• Journal of Periodontal and Implant Science
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• v.44 no.4
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• pp.207-213
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• 2014

Purpose: The study was aimed at investigating changes in periodontal parameters and superoxide dismutase activity triggered by root surface debridement with and without micronutrient supplementation in postmenopausal women. Methods: Forty-three postmenopausal chronic periodontitis patients were divided into two groups: group 1 (n=22) were provided periodontal treatment in the form of scaling and root planing (SRP) and group 2 (n=21) patients received SRP along with systemic administration of micronutrient antioxidants. Patients in both groups were subjected to root surface debridement. Group 2 patients also received adjunctive micronutrient antioxidant supplementation. Serum and salivary superoxide dismutase (SOD) activity along with periodontal parameters were recorded at baseline and 3 months after therapy. Results: Salivary and serum SOD values significantly (P<0.05) improved with periodontal treatment. Improvement in systemic enzymatic antioxidant status along with reduction in gingival inflammation and bleeding on probing (%) sites was significantly greater in group 2 as compared to group 1. Conclusions: Adjunctive micronutrient supplements reduce periodontal inflammation and improve the status of systemic enzymatic antioxidants in postmenopausal women.

• Journal of Periodontal and Implant Science
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• v.39 no.4
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• pp.437-441
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• 2009

Purpose: The purpose of this report is to show three cases treated by an intergrated periodontal and restorative dentistry approach. Methods: Three patients with Miller Class Ⅰgingiva recessions associated with cervical lesions were enrolled for treatment. Two patients received a connective tissue graft and resin modified glass ionomer, and one patient was treated with a connective tissue graft, resin restoration. Keratinized gingiva and relative gingival recession were measured. Results: The mean reduction of relative gingival recession was 3.7 mm, and the mean keratinized gingiva increase was 2.5 mm. The percentage of root coverage was 80% in average. No signs of gingival inflammation or bleeding on probing were seen. The patients were satisfied with the final esthetics and had no more dentin hypersensitivity. Conclusions: This report indicates that teeth with Miller ClassⅠ gingival recession associated with cervical lesions can be successfully treated by a connective tissue graft combined with restorative dentistry. However, longitudinal randomized controlled clinical trials must be performed to support this approach.

• Journal of Periodontal and Implant Science
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• v.40 no.5
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• pp.249-253
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• 2010

Purpose: The purpose of this study was to evaluate the improvement of periodontal health of generalized aggressive periodontitis (GAgP) diagnosed patients treated with non-surgical periodontal therapy accompanying systemic antibiotics administration. Methods: Two patients with GAgP were chosen for this study. Clinical indices were taken and a radiographic examination was performed at the baseline of the study and they were treated by periodontal therapy accompanying systemic antibiotics administration. Post-surgical visits were scheduled at regular intervals to check clinical and radiographic changes. Results: Through non-surgical periodontal therapy accompanying systemic antibiotics administration, GAgP patients showed decreased probing pocket depth, sulcus bleeding index, and increased attachment level and clinical index when comparing the initial and six month follow up data. In the six month follow-up radiographic examination after non-surgical periodontal therapy, resolution of the bony defect was observed. Conclusions: Non-surgical therapy combined with systemic antibiotics administration in GAgP patients is suggested to be an effective approach to enhance the periodontal health.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.657-668
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• 2008

Purpose: In this study, we compared low-power $CO_2$ laser treatment to ultrasonic scaling, which is generally approved as a power-driven mechanical instrumentation, and evaluated both of these treatments regarding their clinical effectiveness and change in the volume of in GCF. Material and methods: 20 patients who had gingivitis were selected. all of patients has no systemic problems. Randomly selected, one quadrant received ultrasonic scaling only, another quadrant received ultrasonic scaling and $CO_2$ laser irradiation, the other quadrant received $CO_2$ laser irradiation only. Clinical parameters measured at baseline, 1 weeks, 2weeks, 4weeks and 8weeks. Result: Pocket probing depth and clinical attachment level were not changed during study period. Gingival index of all group were improved after treatment. At 1 weeks after treatment, Gingival index of ultrasonic scaling group was only significantly different compared to control group. At 2 weeks after treatment, gingival index of all experimental group were significantly different compared to control group. At 4 and 8 weeks after treatment, gingival index of all group were increased, but experimental group were lower than control group. Sulcus bleeding index was similar to the results of gingival index. At 1 weeks after treatment, all experimental group were significantly different compared to control group and it maintained during study. At 2 weeks after treatment, sulcus bleeding index of all group were lowest during study. Gingival crevicular fluid were measured with $Periotron^{(R)}$ 8000($Oraflow^{(R)}$, Inc. USA). At baseline, all group were showed moderately severe condition. At 1 week after treatment, laser treatment only group was reduced quantity of gingival crevicular fluid mostly, and all group were reduced quantity of gingival crevicular fluid. At 2 weeks after treatment, all group were health state. At 4 and 8 weeks after treatment, all group were showed recurrent of inflammation, and control group was the most significantly increased. Conclusion: This study showed that the effects of $CO_2$ laser treatment were similar to conventional ultrasonic scaling and this result remained longer than plaque control only. These results suggest possibility of $CO_2$ laser treatment for altered periodontal therapy.

• Journal of Periodontal and Implant Science
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• v.33 no.2
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• pp.167-178
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• 2003

Many researches are being done to study the effect of toothpaste containing natural extracts. The aim of this study was to evaluate the plaque control effect and therapeutic effect of toothpaste products containing chitosan extract. 120 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in the experimental group only used toothpaste containing chitosan and subjects in the control group used toothpaste without chitosan. At first, subjects received scaling and tooth brushing instruction. Gingival index, bleeding index, probing pocket depth, probing attachment level were scored at baseline, 2 months, and 3 months, and plaque index were scored at baseline, 1 month, 2 months, 3 months. Gingival index of experimental group and control group at baseline, 2 months, and 3 months use were 0.71${\pm}$0.66, 0.49${\pm}$0.55, 0.36${\pm}$0.49 and 0.62${\pm}$0.58, 0.51${\pm}$0.52, 0.48${\pm}$0.50 (mean${\pm}$SD), respectively (statistically significant different at p <0.05 ). Plaque index of experimental group and control group at baseline, 1 month, 2 months, and 3 months were 0.52${\pm}$0.50, 0.43${\pm}$0.50, 0.39${\pm}$0.49, 0.29${\pm}$0.46 and 0.49${\pm}$0.50, 0.50${\pm}$0.50, 0.51${\pm}$0.50, 0.45${\pm}$0.50, respectively (statistically significant different at p<0.05 ). Bleeding index of experimental group and control group were 0.40${\pm}$0.49, 0.33${\pm}$0.47, 0.24${\pm}$0.43 and 0.40${\pm}$0.49,0,38${\pm}$0.49,0.30${\pm}$0.46, respectively (statistically significant different at p<0.05). Probing depth of experimental group and control group were 2.41${\pm}$0.64, 2.31${\pm}$0.60, 2.28${\pm}$0.55 and 2.51${\pm}$0.67, 2.47${\pm}$0.63,2.42${\pm}$0.62, respectively (statistically significant different at p${\pm}$0.66, 2.32${\pm}$0.62 and 2.54${\pm}$0.70, 2.51${\pm}$0.69,2.46${\pm}$0.66, respectively (statistically significant different at p<0.05 ). From these finding, it can be concluded that toothpaste containing chitosan have better plaque control effect and therapeutic effect on gingivitis and early periodontitis compared to conventional toothpastes.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.3
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• pp.301-311
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• 2009

Statement of problem: Flapless implant surgery using a soft tissue punch device requires a circumferential excision of the mucosa at the implant site. To date, Although there have been several reports on clinical outcomes of flapless implant surgeries, there are no published reports that address the appropriate size of the soft tissue punch for peri-implant tissue healing. Purpose: In an attempt to help produce guidelines for the use of soft tissue punches, this animal study was undertaken to examine the effect of soft tissue punch size on the healing of peri-implant tissue in a canine mandible model. Material and methods: Bilateral, edentulated, flat alveolar ridges were created in the mandibles of six mongrel dogs. After a three month healing period, three fixtures (diameter, 4.0 mm) were placed on each side of the mandible using 3 mm, 4 mm, or 5 mm soft tissue punches. During subsequent healing periods, the peri-implant mucosa was evaluated using clinical, radiological, and histometric parameters, which included Gingival Index, bleeding on probing, probing pocket depth, marginal bone loss, and vertical dimension measurements of the peri-implant tissues. Results: The results showed significant differences (P <0.05) between the 3 mm, 4 mm and 5 mm tissue punch groups for the length of the junctional epithelium, probing depth, and marginal bone loss during healing periods after implant placement. When the mucosa was punched with a 3 mm tissue punch, the length of the junctional epithelium was shorter, the probing depth was shallower, and less crestal bone loss occurred than when using a tissue punch with a diameter $\geq$ 4 mm. Conclusion: Within the limit of this study, the size of the soft tissue punch plays an important role in achieving optimal healing. Our findings support the use of tissue punch that 1 mm smaller than implant itself to obtain better peri-implant tissue healing around flapless implants.

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.57-64
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• 2014

Purpose: Both chronic periodontitis (CP) and iron deficiency anemia (IDA) induce oxidative stress in the body and cause an imbalance between reactive oxygen species and antioxidants, such as superoxide dismutase (SOD). This study explored the SOD enzyme activity of saliva and serum in CP patients with and without IDA and analyzed the impact of IDA on CP. Methods: A total of 82 patients were divided into four groups: control group (CG, 22), periodontally healthy IDA patients (IDA-PH, 20), CP patients (CP, 20), and IDA patients with CP (IDA-CP, 20). After clinical measurements and samplings, serum and salivary SOD levels were determined using an SOD assay kit. Results: IDA-CP patients exhibited a higher gingival index, bleeding on probing, probing pocket depth, and percentage (%) of sites with a clinical attachment loss (CAL) of ${\geq}6mm$ (P<0.008) than CP patients. The mean salivary and serum SOD levels were significantly lower in the IDA-PH, CP, and IDA-CP patients than in the CG group (P<0.008). A significant positive correlation between salivary and serum SOD activity was observed in IDA (P<0.05). Furthermore, serum and salivary SOD levels were significantly and negatively correlated with all periodontal parameters including the percentage of sites with CAL of 4-5 and ${\geq}6mm$ (P<0.05) except the significant correlation between salivary SOD activity and mean CAL and the percentage of sites with CAL of 4-5 mm (P>0.05) in these patients. Conclusions: Within the limits of this study, it may be suggested that IDA patients with chronic periodontitis have more periodontal breakdowns than patients with chronic periodontitis. Serum and salivary SOD activity levels were lower in the IDA-PH, CP and IDA-CP groups than in the CG. Iron deficiency anemia influenced the serum SOD activity but did not seem to affect the salivary SOD activity in these patients.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.563-572
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• 2004

Since bacterial plaque is known as the major cause of every oral disease, it is necessary to control plaque to maintain periodontal health. Although tooth brushing has been the typical method of plaque control, additional use of plaque control devices are necessary for cleansing interdental areas. Dental floss has been used for a long time as the additional plaque control device and proved to be effective. The newly developed embossed new dental pick is composed of elastic plastic material in form with its tip longer than other toothpick. In addition, as thickness of the tip gradually increases, it can be adapted easily with minimal trauma to interdental gingiva. The embossed tip can remove dental plaque easily, and the opposite end can approach lingual and palatal areas through triple angulation. Therefore, the authors studied the effect of embossed new dental pick and dental floss on periodontally involved 15 patient. The following results were obtained. 1. For embossed new dental pick, probing depth at baseline, 1 week, 4 weeks were $3.6{\pm}0.6mm$, $3.4{\pm}0.5mm$, $3.2{\pm}0.5mm$, respectively, and $4.2{\pm}0.9mm$, $4.1{\pm}0.9mm$, $4.0{\pm}0.9mm$, respectivly for clinical attachment level. 2. In case of embossed new dental pick, bleeding on probing at baseline, 1 week, 4 weeks were $43.0{\pm}4.4%$, $28.5{\pm}5.1%$, $22.2{\pm}5.6%$, respectively, and, at 1 week and 4 weeks, they were significantly different from that of dental floss. 3. Gingival index of toαhpick at baseline, 1 week, 4 weeks were $1.7{\pm}0.5$, $1.0{\pm}0.3$, $0.9{\pm}0.2$, respectively, and, $1.7{\pm}0.5$, $1.1{\pm}0.4$, $1.0{\pm}0.4$, respectively for plaque index, and $3.0{\pm}0.5$, $1.7{\pm}0.5$, $1.4{\pm}0.4$, respectively for proximal plaque index. proximal plaque index at 4 weeks was significantly different from that of dental floss. 4. The result of questionnaire showed that the two types of device were both satisfactory, however, embossed new dental pick had higher preference as well as satisfaction. As a result, embossed new dental pick is thought to be clinically effective for its simplicity and good accessibility.

• Journal of Periodontal and Implant Science
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• v.50 no.5
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• pp.340-354
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• 2020

Purpose: This pilot study was conducted to evaluate the cleaning efficacy of an angled implant brush for home oral hygiene of full-arch fixed-implant prostheses. Methods: Forty-one patients treated with a full-arch implant rehabilitation in the maxilla or mandible (164 implants) for at least 4 months were enrolled. The screw-retained fixed prostheses were removed and baseline (T0) parameters were recorded, including plaque index (PI), probing depth (PD), and bleeding on probing (BOP). All patients completed a 5-item questionnaire on hygiene maintenance and received an implant brush for home hygiene. After 1 month (T1) PI, PD, and BOP were recorded again and patients completed a 7-item questionnaire to evaluate their satisfaction with the implant brush. One-way repeated-measures analysis of variance was conducted to evaluate the significance of changes in PI, PD, and BOP. A P value <0.05 was considered to indicate statistical significance. Results: A statistically significant reduction of BOP (0.62±0.6 at T0 vs. 0.5±0.5 at T1; P=0.032) was found, while no statistically significant changes in PD (1.74±0.5 mm at T0 vs. 1.77±0.5 mm at T1; P=0.050) or PI (1.9±0.7 at T0 vs. 1.7±0.7 at T1; P=0.280) occurred. According to the 7-item questionnaire, patients reported no difficulty in using the angled brush (63.4%) and deemed it highly (46.3%) or very highly (4.8%) effective in improving their home oral hygiene. Conclusions: Within the limits of the present pilot study, the patients experienced a reduction of BOP 1 month after being instructed to use the angled implant brush. The angled implant brush appeared to be a well-accepted device for home-care hygiene of full-arch fixed-implant rehabilitations.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.607-622
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• 2004

Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of $PGE_2$ was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood $PGE_2$. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15% vs. 3.3%, OR 5.118,p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.