthat ﬁve teeth needed to be removed. Prompted by her anxiety about this recommendation, she came to our hospital after
being referred by her acquaintance.
Inﬂammation of the marginal gingiva, deep periodontal pockets, interproximal open contacts, tooth motility and furcation
involvement were observed throughout the jaw.
Diagnosis: Generalized severe chronic periodontitis.
Treatment plan: The following procedures were performed:1）basic periodontal therapy; 2）re-examination; 3）
periodontal surgery; 4）re-examination; 5）rehabilitation of oral function; 6）re-examination; 7）SPT.
Treatment Procedures and Outcomes: Following the re-examination, the patient underwent periodontal surgery, including
removal of the root . A final prosthesis was subsequently delivered to establish stable occlusion and to stabilize theperiodontal tissue, after which the patient was again transitioned to SPT.
Conclusion: In the present case, reconstruction of occlusion improved strength control and the periodontal environment.
Additionally, the patient's improved dietary habits, thorough plaque control, and SPT have continuously suppressed gingival
inﬂammation, thereby stabilizing periodontal tissue, including the furcation region, for a signiﬁcant period（21 years）.

R-26

A Case Report; 14 years after treatment of chronic periodontitis,which has a number of short-root teeth
Shoji Ishitani＊
Ishitani Dental Ofﬁce, Tokyo, Japan

Background and objective: It report about a case of periodontal treatment, localized orthodontic treatment, prosthetic
treatment, performs maintenance, and on the case was held for 14 years to generalized chronic periodontitis patients with a
lot of short root teeth.
Case: Patient;50-year-old, male, Non-smoker First visit;2000 July 15th Chief complaint;Smarting in the lower right backteeth both cold things and warm things
Problems; ① Deep periodontal pockets and bleeding ② Signiﬁcant tartar deposits ③ Canine relationship Class Ⅱ both left
and right ④ Many short root teeth
Diagnosis; Generalized chronic periodontitis with secondary occlusal trauma
Clinical procedures and Outcomes: ① upper left molars; #12 tooth extraction, #14 palatal root resection, and resective
therapy② lower right molars; #30 distal root resection and resective therapy, localized orthodontic treatment for #30 mesial root
③ lower left molars;regenerative therapy（GTR and bonegraft）#14 buccal root was extracted by poor prognosis, and bridge were set to left upper, right upper, and left lower.
Conclusion: This case was appeared to be a large inﬂuence of occlusal trauma cause have many short-root teeth. It has
gotten a relatively good course by firmly carry out the management of the occlusion from the basic treatment tomaintenance. In addition, the prognosis of reliably performed resective therapy seems to be good. I conducted a careful
maintenance without missing the subtle changes in the oral cavity future.

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R-27

Aggressive Periodontitis Associated with Palmoplantar Pustulos
Takaaki Sakuma＊1, 4, Toshizo Toyama2, 4, Keiso Takahashi3

1
3

Sakuma Dental Clinic, 2Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University,
Division of Periodontics, Department of Conservative Dentistry, Ohu University School of Dentistry, 4 The Japan
Institute of Advanced Dental Studies

Background and objective: Palmoplantar pustulosis（PPP）is a skin disease characterized by pustule formation, erythema,and scaling of the affected skin of the palms and soles. It has been suggested that PPP is caused by metal allergy and focal
infection of tonsils and/or periodontium. However, its etiology remains unclear. The aim of this study is to highlight thepathogenesis of a patient with generalized aggressive periodontitis（gAp）and PPP from the standpoint of periodontal
medicine and comprehensive periodontal treatment performed.
Materials and Methods: A 36-year-old man who had been suffering from gAp and PPP. He has not been suffered fromtonsillitis and no metal restoration was done in his mouth. We have examined 1）presence of putative periodontal bacteriaby 16S rRNA-based polymerase chain reaction, 2）inﬂammatory markers and 3）serological type of HLA class II antigens.
Comprehensive treatments including periodontal, orthodontic and dental implant were successfully performed.
Results: Mean pocket depth, Scheiʼs bone loss index and gingival index were 5.2 mm, 57 % and 1.7, respectively.
Bacteroides forsythus was detected from many sites, while neither Porphyromonas gingivalis nor Actinobacillus
actinomycetemcomitans was detected at all. High values of CRP, α-1 anti-trypsin, C3, IgG and IgA but no autoantibodies
in serum were found. HLA-A11, A24, B52, B62, HLA-DR4, 15, DQ1, 3 were detected. Although periodontal treatment was
successfully performed, the values of inﬂammatory markers and clinical ﬁndings of this patient were not improved.
Conclusion: Further studies focusing the association of periodontal infection with refractory dermal diseases including PPP
will be required.

R-28

15 years follow-up of patient with generalized severe chronic periodontitis
Yorinobu Ikeda＊
IKEDA DENTAL OFFICE

Background and Objective: We report herein on a 15-year follow-up of a case of generalized severe chronic periodontitis
with furcation involvement, which was treated with supportive periodontal therapy（SPT）after periodontal regenerationand prosthetic therapies.
Case: A 38-year-old woman May 9, 1998 presenting with a complaint of loose back teeth and back teeth of the gingiva isswollen many times. History of the present illness:The patient noticed that the gum is swollen from two years ago. She camebeen introduced by her friend to our ofﬁce.
Inﬂammation of the marginal gingiva, deep periodontal pockets, interproximal open contacts, tooth motility and furcation
involvement were observed throughout the jaw.
Diagnosis: Generalized severe chronic periodontitis .
Treatment plan: The following procedures were performed: 1）basic periodontal therapy; 2）re-examination; 3）
periodontal surgery including regeneration therapy; 4）re-examination; 5）rehabilitation of oral function; 6）reexamination; 7）SPT.
Treatment Procedures and Outcomes: Following the re-examination, the patient underwent periodontal surgery, including
periodontal regeneration therapies and removal of the roots. A ﬁnal prosthesis was subsequently delivered to establish stable
occlusion and to stabilize the periodontal tissue, after which the patient was again transitioned to SPT.
Conclusions: In the present case, reconstruction of occlusion improved strength control and the periodontal environment.
Additionally, the patientʼs improved thorough plaque control, and SPT have continuously suppressed gingival inﬂammation,
thereby stabilizing periodontal tissue, including the furcation region, for a signiﬁcant period（15 years）.

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R-29

Five-year prognosis of a patient with malocclusion who underwent comprehensive treatment
for severe periodontitis
Mitsuhiro Iwata＊1, Yuko Kuroda2, Kazuma Matsumoto2, Takehiro Shinohara2, Eiji Tanaka2

1

Sakura Dental Clinic, 2Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Hospital

Background: This was a case of a patient with severe periodontitis who exhibited many infrabony defects in the molar
region due to malocclusion-induced trauma. Herein, we report the 5-year prognosis of the patient after periodontal
regenerative and comprehensive orthodontic therapies for functional recovery with implant prosthodontics.
Case: A 54-year-old female patient presented with the chief complaint of masticatory disturbance. In the molar region,
signiﬁcant tooth mobility, a deep periodontal pocket（10 mm）, and infrabony defects were observed. She had lost frontal
teeth occlusion due to signiﬁcant maxillary protrusion. Malocclusion could be an exacerbating factor of infrabony defects.
The diagnosis was generalized severe chronic periodontitis and malocclusion.
Clinical Procedure and Outcomes: After initial preparation, we performed periodontal regenerative therapy for themandibular molar. We placed the implants after using a setup model to determine the maxillary molar position that would
ensure appropriate frontal teeth occlusion after orthodontic treatment. Comprehensive orthodontic treatment was
subsequently performed with the implants used as the anchoring unit. After the orthodontic treatment, a deﬁnitive surgicalprocedure was performed for the mandibular molar in order to place the ﬁnal prosthesis. Consequently, the alveolar bonedeveloped in a normal physiological form, and high cleansability was achieved due to the shallow gingival sulci. Stable
occlusion was established with anterior guidance. A favorable prognosis has been maintained up to 5 years after thetreatment.
Conclusion: Comprehensive treatment can enable stable occlusion and establishment of periodontal tissue and peri-implanttissues with high cleansablilty, even in patients with severe periodontitis and malocclusion. Long-term favorable prognosis
can be expected.

R-30

Treatment strategies for periodontal regenerative therapy of non-contained intrabony defectutilizing CBCT
Haruhiko Ono＊
Ono Dental Clinic

Background: The indication of periodontal regenerative therapy for 1-wall or dehiscence intrabony defect remains difﬁcult,and can lead to undesirable results even when therapy has been provided, i.e., complications of interdental papilla necrosis,
and unsuccessful periodontal regeneration. We performed surgery after close preoperative examination with CBCT anddiscussed the surgical methods. Herein, we report a case in which a favorable prognosis was achieved after re-entry surgery
to conﬁrm bone regeneration.
Case: The female patient was 62 years old at her ﬁrst visit, and did not smoke. She was diagnosed as having moderate tosevere chronic periodontitis in the full mouth. Vertical bone defect and a furcation involvement were conﬁrmed around themesial root of tooth No.30. The patient provided informed consent for the utilization of the unapproved material describedherein.
Clinical Procedures and Outcomes: Based on the CBCT images, it was estimated that the complete debridement waspossible even into the degree 2 furcation area of tooth No.30. It was planned to make an incision in the interdental papilla on
the buccal side. Since the bone defect was 1-wall type, i.e., a non-contained lesion, we determined to use EMD, autogenous
bone, FDBA, and an absorbable membrane. When re-entry surgery was performed 1 year after the regenerative therapy, thebone defect was almost completely repaired with bone-like hard tissues. The patient remains under follow-up observation
after ﬁnal prosthesis.
Conclusion: Close preoperative examination with CBCT could enable successful periodontal regenerative therapy.

JSP/JACP Poster Session AAP2016

Dental Hygiene

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H-01

The potential of periodontal treatment for improving problematic behavior of autistic spectrum
patient
Yuriko Sasakawa＊1, Jin Sekino1, Atsushi Saito2
1

Tokyo Metropolitan Center for Oral Health of Persons with Disabilities, 2Department of Periodontology, Tokyo
Dental College

Background: The patients with autistic spectrum disorder（ASD）often have difficulty in expressing oral and systemic
symptoms or problems. Therefore, oral problems may signiﬁcantly inﬂuence their behaviors and the quality of life（QoL）
including emotional aspect. We report a case of chronic periodontitis and ASD with problematic behavior requiring
periodontal treatment.
Case: A patient was a 34-year-old woman with ASD and severe intellectual disability, who presented with the chiefcomplaint of gingival swelling of the lower right quadrant. She displayed symptoms and problematic behaviors including
speech disappearance, compulsive hair-pulling, decrease in variation of diet and not being able to go to her care facility. She
received medical examination such as brain CT, but no deﬁnite cause was identiﬁed. She had deep periodontal pockets andwas diagnosed as having generalized severe chronic periodontitis.
Clinical Procedures and Outcomes: We performed one-stage full-mouth disinfection（Os-FMD）in combination with
antimicrobial therapy using azithromycin under general anesthesia. Following Os-FMD, we performed monthly supportive
periodontal therapy with behavior control method. Problematic behaviors related to oral function disappeared two weeks
after the Os-FMD, and other problematic behaviors disappeared after two months. Results from interviews with their family
members and caregivers suggest an improvement in QoL.
Conclusion: In this case of chronic periodontitis and ASD, an improvement was observed, following periodontal treatment,
not only in periodontal condition but in problematic behaviors related to oral function. It is also suggested that periodontal
treatment may enhance QoL of such patients.

H-02

The Efﬁcacy of Non-Surgical Treatment on Severe Gingival Recession
Masami Sato＊, Kazuyo Ikeda, Masahiko Ikeda
Ikeda Dental Clinic

Background and objective: Severe gingival recession leads to root exposure that causes various problems such as caries,
hypersensitivity and aesthetic problems. Normally severe gingival recession is an indication of periodontal surgery.
However, using non-surgical methods, we improved Miller class Ⅱ gingival recession and obtained favorable outcomes.
We report on two severe gingival recession cases with follow-up periods ranging from 22 to 24 years.
Materials and Methods: Two patients were included in this study（One male, aged 31;and one female, aged 22）. They had
Miller classⅡ recession defects on the labial surfaces of the anterior teeth（41,43）. In these areas, attached gingivae werelost and slight inﬂammation was observed. Pocket depths were 2-3mm. Patients were instructed in an oral hygiene techniqueinvolving wiping plaque once a day from the surfaces of the teeth using toothpicks wrapped with cotton. Patients were
instructed to discontinue brushing.
Results: Gingival creeping was found on the labial surfaces of the two teeth approximately two years after the firstexamination. Despite the fact that they had started regular brushing methods after gingival creeping had been found, they did
not have recurrence of gingival recession. The effects of the treatment has been maintained for periods of 20 to 21 years.
Conclusion: The severe gingival recession of two patients improved remarkably by a method of plaque control that does notexert excess pressure on the gingiva. It is suggested that non-surgical treatment using this method is treatment option forgingival recession.

JSP/JACP Poster Session AAP2016

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H-03

A case of chronic periodontitis improved by comprehensive periodontal therapy
Masako Sakai＊1, Koichi Ito2
1

Dental Hygienist Section, Nihon University School of Dentistry Dental Hospital, 2Nihon University

Background: We report a long-term case（29 years）of chronic periodontitis that was improved by comprehensive
periodontal therapy.
Case: A 39-year-old female presented with the chief complaint of painful, swollen gums. Clinical examination at the ﬁrst
visit revealed 49% of sites with a probing depth ≧4mm and 74% of sites with bleeding on probing. Plaque control record
was 85%.
Clinical Procedures and Outcomes: Basic periodontal treatment was implemented based on a clinical diagnosis of severe
chronic periodontitis. The patient was instructed to brush three times daily using the Bass method and an interdental
toothbrush. Surgical periodontal treatment was subsequently performed at selected probing depths over 4mm. Occlusal
adjustment and perio-orthodontic treatment was carried out as oral rehabilitation. We recalled the patient every 4 months.
Clinical examination at the re-evaluation of all sites with a probing depth 1〜3mm showed no bleeding on probing andplaque control records were 3〜6%.
Conclusion: Early extraction of hopeless teeth and comprehensive periodontal treatment for remaining teeth made it easy to
manage the periodontal tissue. During 29 years of supportive periodontal therapy, the periodontal condition remained
uneventful in most of the teeth. Therefore, it is important to create an adequate periodontal environment for the care ofhealed periodontal tissue by patients and dental hygienists before supportive periodontal therapy.

H-04

Case report: supportive periodontal therapy for severe localized periodontitis
Akina Tsuchikura＊1, Chiharu Kawaguchi1, Toshiaki Shibutani2

1

Devision of oral hygene in Assahi University Hospital, 2Department of Periodontology, Division of Oral Infection
and Disease, Asahi University School of Dentistry

Case: The patient, a 40-year-old female, presented complaining of pus discharge from the lower anterior teeth. Periodontal
examination revealed gingival recession, tooth mobility in lower anterior lesion;21.1% of sites bled on probing, 21.1% of thesites had a periodontal pocket depth ≥ 4 mm. In particular #32 and #41 exhibited a probing pocket depths of 7mm. Therewas grade II mobility in #32, and grade I in #41. Based on the clinical and radiographic ﬁndings, the patient was diagnosed
with localized chronic periodontitis.
Clinical procedure and outcome: Periodontal treatment was initiated with mechanical therapy;including systematic scaling
and planning of all accessible root surfaces and the introduction of meticulous oral hygiene. After the thorough initial phaseof mechanical therapy, the patient was motivated to achieve better plaque control. Flap surgery was performed including theapplication of enamel matrix protein to limited lesions. Reevaluation revealed decreased sites of bleeding on probing, plaquecontrol and improvement in the probing pocket depth. A postoperative radiograph 12 months later showed signiﬁcant boneformation. However, the gingiva between the interdental embrasure is shaped irregularly, which requires careful self-careand professional treatment. The patient was put on regular recall appointments for supportive periodontal therapy. The oral
hygiene maintenance and compliance of the patient was excellent, and there were no signs of recurrence of the disease
throughout the maintenance period of more than two years.
Conclusion: This case suggests that collaboration between the patient and dental professionals can maintain irregulargingival shape conditions.

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H-05

A case report of generalized chronic periodontitis evaluated by PRA
Michiko Ogata＊, Hiroyasu Shimizu
Shimizu Dental Clinic Tokyo, Japan

Background and objective: The primary etiology of the periodontal disease is a bacterial plaque. Various risk factors,
however, may give signiﬁcant inﬂuence on the disease progression. PRA（Periodontal risk assessment）is one of the tool toevaluate the risk of the progression. This study reports a case of generalized chronic periodontitis which underwent
periodontal treatment followed by periodontal maintenance and the risk was evaluated utilizing PRA.
Materials and Methods: The patient is a 58 years old, Asian male. The smoking status was current smoker. The diagnosis is
generalized severe chronic periodontitis. First, OHI was performed utilizing PRA. Then, non-surgical therapy was
performed. After that, regenerative therapies were applied to ﬁve sites where deep periodontal pockets remained. Finally,
every 3-month periodontal maintenance was regularly done for 5 years.
Results: As a result of OHI, smoking cessation and definitive treatment with the regenerative therapy, the periodontal
condition was signiﬁcantly improved. Followed by every 3-month periodontal maintenance, the periodontal condition at 5
years post surgery was more stable. PRA was used to assess the risk at the time of the initial examination then it was high.
Even after non-surgical therapy, the risk was still high therefore regenerative therapy as a deﬁnitive treatment was chosen.
After surgical treatment, the risk changed to medium and it was maintained well at the periodontal maintenance even for ﬁve
years.
Conclusion: Long-term success was achieved by the periodontal treatment based on the risk assessment. PRA may help toevaluate and motivate a patient and make proper treatment planning.

H-06

A case report of localized aggressive periodontitis followed up for 5 years
Yuina Shiokawa＊, Hiroyasu Shimizu
Shimizu Dental Clinic, Tokyo, Japan

Background and objective: Management of furcation involvement is challenging. Management of aggressive periodontitis ischallenging as well. This case report is focused on prognosis of class3 furcation involvement of maxillary molar of
aggressive periodontitis patient who exhibited excellent oral hygiene status.
Materials and Methods: The patient is 43 years old Asian male, former smoker over 10years ago. Clinical ﬁndings suggested
generalized deep periodontal pocket depth and localized radiographic vertical bone loss. Also, class3 furcation involvement
was found on #26. After phase 1 therapy, regenerative therapy was performed to improve vertical bone loss and furcation
involvement. After that, stable periodontal condition was conﬁrmed then periodontal maintenance was done regularly at
every 3month.
Results: The class 3 furcation involvement on #26 was present even after periodontal regenerative therapy and vertical boneloss was improved. After the surgical therapy, every 3 month periodontal maintenance was performed in order to maintainresidual pockets. The patientʼs oral hygiene status has been improved then PCR significantly changed to less than 10%,which was maintained at 7 years post the surgery and it was originally 40% at the initial examination. Class 3 furcation
involvement on #26 has been maintained by the careful self- brushing and subgingival ultrasonic instrumentation atperiodontal maintenance.
Conclusion: Class 3 furcation involvement of aggressive periodontitis is expected to have poor prognosis because the patientis genetically susceptible to the periodontal disease. It may be however possible to achieve long-term success by the surgicalapproach and excellent plaque control level.

JSP/JACP Poster Session AAP2016

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H-07

Systemic Antibiotics and Regenerative Therapy for Generalized Severe Chronic Periodontitis
Yuko Shimoda＊, Rumi Fukamizu, Tetsuya Mizukami
Mizukami Dental Clinic

Background: A case with generalized severe chronic periodontitis was dramatically improved by medication of azithromycin
accompanied by the single-time full-mouth scaling and root planning（FM-SRP）followed by periodontal regenerative
therapy. The good prognosis in the maintenance phase is reported.
Case: A 51 year-old female patient presented on 2008/9/2 with the chief complaint of pain at #36（mandibular left ﬁrst
molar）. She was not a smoker without any particular medical history. Clinical and radiographic examinations revealed
generalized gingivitis with periodontal abscess at #36 and severe bone loss. Original data were PCR 70.1%, 75.9% of deeper
pockets than 4mm, BOP 100%, and suppuration upon probing on multiple sites. P.gingivalis, A.actinomycetemcomitans, T.
forsythia, P.intermedia, and T.denticola were found by PCR-Invader bacterial test. Diagnosis was generalized severe chronic
periodontitis.
Clinical Procedures and Outcomes:
Clinical Procedures:
Initial periodontal treatment such as oral hygiene instructions, scaling, medication of azithromycin with single-time FMSRP, and hopeless-teeth extraction were performed. Regenerative therapy before and after re-examinations, the final
restoration and maintenance were applied.
Outcomes: After the FM-SRP, previously detected 5 bacteria were not detected and data after treatment were as follows;
PCR 9%, PPD>4mm 0%, BOP 0% and bone defect showed notable radiographic improvement. Maintenance therapy was
performed every 2 months. Latest data in January 2015 were PCR 6.8%, PPD>4mm 0%and BOP was 0%.
Conclusion: Patientʼs motivation and treatment efﬁcacy have been increased by the rapid remission of inﬂammation becauseof the single-time FM-SRP with systemic azithromycin medication in the initial treatment phase.

H-08

Management of a patient with chronic periodontal and peri-implant disease: A case report
Yuki Enomoto＊, Yukari Hashizaki, Masahiko Nikaido
Nikaido Dental Ofﬁce, Tokyo, Japan

Background and objective: Not only periodontal diseases, but also peri-implant diseases are becoming major issues in ourdaily practice. In this presentation, we report the patient, who had both periodontal and peri-implant disease.
Case: 63 year-old female patient referred from a general practitioner to us. She had had swollen gingiva frequently,
although she had been seeing by a dentist and a dental hygienist every 3 months. She also received dental implants 5 year
ago which had had bleeding around implants.
Periodontal examination revealed that many teeth had ≥6mm pockets and ≥2 mobility. Plaque index 33% and BOP: 42%.
#16 had bone loss to the apex, so that the tooth was extracted. Peri-implant condition revealed that both implant had ≥7mm
pockets, ≥25% bone loss and mucous membrane was swollen.
Clinical Procedures and Outcomes: After OHI and SRP, her periodontal condition were much improved（PI: 20%, BOP:
28%）However, improvement of peri-implant condition was limited. We performed surgical approach for them, i.e. surface
decontamination and implant plasty. After those approaches, improvement of peri-implant condition has been observed sothat patient has been placed in SPT program.
Conclusion: In the periodontal therapy, patientʼs compliance is very essential. In this case, patient become motivated astreatment progressed. She accepted advanced surgical therapy, such as implant plasty. We continue to provide supportive
therapy to maintain healthy periodontal and per-implant tissue.

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H-09

Impact of preoperative periodontal treatment on postoperative infection in cardiac valve
replacement patients

Hitomi Suzuki＊1, Koichiro Matsuo2, Mieko Okamoto2, Kazuharu Nakagawa2, Risa Watanabe1,
Hiroshige Taniguti2
1

Department of Dentistry and Oral Surgery, Fujita Health University Hospital, 2Department of Dentistry, School of
Medicine, Fujita Health University

Background and objective: Oral infection control is important for patients undergoing cardiac valve replacement（CVR）asprophylaxis of infective endocarditis and the other post-operative complications. In the present study, we examined theeffect of preoperative periodontal treatment on prevention of post-operative infection in CVR patients.
Materials and Methods: We prospectively recruited 55 patients who underwent CVR from August, 2014 to December, 2015
in our hospital as dental intervention group. We also retrospectively reviewed the medical records of 35 patients who had
undergone CVR surgery without dental intervention from April 2012 to March 2014 as control. For the intervention group,
intensive periodontal treatments were conducted before the surgery. Plaque control record（PCR）, bleeding on probing（BOP）and probing pocket depth（PPD）were measured at the first visit to our hospital dental office, one day before
surgery, and more than 7 days after surgery. Days of fever（over 37.5 degree）, days of antibiotics use, and hospital stayafter surgery were counted for both control and intervention groups, and compared statistically between them.
Results: In the intervention group, PPD and BOP signiﬁcantly decreased prior to the CVR surgery, but PCR did not. Days offever, and days of antibiotics use were signiﬁcantly shorter in the intervention group than control, but hospital stay after
surgery did not differ between them.
Conclusion: These ﬁndings suggest that preoperative periodontal treatment can improve oral health condition prior to the
CVR surgery, and would decrease the risk of postoperative infection in those patients.

H-10

Periodontal management of Down syndrome with hypersensitivity: A 22-year case report
Rikako Ishii＊1,2, Jin Sekino1, Atsushi Saito3

1

Tokyo Metropolitan Center for Oral Health of Persons with Disabilities, 2Department of Oral Health Science,
Kyushu University of Nursing and Social Welfare, 3Department of Periodontology, Tokyo Dental College

Background and objective: Severe periodontal disease with early onset is a common clinical feature of patients with Down
syndrome（DS）. In cases with sensory modulation disorder（hypersensitivity）of peri-oral and intraoral area, treatment of
periodontal diseases can be challenging. We report a case of DS patient with gingivitis, who has been treated and maintainedfor 22 years.
Case: The patient was a 7-year-old boy with DS accompanying serious intellectual disabilities. The chief complaint（fromhis family）was difﬁculty in tooth brushing. He had sensory modulation disorder with hypersensitivity around his mouth.
The patient presented with compromised oral condition, with marked plaque accumulation, gingival swelling and halitosis.
He had eating disorder with deviated food habit and speech disorder. At the time of tooth brushing by mother, he exhibitedinjuring behavior to self and others.
Clinical Procedures and Outcomes: A systematic desensitization technique was introduced in home care, and we performed
scaling and professional mechanical tooth cleaning. After problems regarding hypersensitivity and gingival inﬂammation
were improved, we started support of self-care, functional training for food intake and speech therapy. Thereafter, we
continued bimonthly supportive periodontal therapy, and this improvement has been adequately maintained over a 22-year
period.
Conclusion: Although DS patients have inherent risk for periodontal disease, the appropriate behavior management andperiodontal care from early stage could yield favorable oral condition, which can be maintained for long periods.

JSP/JACP Poster Session AAP2016

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H-11

25year Case: Long term prognosis of periodontal maintenance in patient with rheumatoid
arthritis
Makiko Hirose＊, Taishi Hirose, Tetsushi Hirose
Yokohama Kannai perio-Implant Institute（Yuraku Dental Ofﬁce）

Background and objective: We report long term maintenance in perio-patiant with rheumatoid arthritis
Materials and Methods: A 26years old female complained of discomfort with gum.
The patient has rheumatoid arthritis, however scientiﬁc research relation between periodontitis and rheumatoid arthritis are
seldom at the time in 1991. She used to be a smorker and she quit smoke 2005.
After performed Phase1 and Phase2 periodontal treatment, recall maintenance was started.
During the past 25years every 4month recall has been performed.
Range of PCR is 0.64% to36.3%.
She has some clinical attachment loss but any loss of teeth between the period.
Results: Pocket depth ranging from 2 to 4 mm with some additional gingival recession.
Some clinical attachment loss are found but all tooth are well functioned.
Conclusion: We could keep stable periodontal condition in the precisely maintained patient with rheumatoid arthritis.

JSP/JACP Poster Session AAP2016

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The 102nd Annual Meeting of the American Academy of Periodontology
in collaboration with the Japanese Society of Periodontology andJapanese Academy of Clinical Periodontology
Abstracts of JSP/JACP Poster Session
Copyright ©2016 The Japanese Society of Periodontology, the Japanese Academy of Periodontology.
All rights reserved.
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