The 106th Annual Meeting of the American Academy of Periodontology
in collaboration with the Japanese Society of Periodontology,
and the Japanese Academy of Clinical Periodontology.

Abstracts of JSP/JACP Poster Session

November 6-15, 2020
VirtualThe Japanese Society of Periodontology
The Japanese Academy of Clinical Periodontology

第106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・2020年大会
The 106th Annual Meeting of the American Academy of Periodontology
in collaboration with the Japanese Society of Periodontology,
the 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，歯科衛生演題

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

会期：2020年11月 6 日～11月15日
会場：オンライン開催

November 6 -15, 2020
Virtual第106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 2020年大会
JSP/JACP ポスター発表・若手研究者支援協賛企業
相田化学工業株式会社
医歯薬出版株式会社
科研製薬株式会社
ストローマン・ジャパン株式会社
株式会社デンタリード
株式会社トクヤマデンタル
プレミアモード株式会社

（50音順）

General（Basic Research）

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GB-01

Eﬀects of aging in LPS-induced chronic periodontitis mouse model
Hirotsugu Morinaga＊, Keiichi Kanayama, Toru Hasegawa,Takumi Sato, Mitsunobu Kitago, Jyunichi Tatsumi
Department of Periodontology Asahi Unversity of Dentistry

Background and objective: Alveolar bone resorption due to chronic inﬂammation is the main symptom of periodontitis.
Conventional mouse periodontitis models require improvement as a model of chronic inﬂammation, particularly with respect
to the method of inducing inﬂammation during the observation period. In this study, alveolar bone resorption was induced
by a method which caused little mechanical irritation, and periodontitis progression in young and old mice was compared.
Materials and Methods: Lipopolysaccharide（LPS）from Porphyromonas gingivalis was administered 12 times（twice perweek）on the palatal gingiva of 8- or 24-weeks old C57BL/6J mice. The LPS was injected by a microsyringe（33 G）, andthe dose was 20 μg per 1 shot. Maxilla samples were collected 1 week and 4 weeks after the ﬁnal administration, and microCT scans and tissue slices were prepared.
Results: Injection of LPS by the microsyringe did not require strong external force. Results from the micro-CT showed thatbone resorption stimulated by LPS was greater in the older mice than in the young mice. In the comparison between 1 weekand 4 weeks after the ﬁnal administration, the aged mice demonstrated more bone resorption later than the young mice inafter 4 weeks.
Conclusion: LPS administration with a micro-syringe caused alveolar bone resorption in both young and old mice. In older
mice, bone resorption was observed continuously in 4 weeks after LPS administration.

GB-02

Exosomes from dental pulp cells can suppress periodontitis symptoms
Yuta Shimizu＊1, Tomoko Kawaguchi2, Hirotaka Ikami1, Tadashi Yasuda1,
Toshiyuki Shibata2, Ken-ichi Tezuka3, Junichi Tatsumi1

1Asahi University School of Dentistry Department of Periodontology, 2Gifu University Graduate School of
Medicine Department of Oral and Maxillofacial Science, 3Gifu University Graduate School of Medicine
Department of Tissue and Organ Development Regeneration and Advanced Medical Science

Background and objective: Extracellular vesicles, called exosomes, are secreted from various cell types and serve as a tool
in intercellular communications. We have previously established and characterized human leukocyte antigen（HLA）
haplotype homo（HHH）dental pulp cell lines（DPCs）from human third molar teeth. In this study, exosomes secreted
from HHH-DPCs were injected into mice with periodontal disease, and their inhibitory effect for periodontal diseaseprogression was evaluated.
Materials and Methods: For exosomes puriﬁed from HHH-DPCs, we conﬁrmed the particle size, exosome marker, andHLA class I expression and analyzed miRNA expression profiles of both HHH-DPCs and exosomes. Furthermore, we
evaluated the cell migration and proliferation potential of DPCs using HHH-DPC exosomes. We also examined the
suppression eﬀect of HHH-DPC exosomes on periodontal disease progression caused by silk ligation.
Results: HHH-DPC exosomes had a homogeneous and spherical membrane structure, and as compared to HHH-DPCs, they
showed lower expression of HLA class I. HHH-DPC exosomes promoted the migration and proliferation of DPCs, and themiRNA expression profile of HHH-DPC exosomes was similar to that of the original cells. In addition, mice withperiodontal disease showed an inhibitory eﬀect on alveolar bone resorption.
Conclusion: Exosomes promote migration and proliferation of DPCs and exhibit an alveolar bone resorption inhibitory
effect in mice with periodontal disease. This suggests that HHH-DPC exosomes may be used in the treatment of
periodontitis without cell transplantation.

JSP/JACP Poster Session AAP2020

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GB-03

Eﬀects of designer self-assembling peptide hydrogels on periodontal defect healing
Daisuke Matsugami＊1,2, Tasuku Murakami1, Wataru Yoshida1,
Kentaro Imamura1, Fumi Seshima1, Atsushi Saito1, 2

1

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

Background and objective: We previously reported that the local application of self-assembling peptide（SAP）nanoﬁber
hydrogel, RADA16, promotes periodontal healing in vivo. RADA16 can be functionalized by cell adhesion motifs. This
study aimed to investigate the eﬀects of the local application of two designer SAP hydrogels, PRG（2-unit RGD binding
sequence）and PDS（laminin cell adhesion motif）, on the healing of surgical periodontal defects in rats.
Materials and Methods: In vitro, rat periodontal ligament-derived cells were cultured, seeded on each gel, and analyzed bycell proliferation assay（WST-1）. In vivo, standardized periodontal defects were surgically created mesially in the
maxillary first molars of rats. Defects were treated with RADA16, PRG, PDS or left unfilled. After 2 and 4 weeks
postoperatively, healing of periodontal defects was assessed by microcomputed tomography, histological andimmunohistochemical analyses.
Results: Proliferation of PDL-derived cells in PRG group was signiﬁcantly greater than that RADA16 and PDS groups（p＜0.01）at 72 hours. At 4 weeks postoperatively, the bone volume fractions in PRG group（59.1±2.4％）and PDS group（56.9±3.1％）were significantly greater than RADA16 group（48.5±6.3％）（p＜0.05）. Histologically, new boneformation was more pronounced in PRG and PDS groups compared to RADA16 group at 4 weeks postoperatively. In PRG
group, increased proportions of PCNA- and VEGF-positive cells were observed near the newly formed bone adjacent to theroot at 4 weeks postoperatively（p＜0.01）.
Conclusion: The results of this study suggest that designer SAP hydrogels, especially PRG, enhanced periodontal healing byincreasing cell proliferation and angiogenesis.

GB-04

Eﬀect of CTLA-4 on bone resorption in periodontitis model mouse
Saki Nakane＊1, Kentaro Imamura1, Eiichi Suzuki1, 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: CTLA-4 is one of the immune checkpoint receptors expressed on the cell surface of T cells. It
has been reported that CTLA-4 may suppress bone resorption in rheumatoid arthritis. However, its eﬀect on alveolar bone
resorption has not been clarified. The purpose of this study is to investigate the role of CTLA-4 in bone resorption inperiodontitis.
Materials and Methods: Periodontitis was induced by silk ligature to the second molar in C57BL/6 mice, CTLA-4-Ig wasadministered intraperitoneally. The effect of CTLA-4-Ig on alveolar bone resorption and osteoclast differentiation was
evaluated by µCT and TRAP staining. In vitro, Raw264.7 cells were treated with RANKL and CTLA-4-Ig, and the role of
CTLA-4-Ig on the osteoclast differentiation was evaluated. The expression levels of osteoclast differentiation markers（c-fms, Carbonic anhydrase II, and Cathepsin K）and signaling molecule downstream of CTLA-4（PPA2）were assessedby qRT-PCR. The number of osteoclasts was counted by TRAP staining.
Results: Bone resorption and the number of osteoclast-like cells were decreased by administration of CTLA-4-Ig inperiodontitis model mice. In vitro, CTLA-4-Ig treatment significantly reduced mRNA expression of osteoclast
diﬀerentiation markers and the number of osteoclast-like cells. In addition, the expression level of PPA2 was increased by
CTLA-4-Ig treatment in a concentration-dependent manner.
Conclusion: Our data showed that administration of CTLA-4-Ig reduced the bone resorption and the number of osteoclasts.
In addition, the expression of PPA2 was increased by CTLA-4-Ig. In conclusion, it is suggested that CTLA-4-Ig reduces
alveolar bone resorption through the inhibition of osteoclast diﬀerentiation via activation of PPA2 at local periodontitis site.

JSP/JACP Poster Session AAP2020

3

GB-05

Combined eﬀects of FGF-2 and DBBM on periodontal healing: a preclinical investigation
Tasuku Murakami＊1, Daisuke Matsugami1,2, Wataru Yoshida1, Takahiro Bizenjima1,
Kentaro Imamura1, Fumi Seshima1, Atsushi Saito1,2
1

Department of periodontology, Tokyo Dental College,
2
Oral Health Science Center, Tokyo Dental College

Background and objective: Fibroblast growth factor（FGF）-2 has been reported to promote periodontal healing and used
for periodontal regeneration therapy. Deproteinized bovine bone mineral（DBBM）has osteoconductivity and has beenclinically applied as a scaffold material. However, information is limited regarding the combined effects of FGF-2 andDBBM on periodontal healing. The purpose of this study is to investigate the effects of the combination of FGF-2 andDBBM on the healing of surgically created periodontal defects in rats.
Materials and Methods: Periodontal defects were created mesially to the maxillary ﬁrst molars in Wistar rats. Defects were
ﬁlled with FGF-2, DBBM, FGF-2+DBBM, or left unﬁlled. Microcomputed tomography, histological（H&E staining）, andimmunohistochemical（PCNA staining）examinations were used to evaluate periodontal healing at 2 or 4 weeks
postoperatively.
Results: At 2 weeks postoperatively, bone volume fraction was significantly greater in the FGF-2 and FGF-2+DBBM
groups than that in the Unﬁlled and DBBM groups. At 4 weeks postoperatively, bone volume fraction was signiﬁcantly
greater in FGF-2, DBBM, and FGF-2+DBBM groups than that in the Unﬁlled group. Histological assessment showed that
newly formed bone in the FGF-2 and FGF-2+DBBM groups appeared to be greater than in the Unﬁlled group. Proportionsof PCNA-positive cells above newly formed bone in the FGF-2, DBBM, and FGF-2+DBBM groups were signiﬁcantly
greater than the Unﬁlled group at 2 weeks.
Conclusion: These ﬁndings suggest that the combination of FGF-2 and DBBM enhances bone formation in the treatment of
periodontal defects.

GB-06

Quantitative changes of Porphyromonas gingivalis and EBV DNA in saliva before and after
initial periodontal therapy in Japanese periodontitis patients
Yorimasa Ogata＊1, Ayako Kato1, Kenichi Imai2, Yorinobu Ikeda1
Department of Periodontology, Nihon University School of Dentistry at Matsudo,
2
Department of Microbiology, Nihon University School of Dentistry1

Background and objective: Recently, Epstein-Barr virus（EBV）is thought to be involved in the pathogenesis ofperiodontitis as well as Porphyromonas gingivalis which is the representative periodontopathic bacteria. The purpose of
initial periodontal therapy（IPT）is to enhance motivation and remove calculus, periodontopathic bacteria and theirbyproducts, in order to restore periodontal health. To elucidate the eﬀects of IPT on incidence of P. gingivalis and EBVDNA, we used whole saliva samples from the chronic periodontitis（CP）patients.
Materials and Methods: Twenty CP patients were recruited and determined periodontal status by probing pocket depth（PD）,
bleeding on probing（BOP）and intraoral radiography, and whole saliva were collected at ﬁrst visit and after IPT. Saliva
samples were subjected to a real-time PCR to detect P. gingivalis and EBV DNA.
Results: P. gingivalis and EBV DNA were detected in 20（100％）and 14（70％）saliva samples from the CP patients at
ﬁrst visit. After IPT, number of detections of P. gingivalis and EBV DNA were decreased to 17（85％）and 9（45％）
saliva samples from the patients. Coexistence of P. gingivalis and EBV DNA were detected in 14 saliva samples from thepatients at ﬁrst visit, and signiﬁcantly decreased to 8（40％）after IPT. Signiﬁcant improvements in mean PD and BOP
were observed after IPT.
Conclusion: These results suggest that the IPT was eﬀective in improvement of clinical parameters such as PD and BOP and
reducing the coexistence of P. gingivalis and EBV in the saliva from CP patients.

JSP/JACP Poster Session AAP2020

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GB-07

Bone regeneration by novel combination materials using phosphorylated pullulan andtriphosphate calcium
Yasuhito Morimoto＊1,2, Tomoka Hasegawa2, Hiromi Hongo2,
Tsutomu Sugaya1, Yasuhiro Yoshida3, Norio Amizuka2
1

Periodontology and Endodontology, 2Developmental Biology of Hard tissue,
Biomaterial Engineering, Faculty of Dental Medicine, Hokkaido University

3

Background and objective: Phosphorylated pullulan（PPL）is a unique material which shows a high aﬃnity to crystalline
calcium phosphate. In this study we have examined a novel component mixed with PPL and α-tricalcium phosphate（TCP）
or β-TCP if it has the preferable osteoconductivity, when grafted into the bone defects.
Materials and Methods: Bone defects with a diameter of 2 mm were formed in the tibial cortical bone of ten-weeks-old
Wistar rats, and then filled with PPL, β-TCP, α-TCP, PPL+β-TCP, or PPL+α-TCP. After 1-, 2-, and 4-weeks, theregenerated bones were histochemically evaluated by examining histochemistry of TRAP, ALP, osteopontin, von Kossa
staining and element mapping using an electron probe micro-analyzer（EPMA）.
Results: There was no inﬁltration of inﬂammatory cells in the region of bone defects of all the groups. At 1- or 2-weeks,
TRAP-reactive/cathepsin K-positive osteoclasts and ALP-positive osteoblasts were localized on the α-TCP/β-TCP
granules, as well as PPL, the surface of which showed osteopontin-positivity. At 4 weeks, new bones were formed on not
only the grafted α-TCP/β-TCP granules but also directly on the PPL. Interestingly, the grafted PPL allowed the invasion ofvascular endothelial cells and osteoblastic cells inside, and also showed the distribution of calcium phosphate crystals whenestimated by EPMA and von Kossa staining. Thus, PPL appeared to trap calcium phosphates inside.
Conclusion: It seems likely that PPL could effectively serve as an adequate scaffold for bone regeneration, and that the
combined components with PPL and TCP could provide a favorable microenvironment for bone regeneration.

GB-08

Lamin A is required for mechanical stress-dependent osteoblast responses
Ayano Nakamura＊1, Takashi Nakamura2, Toshifumi Azuma2,3, Atsushi Saito1,3

1

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

Background and objective: Lamin A is an intermediate ﬁlament underlying inner nuclear membrane being connected to actin
cytoskeleton via LINC proteins. It controls chromatin organization, DNA duplication, and transcription. We hypothesizedthat cell nuclear membrane associated proteins like Lamin A play an important role to transmit mechanical stress toosteogenesis mechanism, and thus are involved in the progression of periodontal diseases. In this study, we aim toinvestigate the role of Lamin A in the mechanical stress response during osteoblastic diﬀerentiation.
Materials and Methods: Lmna+/- mice were purchased from the Jackson Laboratory. Calvarial-osteoblasts were isolated ofnewborn WT and Lmna-/- littermate mice. The calvariae were digested for 10 minutes at 37℃ with αMEM containing 0.1％
collagenase and 0.2％ dispase. Primary osteoblasts were seeded onto a stretch chamber at a density of 3x105 cells / well andcultured in osteoblast diﬀerentiation medium under continuous cyclic stretch of 6％ amplitude at a rate of 5 cycles/min for
7days using Cell Stretching System. Osteoblastic diﬀerentiation was assessed by ALP staining and quantitative RT-PCR for
Alpl, Col1a1, Runx2, and Bglap2.
Results: ALP staining tended to be lower in Lmna-/- osteoblasts than WT osteoblasts, and both decreased under mechanicalstress. The expression levels of marker genes tended to be lower in stressed Lmna-/- osteoblasts than in stressed WT
osteoblasts. Early differentiation markers Alp, Col1a1, and Runx2 were decreased in a stress-dependent manner in both
cells.
Conclusion: It is suggested that Lamin A is involved in the mechanical stress response during osteoblastic diﬀerentiation.

JSP/JACP Poster Session AAP2020

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GB-09

Amelogenin suppresses IFNγ-induced MHC class II expression in macrophages
Karen Yotsumoto＊, Terukazu Sanui, Urara Tanaka, Hiroaki Yamato, Yuki Nakao,
Yukari Watanabe, Chikako Hayashi, Takao Fukuda, Fusanori Nishimura

Department of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
Background and objective: Enamel matrix derivatives（EMDs）-based regenerative therapy is known to promote better
healing with minimal inflammatory response after periodontal surgery. We previously demonstrated that amelogenin
suppressed major histocompatibility complex class II（MHC II）gene expression in monocytes using DNA microarray
analysis. The aims of this study were to understand the molecular mechanism how amelogenin suppressed IFNγ-induced
MHC II expression.
Materials and Methods: THP-1 macrophages were pretreated with amelogenin and stimulated with IFNγ. The cell surface
expression of MHC II molecules was evaluated by ﬂow cytometry, and signal transduction was analyzed by real-time PCR
and western blotting. The uptake of labeled amelogenin into macrophages was monitored by confocal microscopy. Histone
modiﬁcation of class II transactivator（CIITA）promoter region was assessed by chromatin immunoprecipitation. T cell
activation was evaluated by mixed leukocyte reaction（MLR）.
Results: Amelogenin down-modulated IFNγ-induced cell surface expression of MHC II, following accumulation in the
nucleus at 15 min, and inhibition of subsequent CIITA expression. Reduced MHC II expression on macrophages pretreatedwith amelogenin down-regulated T cell activation markers, T cell proliferation, and IL-2 production in MLR. H3K27ac andH3K4me3 in CIITA promoter IV region, both of which are essential for conversion to euchromatin, were markedly
suppressed by amelogenin.
Conclusion: The results show that amelogenin suppresses MHC II expression by altering chromatin structure and inhibiting
CIITA transcription activity, and attenuates subsequent T cell activation. Clinically observed accelerated healing after
periodontal surgery by EMDs may, at least in part, be mediated by the mechanism elucidated in this study.

GB-10

Therapeutic potential of exosomes derived from GMSC in periodontal disease

Yuki Nakao＊, Takao Fukuda, Takanori Shinjo, Yukari Watanabe, Chikako Hayashi, Hiroaki Yamato,
Karen Yotsumoto, Urara Tanaka, Terukazu Sanui, Fusanori Nishimura
Department of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
Background and objective: Mesenchymal stem cells from gingiva（GMSCs）are easier to isolate, and appear to secrete
higher amounts of exosome than other MSCs. Our preliminary data demonstrated that exosome from TNF-T-stimulated
GMSCs markedly drove macrophage polarization toward anti-inﬂammatory（M2）phenotype, suggesting that this negative
feedback loop could be beneﬁcial for better wound healing. To further investigate the therapeutic potential of exosomes from
GMSCs, we investigated its eﬀect on alveolar bone loss from the viewpoint of exosomal miRNA.
Materials and Methods: GMSCs were isolated from gingival tissues under the approval of Institutional Board protocol（2019-374）, and the exosomes were puriﬁed from culture supernatant. To examine the protective role of GMSC-derived
exosomes on periodontal tissue destruction, the ligature-induced alveolar bone loss was created in mice. Exosomes were
injected into the palatal gingiva of mice using a split-mouse experimental design. The eﬀect of exosome from GMSCs on
RANKL expression in LPS-stimulated human periodontal ligament cells（hPDLCs）was examined. After TNF-.
stimulation, expression proﬁles of exosomal miRNA in GMSCs were analyzed by miRNA array. Signaling pathways leading
to LPS-induced RANKL expression were analyzed, and the involvement of exosomal miRNA in RANKL expression wasinvestigated.
Results: Exosomes from GMSCs markedly suppressed alveolar bone resorption in mice model of periodontitis. Exosome
from GMSC signiﬁcantly inhibited RANKL expression in LPS-treated PDLCs, and the eﬀect was further enhanced by priortreatment of GMSCs with TNF-,.
Conclusion: Exosomes derived from GMSCs suppressed bone loss, and TNF- -induced exosomal miRNA was essential forthe suppression of RANKL expression.

JSP/JACP Poster Session AAP2020

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GB-11

Combined eﬀects of geranylgeranylacetone and amelogenin on periodontal tissue regeneration
Hiroaki Yamato＊, Terukazu Sanui, Karen Yotsumoto, Yuki Nakao, Yukari Watanabe, Chikako
Hayashi, Takao Fukuda, Urara Tanaka, Fusanori Nishimura
Department of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University

Background and objective: We previously reported that amelogenin（rM180）directly binds to glucose-regulated protein
78（GRP78）, a member of heat-shock protein family, and that cell migration activity was enhanced when GRP78overexpressing human periodontal ligament cells（hPDLCs）were treated with rM180. Geranylgeranylacetone（GGA）isa heat-shock protein-inducing medication that is commonly used to treat gastric ulcers. In this study, therefore, wehypothesized that GGA and amelogenin exhibit synergistic eﬀect for better healing and tested its possibility using hPDLCs.
Materials and Methods:
1. GGA-induced GRP78 expression and its eﬀect on cell functions was evaluated.
2. Microarray analyses to identify genes upregulated by the stimulation with or without GGA or GGA+ rM180 in hPDLCs,
and its veriﬁcation was performed.
3. The tube formation by supernatants from hPDLCs treated with each stimulation was investigated using human umbilicalvein endothelial cells（HUVECs）.
Results & Conclusion: We found that GGA increased GRP78 protein expression at 18 hours after the stimulation, andenhanced cell migration. Microarray analysis demonstrated that the increased GRP78 expression triggered the production of
angptl4 and amphiregulin, both of which are involved in enhanced angiogenesis and subsequent wound healing. Moreover,
the addition of rM180 further accelerated the hPDLCs cell migration and tube formation of HUVECs due to the upregulationof IL-8, MCP-1, and IL-6, all of which are known as angiogenesis-inducing factors. Neutralizing antibodies against thesecytokines significantly inhibited tube formation by HUVECs. Thus, the combined application of GGA and rM180 may
create a suitable environment for periodontal wound healing.

GB-12

Investigating the mechanism of environmental stress response in Treponema denticola

Toshiya Fukasawa＊1,2, Yurie Kitamura1, Keiko Yamashita1, Hiroyuki Asai3, Kazuyuki Ishihara2,4,
Atsushi Saito1,2
1

Department of Periodontology, Tokyo Dental College, 2Oral Health Science Center, Tokyo Dental College,
3
Asai Dental Clinic, 4Department of Microbiology, Tokyo Dental College

Background and objective: Bacteria are exposed to environmental stresses in oral cavity. To adapt to environmental stresses,
bacteria usually regulate gene expressions using DNA-binding proteins. Treponema denticola has been frequently isolated
from the lesion of chronic periodontitis and must overcome environmental stresses to colonize. We have reported that theexpressions of some genes coding for DNA-binding protein in T. denticola are regulated by environmental stress such as
low nutrient conditions. The purpose of this study is to investigate the role of a novel T. denticola DNA-binding protein in
the response to environmental stresses.
Materials and Methods: A mutant deﬁcient in the gene coding for a DNA-binding protein was constructed by homologous
recombination. Under low nutrient conditions, the growth and proteolytic activities（dentilisin and oligopeptidase B）were
evaluated. The viability of the cells was measured under oxygen, osmotic downshift and heat stresses.
Results: Under low nutrient medium, the growth of the mutant strain was signiﬁcantly decreased compared with wild type at
24-96 hours and the dentilisin activity of the mutant strain was significantly decreased compared with wild type. The
viability of the mutant strain was signiﬁcantly decreased under oxygen stress and increased under heat stress at 1, 2 hours.
No signiﬁcant diﬀerence was observed between the mutant and wild type strains under osmotic downshift stress.
Conclusion: It is suggested that the DNA-binding protein is involved in the growth, dentilisin activity and survival of T.
denticola under environmental stresses such as low nutrient, oxygen, and heat.

JSP/JACP Poster Session AAP2020

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GB-13

Roles of PDLIM5 in periodontal ligament and gingival epithelial cells
Asuka Yuda＊1, Shinsuke Fujii2, C.A.McCulloch3, Michihiko Usui4, Shinya Murakami5,
Hidefumi Maeda6, Naohisa Wada1

1

Division of General Dentistry, Kyushu University Hospital, Kyushu University, 2Laboratory of Oral Pathology,
Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3Facultyof Dentistry, University of Toronto, 4Division of Periodontology, Department of Oral Function, Kyushu Dental
University, 5Department of Periodontology, Osaka University Graduate School of Dentistry, 6Division of Oral
Rehabilitation, Department of Endodontology and Operative Dentistry.
Background and objective: During wound hearing, inhibition of gingival downgrowth play a critical role in leading tosuccessful periodontal regeneration. Cell extensions play an important role in several processes, such as wound healing andmatrix remodeling. PDLIM5 is a member of the PDZ-LIM proteins. We recently reported that PDLIM5 was required for cellextensions formation in mouse ﬁbroblast cells. In this study, we investigated the eﬀects of PDLIM5 on association with cellextensions formation and migration activity of human periodontal ligament（HPDL）and gingival epithelial（HGE）cells.
Materials and Methods: We used 2 types of cells；SV40T-Ag and human TERT immortalized HPDL ﬁbroblast cell lines（1-11）,
and SV40T-Ag immortalized HGE cell lines（OBA-9）. PDLIM5 expression in 1-11 and OBA-9 was conﬁrmed by immunoblot
analysis. To examine the roles of PDLIM5 in 1-11 and OBA9, PDLIM5 was knocked down by two diﬀerent siRNAs. 1-11 andOBA-9 with PDLIM5-knockdown were planted on grid-supported ﬂoating collagen gels, and formation of cell extensions
was examined. 1-11 and OBA-9 with PDLIM5-knockdown were cultured in cell culture inserts for cell migration assay.
Results: PDLIM5 expression was observed by immunoblot analysis in 1-11 and OBA-9. 1-11 with PDLIM5-knockdown
reduced cell extensions formation and migration activities, compared with control cells.
OBA-9 with PDLIM5-knockdown promoted cell extensions formation and migration activities, compared with control cells.
Conclusion: These results suggested that PDLIM5 may regulate cell extensions formation and migration activity of HPDL
and HGE cells during wound hearing. PDLIM5 would be used as a therapeutic agent for periodontal regeneration.
GB-14

Functional analysis of a DNA binding protein-coding gene in Treponema denticola

Keiko Yamashita＊1, Yurie Kitamura1,2, Toshiya Fukasawa1,2, Atsushi Saito1,2, Kazuyuki Ishihara2,3
1

Department of periodontology, Tokyo Dental College, 2Oral health science center, Tokyo Dental College,3
Department of microbiology, Tokyo Dental College

Background and objective: Treponema denticola is one of the predominant bacteria in deep periodontal pockets. T. denticola
has various virulence factors, such as major outer sheath protein（Msp）. However, the mechanism of the Msp expression
has yet to be clariﬁed. We previously found some genes coding for transcriptional regulators which might be implicated in
the regulation of msp expression. Among them, we focused on a gene coding for a DNA binding protein. The objective of
this study is to clarify the regulation mechanism of Msp expression through analysis of the function of the gene encoding the
DNA binding protein.
Materials and Methods: We constructed the mutant strain deficient in the gene coding for the DNA binding protein byhomologous recombination. Using this newly constructed mutant, we performed genetic analysis by DNA microarray and
qRT-PCR. Based on the results of the genetic analysis, we also analyzed some phenotypic changes of the mutant.
Results: The expression levels of msp or other genes coding for virulence factors in the mutant were similar to those of wild
type. However, the genes implicated in the motility of T. denticola were signiﬁcantly upregulated. Also, the moving patternof the mutant was considerably changed.
Conclusion: The gene coding for the DNA binding protein does not play a direct role in the regulation of msp or other genes
coding for virulence factors. However, it is suggested that the DNA binding protein plays a certain role in the regulation of
the genes implicated in the motility of T. denticola.

JSP/JACP Poster Session AAP2020

8

GB-15

Butyric acid modulates periodontal mechanical sensitivity in periodontitis in mice
Naoki Murakami＊1, 2, Masamichi Shinoda2, Koichi Iwata2, Hidekazu Nagashima1,
Hirotaka Akiyama1, Shingi Arai1, Shuichi Sato1

Department of Periodontology, Nihon University School of Dentistry, 2Department of Physiology, Nihon
University School of Dentistry1

Background and objective: It is well known that periodontitis gradually progresses accompanied by alveolar bone loss andprogressive inflammation without periodontal pain. However, the modulating mechanism of periodontal mechanicalsensitivity in periodontitis is poorly understood. In this study, we examined the involvement of butyric acid in the changes inperiodontal mechanical sensitivity in experimental periodontitis produced by Porphyromonas gingivalis（P.g.）in mice.
Materials and Methods: Under deep anesthesia, a 5-0 silk ligature was tied around the maxillary second molar, and P.g. was
inoculated into the tied silk ligature to establish the murine model of experimental periodontitis. Under light anesthesia,
mechanical stimulation was applied to the gingival tissue adjacent to cervical regions of the maxillary second molar by using
electronic von Frey anesthesiometer and the mechanical head withdrawal threshold（MHWT）was measured for 14 days.
On day 2 following the ligation, the expression of short-chain fatty acid receptor, GPR41, in trigeminal ganglion and theamount of butyric acid in the inflamed periodontal tissue. Moreover, we examined the changes in the MHWT in theexperimental periodontitis model by daily intra-periodontal GPR41 antagonist, hydroxybutyric acid administration.
Results: There was no change in the MHWT in the experimental periodontitis model for 14 days. GPR41 was expressed intrigeminal ganglion neurons and butyric acid was increased on day 2 following the ligation. The daily hydroxybutyric acidadministration decreased the MHWT decreased on day 8 following the ligation.
Conclusion: Butyric acid produced by P.g. in the periodontal tissue may contribute to periodontal mechanical sensitivity inperiodontitis.

GB-16

Investigation of junctional epithelial stem/progenitor cells using the multicolor lineage tracing
method.
Keisuke Tanaka＊1, 2, Junichi Tanaka2, Ryo Aizawa1, Mayu Kato-Tanaka1,
Hiroo Ueno3, 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, 3Department of Stem Cell Pathology, Kansai Medical
University

Background and objective: The junctional epithelium（JE）has a distinctive contribution to infection prevention, owing to
its location on the front lines of defense in the oral cavity, where it directly contacts the tooth surface. However, it remains
unclear whether the stem/progenitor cells exist in the JE. The aim of this study was to investigate the cell lineage and theexistence of stem/progenitor cells in the JE using the multicolor lineage tracing method.
Materials and Methods: All of the cells in the body were randomly labeled with four colors（green: GFP, blue: mCerulean,. The cell lineage
orange: mOrange, red: mCherry）using Rosa26CreERT2/rbw mice at postnatal week 4 with tamoxifen（TAM）
was analyzed in the JE of Rosa26CreERT2/rbw mice at 3 days, 4 and 8 weeks after TAM injection by ﬂuorescence microscopy.
Results: Labeled cells with four colors were found in the JE of Rosa26CreERT2/rbw mice at 3 days after TAM injection. Tworegions within JE were distinguished by colors and were diﬀerent from the oral epithelium in Rosa26CreERT2/rbw mice at 4 and8 weeks after TAM injection. Furthermore, three-dimensional imaging indicated the existence of two clonal cells in the JEof those mice.
Conclusion: Present study possibly suggested the existence of stem/progenitor cells in the JE. The long-term multicolor
lineage tracing observations will be needed to determine whether the stem/progenitor cells of JE survives in the long term
and contribute to homeostasis of JE.

JSP/JACP Poster Session AAP2020

9

GB-17

Endotoxemia by Porphyromonas gingivalis aggravates inﬂammation in brown adipose tissue
Masahiro Hatasa＊1, Yujin Ohsugi1, Sayaka Katagiri1, Tomomitsu Hirota2, Kazuki Watanabe1,
Shogo Maekawa1, Naoki Sasaki3, Hiromi Niimi1, Tuyoshi Shimohira1, Kazuki Morita1,
Sumiko Yoshida1, Hiroshi Nitta3, Takanori Iwata1

1

Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University,2
Department of Molecular Genetics, Research Center for Medical Science, The Jikei University School of Medicine,3
Behavioral Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University

Background and objective: Adipose tissue is known as not only storage organ for energy, but also endocrine organ. Since
adipocytes produce various kinds of adipocytokines, including adiponectin and inflammatory cytokines, many studies
suggested the relationship between adipocytes and systemic diseases. Especially, several reports have shown that thefunctional decline of brown adipose tissue is related to obesity. Previously, we reported that intravenous injection ofsonicated Porphyromonas gingivalis（Pg）increases body weight and visceral fat volumes in mice. However, the direct
eﬀects of bacillaemia by Pg on adipocytes remain unclear. This study was performed to evaluate the eﬀect of sonicated Pg
injection on adipocytes in short-term.
Materials and Methods: Endotoxemia was induced in male C57BL/6J mice（12-weeks-old）by intravenous injection ofsonicated Pg. The mRNA expression level in brown adipose tissue from interscapular fat was evaluated by qPCR at 18 hours
after Pg injection. Microarray analysis was performed in brown adipose tissue at 18 hours after Pg injection.
Results: The mRNA expression of inflammation-related genes in brown adipose tissue were increased, and Adipoq
expression was decreased. Gene set enrichment analysis revealed enrichedment of several inﬂammation-related gene sets
and downregulation of several gene sets, including PI3K AKT mTOR signaling, cholesterol homeostasis, and bile acids
metabolism in brown adipose tissue at 18 hours after Pg injection.
Conclusion: Endotoxemia by periodontitis may elicit inﬂammation and change the endocrine and lipid metabolism in brown
adipose tissue. These results suggested that endotoxemia by periodontitis might aﬀect obesity through disturbance of adipocytes.
GB-18

Insulin resistance in gingival ﬁbroblasts exacerbates experimental periodontitis in mice

Takanori Shinjo＊1, Thomas Van Dyke2, Hatice Hasturk2, George L King3, Fusanori Nishimura1
Section of Periodontology, Kyushu University, 2Forsyth Institute, 3Joslin Diabetes Center, Harvard Medical School

1

Background and objective: Periodontitis is known to be exacerbated and insulin resistance in the gingiva was shown in in
obesity and diabetes. We aimed determine how and in which type of cell insulin resistance contributes to exacerbation of
periodontitis in obesity and diabetes.
Materials and Methods: Smooth muscle protein 22α-Cre-IRfl/fl（SMIRKO）mice were generated by crossbreeding IRfl/fl
mice with SM22α-Cre mice. SMIRKO, wild-type（WT）and WT mice fed with high-fat-diet（HFD）for 8 weeks wereused. Gingiva samples were stimulated with 0-100nM insulin for 10 minutes. Experimental periodontitis was induced by
7-0 silk ligation around maxillary 2nd molars for 4 and 14 days. Additionally, primary gingival ﬁbroblasts（GFs）were
stimulated with E.coli lipopolysaccharides（LPS）for 6 hours in the presence or absence of pretreatment of 100nM insulin
pretreatment for 30 minutes.
Results: Gingival insulin receptor-beta（IRβ）expression in SMIRKO and HFD-fed mice was decreased by 70％ and 50％, respectively, with comparable reductions in insulin-induced phosphorylation of Akt. Ligature-induced alveolar boneloss in SMIRKO and HFD-fed mice was greater by 70％ and 40％ , respectively, as compared to regular diet（RD）-fed
WT mice. Neutrophil recruitment was delayed signiﬁcantly in both SMIRKO and HFD-fed mice. Similarly, decreased gene
expression of the neutrophil-recruiting factor CXCL1 was seen in the gingiva at day 4. Unlike SMIRKO and HFD mouse
GFs, WT GFs showed that insulin enhanced LPS-induced CXCL1 expression.
Conclusion: These data provided the ﬁrst evidence that insulin action is critical for neutrophil recruitment during infection
by enabling CXCL1 expression in GFs, which is inhibited in diabetes in response to bacterial LPS stimulation.

JSP/JACP Poster Session AAP2020

10

GB-19

Combination of functional water with hydroxyapatite / collagen composite accelerate boneregeneration
Yasumasa Ozawa＊1, Takahiro Gojoubori2, Hirotaka Ota2, 3, Akira Hasuike1, 4, Hisashi Suguro4, 5,
Tetsuya Nishida1, 4, Osamu Kishida1, Yuichi Saito1, Masatake Asano2, 3, Shuichi Sato1, 4Department of Periodontology, Nihon University School of Dentistry , 2Department of Pathology, Nihon University
School of Dentistry, 3Division of Immunology and Pathobiology, Dental Research Center, Nihon University Schoolof Dentistry, 4Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of
Dentistry, 5Department of Endodontics, Nihon University School of Dentistry1

Background and objective: Hydroxyapatite / collagen composite（HA/Col）can regenerative bone. Acid electrolyzed
functional water（FW）generated by electrolyzing saline has a sterilizing eﬀect. We have reported that FW accelerate theregeneration in rat mandibular boneʼs defect. Therefore, we evaluated the eﬀects of these combinations.
Materials and Methods: Artificial bone defects（5.0 mm diameter）were made on the 8-week-old female Wister rats
calvaria. The combinatorial group: 1 minute FW irrigation and HA/Col ﬁlling, The HA/Col group: 1 minute PBS irrigationand HA/Col ﬁlling, The FW group: 1 minute FW irrigation, HCL group: 1 minute HCL irrigation. The control group: PBS
irigation. New bone was measured by micro-CT for 6 weeks after surgery. Peripheral blood was collected before and 1, 6
and 24 h after surgery and subjected to ELISA. The surgical area was observed histologically and analyzed genetically.
Results: New bone was signiﬁcantly enhanced in the combinational group after 2-weeks of surgery. The enhanced boneformation was conﬁrmed with histological examination（HE）and the TRAP staining revealed the increased accumulationof osteoclasts around the bony rim in the combinational group. Real-time PCR analysis revealed that the expression of
osteogenesis- and angiogenesis-related mRNAs was increase in the combinational group. Among them, FGF2 concentrationin the peripheral blood increased in the combinational group 1 and 6 hours after surgery.
Conclusion: These ﬁndings suggest that FW facilitates new bone formation by inducing angiogenesis- and bone remodelingrelated genes. Taken together, FW was shown to improve the bone regeneration when used in combination with HA/Col.
GB-20

Role of quiescent osteoclast precursors in occlusal trauma in mice
Yasunori Yamashita＊, Yukio Ozaki, Kanako Higuchi, Masayuki Oohira,Megumi Mae, Ziauddin S.M., Atsutoshi Yoshimura

Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences
Background and objective: Traumatic occlusion promotes bone resorption at alveolar bone crest and furcation area andinduces osteoclasts in a relatively short period. It was reported that cell cycle–arrested quiescent osteoclast precursors（QOP）preexist at the site of osteoclastogenesis（J Cell Biol, 2009）. The purpose of this study was to clarify the role of
QOP in bone resorption caused by traumatic occlusion.
Materials and Methods: Occlusal trauma was induced in the lower left ﬁrst molar of mice by bonding a wire to the upper
left ﬁrst molar. The mice were injected intraperitoneally with bromodeoxyuridine（BrdU）, which can be incorporated into
dividing nuclei. The number of osteoclasts and percentage of BrdU-positive nuclei in total osteoclasts nuclei were counted
after tartrate-resistant acid phosphatase（TRAP）and BrdU double labeling. QOP was detected as TRAP-positive and
BrdU-negative cells.
Results: Following the application of traumatic occlusion for 2 days, hyalinized tissue appeared in the furcation area at theﬁrst molar in the mice. On day 3, many osteoclasts were observed at the top of the inter-radicular septum. A few TRAPpositive and BrdU-negative cells emerged in the furcation area on day 1 and increased until day 3. On day 5, TRAP-positive
and BrdU-negative cells were found in the furcation area.
Conclusion: QOP accumulated in the furcation area immediately after the application of traumatic occlusion, suggesting that
QOP played an important role in the rapid alveolar bone resorption caused by traumatic occlusion.

JSP/JACP Poster Session AAP2020

11

GB-21

Advanced glycation end products promote the COX2 expression of osteoblasts

Keiko Tomita＊1, Natsuko Tanabe2, Takashi Kato1, Noriyuki Arai1 Naoto Suzuki2, Shuichi Sato1
1

Department of Periodontology, Nihon University School of Dentistry, 2Department of Biochemistry, Nihon
University School of Dentistry

Background and objective: Periodontitis has been shown correlation with various metabolic syndrome. Particularly, an
epidemiological study showed that diabetes is associated with periodontitis（Demmer et al., 2011）. Advanced glycation end
products（AGEs）are formed by between the excess sugars and proteins produced from hyperglycemic disorders such as
diabetes. Thus, the involvement of advanced glycation end products（AGEs）has been focused as an important factor of
diabetes. However, the mechanism of AGEs effects on periodontitis are not well understood. We therefore aimed toinvestigate the eﬀect of AGEs on the expression of cyclooxygenase（COX）which is the synthetase of prostaglandin E2 is amajor factor of inﬂammation that causes the production of RANKL.
Materials and Methods: MC3T3-E1 cells were stimulated with LPS（10 ng/ml）and AGEs（100 μg/ml）. mRNA
expression of COX1, COX2, and RAGE was determined on days 3, 7, and 14 of culture using real-time PCR
Results: LPS + AGE increased mRNA levels of COX2 on day 14 of culture compared to LPS alone. LPS + AGE also
increased mRNA levels of RAGE on day 3 of culture compared to LPS alone. However, LPS + AGE did not aﬀect mRNAlevels of COX1 on day 3, 7, 14 of culture.
Conclusion: These results suggest that AGEs affect LPS-induced inflammation of osteoblasts. AGEs may promote
inﬂammatory bone resorption.

GB-22

Eﬀect of topical PTH administration in rat calvarial GBR model

Akira Hasuike＊1,2, Tatsuya Kubota1, Keiko Tomita1, Kenji Tanaka 1, Yasuo Tsuji1, Shuichi Sato1,2
1

Department of Periodontology, Nihon University School of Dentistry, 2Division of Advanced Dental Treatment,
Dental Research Center, Nihon University School of Dentistry

Background and objective: Intermittent administration of PTH（1-34）is one of common treatments of osteoporosis, andnot only increases the bone density but also promotes osteogenesis. In previous studies, we have shown that intraperitoneal
administration of PTH（1-34）promotes vertical bone augmentation in calvarial GBR model of ovariectomized
osteoporosis model rats. In this study, we investigated the eﬀect of local administration of PTH（1-34）on the same animalmodel.
Materials and Methods: At 6 weeks of age, ovariectomy（OVX-PTH rats）or Sham operation（control rats）was
performed. At 14 weeks of age, plastic caps were placed on calvaria of both group rats, following bone marrow penetration.
In the OVX-PTH rats, PTH（1-34）（35 μl / kg）was locally administered to the calvaria three times a week, the sameamount of saline was locally administered to control rats. Micro-CT images were taken every other week until week 12, andquantitative analysis of new bone-like tissue was performed. At 12 weeks, histochemical sections were prepared, andimmunostained..
Results: Formation of newly bone-like tissue was observed in both the groups in micro-CT. There was no significant
diﬀerence between two groups in the amount of newly formed bone-like tissue. Histological observation showed that many
blood vessels, osteoblasts and osteoclasts were found in the new bone in both groups by HE staining.
Conclusion: It was showed that intermittent topical administration of PTH（1-34）to the GBR site reduced the eﬀects ofestrogen deﬁciency on bone augmentation and restored bone growth to healthy levels.

JSP/JACP Poster Session AAP2020

12

GB-23

Collagen membrane as GBR material in rat vertical augmentation model
Shuichi Sato＊1,2, Yasumasa Ozawa1,2, Tatsuya Kubota1, Hisashi Ujiie1,
Kazunari Ando1, Akira Hasuike1,2

1

Department of Periodontology, Nihon University School of Dentistry, 2Division of Advanced Dental Treatment,
Dental Research Center, Nihon University School of Dentistry

Background and objective: In GBR（Guided Bone Regeneration）procedure, a space for bone regeneration is secured byusing GBR barriers. Recently, highly permeable materials such as absorbable membranes have been clinically used for
GBR. In this study, the effects of collagen membrane for GBR were examined by both radiographic and histologicalassessments in rat calvaria.
Materials and Methods: Ten-week-old male rats（F344 / jcl）were used. The calvaria of rats were exposed, and plastic
pipes were placed bilaterally. Each pipe was ﬁlled with Bio-Oss®, and collagen membranes（Bio-Gide®）were put on thehalf of plastic pipes as lid（BG）. The others were kept with no tops（OP）. Surgery was performed at week 0, and images
were taken up to 12 weeks by using with micro-computed tomography（micro-CT）. In addition, paraﬃn-embedded andresin-embedded sections at 12 weeks were assessed histologically.
Results: Formation of newly bone-like tissue was observed in both the groups in micro-CT. There was no significant
diﬀerence between two groups in the amount of newly formed bone-like tissue. Histological observation showed that newbone formation was observed surrounding Bio-Oss® particles at 12 weeks in both groups. However, inﬁltration area ofﬁbrous connective tissue was conﬁrmed in the upper part inside of pipes in the OP group.
Conclusion: Although inﬁltration of ﬁbrous soft tissue was large in OP groups, newly formed bone tissue was conﬁrmed in
rat calvaria GBR model made with high permeable barrier.

GB-24

Proinﬂammatory nature of aspirated periodontopathic bacteria may cause pneumonia
Norihisa Watanabe＊1, Sho Yokoe1, Kenichi Imai2, Shuichi Sato1

Department of Periodontology, Nihon University School of Dentistry, 2Department of Microbiology, Nihon
University School of Dentistry1

Background and objective: Aspiration pneumonia is a major health problem owing to its high mortality rate in elderly
people. The secretion of proinﬂammatory cytokines such as IL-8 and IL-6 by respiratory epithelial cells, which is induced
by infection of respiratory bacteria such as Streptococcus pneumoniae（S.p）, contributes to the onset of pneumonia. These
cytokines thus play a key role in orchestrating inﬂammatory responses in the lower respiratory tract. Although emerging
evidence has revealed an association between aspiration pneumonia and periodontitis, how periodontitis contributes to theonset of aspiration pneumonia remains unclear. Most periodontopathic bacteria are anaerobic and are therefore unlikely tosurvive in the lower respiratory organs of humans. Hence, we aimed to elucidate whether exposure to heat-inactivatedperiodontopathic bacteria induces proinﬂammatory cytokine production by several human respiratory epithelial cells and in
the lower respiratory organs and serum in mice.
Results: Periodontopathic bacteria, especially Fusobacterium nucleatum（F.n）strongly induced IL-8 and IL-6 production
by BEAS-2B bronchial epithelial cells. In addition, F.n induced IL-8 production by A549 alveolar epithelial cells as well as
IL-8 and IL-6 production by Detroit 562 pharyngeal epithelial cells. Furthermore, F.n induced considerably higher cytokine
production than S.p. This was also observed in the entire lower respiratory organs and serum in mice.
Conclusion: F.n is a powerful inﬂammatory stimulant for respiratory epithelial cells and can stimulate cytokine production,
thereby potentially contributing to the onset of aspiration pneumonia.

JSP/JACP Poster Session AAP2020

13

GB-25

Laser irradiation decreases Sost expression in bone and osteogenic cells

Yujin Ohsugi＊1, Sayaka Katagiri1, Tomomitsu Hirota2, Hiromi Niimi1, Masahiro Hatasa1,
Kazuki Watanabe1, Tsuyoshi Shimohira1, Koji Mizutani1, Moe Kitazawa3, Ayumi Matsuzawa3,
Hiroshi Kadokura4, Satoshi Yokose4, Takanori Iwata1, Akira Aoki1
1

Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental
University, 2Department of Molecular Genetics, Research Center for Medical Science, The Jikei University Schoolof Medicine, 3Department of Epigenetics, Medical Research Institute, Tokyo Medical and Dental University,
4
Division of Endodontic and Operative Dentistry, Department of Restorative and Biomaterials Sciences, School of
Dentistry, Meikai University
Background and objective: Er: YAG laser has been applied for bone ablation in both periodontal and peri-implant surgery.
However, the eﬀects of Er: YAG laser irradiation on bone tissue remain unclear. The purpose of this study was to evaluate
comprehensive and sequential gene expression in Er: YAG laser-ablated, bur-drilled, and non-treated control bones toclarify the biological responses. Furthermore, bio-stimulation eﬀect of Er: YAG laser on osteogenic cells was investigated.
Materials and Methods: The calvarial bone of male, 10-week-old Wistar rats was ablated by Er: YAG laser andconventional bur. Gene expression in the laser-ablated, bur-drilled, and non-treated control bones at 6, 24, and 72 h were
evaluated by microarray. Osteoblast-like cells were isolated from the calvaria of 3–5-days-old Wistar rats and cultured withosteoinduction medium to induce osteogenic cells. Osteogenic cells were irradiated using Er: YAG laser at energy ﬂuencesof 1.5 and 3.1 J/cm2.
Results: Gene expression patterns were clearly diﬀerent among non-treated, bur-drilled, and laser-irradiated bone tissues at
24 hours. Gene Set Enrichment Analysis showed inﬂammation-related gene sets were enriched in the bur-drilled bone at 6h, whereas these gene sets were enriched in the laser-ablated bone at 72 h compared to that of the control bone. Er: YAG
laser irradiation suppressed Sost expression both in bone tissue and osteogenic cells. Diﬀerentially expressed genes between
bur-drilled and laser-ablated bone showed that less inﬂammation was induced in the laser-ablated bone.
Conclusion: Our study suggests that bone ablation with Er: YAG laser may stimulate osteocytes in the bone tissue andinduce advantageous responses in new bone formation.
GB-26

Involvement of CXCR4 in alveolar bone resorption in periodontitis-mice
Hidekazu Nagashima＊1, Naoki Murakami1,2, Hariu Kotaro1, Takane Masatoshi1,
Masamichi Shinoda2 , Koichi Iwata2 , Shuichi Sato1

Department of Periodontology, Nihon University School of Dentistry, 2Department of Physiology, Nihon
University School of Dentistry1

Background and objective: Periodontitis caused by bacterial infection progresses periodontal tissue destruction little by little.
As a result, teeth lose their supporting structures, and this leads to the loss of a tooth. CXC-chemokine receptor 4（CXCR4）
is known to be expressed in lymphocytes, fibroblasts, and osteoclasts in periodontal tissues, suggesting that periodontal
CXCR4 signaling contributes to alveolar bone resorption at the periodontitis. However, the role of CXCR4 signaling in thepathogenesis of periodontitis has remained unknown.
Materials and Methods: We established a mouse model of periodontitis by ligating a silk thread to the upper molar andinoculating Porphyromonas gingivalis（P.g.）. In order to conﬁrm whether this periodontitis model progress without pain,
the mechanical pain threshold at periodontal tissue was compared with positive control using CFA. Furthermore, a CXCR4
neutralizing antibody was administered to periodontal tissue after P.g. inoculation, bone resorption was observed in theexperimental period using μ-CT, and tissue staining was performed to observe cells inﬁltrated locally.
Results: It was indicated that this periodontitis model using P.g. progress with no pain increase. In this periodontitis model,
administration of CXCR4 neutralizing antibody enhanced inﬂammatory cell inﬁltration in periodontal tissue on day 14 of
the experimental periods and enhanced bone resorption on days 4 to 14.
Conclusion: These ﬁndings suggest that periodontal CXCR4 signaling in several type of immune cells in the situation of
periodontitis induced by P.g. depresses alveolar bone resorption. CXCR4 signaling might be a target for therapeuticintervention to prevent alveolar bone resorption in periodontitis.

JSP/JACP Poster Session AAP2020

14

GB-27

The eﬀects of Er: YAG laser irradiation on primary osteoblast-like cells
Hiromi Niimi＊1, Yujin Ohsugi1, Sayaka Katagiri1, Kazuki Watanabe1, Masahiro Hatasa1,
Tsuyoshi Shimohira1, Shogo Maekawa1, Tomomitsu Hirota2, Hiroshi Kadokura3,
Satoshi Yokose3, Takanori Iwata1, Akira Aoki1

1

Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental
University, 2Department of Molecular Genetics, Research Center for Medical Sciences, The Jikei University Schoolof Medicine, 3Division of Endodontic and Operative Dentistry, Department of Restorative and Biomaterials
Sciences, School of Dentistry, Meikai University
Background and objective: A number of reports have shown that various lasers have favorable biological eﬀects on cells.
However, the eﬀects of low-level Er: YAG laser irradiation on osteoblasts remain unclear. The purpose of this study was toevaluate the effects of low-level Er: YAG laser irradiation on proliferation and osteogenic differentiation of primaryosteoblast-like cells.
Materials and Methods: Osteoblast-like cells isolated from the calvariae of 3–5-day-old Wistar rats were irradiated by Er:
YAG laser at energy ﬂuences of 2.2, 3.3, or 4.3 J/cm2. Cell surface temperature was measured and cell proliferation was
evaluated. Calciﬁcation was evaluated by measuring the Alizarin red S staining area after 7-day-culture with osteoinductive
medium. Gene expressions in non-irradiated and laser-irradiated cells were evaluated by qPCR at 3, 6, and 12 hours after
irradiation. Microarray analysis was performed to comprehensively evaluate gene expressions of non-irradiated cells andirradiated cells at 3.3 J/cm2 at 6 hours after irradiation.
Results: No pronounced increase of cell surface temperature was induced by low-level Er: YAG laser irradiation, and theirradiation did not aﬀect osteoblast-like cell proliferation. Calciﬁcation was signiﬁcantly increased 7 days after irradiation at
3.3 J/cm2. Bglap expression was signiﬁcantly increased in cells irradiated at 3.3 J/cm2 at 6 hours post-irradiation. Microarray
analysis showed that irradiation at 3.3 J/cm2 up-regulated of inﬂammation-related genes and down-regulated of Wisp2.
Gene set enrichment analysis clariﬁed enrichment of inﬂammation-related and Notch signaling gene sets.
Conclusion: Low-level Er: YAG laser irradiation enhanced calciﬁcation of primary osteoblast-like cells via enhanced Bglap
expression and enriched Notch signaling.
GB-28

Eﬀects of Porphyromonas gingivalis LPS on cardiac function in mice
Ichiro Matsuo＊
Department of Periodontology, Tsurumi University School of Dental Medicine

Background and objective: Periodontitis was recently reported to induce activation of sympathetic nervous systems. On theother hand, chronic activation of sympathetic activity is known to induce the development of cardiac remodeling and heart
failure. We thus examined in mice treated with lipopolysaccharide derived from Porphylomonas gingivalis（PG-LPS）at a
dose equivalent to the circulating levels in patients with periodontitis with/without ß-adrenergic receptor（ß-AR）blocker
propranolol（PPL）.
Materials and Methods: Mice（C57BL6/J）were divided into four groups: 1）Control group, 2）LPS group（0.8mg/kg/
day i.p.）, 3）PPL group（via the drinking water containing 1g/L）, and 4）PPL+LPS group.
Results: After 1 week, we examined the cardiac function using echocardiography. Cardiac function as exempliﬁed by the left
ventricular cardiac function was signiﬁcantly decreased by the treatment of PG-LPS（Control（n=6）vs. LPS（n=6）: 66 ±0.5 vs. 57 ± 0.9％, P＜0.001 vs. Control）. However, co-treatment of PPL suppressed the decrease of PG-LPS-mediated cardiac
dysfunction（62 ± 0.6％ , n=5, P＜0.001 vs. LPS group）. The number of apoptotic myocytes was increased（approximately
10-fold）and the area of ﬁbrosis was increased（approximately 2-fold）. Again, these increases were abrogated by the cotreatment of PPL. The impairment of cardiac function in PG-LPS-treated mice appears to involve dysregulation of Ca2+
homeostasis in cardiac myocytes induced by ß-AR activation and its downstream molecules via PG-LPS.
Conclusion: Our results indicated that ß-AR signaling might be new therapeutic targets for treatment of cardiovasculardisease in patients with periodontitis.

JSP/JACP Poster Session AAP2020

15

GB-29

LIPUS stimulation promotes collagen synthesis via P2X7 receptor.
Soichiro Manaka＊, Natsuko Tanabe, Keiko Tomita, Yoshitomo Moriya,
Eiji Goke, Naoto Suzuki, Shuichi Sato1
Nihon University School of Dentistry

Background and objective: Low-intensity pulsed ultrasound（LIPUS）is a clinically applied medical device in the medical
and dental ﬁelds. In addition, it has been reported that P2X7 receptor, a receptor for adenosine triphosphate, is involved inbone formation by mechanical signaling. Further, type I collagen（Col I）is one of the major protein components ofextracellular matrix protein produced in bone tissue and is particularly involved in osteoblastic bone formation. However,
the interaction between LIPUS-induced ATP and collagen metabolism at the P2X7 receptor has not been clariﬁed. In thisstudy, we examined the role of P2X7 receptor on collagen metabolism in LIPUS-induced bone formation by cell biologicaland molecular biology.
Materials and Methods: Osteoblastic MC3T3-E1 cells were seeded on a 6 well plate and cultured in the presence or absenceof the selective P2X7 receptor inhibitor A438079, followed by 30 min/day of LIPUS stimulation using OSTEOTRON D2. In
addition, these cells transfected with P2X7 shRNA（P2X7 knockdown cells；shP2X7）were also prepared and stimulatedwith LIPUS under the same conditions. The protein expression of Col I and matrix metalloproteinases（MMPs）was
determined using ELISA.
Results: In both osteoblastic MC3T3-E1 cells in the presence of A438079 and their P2X7 knockdown cells（shP2X7）,
LIPUS stimulation reduced the protein expression of Col I, whereas induced the protein expression of MMP-1, 3, and 13.
Conclusion: These results suggest that LIPUS promotes osteogenesis by stimulating osteoblastic collagen metabolism to thesynthetic system via the P2X7 receptor.

GB-30

The eﬀect of sword bean extract on periodontitis and atherosclerosis in miceShunsuke Yanase＊1, Kosei Matsumoto1, Ayuko Takada2, Yasushi Furuichi1

Department of Oral Rehabilitation, Division of Periodontology and Endodontology School of Dentistry, Health
Sciences University of Hokkaido, 2Division of Biochemistry, Department of Oral Biology, Health Sciences
University of Hokkaido

1

Background and objective: Recently, several studies have suggested that periodontitis accelerates atherosclerosis（AC）.
Our laboratory reported that sword beans extract（SBE）has eﬀects for anti-inﬂammatory and anti-bacterial in periodontal
tissue. The purpose of this study was to examine the eﬀect of SBE on AC accelerated by periodontitis.
Materials and Methods: Six-weeks-old male ApoE-/- mice were induced periodontitis by oral P. gingivalis infection（P. g）
or 5-0 silk ligature tied around the molars（Lig）. They were randomly divided into six groups as follows: ① AC（Control）,② P. g, ③ Lig, ④ SBE（added to drinking water starting at 7 weeks of age）
, ⑤ P. g+SBE, ⑥ Lig+SBE. All the mice fed
high fat diet. At the age of 17 weeks, all the mice were sacriﬁced. Periodontal tissue and aorta were evaluated histologicallyand morphologically. The gene expressions of iNOS, IL-6 and TNF-α in the heart tissue were evaluated.
Results: The amount of alveolar bone loss in the Lig+SBE was signiﬁcantly lower than that of the Lig. In analysis of thecross sections in aorta, P. g ＋ SBE and Lig ＋ SBE were signiﬁcantly lower in area of atherosclerosis than P. g and Lig.
Gene expression of iNOS and TNF-α in the heart of P. g ＋ SBE were signiﬁcantly lower than that of P. g.
Conclusion: This study indicated that SBE down-regulated iNOS gene expression and inhibited progression of AC
accelerated by periodontitis. It was suggested that SBE could be applied as a therapeutic agent for AC.

JSP/JACP Poster Session AAP2020

16

GB-31

LIPUS enhances rhBMP9-induced bone formation in rat calvarial bone defects
Takatomo Imafuji＊, Yoshinori Shirakata, Yukiya Shinohara,
Toshiaki Nakamura, Kazuyuki Noguchi

Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences
Background and objective: It has recently been reported that bone morphogenetic protein（BMP）-9 has great
osteoinductive properties in pre-clinical studies in various craniofacial/periodontal bone defects. Bone repair is also
regulated by local mechanical stimulation. Therefore, the aim of this study was to examine the combined eﬀects of Lowintensity pulsed ultrasound（LIPUS）and recombinant human（rh）BMP-9 on bone healing in rat calvarial defects.
Materials and Methods: Circular calvarial defects were surgically created in 18 wistar rats. The animals were divided into
two groups（LIPUS-applied（+）and LIPUS-non-applied（-））and the 36 defects in each group randomly received thefollowing treatments: absorbable collagen sponge（ACS）（φ 2.7 mm）implantation（ACS）, ACS with 1.0 µgrhBMP-9（rhBMP9/ACS）and empty control（control）. As a result, the following 6 groups（control（+）/（-）, ACS（+）/（-）,
and rhBMP9/ACS（+）/（-））were evaluated. The LIPUS-applied group received daily LIPUS exposure starting
immediately after the surgery. At 4 weeks, the animals were sacriﬁced for micro-CT and histologic evaluation.
Results: Postoperative clinical healing was uneventful at all 72 sites. More new bone was observed in the LIPUS-applied, newly formed bone area（+）group compared to the LIPUS-non-applied（-）group. The bone volume（2.46±0.65mm3）（NBA）（1.25±0.31mm2）and NBA/total defect area（62.80±11.87％）in the rhBMP9（+）group were significantly
greater than those（1.76±0.44mm3, 0.88±0.22mm2 and 42.66±7.03％ respectively）in the rhBMP9（−）group（p＜0.05）. Furthermore, the rhBMP9（+）group showed the highest level of bone formation among all the groups.
Conclusion: The present results suggest that LIPUS enhances rhBMP-9-induced bone formation in calvarial defects in rats.

GB-32

Behavior of MC3T3-E1 cells on strontium doped titanium surface
Urangoo Sugarbaatar＊1, Takashi Kado1, Takashi Nezu2, Futami Takebe Nagano2,
Yuki Ichioka1, Kazuhiko Endo2, Yasushi Furuichi1

1

Division of Endodontology and Periodontology, 2Division of Biomaterials and Bioengineering, Department of Oral
Rehabilitation, Health Sciences University of Hokkaido.

Background and objective: The purpose of the study was to establish a new and simple coating method on the mirrorﬁnished Ti surfaces to enhance titanium/bone integration.
Materials and Methods: Commercially pure grade-2 titanium disks were mechanically polished using colloidal silica. The
test groups were immersed in 5％ NaOCl solution for 24 h and ultrasonically cleaned in distilled deionized water（DDW）,
dipped in 1％ Sr（NO3）
2 solution for 30 seconds, dried with spinning and were subsequently treated with or w/o ultrasonic
DDW. The control group was as-polished titanium disks. The concentrations of various ions, doped in each surface, were
evaluated with SPM, strontium ions concentration released were examined with ICP-OES and wettability was measured.
Afterward, specimens were transferred to 24 well plates and MC3T3-E1 cells were seeded at 100x103/well. After 2h,
attached cells to each surface were counted.
Results: Sr ions released on day 1 of the NaOCl-Sr specimens was 5.69 ppm, 0.05 ppm on day 3 and within 1 week almost
no Sr ions was detected. The Sr ions of the NaOCl-Sr-washed specimens, on day 1 was 0.64 ppm, which as one order ofmagnitude lower than that of the NaOCl-Sr. The amount of released Sr ions decreased with time. The number of theattached cells on the NaOCl-Sr was higher than on the NaOCl-Sr-washed surface. The NaOCl-Sr-washed and as-polishedsurfaces were less adhesive than the polystyrene-dish.
Conclusion: The Sr doped smooth titanium surface could be created by simple chemical treatments. The surfaceʼs physicalproperties were enhanced by Sr inducement.

JSP/JACP Poster Session AAP2020

17

GB-33

Eﬀect of aging on junctional molecules of gingival epithelial cells
Sarita Giri＊1, Ayuko Takada2, Matsushita Kenji3, Masae Furukawa3, Yasushi Furuichi1

Division of Periodontology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health
Sciences University of Hokkaido, 2Division of Biochemistry, Department of Oral Biology, School of Dentistry,
Health Sciences University of Hokkaido, 3Department of Oral Disease Research, National Centre for Geriatrics andGerontology
1

Background and objective: Aging causes progressive dysfunction in the mechanical and biochemical function of tissues.
Junctional molecules have critical role in maintaining epithelial homeostasis. Age related destruction of gingival tissues
might be the consequences of altered junctional molecules. We aimed to elucidate altered expression of clauin-1, 2 andE-cadherin in young and senescence induced gingival epithelial cells with and w/o Porphyromonas gingivalis
Lipopolysaccharides（Pg LPS）.
Materials and Methods: Human gingival epithelial cells（HGEP）were treated with hydrogen peroxide（H2O2）to induce
senescence. 400µM of H2O2 was considered as optimal concentration to induce senescence, which was conﬁrmed from thevitality test, senescence associated β-galactosidase staining and mRNA expression of senescence markers, p16, p21 and p53.
The cells were divided into four groups；young cells（Control）, young+H2O2（Old）, young+LPS（Y+LPS）and old+LPS（O+LPS）. For LPS treatment, cells were treated with Pg LPS（1µgmL-1）. The mRNA and protein expression of junctional
proteins such as claudin-1, -2 and E-cadherin were compared using quantitative real time polymerase chain reaction andwestern blot, respectively. Mann-Whitney U test was used to test the signiﬁcance.
Results: The mRNA expression of claudin-1, -2 and E-cadherin were all upregulated in the old cells as compared to young
and Y+LPS cells whereas claudin-1 and E-cadherin was downregulated in O+LPS cells as compared to old cells（p＜0.05）.
The protein expression, conﬁrmed by western blot were all in accordance with the mRNA expression.
Conclusion: Age related alteration of junctional molecules may be responsible for progressive tissue destruction in elderly
gingival tissues.
GB-34

Eﬀects of mechanical stress on cells derived from human oral mucosa
Toshiro Yamamoto＊, Kenta Yamamoto, Tetsuya Adachi, Taku Asai,
Fumishige Oseko, Narisato Kanamura

Department of Dental Medicine, Kyoto Prefectural University of Medicine Graduate School of Medical Science
Background and objective: The oral mucosa is exposed to mechanical stress（MS）including occlusal force via the denture.
In this study, we applied MS to cells derived from human oral mucosa and evaluated its eﬀects.
Materials and Methods: Subconﬂuent human oral mucosal epithelial cells（HO-1-N-1）and human gingival ﬁbroblasts（HGF）were used to seed 1 105 cells/dish and, after 24 hours, subjected to MS（1 and 3 MPa, 60 min）using a hydrostaticpressurizer. Morphological changes of the cells were examined by Giemsa stain, and changes in cell activity were measured
by the WST assay. mRNA was collected from the cells, and inflammatory cytokines and growth factors genes were
measured by real-time RT-PCR assay and ELISA.
Results: HO-1-N-1 showed no morphological change by Giemsa stain but exhibited a signiﬁcant decrease in cell activity
by WST assay. In HO-1-N-1, the expression of inﬂammatory cytokines, and ICAM mRNA was signiﬁcantly increased after
MS at 1 MPa but was attenuated at 3 MPa. In HGF, the expression of IL-6 mRNA was enhanced. In HO-1-N-1 and HGF,
the IL-6 and IL-8 protein levels increased signiﬁcantly after MS. In HGF, the EGF and FGF-2 protein levels increased
signiﬁcantly by stimulation at 3 MPa.
Conclusion: MS applied to the oral mucosa caused a decrease in the activity of oral mucosal epithelial cells and induced
enhancement of inﬂammatory cytokine production. Also, excessive MS was suggested to promote the cure of oral mucosa
wounds by promoting the production of growth factors in the oral mucosa.

JSP/JACP Poster Session AAP2020

18

GB-35

Anti-inﬂammatory eﬀects of β-cry on 5FU-induced cytokine production in hOMF
Fumishige Oseko＊, Toshiro Yamamoto, Yoshiki Sato, Shigeta Takizawa,
Keiji Adachi, Mitunobu Akane, Masaru Nishigaki, Narisato Kanamura

Department of Dental Medicine, Kyoto Prefectural University of Medicine Graduate School of Medical Science
Background and objective: Beta-cryptoxanthin（β-cry）, a carotenoid abundant in satsuma mandarin, has anticancer andantioxidant eﬀects. We previously reported the anti-inﬂammatory eﬀects of β-cry on the periodontal ligament. However, theeﬀects of β-cry on oral mucositis, an adverse event due to cancer chemotherapy, remain unclear.
Fluorinated pyrimidines are frequently employed for oral cancers, with a high incidence of stomatitis. In the present study,
we examined the eﬀects of 5-ﬂuorouracil（5-FU）and β-cry on oral mucosal ﬁbroblasts.
Materials and Methods: Human oral mucosal ﬁbroblasts（hOMF）were cultured with 5FU（1 Hg/mL）and/or β-cry（100nM）. Then, a cell proliferation test was performed by WST assay and the expressions of inflammatory cytokines andapoptosis-related genes were examined by real-time RT-PCR.
Results: The proliferation of hOMF was inhibited by the addition of 5-FU, and the inhibition was suppressed with β-cry.
Inﬂammatory cytokines, such as IL-1β, IL-6, and IL-8, and the ratio of Bax/Bcl-2 in hOMF were increased with 5-FU, andthe increase was suppressed with β-cry.
Conclusion: Beta-cry may have anti-cytotoxic and anti-inﬂammatory eﬀects on oral mucositis caused by 5-FU, suggestingthat it may provide a novel method for preventing oral mucositis due to cancer chemotherapy.

JSP/JACP Poster Session AAP2020

General（Clinical Research）

19

GC-01

Clinical outcomes of rhFGF-2 therapy with M-MIST for intrabony defects
Kentaro Imamura＊, Jooree Iwaki, Kouki Yoshikawa, Hideto Aoki, Takahiro Bizenjima,
Daisuke Irokawa, Fumi Seshima, Atsushi Saito
Department of Periodontology, Tokyo Dental College

Background and objective: Modiﬁed Minimally Invasive Surgical Technique（M-MIST）（Cortellini and Tonetti 2009）
was designed to improve wound stability and reduce patient morbidity. This case-series aimed to evaluate clinical outcomesof periodontal regenerative therapy using recombinant human ﬁbroblast growth factor（rhFGF）-2 with M-MIST for thetreatment of intrabony defects.
Methods: Following initial periodontal therapy, six intrabony defects（mean depth；3.6 mm, width；2.1 mm）in four
patients received rhFGF-2 therapy with M-MIST. A buccal incision was placed to gain access to the defect without
interdental and lingual incisions. After granulation tissues were removed by sharp dissection and root instrumentation, 0.3％
rhFGF-2 was applied to the defect. Flaps were immediately closed by sutures. Probing depth（PD）, clinical attachmentlevel（CAL）, gingival margin（GM）, and radiographic bone fill were evaluated at baseline, 3 and 6 months
postoperatively.
Results: The mean surgical time was 48 ± 5 minutes. Early wound healing was uneventful: primary wound closures wereobtained in all sites at 1 week postoperatively. Patients did not report any pain or swelling. At 6-months postoperatively,
mean PD reduction was 3.8 ± 0.8 mm and CAL gain was 4.3 ± 0.5 mm. A minimal increase in gingival recession（-0.5± 0.5 mm）was recorded. An improvement in radiographic bone ﬁll（53.3± 33.3％）was noted.
Conclusion: This case series showed that rhFGF-2 therapy with M-MIST yielded favorable clinical and radiographic
outcomes in the treatment of intrabony defects.

GC-02

Periodontal regeneration using rhFGF-2 with DBBM: An 18-month follow-up of arandomized controlled trial

Hideto Aoki＊1, 2, Atsushi Saito1, 2, Masahiro Sato1, Kouki Yoshikawa1, Wataru Yoshida1,
Yurie Kitamura1, Daisuke Matsugami1, 2, Daichi Kita1, 2, Kentaro Imamura1, 2, Daisuke Irokawa3,
Takahiro Bizenjima3, Akihito Soma1, Yasuo Hosaka1, Fumi Seshima1, Sachiyo Tomita3
1

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

Background and objective: In our earlier randomized controlled trial comparing use of recombinant human ﬁbroblast growth
factor（rhFGF）-2 in combination with deproteinized bovine bone mineral（DBBM）and rhFGF-2 alone in the treatment
of intrabony defect, we reported no signiﬁcant diﬀerence in clinical attachment level（CAL）gain between groups at 6
months. We also showed that the combination therapy yielded an enhanced radiographic outcome. The aim of this follow-up
study is to evaluate the outcomes at 18 months postoperatively.
Materials and Methods: Participants in the base study（Saito et al. JCP 2019）were reevaluated at 12 and 18 months
postoperatively. Original measures（clinical parameters and patient-reported outcome measure）were repeated.
Radiographic bone ﬁll was evaluated at 12 months.
Results: At 18 months postoperatively, a total of 38 sites in 30 patients were reevaluated. In both test（rhFGF-2+DBBM）
and control（rhFGF-2 only）groups, there was a progressive improvement in CAL and PD values during maintenance care.
No significant difference between groups was observed. At 12 months, mean value for radiographic bone fill in the test
group（54.6％）was significantly greater than that in the control group（36.7％）（p = 0.003）. In both groups, nosigniﬁcant change in total OHRQL score was observed at 18 months.
Conclusion: In the treatment of intrabony defects using rhFGF-2, with or without DBBM, further improvement in CAL wasobserved at 18-month follow-up. The combination therapy yielded a signiﬁcantly greater bone ﬁll. In both groups, favorable
clinical outcomes can be sustained for at least 18 months.

JSP/JACP Poster Session AAP2020

20

GC-03

Oral health behavior and the oral condition of pregnant women

Nobuhiro Chinju＊1, Michiko Furuta1, 2, Masayuki Nakano1, Koji Obara1, Masahiro Ikeda1,
Izumi Kominami1, Takehiro Harada1, Megumi Oishi1, Yuko Koishi1, Satoru Haresaku1, 3,
Yukio Ishikura1, Kazuyoshi Tanaka1, Keisuke Moritani1, Kimihiko Mishima1, Cyuken Ryu1,
Kiyotaka Hagiwara1, Yasufumi Tajima1, Yuka Okabe1, 2, Shinya Yasumoto1, Shinji Kanda1
1

Fukuoka Dental Association, 2Section of Preventive and Public Health Dentistry, Division of Oral Health, Growthand Development, Faculty of Dental Science, Kyushu University, 3Department of Nursing Division of Basic
Medical Science and Fundamental Nursing, Fukuoka Nursing College

Background and objective: The association between periodontal disease and low birth weight has been previously reported.
Therefore, maintaining good oral hygiene during pregnancy is important to reduce the risk of a poor pregnancy outcome.
The objective of this study was to investigate oral health behavior in relation to oral condition in pregnant women.
Materials and Methods: Fukuoka City provides health services, including dental examinations, for pregnant women. Pregnant
women who underwent examinations between 2018 and 2019（n = 4,275）participated in this study. The presence of
decayed teeth was evaluated, and periodontal disease was assessed using the modiﬁed Community Periodontal Index（CPI）.
Results: The percentage of pregnant women with decayed teeth and deep periodontal pockets（pocket score 2 in CPI）was
49.4％ and 12.9％ , respectively. Logistic regression analysis showed that the presence of decayed teeth was associated withno regular dental visits before pregnancy（odds ratio［OR］2.22, 95 ％ conﬁdence interval［CI］1.95–2.52）and eating
between meals, three times and over per day（OR 1.24, 95％ CI 1.00–1.54）. The deep periodontal pockets were associatedwith no regular dental visits before pregnancy（OR 1.61, 95％ CI 1.31–1.98）and no use of dental ﬂoss（OR 1.26, 95％
CI 1.04–1.52）.
Conclusion: This study found that pregnant women who did not regularly visit a dental clinic before pregnancy tended tohave poor oral conditions. It is suggested that pregnant women focus on their oral health behavior in order to maintain goodoral health.
GC-04

Systemic parameters associated with periodontal inﬂamed surface area
Toshiya Fujii＊1, Norio Aoyama1, Mariko Ozawa1, Sayuri Kida1, Ichirota Nozawa2,
Motoki Fujiwara2, Katsushi Tamaki2, Masato Minabe1

Department of Oral Interdisciplinary Medicine, Kanagawa Dental University, 2Department of Critical Care
Medicine and Dentistry, Kanagawa Dental University,

1

Background and objective: The association between periodontitis and systemic disease has been shown, and it has beenreported that patients with severe periodontal disease are likely to develop systemic disease. Periodontal inﬂamed surfacearea（PISA）is the total surface area of the periodontal pocket at the sites with bleeding on probing. Although theusefulness of PISA as a periodontal indicator, information on the link between PISA and markers for systemic disease is still
scarce. The purpose of the present study was to clarify systemic parameters associated with PISA.
Materials and Methods: Subjects were recruited at Medical and Dental Collaboration Center in Kanagawa Dental University
Hospital from 2018 to 2020. PISA was calculated from the periodontal pocket depth and bleeding on probing, and oral
function examinations, body composition analysis, and blood tests were performed. Comparative analysis was performed for
PISA and markers of general condition. The Ethics Committee of Kanagawa Dental University approved the protocol of thepresent study（No, 553）.
Results: Totally 200 participants（136 women and 64 men）with mean age of 68.3 were enrolled in this study. The systemic
markers correlated with PISA were body fat mass, percent body fat, body mass index, waist circumference, calf
circumference, and serum gamma-GTP. In addition, oral markers correlated with PISA were protein, leukocyte, halitosis,
salivary occult blood, and red-complex bacteria in dental plaque.
Conclusion: The results of this study revealed a link between PISA, a periodontal inﬂammation marker, and many systemic
and oral disease markers.

JSP/JACP Poster Session AAP2020

21

GC-05

Risk factors for chemotherapy-induced febrile neutropenia in hematological cancer patients
Yuka Sogawa＊1, 2, Makoto Fukui1, Shingen Nakamura3, Kimiko Sogabe3,
Ryohei Sumitani3, Masami Yoshioka2, Masahiro Abe3, Daisuke Hinode1

1

Department of Hygiene and Oral Health Science, Tokushima University Graduate School of Biomedical Sciences,2
Tokushima Bunri University Faculty of Health and Welfare, 3Department of Hematology, Endocrinology andMetabolism, Tokushima University Graduate School of Biomedical Sciences

Background and objective: Febrile neutropenia（FN）is one of the frequent adverse events of hematological cancer
chemotherapy. The aim of this study is to investigate the association between chemotherapy-induced FN and oral bacteria
and/or oral immunity in patients with hematological cancer.
Materials and Methods: Thirty-two patients with hematological cancer who received their ﬁrst chemotherapy at Tokushima
University Hospital were enrolled in the study. The chemotherapeutic drug used, the systemic condition, the period including
the presence of fever were obtained from the patient medical record. Secretory immunoglobulin A（sIgA）in saliva and theanaerobic bacteria in tongue coating of each subjects was assessed before the ﬁrst chemotherapy.
Results: Eleven subjects had an onset of FN（FN subjects）and 21 subjects did not（non-FN subjects）during theobservation periods. A signiﬁcant diﬀerence was observed in the levels of sIgA between two groups（p＜0.05）. The rate of
F. nucleatum count per total bacterial count（％）showed a higher tendency in the FN subjects than that in the non-FN
subjects（p =0.088）. Using ROC curve analysis, the optimal cut-oﬀ point based on the AUC in the F. nucleatum / sIgA ratio
was 0.023, and the risk of FN onset was signiﬁcantly higher among the group of ≥ 0.023 F. nucleatum / sIgA ratio comparedwith the group of＜0.023（HR 36.3, p＜0.01）.
Conclusion: These results suggest that the rate of F. nucleatum and the levels of sIgA at baseline might be related to FN
onset as risk factors.

GC-06

Eﬃcacy of toothbrushes with titanium dioxide electrode and solar cell
Masaya Yoshimine＊, Hisahiro Kamoi
Department of Dental Clinic, Nippon Medical School Chiba Hokusoh Hospital

Background and objective: Eﬀective control of dental plaque by daily brushing is critical for oral health. Toothbrushes withtitanium dioxide electrode and solar cell have been reported to be eﬃcient；this study was designed to evaluate the dental
plaque removal eﬀect of these toothbrushes.
Materials and Methods: The subjects included 8 members of the Nippon Medical School Chiba Hokusoh Hospital Dental
Clinic, who had thorough knowledge regarding the techniques of maintaining oral hygiene. The six teeth selected by
Ramfjord（16, 21, 24, 36, 41, and 44）were used. The toothbrushes comprised the sonic powered type（SOLADEYRHYSHM 2®, group R2）, the manual type with large solar cell（SOLADEY N4®, group N4）, and the manual type withsmall solar cell（SOLADEY 3®, group SO3）；all were manufactured by Shiken Co., Ltd. The Rustogi Modified Navy
Plaque Index was used.
Results: The rate of dental plaque removal in the entire mouth was 77.1％ for group R2, 63.8％ for group N4, and 55.2％
for group SO3；the same trend was noted on the surface of all six teeth.
Conclusion: In this study, toothbrushes with titanium dioxide electrode and solar cell, both sonic-powered and manualtypes, were eﬀective for plaque control.

JSP/JACP Poster Session AAP2020

22

GC-07

Retrospective study of dental implant treatment for patients with periodontitis.
Mikiko Yamazaki＊1, Kosaku Yamazaki2, Keiso Takahashi2

1

Department of Endodontics and Periodontics , Ohu University, Graduate School of Dentistry, 2Division of
Periodontics, Department of Conservative Dentistry, Ohu University School of Dentistry

Background and objective: Although the choice of rehabilitation with implant-supported ﬁxed prostheses in periodontal
therapy is increasing, the pathogenesis of peri-implant disease in the patients with periodontitis is still unclear. We
performed a retrospective study to assess the outcome of implant treatment for the patients with periodontitis and thepossible risk factors of peri-implant disease.
Materials and Methods: Eighty seven patients had been treated comprehensively from 2006 to 2018 in Ohu University
Dental Hospital and then 342 implants were enrolled for this retrospective study. Success rates were calculated from thedegree of marginal bone loss（MBL）as part of a prognostic study. Various clinical data and patients-related risk factors
such as smoking habit, occlusal parafunction, bone augmentation and diabetes mellitus, were analyzed. Chi-square test wasused for statistical processing.
Results: The average period after getting occlusal function was 63.8 ± 29.9 months and the survival rate was 95.9％.
Compared with survival implants, the disintegrated implant had a single implant and bone augmentation with artiﬁcial bone
（GBR）compared with survival implants. The success rate calculated by MBL＜3.0mm was 85.7％ , while MBL ≧ 3 mm
were found in the patients with high risk for periodontitis compared with others（p＜0.05）.
Conclusion: These results suggest that prostheses with a single implant and GBR could be risk for disintegration of implant
and the progression of peri-implantitis is much faster for high-risk patients with periodontitis than the others.

GC-08

Carotid artery calciﬁcation and periodontal disease progression in Japanese people
Nanae Dewake＊1, Yasuaki Ishioka1, Keiichi Uchida2, Akira Taguchi3,
Akihiro Yoshida4, 5, Nobuo Yoshinari 2, 4

1

Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental
University, 2Department of Collaborative oral health, Matsumoto Dental University Hospital, 3Department of Oraland Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 4Department Oral Health
Promotion, Graduate School of Oral Medicine, Matsumoto Dental University, 5Department of Oral Microbiology,
School of Dentistry, Matsumoto Dental University.
Background and objective: The purpose of this study is to evaluate the association between alveolar bone loss（ABL）
detected on panoramic radiographs and carotid artery calciﬁcation（CAC）, which is the ﬁnal step in the development of
atherosclerosis, detected on Computed Tomography（CT）.
Materials and Methods: The subjects were 295 patients（mean age ± SD, 64.6±11.8 years）who visited Matsumoto
Dental University hospital between 2014 and 2018. The rate of ABL and number of present teeth were measured on
panoramic radiographs. Univariate analyses with the t-test and the chi-squared test were used to evaluate the diﬀerences inage, gender, history of diseases, number of present teeth and ABL between subjects with and without CAC. Moreover,multivariate logistic regression analysis with forward selection was used. Finaly, receiver operating characteristic curve（ROC）analysis was used to clarify how degree for the identiﬁcation of CAC by ABL.
Results: Number of subjects with and without CAC was 121 and 174. Univariate analyses showed that CAC wassignificantly associated with age, hypertension, osteoporosis, number of present teeth and ABL. Multivariate logistic
regression analysis with forward selection adjusted for covariates revealed that the presence of CAC was significantly
associated with age（OR=1.096, 95％CI=1.051-1.143）, hypertension（OR=3.748, 95％CI=1.748-8.037）and ABL（OR=1.233, 95 ％ CI=1.167-1.303）, signiﬁcantly. In the ROC analysis predicting the presence of CAC, AUROC was thehighest 0.932（95％ CI= 0.904-0.960）for ABL, signiﬁcantly.
Conclusion: It was suggested that measurement of ABL on panoramic radiographs may be an eﬀective tool for identifying
patients with an increased risk of CAC.

JSP/JACP Poster Session AAP2020

23

GC-09

The inﬂuence of periodontal disease in peripheral artery disease patients
Keitetsu, Kure＊1, Norio, Aoyama2, Takanori, Iwata1

1

Department of Periodontology, Tokyo Medical and Dental University, 2Division of Periodontology, Kanagawa
Dental University

Background and objective: Peripheral artery disease（PAD）is a kind of arteriosclerosis that leads to ischemia in extremity.
Some studies reported that patients with periodontitis are at a risk for PAD. But evidence on the relationship between thesetwo diseases has not yet been clarified completely. Therefore, we performed a cross-sectional study to assess thisrelationship by comparing patients with PAD to those with arrhythmia（ARR）as a control group.
Materials and Methods: A large-scale survey was conducted on patients who received cardiovascular care at Tokyo Medical
and Dental University Hospital. Clinical dental ﬁndings such as PPD, BOP, CAL and number of tooth loss were measured in
all patients. Subgingival plaque, salivary samples, peripheral blood samples were also collected. Besides, we performed
real-time PCR and ELISA to detect inﬂammatory mediator levels such as tumor necrosis factor（TNF）-alpha, interleukin（IL）-6, matrix metalloproteinase（MMP）-2, 8, 9 and bacterial counts and anti-bacterial antibody titers in the samples. All
patients with PAD and one tooth at least were extracted from the overall study population. We extracted patients with ARR
by matching the sample size of the group in terms of age, prevalence of hypertension, dyslipidemia, diabetes, obesity, andthe smoking rate（n=20 for each）.
Results: There were signiﬁcantly higher values in PAD patients than ARR in terms of serum levels of TNF-alpha, IL-6,
MMP-8, 9 and tooth loss. Multivariate logistic analysis also showed that signiﬁcantly higher odds ratios were observed in
tooth loss and TNF-alpha of PAD than ARR.
Conclusion: This study suggested that periodontal inflammation might be correlated with PAD through systemic
inﬂammation.

GC-10

Genetic and Environmental Factors on Periodontitis in Elderly Twins

Kuniko Ikegami＊1, Motozo Yamashita1, Koji Miki1, Arisa Nishikawa2, Kouki Hashimoto2,
Tatsuya Morikawa2, Noboru Takeshita2, Kazunori Ikebe3, Masahiro Kitamura2, Shinya Murakami2
1

Department of Periodontology & Endodontics, Osaka University Dental Hospital, 2Department of Periodontology,
Division of Oral Biology and Disease Control, Osaka University Graduate School of Dentistry, 3Department of
Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry

Background and objective: Periodontitis is caused by dental bioﬁlms, while the genetic and environmental factors aﬀect theonset and progression of the disease through life. In this study, we aimed to evaluate the eﬀort ratios between genetic andenvironmental factors on periodontitis by comparing the clinical phenotypes of periodontitis in pairs between monozygotic（MZ）and dizygotic（DZ）twin pairs in elderly Japanese populations.
Materials and Methods: 147 pairs of twins were examined at the Twin Research Center of Osaka University Graduate
School of Medicine. The following tests were performed: 1）remaining teeth, 2）probing depth（PD）, 3）percentage of
bleeding on probing（BOP）sites（％）, 4）score of bone resorption, 5）Serum antibody titer for periodontopathic
bacteria. dental plaque.
Results: Twin intra-class correlations for PD and ％ of BOP sites in MZ twins was higher than DZ twins. On the other hand,those for the number of remaining teeth and score of bone resorption in MZ twins was comparable to DZ twins. In MZ
female twins, intra-class correlations for ％ of BOP sites were high but for PD, score of bone resorption and number ofremaining teeth were low.
Conclusion: For the pathology of periodontitis, PD and BOP, which are related to the patientʼs inﬂammatory responses, arelikely to be relatively inﬂuenced by genetic factors, while bone resorption and tooth retention are likely to be relatively
inﬂuenced by environmental factors in elderly populations.

JSP/JACP Poster Session AAP2020

Case Report

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CR-01

Case reports: Periodontal regeneration with FGF-2 plus β-TCP

Shin-ichi Takayama＊, Yuhei Hashimoto, Hirofumi Kanda, Nana Matsuno, Shiori Yamamoto
Takayama Dental Clinic
Background: Human recombinant ﬁbroblast growth factor（FGF-2）was approved as a periodontal regenerative medicine
in Japan and has been commercially available（Regroth®）since 2016. Several clinical reports demonstrated that FGF-2
even alone could induce periodontal regeneration efficiently. However, in cases where bone defects are large andcomplicated, complete recovery by FGF-2 might not be possible. In this report, successful cases treated with FGF-2 plus
β-tricalcium phosphate（β-TCP）as a bone ﬁlling material will be presented.
Case: Three patients（male 54-year-old, female 50-year-old, female 65-year-old）presented with severe one-wallinfrabony defects at each anterior tooth site（#23, #12, #43, respectively）.
Clinical Procedures and Outcomes: The periodontal regenerative operation with FGF-2 plus β-TCP（Cerasorb® M granulat
dental, 150- 500 µm, Curasan, Germany）was performed. The incision line was avoided above the bone defect wherever
possible. Full thickness buccal and lingual mucoperiosteal ﬂaps were reﬂected. Residual calculus and granulation tissues
were thoroughly debrided and the root surfaces were treated with 24％ EDTA（Prefgel®, Straumann, USA）for 2 minutes.
Then, FGF-2 plus β-TCP were applied into the infrabony defects. Buccal and lingual ﬂaps were closed with simple sutures
under tensionless. Professional cleaning of the surgical sites was performed every visit and periodontal and dental X-ray
examinations were carried out after the operation carefully. 5-7 months after the operation, the new bone formation wasobserved at the bone defects in each patient.
Conclusion: These case reports suggest that FGF-2 plus β-TCP could be useful for periodontal regeneration in cases wherebone defects are severe.

CR-02

Treatment of chronic periodontitis using rhFGF-2 in combination with DBBM
Takahiro Bizenjima＊1, Daisuke Irokawa2, Yasuo Hosaka2, Junichi Takahashi2,
Sachiyo Tomita2, Atsushi Saito2

1

Tokyo Dental College Chiba Dental Center, Chiba, Japan, 2Department of Periodontology, Tokyo Dental College

Background: Here we report a 1.5-year follow-up of a chronic periodontitis patient who had received periodontal
regenerative therapy using rhFGF-2 with deproteinized bovine bone mineral（DBBM）.
Case: The patient was a 49-year-old woman who presented with the chief complaint of swollen gums. An initial
examination revealed that 33.4 ％ of sites with a probing depth（PD）of ≥ 4 mm and 29.5 ％ of sites with bleeding on
probing. The OʼLeary plaque control record was 34.6％ . Radiographic examination revealed angular bone resorption in #22, 33, 36, 46 and 47. A clinical diagnosis of generalized chronic periodontitis（Stage Ⅲ Grade B）was made.
Clinical Procedures and Outcomes: The patient underwent initial periodontal therapy including plaque control, scaling androot planing. After reevaluation, periodontal regenerative therapy using rhFGF-2 were performed on #22 and 46, 47.
Combination therapy with rhFGF-2 + DBBM was performed on #33, 36. Following reevaluation, the patient was placed on
supportive periodontal therapy. A 3.3 mm gain in mean clinical attachment level（CAL）was observed at the sites treatedwith rhFGF-2 at 1.5 year after surgery. In #33 and 36, rhFGF-2 + DBBM, treatment yielded CAL gains of 4.0 mm and 3.0mm, respectively. Distinct radiographic bone ﬁll was observed at 1.5 year following the treatment with rhFGF-2 + DBBM.
Conclusion: In the present case, periodontal regenerative therapy resulted in a decrease in PD and improvement in CAL.
Combination therapy using rhFGF-2 + DBBM yielded an enhanced radiographic bone fill. This improvement has beenadequately maintained over a 1.5-year period.

JSP/JACP Poster Session AAP2020

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CR-03

Two-year follow-up case of periodontal regenerative therapy using rhFGF-2

Daisuke Irokawa＊1, Takahiro Bizenjima2, Kizuku Seida3, Sachiyo Tomita1, Atsushi Saito1,4
1

Department of Periodontology, Tokyo Dental College, 2Tokyo Dental College Chiba Dental Center, 3Seida Dental
Clinic, 4Oral Health Science Center, Tokyo Dental College

Background and objective: Here we report a two-year follow-up of a chronic periodontitis patient who received periodontal
regenerative therapy using rhFGF-2.
Case: The patient was a 54-year-old man who requested treatment of periodontal disease. Initial examination revealed 57.4
％ of sites with a probing depth（PD）of ≥ 4 mm, mean PD was 4.3 mm. The level of plaque control as assessed by theOʼLeary plaque control record was 92.6％. Radiographic examination revealed angular bone resorption in #14 and 33.
Patientʼs oral health-related QoL was assessed by the OHRQL instrument. The total OHRQL score in this patient was 21. A
clinical diagnosis of generalized chronic periodontitis（Stage III, Grade B）was made.
Clinical Procedures and Outcomes: The patient underwent initial periodontal therapy including plaque control, scaling androot planing, and root canal treatment. After reevaluation, a series of surgical interventions were performed in #14-16, 26,
27, 33-37, 46, 47. Because the distal aspect of #14 and 33 had intrabony defect, regenerative therapy using rhFGF-2 was
performed. Following reevaluation, then the patient was placed on supportive periodontal therapy. At 2 years
postoperatively, in #14 and 33, the treatment yielded clinical attachment level（CAL）gains of 3.5 mm and 2.5 mm,
respectively. Distinct radiographic bone ﬁll was observed following the treatment with rhFGF-2. Sites with a PD of ≥ 4 mm
improved to 4.9％ and mean PD to 2.6 mm. The total OHRQL score was improved to 10.
Conclusion: At 2 years postoperatively, the regenerative therapy using rhFGF-2 yielded improvements in clinicalparameters, radiographic bone ﬁll and patientʼs oral-health related QoL.

CR-04

Treatment of chronic periodontitis using rhFGF-2 and GTR with bone graft
Kouki Yoshikawa＊, Atsushi Saito
Department of Periodontology, Tokyo Dental College

Background: Here we report a 1-year follow-up of a chronic periodontist patient who had received periodontal regenerative
therapy using recombinant human fibroblast growth factor（rhFGF）-2 and guided tissue regeneration（GTR）withautogenous bone graft.
Case: The patient was a 71-year-old woman who presented with the chief complaint of mobile tooth（#14）. An initial
examination revealed that 53％ of sites with a probing depth（PD）of ≥ 4 mm, mean PD was 3.6 mm, and 28％ of sites
with bleeding on probing. The OʼLeary plaque control record was 62％ . Radiographic examination revealed angular bone
resorption（#14, 15）. Furcation involvement was Degree Ⅱ for #46. Patientʼs oral health-related quality of life wasassessed by the OHRQL instrument. The total OHRQL score was 23. A clinical diagnosis of generalized chronic
periodontitis（Stage Ⅳ , Grade B）was made.
Clinical Procedures and Outcomes: The patient underwent initial periodontal therapy. After reevaluation, periodontal
regenerative therapy using rhFGF-2 was performed on #14 and 15. Combination therapy with GTR and autogenous bone
graft was performed on #46. Following reevaluation, the patient was placed on supportive periodontal therapy. A 2 mm gainin clinical attachment level（CAL）was recorded at the sites treated with rhFGF-2 at 1 year after surgery. In #46, GTR ＋bone allograft, treatment yield a CAL gain of 4 mm. An improvement in radiographic bone ﬁll was noted. OHRQL score
was reduced to 10.
Conclusion: In the present case, periodontal regenerative therapy resulted in a decrease in PD and improvement in CAL,
radiographic bone ﬁll and OHRQL score.

JSP/JACP Poster Session AAP2020

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CR-05

The 27-year course of generalized chronic periodontitis in a patient with posterior bite collapse
Mitsutaka Funakoshi＊
Funakoshi Dental Oﬃce

Purpose: Posterior bite collapse can cause secondary occlusal trauma and progression of periodontitis. In the present case,combined periodontal and partial orthodontic treatment improved the occlusion and periodontal environment for easier selfcare and enabled the patient to maintain a favorable condition for 27 years, despite not visiting a clinic for 12 years duringthat period.
Case description: A 42-year-old female presented to the authorʼs clinic on November 14, 1992 with a chief complaint ofdifficulty in chewing with her back teeth. Generalized gingival redness and swelling were observed in addition to aperiodontal pocket of over 4 mm. Vertical bone defect with a deep periodontal pocket was observed.
Diagnosis: Generalized moderate chronic periodontitis with secondary occlusal trauma
Treatment protocol: The treatment protocol consisted of the following:（1）initial periodontal therapy,（2）re-evaluation,（3）partial orthodontic treatment,（4）periodontal surgery,（5）re-evaluation,（6）restorative dental treatment, and（7）supportive periodontal therapy（SPT）.
Treatment course: Partial orthodontic treatment was performed in the mandible to straighten teeth 37 and 47 as well as
improve the position of each mandibular tooth. Flap surgery was performed on teeth 37, 42, 43, and 47. After restorative
dental treatment, stabilization of the occlusion and periodontal tissues was conﬁrmed, and treatment was transitioned to SPT.
Results and conclusions: The present case suggests the importance of creating proper occlusion and a favorable oral
environment that facilitates easy self-care for the patient.

CR-06

Treatment of generalized chronic periodontitis with rhFGF-2 and GTR
Jooree Iwaki＊1, Kentaro Imamura1, Kobun Tanaka2, Hiroki Sugito3,4 and Atsushi Saito1

1

Department of Periodontology, Tokyo Dental College, 2Tanaka Dental, 3Department of Operative Dentistry,
Cariology and Pulp Biology, Tokyo Dental College, 4Department of Dental Hygiene, Tokyo Dental Junior College
Background: For the treatment of deep angular bone defects, periodontal regenerative therapy is indicated. We report a caseof generalized severe chronic periodontitis treated by periodontal regenerative therapy；recombinant human fibroblast
growth factor（rhFGF）-2 and guided tissue regeneration（GTR）.
Case: The patient was a 54-year-old woman who presented with the chief complaint of swelling in maxillary right gingiva.
An initial examination revealed that 30.4％ of sites with a probing depth of ≥ 4 mm. The prevalence of sites with bleedingon probing was 57.7％ . The plaque control record was 66.1％ . Radiographic examination revealed vertical bone defects
around the molars. A clinical diagnosis of generalized chronic periodontitis（Stage III, Grade C）was made.
Clinical Procedures and Outcomes: The patient underwent initial periodontal therapy. An improvement was observed inperiodontal conditions at reevaluation. A series of periodontal regenerative therapy with rhFGF-2 were performed on
angular bone defects in #14, 15, 25, 27. GTR was performed on #37, 47. Open ﬂap debridement was performed on #16, 17,
26, 36, 46. Following reevaluation, the oral function was restored using all-ceramic crowns（#21, 26）. Then the patient wasplaced on supportive periodontal therapy.
Conclusion: In the present case of generalized chronic periodontitis, periodontal regenerative therapy with rhFGF-2 andGTR resulted in a stable periodontal condition that facilitated favorable level of plaque control.

JSP/JACP Poster Session AAP2020

28

CR-07

A Case of regenerative therapy of maxillary canine with intrabony defect for periodontal
prosthesis.
Wataru Atsuta＊, Yuka Atsuta
Blossom dental oﬃce

Background: In patients with periodontitis, the occlusal load on the anterior teeth increases due to the missing molar teeth,
along with progression of shifting of diseased teeth and occlusal collapse due to secondary occlusal trauma. In such a case,the propriety of preserving a single tooth has a notable eﬀect on the prosthetic design. This patient underwent correction andregeneration therapy for severe periodontitis and intrabony defect due to occlusal trauma in a canine. Occlusal reconstruction
was performed using prosthesis and good progress was achieved.
Case: The patient was a 58-year-old female who was ﬁrst examined in September 2018 for chief complaint of swelling in#23 region, and oral examination revealed grade-2 mobility and swelling in #23. A dental radiograph showed intrabony
defect extending up to 1/3rd of the root. Her medical history revealed hypertension and a non-smoker.
Clinical procedure and outcome: An old bridge prosthesis using #23 as abutment teeth was removed, and after performing
primary periodontal treatment, #23 was extruded. We then performed regeneration therapy using b-FGF in order to restore
the periodontal tissue of #23 that supported the maxillary prosthesis. It had a double crown bridge structure for removable
design due to corresponding future washout of cement.
Conclusion: Bone formation in the anterior tooth area of #23 improved, and the tooth has remained stable. When designing
prosthesis that uses periodontally aﬀected teeth with intrabony defects as abutments, the recovery of supporting periodontal
tissue by correction and regeneration therapy is extremely useful for achieving stability.

CR-08

Orthodontic treatment in two patients with severe periodontitis and high pathological mobilityof the anterior teeth
Shoji ISHITANI＊
Ishitani Dental Oﬃce

Background: Pathological tooth migration is often observed as periodontitis progresses. Here, we report two cases of severe
periodontitis with signiﬁcant morbid tooth migration for which extraction was considered, but where orthodontic treatment
successfully led to conservation of the teeth.
Case 1: The patient was a 52-year-old woman who was a smoker. The date of initial consult was April 16, 2014. The chiefcomplaints were gingival swelling and hemorrhage. The patient ﬁrst went to another hospital and was recommended to visit
a periodontist. The patient had a medical history of pediatric asthma and slight hypertension. Oral examination indicatedgingival reddening and swelling, as well as deep periodontal pockets. Overbite and overjet were also observed, her #11 tooth
was greatly displaced in the labial direction, and the mandibular anterior teeth showed protrusion and crowding.
Case 2: The patient was a 42-year-old woman. Her details are printed on the poster.
Details of Treatment and Results: In both cases, re-evaluation was performed after completion of basic periodontal
treatment, and orthodontic treatment or deﬁnitive periodontal surgery was performed. Oral function recovery therapy was
initiated, which was followed by supportive periodontal therapy（SPT）.
Conclusion: Both cases showed pathological tooth migration to the extent that extraction was considered, but the use oforthodontic treatment and attempts to conserve the teeth as much as possible greatly contributed to patient motivation andled to the teeth being retained.

JSP/JACP Poster Session AAP2020

29

CR-09

New surgical approach for the treatment of periodontal intrabony defects
Yoshihiro Iwano＊1,2, Satoka Shimizu1, Momo Hasegawa1, Ryoko Kageno1
Iwano Dental Clinic, 2Department of Periodontology, Nihon University School of Dentistory

1

Background: In this study, we devised a new surgical approach for the treatment of periodontal intrabony defects.
Cases: Case 1 was a 65-year-old male（non-smoker）with target tooth 27 showing distal probing pocket depth（PPD）of
9 mm.
Case 2 was a 48-year-old female（non-smoker）with target tooth 47 showing distal PPD of 8 mm.
Treatment and Results: Procedure: A #390 scalpel blade was tilted to approximately 45°, and a full-thickness incision to theperiosteum was made at an angle of approximately 30°from the distolingual line angle of the second molar while avoiding
the bone defect. After making an incision on the gingival sulcus on the distal-most surface of the second molar, a horizontal
incision was made in the bone defect from the lingual side to the buccal bone crest to form an interdental papilla-like buccal
valve. After removal of infected granulation tissue, followed by debridement and application of periodontal tissue
regeneration material, the bone graft material was packed. A needle was inserted into the buccal valve and lingual
keratinized gingiva to perform internal cross-mattress suturing, and the thread on the lingual side was used to perform
modified mattress suturing. One to two more simple sutures were applied at the distal-most end, and suturing wascompleted.
In the re-evaluation performed 9 months postoperatively, dental computed tomography showed the presence of boneformation and amelioration of the PPD.
Conclusion: This method is a minimally invasive procedure that allows for easy dissection, rapid completion of theprocedure, and secure wound closure.

CR-10

10-year follow-up of severe chronic periodontitis with occlusal trauma
Takamasa Ohyagi＊, Kiwa Ohyagi
Ohyagi dental clinic

Background: Severe chronic periodontitis causes the aﬀected tooth loses attachment and increases mobility, resulting in
occlusal trauma. We report on a periodontitis patient with occlusal trauma over a ten-year follow up.
Cases: A 58-year-old female presented on May , 2007 with the chief complaint of gingival swelling and pain in the
maxillary left region. 44.4％ of sites had a PPD ≥4 mm and 57.2％ of sites exhibiting BOP. Tooth mobility 1 〜 3 and PPD≥6 mm in the molars with occlusal interference at the non-working side on jaw movements. #25 had a PPD 10 mm palatally,
with mobility 3. #47 had a PPD 10mm mesially, with mobility 3 and a two-wall bony defect mesially detected.
Clinical Procedures and Outcomes: Full mouth disinfection was performed with azithromycin because P. gingivalis was
detected by the real-time PCR（5.36％）. Three months later, BOP improved（8％）but the mobility in the molars
remained. Therefore, #38 and 48 were extracted and occlusal adjustment was performed on the molars. At the reevaluation,
tooth mobility improved. Regenerative therapy was performed on #15 and 47 for the intrabony defects and seven months
later the regeneration was conﬁrmed. #15 was splinted to #14
Conclusion: Periodontal treatment combined with occlusal adjustment reduced tooth mobility, indicating trauma from
occlusion was involved with periodontitis progression. No significant change was observed over ten years, aside fromenamel defect on #47 which was treated with a crown restoration. SPT will continue while controlling and eliminating
trauma factors as well as inﬂammation.

JSP/JACP Poster Session AAP2020

30

CR-11

Long term observation: healing pattern after periodontal treatments
Akira Makino＊
MAKINO Dental oﬃce

Background: Long epithelial attachment（LEA）, which is previously known as an unstable healing condition, is considered
to be a healing pattern after scaling and root planing（SRP）and open ﬂap debridement（OFD）. However, an animal study
by Shimono et al［1］ demonstrated that LEA could be eventually replaced by connective tissue attachment（CTA）. Here,I report the ﬁndings showing the replacement of LEA by CTA in a patient with severe periodontitis who has undergone
periodontal maintenance（PM）for 25 years.［1］Shimono M. Pathology of Wound Healing, New Edition – Answeringfrom Basic Science to Clinical Questions –, Ishiyaku Publishers, Tokyo,2011.
Case Report: A 43-year-old woman ﬁrstly visited our dental clinic with chief complaint of gingival swelling and pain of
tooth #27 on September, 1995. Full mouth radiographs indicated alveolar bone loss（stage IV/grade C periodontitis）.
Clinical Treatment and Outcomes: Following SRP and occlusal adjustment, OFD was carried out, consequently,
inﬂammation disappeared and a stable condition was returned in the periodontal tissues. During the PM period, the gingiva
has become thick, and even the lamina dura has been radiographically apparent. Volume rendered 3D CT image showed theregeneration of alveolar bone after 25 years of the debridement, suggesting that LEA is replaced by CTA.
Conclusion: Long epithelial attachment is not an unstable periodontal healing pattern, but can be replaced by connective
tissue. Continuing maintenance care for eliminating periodontal pockets and preventing a recurrence of flare-up is ofextremely importance.

CR-12

A case of Root Coverage for gingival recessions with Subepithelial connective tissue and bFGF
Koshi Terai＊1,Chujo Kitamura2, Koichiro Fujibayashi³, Hiroyuki Takino⁴
1

Takino Dental Clinic ,2Kitamura Dental Clinic,³Fujibayashi Dental Clinic,⁴Takino Dental Clinic

Background: The use of subepithelial connective tissue in root coverage evidentially presents permanent treatment results.
Its combined use with the basic ﬁbroblast growth factor（bFGF）seems more eﬀective because it promotes the growth ofperiodontal ligament ﬁbroblasts and the migration and proliferation of multiple cells forming the periodontal tissue, e.g.,vascular endothelial cells, epithelial cells, and osteoblasts.
We presented a case where root coverage using subepithelial connective tissue and bFGF favorably treated the gingi-val
recession of the maxillary anterior teeth.
Case: Patient: 51-year-old woman（non-smoker）
Initial visit: November 2018
Chief complaint: Cosmetic disturbance
General medical history: None
Dental history: Dental treatment at another clinic ﬁve years previously
Examination findings: Mild gingival recession of 11 and 21 and 3 mm gingival recession of 23（Class I under Miller's
classiﬁcation）
Treatment and Results: 1）Basic periodontal treatment, 2）Re-evaluation, 3）Periodontal surgery（root coverage）, 4）
Re-evaluation, and 5）Maintenance
Periodontal surgical treatment:
23: Coronally-advanced ﬂap using subepithelial connective tissue
11 and 21: Modiﬁed coronally-advanced tunneling technique using bFGF combined with subepithelial connective tissue
Three months postoperatively, follow-up was performed once a month along with regular maintenance.
Currently, periodontal tissue at the transplant site is stable and the postoperative course is favorable.
Conclusion: Remarkable root coverage was achieved at the gingival recession site using bFGF, a cell-growth factor having
various cell growth and angiogenic eﬀects. Thus, better results can be obtained with root coverage than with conventional
methods. However, continued investigations on controlling the disease progression are necessary.

JSP/JACP Poster Session AAP2020

31

CR-13

Periodontal regenerative therapy using rhFGF-2 and DBBM for furcation defects
Masahiro Sato＊1, Naoko Watanabe2, Atsushi Saito1,3

1

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

Background: The key points in treatment of furcation involvements are to prevent further attachment loss and to makemaintenance easier. Here we report a chronic periodontitis case with furcation involvements treated by rhFGF-2 with
deproteinized bovine bone mineral（DBBM）.
Case: The patient was a 50-year-old man who requested treatment of periodontal disease. An initial examination revealed
that 30.4％ of sites with a probing depth（PD）of ≥ 4 mm and 69.6％ of sites with bleeding on probing（BOP）.
Radiographic examination revealed angular bone resorption in #17, 24, 26, 32, 34 and 46. Furcation involvements（DegreeⅡ）were observed in #26 and #46. A clinical diagnosis of generalized chronic periodontitis（Stage Ⅲ Grade B）was
made.
Clinical Procedures and Outcomes: The patient underwent initial periodontal therapy. After reevaluation, periodontal
regenerative therapy using rhFGF-2 were performed on #32 and combination therapy with rhFGF-2 + DBBM was
performed on #26, 34 and 46. Following reevaluation, oral function was restored using a ﬁxed bridge prosthesis. At thetransition to supportive periodontal therapy, 1.2％ of sites presented with a PD of ≥4 mm and 9.9％ of sites with BOP. At 2
years postoperatively, a 3.0 mm gain in clinical attachment level（CAL）was observed in #32 treated with rhFGF-2.
Furcation involvements in #26 and 46 treated with rhFGF-2 + DBBM yielded CAL gain of 4.0 mm.
Conclusion: In the present case of chronic periodontitis with furcation involvements, the regenerative therapies resulted in adecrease in PD, improvement in CAL, and favorable osseous architecture.

CR-14

Improvement of uneven cervical line and gummy smile with periodontal surgery: A case report
Koichiro Fujibayashi＊1, Tsuyoshi Kamiyama2, Chujo Kitamura3,
Koshi Terai4, Mitsuhiro Iwata5, Hiroyuki Takino6

1

Fujibayashi Dental Clinic,2Kamiyama Dental Clinic,3Kitamura Dental Clinic,4Takino Dental Clinic, 5Sakura Dental
Clinic, 6Takino Dental Clinic

Background: Bone level, gingival level, and continuity of the dentition are important for the long-term stability of theperiodontium. The gingival level can be corrected by prosthetic restoration；however, periodontal surgery is required incomplicated cases. Several criteria inﬂuence the esthetic goals, including the smile line, classiﬁed as low, average, or high.
The gummy smile（＞3 mm of gingival exposure）is usually considered unesthetic. Obtaining an ideal gum line requires
assessment of bilateral symmetry, parallelism, gingival zenith point, and interdental papillary height. The factors aﬀecting
the gum line include bone morphology, bone level, tooth position and inclination, root shape, attached gingival width andmode of attachment, and biotype of these, bone level based on the biological width is the most important.
Case: A 26-year-old female patient presented with a chief complaint of unesthetic upper front teeth. Medical history: N.P.
Non smoker
Treatment & Result: This case was assessed as type 2 subgroup B based on the altered passive eruption classiﬁcation by
Coslet. Periodontal surgery and prosthetic therapy were performed.
Conclusion: We achieved esthetic restoration, periodontal stability, and patient satisfaction in this case. In addition to paying
attention to the shape and shade of the crowns for an aesthetic appearance during dental treatment, an optimal treatment plan
based on examination and diagnosis of the relationship between the gums and teeth, i.e., the harmony of the cervical line,
must be formulated. Moreover, the harmony between excessive gingival display and the lips and the relationship with thesmile line must also be considered.

JSP/JACP Poster Session AAP2020

32

CR-15

Periodontal regenerative therapy with EMD: a four-year follow-up case
Fumi Seshima＊1, Yasugi Matsumoto2, Atsushi Saito1
1

Department of Periodontology, Tokyo Dental College, 2Matsumoto Dental Clinic

Background and objective: Here we report a four-year follow-up of a chronic periodontitis patient who received periodontal
regenerative therapy with enamel matrix derivative（EMD）.
Case: The patient was a 50-year-old woman who complained of mobile teeth in the molar region. Initial examination
revealed 52.6 ％ of sites with a probing depth（PD）of ≥ 4 mm, full-mouthmean PD was 3.8 mm. The OʼLeary plaquecontrol record was 53.8％ . Radiographic examination revealed angular bone resorption in #13,15,24,27,33,35,37,46,47. A
clinical diagnosis of generalized chronic periodontitis（Stage III, Grade B）was made.
Clinical Procedures and Outcomes: The patient underwent initial periodontal therapy including plaque control, scaling androot planing. After reevaluation, a series of surgical interventions were performed in #13,15-17,24,27,33,35,37,46,47.
Regenerative therapy using EMD was performed on the narrow intrabony defects of #13,46,47, and combination therapy
using EMD and autogenous bone graft was performed on the wide and deep intrabony defects of #15,24,27,33,35,37.
Following reevaluation, then the patient was placed on supportive periodontal therapy. At 4 years postoperatively, #13,46,47
yielded clinical attachment level（CAL）gains of 4 ± 2.4 mm and #15,24,27,33,35,37 yielded CAL gains of 2.5 ± 0.8mm, respectively. Distinct radiographic bone ﬁll was observed following the treatment with EMD. Sites with a PD of ≥ 4mm improved to 4.5％ and mean full-mouth PD was reduced to 2.2 mm.
Conclusion: At 4 years postoperatively, the regenerative therapy using EMD yielded improvements in clinical parameters
and radiographic bone ﬁll.

CR-16

Generalized-chronic periodontitis and type-2 diabetes with comprehensive periodontal
therapy
Mana Nasu＊, Satoru Morikawa, Taneaki Nakagawa
Department of Dentistry and Oral Surgery, Keio University School of Medicine

Background: Chronic periodontitis and diabetes are closely linked, and it is known that controlling periodontitis improves
blood sugar level. We report the case of a patient who received periodontal and regenerative therapy. She improved withsupportive periodontal therapy（SPT）and blood sugar control.
Case: A 67-year-old woman, who was diagnosed with type 2 diabetes mellitus and fatty liver, visited the hospital after
experiencing a strange feeling in tooth #9. An X-ray image revealed a lesion on the apex of the symptomatic tooth（tooth#9）. Gingival swelling and deep periodontal pockets were observed in the molars due to uncontrolled diabetes. Mildhorizontal bone resorption was observed throughout the jaw, especially in tooth #30, which was furcated. Teeth #2 and #31
had a cross-bite.
Clinical Procedures and Outcomes: 1.Initial periodontal treatment, instruction on oral hygiene, and tooth #9 apicectomy 2.
Re-evaluation 3. Periodontal surgery（tooth #30 periodontal regenerative therapy using basic ﬁbroblast growth factor andautologous bone）5. Re-evaluation 6. Final prosthesis 7. SPT.
Conclusion: The periodontal pockets improved, and gingival swelling was not observed. The patient's blood sugar control
improved. Although pockets were observed in the molars, the tissue was stable, and bleeding on probing was not observed.
Tooth #9 was in a good condition after apicectomy, and recurrence was not observed. Night guards were prescribed for the
cross-bite on the left side of teeth #2 and #31 to reduce an occlusal overload with tooth #30. Interval between SPT continued
for a few months for control of plaque formation.

JSP/JACP Poster Session AAP2020

33

CR-17

Restore Oral functions with Periodontal Therapy with GTR
Yoko Koide＊, Matsuo Yamamoto
Department of Periodontology, Showa University School of Dentistry

Background: In Dec 2010, the patient（58-year-old male）had a concern regarding his discomfort while chewing. Thiswas due to the prosthesis being detached causing diﬃculty in chewing by the teeth at the posterior region, and then anterior
periodontal destruction. In order to treat the masticatory function, we used the prosthetic treatment and periodontal approach.
Case: Gingival swelling and redness were observed throughout the jaw. The probing depth ≥4 mm was 34％ , bleeding on
probing was 31％. Class I furcation involvement was observed in tooth #17 #18 and #27. Vertical bone resorption wasobserved in tooth #24, #31, #45, and #46. Severe bone resorption（up to root apex）was observed at tooth #14, #22, and#27. According to the above ﬁndings, the patient was diagnosed as Generalized Severe Chronic Periodontitis with Occlusal
Trauma（Stage IV and Grade B）.
Clinical procedures and Outcomes: Initial therapy was performed between January 2011 and September 2012. This wasfollowed up by periodontal surgery which involved a Guided Tissue Regeneration with absorbable membrane and an
autogenous bone graft at tooth #46 and a ﬂap surgery at tooth #17 and #18 until September of 2014. After the re-evaluation,oral rehabilitation was completed with the use of a fixed and removable partial denture. Maintenance therapy has been
performed since 2016.
Conclusion: This case report presented that recovering masticatory functions by using a therapeutic appliance and severe
intrabony defects can be treated with absorbable membrane and autografts. This method improved the periodontal
parameters and radiographic bone ﬁll.

CR-18

Management of calcium channel blocker-associated gingival overgrowth without changing
medication
Satoru Morikawa＊, Mana Nasu, Taneaki Nakagawa
Department of Dentistry and Oral Surgery, Keio University School of Medicine

Background: Drug-induced gingival overgrowth is a well-known side eﬀect of calcium channel blocker administration for
cardiovascular conditions. Although gingival overgrowth induces periodontitis, dental caries, and masticatory dysfunction,
the recommendation to discontinue calcium channel blockers is controversial.
Case: We report a clinical case of severe periodontitis in a 66-year-old Japanese male with a past medical history of
hypertension and type 2 diabetes mellitus. He exhibited gingival overgrowth which covered the teeth. He consulted with his
physician about changing or finding an alternative for nifedipine, which was linked to gingival overgrowth. Ultimately,
nifedipine was discontinued and amlodipine was started during the course of his periodontal disease treatment.
Clinical Procedures and Outcomes: Periodontal treatment consisted of absolute oral hygiene instruction and scaling/rootplanning. Because the patientʼs blood pressure was poorly controlled, nifedipine was resumed during periodontal treatment.
However, his periodontal clinical scores were signiﬁcantly improved without changing to another calcium channel blocker.
Conclusion: Rather than being a direct eﬀect of calcium channel blocker administration, aggressive gingival overgrowth
may instead result from poor oral hygiene. Signiﬁcant improvement of gingival overgrowth was observed following basic
periodontal treatment, periodontal surgery, and intensive and regular follow-ups to monitor oral hygiene without changing
the calcium channel blocker.

JSP/JACP Poster Session AAP2020

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CR-19

Ten-year follow-up of a patient who underwent comprehensive treatment for severe chronic
periodontitis
Takashi Takiguchi＊, Matsuo Yamamoto
Department of Periodontology Showa University School of Dentistry

Background and Objective: Severe chronic periodontitis is an inﬂammatory disease in the periodontium that is characterized
by progressive destruction of attachment and bone loss. We report the 10-year follow-up of a patient after periodontal
regenerative and localized orthodontic therapies for functional recovery with prosthodontic implants.
Case: A 45-year-old woman had a chief complaint of tooth mobility and swelling of back teeth. She reported that thegingiva had been swollen for 3 years. She was referred by a general practitioner to our dental hospital. In the molar region,
signiﬁcant tooth mobility, a deep periodontal pocket（8 mm）, and infrabony defects were observed. The diagnosis was
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）re-examination；and（7）supportive periodontal therapy.
Clinical Procedure and Outcomes: After basic periodontal therapy, we performed periodontal regenerative therapy andlocalized orthodontic therapies. A ﬁnal prosthesis was chosen to serve as a dental implant for establishing stable occlusion.
Consequently, the alveolar bone developed in a normal physiological form, and thorough cleansing of the oral cavity wasachieved because of the shallow gingival sulci. The patientʼs favorable condition has been maintained in the 10 years since
the treatment. Conclusion: Comprehensive treatment can enable stable occlusion and establishment of periodontal tissue
with high cleansablilty, even in patients with severe periodontitis. As a result, long-term favorable prognosis can be
expected.

CR-20

Aberrant occlusal trauma can cause cemental tears that induce periodontitis.
Kosaku Yamazaki＊1, Mikiko Yamazaki2, Keiso Takahashi1

1Division of Periodontics, Department of Conservative Dentistry, Ohu University School of Dentistry. 2Departmentof Endodontics and Periodontics , Ohu University, Graduate School of Dentistry.

Background: Multiple risk factors are involved in the progression of periodontal disease. Especially, local factors, such as
anatomic anomaly, occlusal trauma and inadequate dental arch may induce a site-specific exacerbation of periodontal
tissues. Cemental tears（CTs）has been sometimes found when periodontal surgery has been performed where acutegingival inﬂammation and tissue destruction had been occurred previously. We show the 3 case series of subcliagnostic CTs
and discuss the possibility that occlusal trauma may induce the CTs and play a role on the progression of periodontitis.
Cases: Three patients, 55, 70 and 71-year-old, were enrolled. We observed all of them had a habitual bruxism. Clinicalﬁndings were recorded before and after treatment. CTs were not found from oral radiographs at their ﬁrst visit but ﬁrstly
found during periodontal surgery. During periodontal surgery, regenerative periodontal therapy with Emdogain® was
performed after meticulous root debridement. After the treatment, clinical indices were improved. The probing pocket depth
decreased to less than 3 mm without BOP and the radiolucency was improved and the lamina dura was observed at all thesites. In all cases, it was stable for at least 5 years under the control of occlusal dysfunction.
Conclusion: Aberrant occlusal trauma can cause CTs and then induce the rapid destruction of periodontal tissues. Treatment
regimen by both regenerative periodontal therapy and the regulation of occlusal trauma may be eﬀective.

JSP/JACP Poster Session AAP2020

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CR-21

Non-surgical treatment and microbiome of periodontitis and peri-implantitis: seven-year
follow-up.
Keiji Komatsu＊1, Takahiko Shiba1, Takayasu Watanabe2, Takashi Nemoto1,
Tatsuro Koyanagi1, Yasuo Takeuchi1, Takanori Iwata1
1

Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental
University, 2Department of Chemistry, Nihon University School of Dentistry

Background and objective: Non-surgical therapy is a standard method for periodontitis and has been reported to beineffective for peri-implantitis. Here we report a case of successful non-surgical treatment for peri-implantitis andperiodontitis with long-term stability.
Case: The patient was a 69-year-old man with chief complaints of discomfort in right maxilla. #17 implant showed probing
depth（PD）8mm with bleeding on probing（BOP）, and #34 teeth showed PD 5mm with BOP. Bone loss wasradiographically observed around both diseased sites. O'Leary plaque control record（PCR）was 54.8％ at the ﬁrst visit.
Clinical Procedures and Outcomes: An ultrasonic instrument and gracey curettes were used for decontamination of #17 and#34 after the PCR reached a level of 10％ . At the 7-year follow-up, no periodontal problems were observed in both sites
and good oral hygiene was maintained. Microbial analysis based on 16S rDNA sequencing was conducted before and after
treatment. Periodontal pathogens including Porphyromonas gingivalis were predominant at #17 and #34 before treatment,
whereas they were decreased at both sites after the follow-up. The bacterial composition within the microbiota after thefollow-up was predicted to be similar to that of the healthy site.
Conclusion: This case report demonstrated clinically and bacteriologically that non-surgical treatment can be eﬀective inperi-implantitis. Improvement of self-performed plaque control and low-amount horizontal bone loss would be key points
for the success of treatment. Periodic inspection of the bacterial composition within the peri-implant microbiota may be
useful in clinical practice.

CR-22

A case report of severe chronic periodontitis with diabetes
Tatsuo Hirano＊1, Takamasa Ohyagi2, Naomasa Yasuda3, Yuichiro Togashi4,
Kento Murao1, Tetsuaki Hirano1, Daiji Yamaguchi1, Jiro Hirano1
1

Hirano dental clinic, 2Ohyagi dental clinic, 3Carna dental clinic, 4Togashi dental clinic

Background: Patients with diabetes mellitus（DM）and severe chronic periodontitis need not only a medical but a dental
approach. In such patients, surgical approach is required after evaluating initial preparation and controlling DM. We report asevere chronic periodontitis patient with DM.
Case: A 46-year-old male presented on July, 2017 with the chief complaint of tooth mobility in the mandibular left region.
He had been taking antihypertensive and antidiabetic drugs. His BP and HbA1c were 130/95 and 7％ , respectively. Anterior
guidance was lost, 46％ of sites had PPD ≧4mm and 65％ of sites exhibited BOP. Molars showed tooth mobility 1 to 3,
sites with PPD ≧6 mm, and furcation involvements. #13 had a palatal 10 mm PPD, with mobility 2 and a mesial 1 to 2-wallbony defect. #15 had a mesial 8mm PPD, with mobility 2 and a mesial 1 to 2-wall bony defect.
Clinical Procedures and Outcomes: 8 months after initial preparation, BOP and PPD ≧4mm improved to 18％ and 30％ ,respectively. SRP with anesthesia and occlusal adjustment was subsequently performed, followed by resolution of themobility in the molars. Regenerative therapy was performed in the intra-bony defects of #13 and 15. #13 and 15 weretreated by a ﬁxed partial denture.
Conclusion: Initial preparation combined with SRP and occlusal adjustment improved root furcation involvements, reduced
tooth mobility and exhibited remission of diabetes. These were considered to be due to the reduction of inﬂammation by
periodontal treatment. SPT will continue while controlling and eliminating trauma factors as well as inﬂammation.

JSP/JACP Poster Session AAP2020

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CR-23

Long-term comprehensive management of generalized severe chronic periodontitis: A casereportMayumi Nakayama＊
Ukita Dental Clinic

Background: Severe chronic periodontitis can cause pathological tooth migration or malalignment. Thus, maintaining
appropriate and stable tooth alignment is essential in the management of severe chronic periodontitis. This case reportpresents the failure, recovery, and practical consideration in the 10-year long-term management of tooth alignment in apatient with severe chronic periodontitis.
Case: A 63-year-old female ﬁrst visited on February 21, 2009, with severe periodontal disease associated with crowding ofanterior teeth and occlusal trauma.
Clinical Procedures and Outcomes: First, initial periodontal treatment was initiated. After reevaluation, periodontal surgicaltreatment with Emdogain® and autologous bone grafting were performed. After 6 months, we performed partial orthodontic
treatment. Finally, periodontal prostheses were performed on the upper and lower molars. Both the upper and lower anterior
teeth remained ﬁxed for a while and were placed in SPT. After 8 years and 6 months, ﬂare-ups occurred at 12, 11 Out；thus,
we used 12, 11, 21, and 23 abutment teeth and a 22-pontic bridge to replace them. Currently, a decade has passed since webegan this treatment, and the patientʼs severe chronic periodontitis has been managed well.
Conclusion: The tooth position in the splint with resin and occlusal adjustment must be judiciously considered to maintainstable dentition, as a temporary splint needs repair because of the composite resin deterioration. Hence, ﬁxed prosthesis
could be preferred over temporary splint to maintain stable dentition in the management of chronic periodontitis.

CR-24

One-stage full mouth a-PDT in severe chronic periodontitis: A case report.
Yasuhiro Nakayama＊
Nakayama Dental Clinic

Background and objective: Antimicrobial photodynamic therapy（a-PDT）has a potential to be an effective treatment
adjunct in non-surgical treatment of chronic periodontitis. One-stage full mouth disinfection（Os-FMD）protocols havebeen proven to be a relevant treatment option. This case report shows Os-FMD combination with a-PDT in treatment ofsevere chronic periodontitis patient.
Case: A 51-year-old male visited my clinic in February 2019, with the chief complaint of occlusal pain. Periodontal pocket
depth was 3 to 10 mm. The percentage of sites with PPD ≧4mm was 48.8％ . The percentage of BOP was 34％ . Mobilityof most molars was second or third degree. The patient was diagnosed as generalized severe periodontitis.
Clinical Procedures and Outcomes: Before one-stage full mouth a-PDT, #17,27,37, and 47 were extracted. After meticulous
supragingival scaling, the a-PDT with subgingival SRP was applied in one session as a one-stage full-mouth a-PDT on all
periodontal sites. a-PDT involves toluidine blue as photosensitizer and diode laser（632-644 nm）as light source.
The result was satisfactory. The percentage of sites with PPD ≧4mm decreased to 2.8％ . The percentage of BOP decreased
to 0％ . A signiﬁcant improvement of periodontal condition was achieved.
Conclusion: The result of this treatment show that Os-FMD combination with a-PDT is an useful adjunct in non-surgicaltreatment to improve periodontal condition, and to shorten treatment period in chronic periodontitis.

JSP/JACP Poster Session AAP2020

Dental Hygiene

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DH-01

The dynamic responses during maintenance phase after the regenerative surgery by FGF-2
Nana Matsuno＊, Shin-ichi Takayama
Takayama Dental Clinic

Background: The efficacy of human recombinant fibroblast growth factor（FGF-2）medicine（Regroth®）has been
demonstrated by many clinical cases in Japan. However, there is no report on how periodontal tissue regenerated byRegroth® changes over a long period of time. We will report a case in which the social and environmental impact on thepatient was observed markedly during the maintenance phase following the periodontal regenerative surgery.
Case: A 42-year-old female with a one-walled severe infrabony defect and Class III furcation involvement at tooth #36,
and Class II furcation involvement at tooth #37（lingual）underwent the periodontal regenerative surgery by Regroth®
without any bone ﬁlling materials.
Clinical Procedures and Outcomes: The supportive periodontal therapy（SPT）and radiographic observation have been
provided for this patient following the surgery. Fifteen months after the operation, the new bone formation was observed
dominantly. From the 15th month through the 18th month, however, the patient was unable to follow through the SPT due tothe overwhelming load of social duties. As this caused a rapid deterioration of periodontal tissue, the immediate attention
was given by the dental hygienist to reengage the patient with the SPT. This action has resulted in the dramaticalimprovement in the patientʼs periodontal condition.
Conclusion: This case suggests that the long-term SPT is very important at the periodontal regenerative surgical site. It isnecessary for dental professionals to pay a close attention to diﬃcult social situations patients may face in order to maintainthe positive results of surgery.

DH-02

Non-surgical periodontal treatment of a patient with generalized severe chronic periodontitis
Satoka Shimizu＊1, Momo Hasegawa1, Ryoko Kageno1, Yoshihiro Iwano1,2
Iwano Dental Clinic, 2Department of Periodontology, Nihon University School of Dentistory

1

Background: We reported a case of generalized severe chronic periodontitis that was ameliorated by non-surgicalperiodontal treatment performed by a dental hygienist.
Case: A 61-year-old male patient first visited our hospital on December 25, 1994 with a chief complaint of gingival
enlargement.
Gingival redness and enlargement were observed in the entire jaw, PCR was 91.3％ , bleeding on probing（BOP）was 28.8％, and PPD at ≥7 mm was 8.3％.
The patient was diagnosed with generalized severe chronic periodontitis.
Treatment and Results: Scaling and root planning（SRP）were performed by coordinating with the dentist regarding thetime of removal of the defective prosthesis, etc. Cleaning tools were changed according to the changes in the oral
environment during treatment, such as application of a periodontal treatment device, gingival recession after SRP, andapplication of an orthodontic device. The PPD of up to 12 mm improved to 2 mm. Moreover, maintaining the patient's
motivation helped to reduce all the periodontal pockets to＜3 mm without periodontal surgery. It has been almost 3 years
since the transition to supportive periodontal therapy, and the PPD is ≤ 3 mm for all teeth with the use of ﬁve cleaning tools
and the periodontal condition has remained stable with PCR of 4.9％ and BOP of 2.8％.
Conclusion: It can be surmised that by assessing the patient's personality and degree of interest in the oral hygiene, severe
chronic periodontitis can be ameliorated with non-surgical treatment by ensuring suﬃcient communication and building a
relationship of trust.

JSP/JACP Poster Session AAP2020

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DH-03

Response to inﬂammation due to changes in the general condition
Momo Hasegawa＊1, Satoka Shimizu1, Ryoko Kageno1, Yoshihiro Iwano1,2
Iwano Dental Clinic, 2Department of Periodontology, Nihon University School of Dentistory

1

Background: We reported a case of recurrence of periodontitis associated with a change in the general condition of thepatient.
Case: A 42-year-old female patient ﬁrst visited our hospital in June 2015 with a chief complaint of gingival enlargement
between teeth 16 and 17. Radiographic imaging revealed loss of alveolar bone between 16 and 17. A grade I furcation lesion
was observed at the distal portion of 16.
Treatment and Results: Basic periodontal treatment was performed for the gingival enlargement between 16 and 17, and all
PPDs became ≤4 mm and the BOP and PCR stabilized（4.8％ and 4.2％ , respectively）；therefore, the transition to SPT
was made in May 2016. With onset of herpangina in August 2017, the patient showed decreased maintenance of oral
hygiene, and the gingival enlargement between 16 and 17 recurred with a 6-mm PPD. Changes in appointments by thepatient due to poor physical condition were noted, and she visited the internal medicine department after experiencing
fatigue for several months. The results indicated a decrease in the values of the thyroid gland parameters and decrease inimmunity strength. Considering the stamina and oral condition of the patient, the SPT interval was set to 1 month, andthorough oral cleaning guidance was given and symptoms ameliorated.
Conclusion: Because of the recurrence of inﬂammation due to changes in the general condition in the present case, a review
of oral cleaning tools was performed and the appropriate SPT interval was continued, thereby leading to stabilization ofsymptoms.

DH-04

A case of 35-year-successful periodontal treatment in chronic periodontitis
Masami Sato＊, Kazuyo Ikeda, Masahiko Ikeda
Ikeda Dental Clinic

Background: Oral health is a key INDICATOR of overall health, well-being and quality of life（WHO）.
Case: In 1985, a ﬁfty-six year-old female with chief complaint of pain in left molars visited our clinic. The narrowgingival width and 4-8mm of overall periodontal pockets were recognized. X-ray examination showed thehorizontal bone absorption.
Clinical Procedures and Outcomes: The patient received a diagnosis of chronic periodontitis with crowded dentalarch and started the treatments with basic periodontal treatments, orthodontic treatments, and prosthodontics
treatments. In 1988, the treatment shifted to follow up phase with SPT. The SPT consists of 1. Strengthen
motives, 2. Estimation of plaque control, 3. Periodontal tissue examination, 4. Interviewing about the diet,
5. Estimation of the occlusion, 6. Removal of calculus, and 7. Ordinary dental treatments if necessary. At present,
the patient turned 91-year old and does not have problems to live alone. She has been showing the active
attitudes toward to the good health and keeps coming for recalls. Overall probing pocket depth was kept around2 - 3mm and the plaque control had been well performed（Plaque Score = 7.4％）.
Conclusion: Despite getting chronic periodontitis 35-years ago, this case went well probably because the patient
has been highly motivated to be health. It is suggestive that dental hygienist has important roles in SPT especiallyduring strengthen motives toward to overall health.

JSP/JACP Poster Session AAP2020

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The 106th Annual Meeting of the American Academy of Periodontology in collaboration
with the Japanese Society of Periodontology,
and the Japanese Academy of Clinical Periodontology.
Abstracts of JSP/JACP Poster Session
Copyright ©2020 The Japanese Society of Periodontology, Japanese Academy of Clinical Periodontology.
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