• Journal of Periodontal and Implant Science
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• v.39 no.2
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• pp.157-166
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• 2009

Purpose: There are numerous reports about the usefulness of antibiotics such as doxycycline or metronidazole in the conventional treatment for the patients with chronic periodontal diseases. However, seldom are the reports about effects of vitamins or nutraceuticals. The purpose of this study was to evaluate the effects of nutrient supplement including multiple vitamins and neutraceuticals with PRF-K2 from plants and seaweed in treatment of the patients with chronic periodontitis which is needed a nonsurgical or a surgical treatment by evaluating the clinical parameters and the gingival crevicular fluid volume. Methods: The systemically healthy and nonsmoking patients diagnosed with chronic periodontitis were divided into a nonsurgical group and a surgical group. They were also divided into the test group with nutrient supplements and the control group without nutrient supplements. In the nonsurgical group, the clinical parameters (probing depth, clinical attachment level, sulcus bleeding index, and plaque index) and the gingival crevicular fluid volume were checked on baseline, at 1 week, at 3 week and at 9 week after a supplement treatment. In the surgical group, the clinical parameters and the gingival crevicular fluid volume were also checked at 15 week after a surgical treatment. Results: In both nonsurgical and surgical groups, reduction of pocket depth and increment of clinical attachment level were revealed in the test group compared with the control group, but there was not statistically significant difference (p>0.05), and sulcus bleeding index was decreased with statistically significant difference (p<0.05). In addition, plaque index was decreased with statistically significant difference (p<0.05) in the nonsurgical group. Gingival crevicular fluid volume was decreased with statistically significant difference (p<0.05) at week 9 in both non-surgical and surgical groups. Conclusions: In conclusion, our results demonstrate that providing nutrient supplement in both nonsurgical or surgical periodontal treatments may improve gingival inflammation and gingival crevicular fluid.

• Journal of Periodontal and Implant Science
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• v.31 no.4
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• pp.777-785
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• 2001

치주질환이 진행되는 동안이나 치주처치후 치유되는 과정에서 치조골의 변화가 야기되는데 방사선 사진은 치조골 변화를 감지하는 유일한 비외과적인 방법이다. 미묘한 치조골 변화의 진단은 치료시나 유지관리기 환자의 평가시 중요한 바, 최근에는 규격화시킨 디지털 영상을 이용하여 정량적인 골변화 측정이 가능하게 되었다. 본 연구의 목적은 중등도의 치주질환을 지닌 환자에서 국소마취하에 초기 치주처치를 시행한후 참조체와 함께 구내 방사선 사진을 촬영하고 디지털화 한 다음 참조체 당량치를 이용하여 치조골의 밀도변화를 평가하기 위한 것이다. 이 연구를 위하여 치주질환에 이환된 환자 5명(남자 3명, 여자 2명 : 평균 47.4세)에서 탐침깊이가 5㎜ 이상이고 골내낭이 있는 제 $1{\cdot}2$ 소구치, 제 $1{\cdot}2$ 대구치 40개(상악 24개, 하악 16개)를 대상으로 구강위생교육과 치석제거술, 치근면활택술을 시행하였다. 임상지수는 술전과 술후 8주째에 측정하였고, 방사선 사진은 술전, 술후 2주, 4주, 6주, 8주째에 촬영하였고, 구리 스텝웨지를 사용하여 규격화 하였다. 촬영된 영상은 NIH image program(U.S.A)에 의해 분석되어졌고 이들 자료를 통해 다음과 같은 결과를 얻었다. 1. 치조골의 밀도는 초기치료후 2주째 까지는 감소된 양상을 보이다가 4주 이후로는 점차적으로 증가하는 양상을 보였다. 2. 치조골의 밀도는 초기치료전과 비교시 초기치료수 6주째와 8주째에서 유의한 차이를 보였다.(p<0.01) 3. 상하악 간의 치조골 밀도는 유의한 차이를 보이지 않았다(p>0.05). 이상과 같은 결과를 통하여 볼때 초기 치주처치만으로도 치조골의 밀도가 증가됨을 확인할 수 있었다.

• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.645-660
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• 1998

The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.388-395
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• 1996

Congenital muscular torticollis(CMT) is a disorder characterized by shortening of at least one of the cervical muscles and tilting of the head to opposite side. The most commonly affected muscle is the sternocleidomastoid muscle. Pathogenesis and etiology of congenital muscular torticollis were not clearly identified, but considered as fetal malposition, birth trauma, vascular accident, heredity, infection and CNS pathology. Untreated congenital muscular torticollis often causes facial asymmetry and This is the rasult of tensional rotation of the face toward affected side. So early treatment may prevent facial and neck asymmetry and limitation of neck movement. There are many treatment methods in CMT, including conservative and operative method, but presently Bipolar release and Z-Plasty of SCM muscle has been introduced when the conservative treatment had failed. The benefits of this method are to preservation of the normal Neck V-contour and improvement of the neck motion. We treated CMT using Bipolar release and Z-plasty in two patients. After that the patients improved on the range of neck motion and maintained the normal V-conture of the neck, so we report two cases of CMT with literatures.