• Title/Summary/Keyword: Blood loss

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Effect of tranexamic acid on blood loss reduction in patients undergoing orthognathic surgery under hypotensive anesthesia: a single-center, retrospective, observational study

  • Keisuke Harada;Noritaka Imamachi;Yuhei Matsuda;Masato Hirabayashi;Yoji Saito;Takahiro Kanno
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.2
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    • pp.86-93
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    • 2024
  • Objectives: Orthognathic surgery is a surgical procedure performed by intraoral approach with established and safe techniques; however, excessive blood loss has been reported in rare cases. In response, investigative efforts to identify methods to reduce the amount of blood loss have been made. Among such methods, the administration of tranexamic acid was reported to reduce the amount of intraoperative blood loss. However, few studies to date have reported the effect of tranexamic acid in orthognathic surgery under hypotensive anesthesia. The present study aimed to investigate the effect of the administration of tranexamic acid on intraoperative blood loss in patients undergoing bimaxillary (maxillary and mandibular) orthognathic surgery under hypotensive anesthesia. Patients and Methods: A total of 156 patients (mean age, 27.0±10.8 years) who underwent bimaxillary orthognathic surgery under hypotensive anesthesia performed by the same surgeon between June 2013 and February 2022 were included in this study. The following data were collected from the medical records of each patient: background factors (age, sex, and body mass index), use of tranexamic acid, surgical procedures, previous medical history, duration of surgery, American Society of Anesthesiology physical status findings before surgery, intraoperative blood loss as a primary outcome, in-out balance, and blood test results. Descriptive statistics were calculated for statistical analysis, and a t-test and the chi-squared test were used for between-group comparisons. Group comparisons were performed after 1:1 propensity score matching to adjust for confounding factors. Statistical significance was set at P<0.05. Results: Comparison between the groups based on the use of tranexamic acid revealed a significant difference in operation time. Propensity score matching analysis revealed that intraoperative blood loss was significantly lower in the tranexamic acid group. Conclusion: The administration of tranexamic acid was effective in reducing intraoperative blood loss in patients undergoing bimaxillary orthognathic surgery under hypotensive anesthesia.

Blood haematology, muscle pH and serum cortisol changes in pigs with different levels of drip loss

  • Koomkrong, Nunyarat;Boonkaewwan, Chaiwat;Laenoi, Watchara;Kayan, Autchara
    • Asian-Australasian Journal of Animal Sciences
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    • v.30 no.12
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    • pp.1751-1755
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    • 2017
  • Objective: An experiment was conducted to study the blood haematology, muscle pH, and serum cortisol changes in pigs with different levels of drip loss. Methods: Two groups (low and high) of 20 animals were selected from 100 pigs based on drip loss. All [$Duroc{\times}(Large\;White{\times}Landrace)$] pigs were slaughtered according to standard slaughtering procedures. At exsanguinations, blood samples were taken for the haematological parameters and serum cortisol analysis. The muscle samples were taken from longissimus dorsi muscle to evaluate the muscle pH and drip loss. Results: Haematological parameters of low drip loss group showed higher content of white blood cells and monocytes than high drip loss group (p<0.05). The low drip loss group had higher muscle pH at 45 min (p<0.05) and 24 h (p<0.001) post-mortem than the high drip loss group. However, there was no significant difference in serum cortisol levels (p>0.05). Conclusion: Drip loss is mainly affected by the muscle pH decline after slaughter and also might be affected by white blood cells and monocytes.

THE EFFECT OF KWI RYONG TANG ON THE HEMATOCRIT AND HEMOGLOBIN IN THE BLOOD OF THE RABBIT (귀용탕(歸茸湯) 투여(投與)가 가토혈중(家兎血中) Hematocrit 및 Hemoglobin에 미치는 영향(影響))

  • Kim, Byong-Wun
    • The Journal of Internal Korean Medicine
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    • v.1 no.1
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    • pp.44-49
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    • 1976
  • To investigate the effect of Kwi Ryong Tang a precious tonic of herbal drugs, the blood of rabbit was depleted from the heart for the purpose of experiment and the author administered the Kwi Ryong Tang to that rabbit. This effect of the tonic on the experimental groups was Compared with that of the control group and the author observed the following results; 1. In the experimental group treated with Kwi Ryong Tang before the depletion of the blood, the recovery of blood, the recovery of blood loss is some what accelerated that in the control group. 2. In the experimental group treated with Kwi Ryong Tang after the depletion of the blood, the recovery of blood loss is slightly accelerated that in experimental group which was treated with Kwi Ryong Tang before the depletion of the blood. 3. In the experimental group treated with Kwi Ryong Tang before and after the depletion of the blood, the recovery of the blood loss is markedly accelerated Comparing, that in the experimental group which was treated with Kwi Ryong Tang before or after the depletion of the blood loss.

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Study on the Measurement of $^{51}Cr-tagged$ Red Cell Survival - Reevaluation of its method & the effect of Blood loss on red cell suruival with $^{51}Cr$ - (방사성동위원소(放射性同位元素) $^{51}Cr$을 이용(利用)한 적혈구수명(赤血球壽命) 측정(測定)에 관(關)한 고찰(考察) -$^{51}Cr$-적혈구수명(赤血球壽命) 측정법(測定法)의 재평가(再評價)와 실혈(失血)이 수명측정(壽命測定)에 미치는 영향(影響)에 관(關)한 연구(硏究))

  • Choi, Hak-Yong;Koh, Chang-Soon;Lee, Moon-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.2
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    • pp.55-66
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    • 1970
  • Reappraisal measurements of apparent half survival time of red cell by $^{51}Cr$ method was made and effects of blood-letting over red cell survival were observed. The study was performed on 53 normal male subjects under three different experimental conditions. 1. Group 1 Mean $^{51}Cr$ red cell half survival by ACD wash method was 29.7 days. $T\frac{1}{2}$ of Ascorbic acid method was 29.0 days in group with 100 mg dose and 29.1 days in group with 50 mg dose respectively. There was no difference between these two methods in regards to red cell half survival. No difference were noted in amount of ascorbic acid administered. 2. Group 2 As daily amount of blood loss is increased the shortening of red cell half survival was noted. Rapid phase was seen when blood loss ranged 10 to 25 ml per day, while slow phase noted when more loss amounted 25 ml or more daily. Thus, it was clear that there was more than an exponential relation between $T\frac{1}{2}$ and the amount of blood loss. 3. Group 3 $T\frac{1}{2}$ measured by cpm per whole blood was within normal range and $T\frac{1}{2}$ measured by cpm per red cell mass showed shortening tendency when compared with the former in the group measured after blood loss (from 25 ml daily up to 100 ml daily in 10 days). In the group with rather constant blood loss of 100 ml daily for 10 consecutive days revealed the significant difference in two measurements (P<0.01). 4. $T\frac{1}{2}$ in non-steady state When red cell production is increased compared with red cell destruction, $T\frac{1}{2}$ measured by cpm per red cell mass being shorter than that by cpm per whole blood. Shortening of $T\frac{1}{2}$ measured by cpm per whole blood is more prominent. if red cell destrction is enhanced and exceeds production. 5. It is clear that when expressing red cell destruction rate, $T\frac{1}{2}$ measured by cpm per whole blood is more adequate and production more consistent with cpm red cell mass. 6. $T\frac{1}{2}$ measured during blood-letting, when corrected by amount of blood loss, it remains normal. It is erroneous to use conventional equational when measuring $T\frac{1}{2}$ in non-steady. $T\frac{1}{2}$ measured by cpm per whole blood is considred more applicable in clinical evaluation.

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Studies on Ancylostomiasis I. An Experimental Study on Hookworm Infection and Anemia (구충증(鉤蟲症)에 관(關)한 연구(硏究) 제1편(第1篇) 구충(鉤蟲)의 감염(感染) 및 구충성빈혈(鉤蟲性貧血)에 관(關)한 고찰(考奈))

  • Lee, Mun-Ho;Kim, Dong-Jip;Lee, Jang-Kyu;Seo, Byong-Sul;Lee, Soon-Hyung
    • The Korean Journal of Nuclear Medicine
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    • v.1 no.1
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    • pp.55-66
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    • 1967
  • In view of its prevalence in the Far East area, a more detailed knowledge on the hookworm infection is one of the very important medical problems. The present study was aimed to; determine the infectivity of the artificially hatched ancylostoma duodenale larvae in man after its oral administration, evaluate the clinical symptomatology of such infection, determine the date of first appearance of the ova in the stool, calculate the blood loss per worm per day, assess the relation-ships between the ova count, infectivity(worm load), blood loss and severity of anemia. An erythrokinetic study was also done to analyse the characteristics of hookworm anemia by means of $^{59}Fe\;and\;^{51}Cr$. Materials and Methods Ten healthy male volunteers(doctors, medical students and laboratory technicians) with the ages ranging from 21 to 40 years were selected as the experimental materials. They had no history of hookworm infection for preceding several years, and care was taken not to be exposed to reinfection. A baseline study including a through physical examinations and laboratory investigations such as complete blood counts, stool examination and estimation of the serum iron levels was done, and a vermifuge, bephenium hydroxynaphoate, was given 10 days prior to the main experiment. The ancylostoma duodenale filariform larvae were obtained in the following manner; The pure ancylostoma duodenale ova were obtained from the hookworm anemia patients and a modified filter paper method was adopted to harvest larger number of infective larvae, which were washed several times with saline. The actively moving mature larvae were put into the gelatine capsules, 150 in each, and were given to the volunteers in the fasting state with 300ml. of water. The volunteers were previously treated with intramuscular injection of 15mg. of chlorpromazine in order to prevent the eventual nausea and vomiting after the larvae intake. The clinical symptoms and signs mainly of the respiratory and gastrointestinal tracts, appearance of the ova and occult blood in the stool etc. were checked every day for the first 20 days and then twice weekly until the end of the experiment, which usually lasted for about 3 months. Roentgenological survey of the lungs was also done. The hematological changes such as the red blood cell, white blood cell and eosinophil cell counts, hemoglobin content and serum iron levels were studied. The appearance of the ova in the stool was examined by the formalin ether method and the ova were counted in triplicate on two successive days using the Stoll's dilution method. The ferrokinetic data were calculated by the modified Huff's method and the apparent half survival time of the red blood cells by the modified Gray's method. The isotopes were simultaneously tagged and injected intravenously, and then the stool and blood samples were collected as was described by Roche et al., namely, three separate 4-day stool samples with the blood sample drawing before each 4-day stool collection. The radio-activities of the stools ashfied and the blood were separately measured by the pulse-height analyser. The daily blood loss was calculated with the following formula; daily blood loss in $ml.=\frac{cpm/g\;stool{\times}weight\;in\;g\;of\;4-day\;stool}{cpm/ml\;blood{\times}4}$ The average of these three 4-day periods was given as the daily blood loss in each patient. The blood loss per day per worm was calculated by simply dividing the daily blood loss by the number of the hookworm recovered after the vermifuge given twice a week at the termination of the experiment. The iron loss in mg. through the gastrointestinal tract was estimated with the daily iron loss in $mg=\frac{g\;Hgb/100ml{\times}ml\;daily\;blood\;loss{\times}3.40}{100}$ 3.40=mg of iron per g Hgb following formula; Results 1. The respiratory symptoms such as cough and sputum were noted in almost all cases within a week after the infection, which lasted about 2 weeks. The roentgenological findings of the chest were essentially normal. A moderate degree of febril reaction appeared within 2 weeks with a duration of 3 or 4 days. 2. The gastrointestinal symptoms such as nausea, epigastric fullness, abdominal pain and loose bowel appeared in all cases immediately after the larvae intake. 3. The reduction of the red blood cell count was not remarkable, however, the hemoglobin content and especially the serum iron level showed the steady decreases until the end of the experiment. 4. The white blood cells and eosinophil cells, on the contrary, showed increases in parallel and reached peaks in 20 to 30 days after the infection. A small secondary rise was noted in 2 months. 5. The ova first appeared in the stool in 40. 1 days after the infection, ranging from 29 to 51 days, during which the occult blood reaction of the stool became also positive in almost cases. 6. The number of ova recovered per day was 164, 320 on the average, ranging from 89,500 to 253,800. The number of the worm evacuated by vermifuge was in rough correlation with the number of ova recovered. 7. The infectivity of ancylostoma duodenale was 14% on the average, ranging from 7.3 to 20.0%, which is relatively lower than those reported by other workers. 8. The mean fecal blood loss was 5.78ml. per day, with a range of from 2.6 to 11.7ml., and the mean blood loss per worm per day was 0.30ml., with a range of from 0.13 to 0.73ml., which is in rough coincidence with those reported by other authors. There appeared to exist, however, no correlation between the blood loss and the number of ova recovered. 9. The mean fecal iron loss was 2.02mg. per day, with a range of from 1.20 to 3.89mg., which is less than those appeared in the literature. 10. The mean plasma iron disappearance rate was 0.80hr., with a range of from 0.62 to 0.95hr., namely, a slight accerelation. 11. The hookworm anemia appeared to be iron deficiency in origin caused by continuous intestinal blood loss.

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Effects of Emitted-Qi therapy and Cold water hterapy on Blood Features and Serum in burned Rats (외기요법(外氣療法)과 냉수처치(冷水處置)가 화상(火傷) 후 흰쥐의 혈액성분(血液成分)에 미치는 영향(影響))

  • Lee Kyung-Won;Kim Kwang-Ho
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.1
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    • pp.17-31
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    • 2000
  • In order to investigate the effects of emitted-qi therapy(EQT) and cold water therapy(CWT) on the inhibition of the blood loss, the protein loss and the electrolyte loss in burned rats. The white blood cell, hematocrit and hemoglobin values in blood, and the total protein, albumin, globulin, $Na^+,\;Cl^-,\;K^+\;and\;Ca^{2+}$ values in serum were measured. The results were obtained as follows; 1. White blood cell count in blood was significantly increased in CWT group compared with control group. 2. Hematocrit value in bolld was significantly increase in EQT and CWT group compared with control group. 3. Hemoglobin value in blood was significantly increased in CWT group compared with control group. 4. Total protein value in serum was significantly increased in CWT group compared with control group. 5. Albumin value in serum was significantly increased in EQT and CWT group compared with control group. 6. Globulin value in serum tended to be increase in EQT and CWT group compared with control group, but it was not significant. 7. A/G ratio in serum was significantly increased in EQT and CWT group compared with contort group. 8. $Na^+$, value in serum was significantly increased in EQT and CWT group compared with ontrol group. 9. $K^+$, value in serum tended to be increased in EQT group compared with control group, but it was not significant. 10. $Cl^-$ value in serum was significantly increased in EQT and CWT group compared with control group. 11. $Ca^{2+}$ value in serum tended to be increased in EQT and CWT compared with control group, but it was not significant. According to the above results, the EQT and CWT inhibited the blood loss, the protein loss and the electrolyte loss. Therefore, it is considered that the EQT and CWT can be applied to the burn therapy.

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Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma

  • Urabe, Masayuki;Ohkura, Yu;Haruta, Shusuke;Ueno, Masaki;Udagawa, Harushi
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.466-472
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    • 2021
  • Background: Major intraoperative hemorrhage reportedly predicts unfavorable survival outcomes following surgical resection for esophageal carcinoma (EC). However, the factors predicting the amount of blood lost during thoracoscopic esophagectomy have yet to be sufficiently studied. We sought to identify risk factors for excessive blood loss during video-assisted thoracoscopic surgery (VATS) for EC. Methods: Using simple and multiple linear regression models, we performed retrospective analyses of the associations between clinicopathological/surgical factors and estimated hemorrhagic volume in 168 consecutive patients who underwent VATS-type esophagectomy for EC. Results: The median blood loss amount was 225 mL (interquartile range, 126-380 mL). Abdominal laparotomy (p<0.001), thoracic duct resection (p=0.014), and division of the azygos arch (p<0.001) were significantly related to high volumes of blood loss. Body mass index and operative duration, as continuous variables, were also correlated positively with blood loss volume in simple linear regression. The multiple linear regression analysis identified prolonged operative duration (p<0.001), open laparotomy approach (p=0.003), azygos arch division (p=0.005), and high body mass index (p=0.014) as independent predictors of higher hemorrhage amounts during VATS esophagectomy. Conclusion: As well as body mass index, operation-related factors such as operative duration, open laparotomy, and division of the azygos arch were independently predictive of estimated blood loss during VATS esophagectomy for EC. Laparoscopic abdominal procedures and azygos arch preservation might be minimally invasive options that would potentially reduce intraoperative hemorrhage, although oncological radicality remains an important consideration.

Blood Loss Prediction of Rats in Hemorrhagic Shock Using a Linear Regression Model (출혈성 쇼크를 일으킨 흰쥐에서 선형회귀 분석모델을 이용한 출혈량 추정)

  • Lee, Tak-Hyung;Lee, Ju-Hyung;Choi, Jae-Rim;Yang, Dong-In;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.47 no.1
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    • pp.56-61
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    • 2010
  • Hemorrhagic shock is a common cause of death in the emergency department. The purpose of this study was to investigate the relationship between blood loss as a percent of the total estimated blood volume (% blood loss) and changes in several physiological parameters. The other goal was to achieve an accurate prediction of percent blood loss for hemorrhagic shock in rats using a linear regression model. We allocated 60 Sprague-Dawley rats into four groups: 0ml, 2ml, 2.5ml, 3 mL/100 g during 15 min. We analyzed the heart rate, systolic and diastolic blood pressure, respiration rate, and body temperature in relation to the percent blood loss. We generated a linear regression model predicting the percent blood loss using a randomly chosen 360 data set and the R-square value of the model was 0.80. Root mean square error of the tested 360 data set using the linear regression was 5.7%. Even though the linear regression model is not directly applicable to clinical situation, our method of predicting % blood loss could be helpful in determining the necessary fluid volume for resuscitation in the future.

Effects of San-Yin-Jio(SP-6) pressure on duration of delivery time and quantity of blood loss for primipara (삼음교(三陰交) 자극이 초산부(初産婦)의 분만(分娩) 소요시간과 실혈량(失血量)에 미치는 효과(效果))

  • Kim, Woo-hwan;Kim, Won-ill;Lee, Kyung-hee;Youn, Hyoun-min
    • Journal of Acupuncture Research
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    • v.20 no.5
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    • pp.82-92
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    • 2003
  • Objective: To appreciate the effect of San-Yin-Jiao(SP-6) pressure on duratof delivery time and quantity of blood loss in order to verify the possibility of application to clinic of San-Yin-Jiao pressure. Methods: The design of this study is nonequivalent control group non- synchronized design. The subjects are 39 persons who are made up of SP-6 pressure applied(experimental) group 20 persons and to control group 19 persons. Collected data were analyzed as frequency, percentage, t-test, $x^2-test$ using SPSS 10.0 WIN Program. Conclusions: San-Yin-Jiao(SP-6) pressure not only make short duration of delivery time, but also decline quantity of blood loss in effect. 1. It could be necessary that the study of the effects of San-Yin-Jio(SP-6) pressure on duration of delivery time and quantity of blood loss for primipara be done repeatedly. 2. It could be necessary to increase this sort of study through free random experimental design in order to generalize this experimental result.

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Evaluation of health screening data for factors associated with peri-implant bone loss

  • Hyunjong Yoo;Jun-Beom Park;Youngkyung Ko
    • Journal of Periodontal and Implant Science
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    • v.52 no.6
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    • pp.509-521
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    • 2022
  • Purpose: Systemic health has a profound effect on dental treatment. The aim of this study was to evaluate peri-implant bone loss and health screening data to discover factors that may influence peri-implant diseases. Methods: This study analyzed the panoramic X-rays of patients undergoing health screenings at the Health Promotion Center at Seoul St. Mary's Hospital in 2018, to investigate the relationship between laboratory test results and dental data. The patients' physical data, such as height, weight, blood pressure, hematological and urine analysis data, smoking habits, number of remaining teeth, alveolar bone level, number of implants, and degree of bone loss around the implant, were analyzed for correlations. Their associations with glycated hemoglobin, glucose, blood urea nitrogen (BUN), creatinine, and severity of periodontitis were evaluated using univariate and multivariate regression analysis. Results: In total, 2,264 patients opted in for dental health examinations, of whom 752 (33.2%) had undergone dental implant treatment. These 752 patients had a total of 2,658 implants, and 129 (17.1%) had 1 or more implants with peri-implant bone loss of 2 mm or more. The number of these implants was 204 (7%). Body mass index and smoking were not correlated with peri-implant bone loss. Stepwise multivariate regression analysis revealed that the severity of periodontal bone loss (moderate bone loss: odds ratio [OR], 3.154; 95% confidence interval [CI], 1.175-8.475 and severe bone loss: OR, 7.751; 95% CI, 3.003-20) and BUN (OR, 1.082; 95% CI, 1.027-1.141) showed statistically significant predictive value. The severity of periodontitis showed greater predictive value than the biochemical parameters of blood glucose, renal function, and liver function. Conclusions: The results of this study showed that periodontal bone loss was a predictor of peri-implant bone loss, suggesting that periodontal disease should be controlled before dental treatment. Diligent maintenance care is recommended for patients with moderate to severe periodontal bone loss.