• Journal of Periodontal and Implant Science
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• v.41 no.1
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• pp.44-50
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• 2011

Purpose: Pathologic tooth migration (PTM) is a tooth displacement which is derived from imbalance of tooth retention force and is dominantly found out in maxillary anterior area. PTM in maxillary anterior area was tried to corrected with periodontal treatment and a clear aligner in this study and the result was evaluated clinically and radiographically. Methods: For the treatment of a patient with chronic periodontal disease accompanied by maxillary anterior pathologic tooth migration, clear aligner was applied to move teeth after a series of case-related periodontal therapy. Clinically, probing depth, gingival recession, clinical attachment level and mobility were measured pre- and post-treatment, and radiographic examination was performed as well. Results: Clinically, we found the decrease of the probing depth, gingival recession, clinical attachment level and mobility. And we could also acknowledge the reduction of vertical and horizontal dimension on infrabony defect radiographically. However, it is still controversial if there was an actual bone filling. Conclusions: Clear aligner is an effective appliance to move teeth since it costs little in terms of expense and time. In addition, it wraps whole crowns, providing advantages to deal with crowding, spacing, and size of arch. In short, clear aligner could be a useful treatment option for PTM patient, since it provides decreased probing depth, gingival recession, clinical attachment level, mobility and esthetical restoration.

• The Journal of the Korean dental association
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• v.55 no.6
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• pp.388-399
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• 2017

Generalized aggressive periodontitis cause intrabony pocket, loss of teeth, and severe alveolar bone defect. As a result, pathologic tooth migration occurs and esthetic problem happens according to this, especially on the anterior teeth of maxilla. The purpose of this study was to assess the multidisciplinary treatment including periodontics, orthodontics and prosthetics of a patient caused by generalized aggressive periodontitis. This study presents a case using full mouth periodontal treatment, immediate orthodontic treatment for 5 months, implantation with guided bone regeneration and free gingival graft, and prosthetic treatment. Treatments took totally 14 months. Periodontal indicators such as probing pocket depth, bleeding on probing, tooth mobility improved. Also, the patient was satisfied with the esthetic and functional improvement.

• Journal of Periodontal and Implant Science
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• v.43 no.3
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• pp.136-140
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• 2013

Purpose: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Methods: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Results: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. Conclusions: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.1
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• pp.1-8
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• 2023

Purpose: The purpose of this study is to analyze the prognostic factors related to tooth loss after 5 years of periodontal surgery in periodontal disease patients. Materials and Methods: From January to December 2017, 22 patients and 124 teeth who underwent periodontal treatment through periodontal surgery were targeted. At the time of treatment, the measured values were evaluated after recording the maximum probing depth, average periodontal probing depth, number of root, furcation involvement, pulp vitality, and prosthesis state on the day of periodontal surgery. Based on the initial records at the time of visit, patient-related factors were gender, age, smoking, tooth loss due to periodontal disease at the time of first visit, diabetes, and maintenance period. The influence of each factor on tooth loss was evaluated. Results: As a result of examining the influence of tooth-related factors on tooth loss, the maximum probing depth depth (P: 0.000), bone loss (P: 0.021) was found to have a significant effect on tooth loss. Conclusion: As a result of examining the influence of patient-related factors on tooth loss, any variables had no significant effect. Bone loss, maximum probing depth acted as statistically significant prognostic factors for tooth loss in patients who underwent periodontal surgery.

• Journal of Periodontal and Implant Science
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• v.39 no.3
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• pp.375-381
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• 2009

Purpose: Root resection can be a valuable procedure when the tooth in question has a high strategic value. The prognosis of root resection has been well documented in previous studies, but the results focused on the palatal root resection have not been discussed in depth. I represent here the short term effectiveness of palatal root resection of maxillary first molars. Methods: Palatal root resection was performed on maxillary first molars of three patients. All the palatal roots were floating state on the radiographic finding and showed full probing depth and purulent exudation at initial examination. Reduction of palatal cusp and occlusal table was performed concomitantly. Endodontic therapy was completed after root resection. Results: Compromised maxillary first molars were treated successfully by palatal root resection in 3 cases. The mobility of resected tooth was decreased a little bit. The probing pocket depth of remaining buccal roots was not increased compared to initial depth. All the patients satisfied with comfort and cost effective results and the fact they could save their natural teeth. Conclusions: Within the above results, palatal root resection is an effective procedure treating compromised maxillary first molar showing advanced palatal bone loss to root apex with or without pulp involvement when proper case selection is performed.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.41-49
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• 1999

The purpose of this study was to evaluate the relationship between osteoporosis and periodontal condition in postmenopausal women. Twenty-eight patients who have been treated at Chonnam national university hospital with osteoporosis(osteoporotic group, mean $age62.2{\pm}6.6$) and 21 normal postmenopausal women with periodontitis(control group, mean $age60.4{\pm}3.7$) were examined. Bone mineral density(BMD) of lumbar spine(L2-L4) was measured by dual energy X-ray absorptiomemtry(DEXA). Percentage to peaked bone mass in osteoporotic group was 70.9% which had lower BMD than in control group(p<0.05). The number of present teeth were 23.6 in osteoporotic group and 23.1 in control group. Percentage of bleeding on probing was 41% in osteoporotic group and 37% in control group. probing depth and attachment level were shown 3.18 mm, 3.63 mm in osteoporotic group and 2.85mm, 3.11mm in control group, respectively. Probing depth and attachment level were significantly greater in osteoporotic group than in control group(p<0.05). The significant negative correlation was found between BMD level and periodontal attachment level(p<0.001, ${\gamma}=-0.56$). These results suggest that osteoporosis may be associated with periodontal breakdown.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.635-645
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• 1999

The present study examines the effects of orthodontic treatment of surgically exposed impacted upper canines or ectopically erupted upper canines to periodontal condition and whether various opening procedures have significant difference in postoperative periodontal status. The subjects included 23 orthodontic patients(7 men, 16 women) with unilateral upper canine impaction treated either with closed eruption technique(group I), with apically positioned flap procedure (group II), and those with canines ectopically erupted through keratinized gingiva (group III). In each subject, the ectopic canine was orthodontically aligned, and changes in periodontal tissue were assessed by measuring keratinized gingival width, attached gingival width, probing depth and bone probing depth. In all three groups, the width of keratinized gingiva was preserved while showed no signs of detrimental periodontal condition such as gingival recession. In all three groups, no significant difference in periodontal pocket depth from control was observed. The width of attached gingiva was significantly greater in patients treated with apically positioned flap procedure(group II) than in patients on other groups.

• Journal of Periodontal and Implant Science
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• v.44 no.4
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• pp.194-200
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• 2014

Purpose: The purpose of this study was to assess and compare the clinical and radiographic outcomes of guided tissue regeneration therapy for human periodontal intrabony defects using two different collagen membranes: a porous nonchemical cross-linking collagen membrane (NC) and a bilayer collagen membrane (BC). Methods: Thirty subjects were randomly assigned and divided into the following 3 groups: a test group (NC+BM), in which a NC was used with xenograft bone mineral (BM), a positive control group (BC+BM), in which a BC was used with xenograft BM, and a negative control group (BM), in which only xenograft BM was used. The following clinical measurements were taken at baseline and 3 months after surgery: plaque index, gingival index, probing pocket depth, gingival recession, and clinical attachment level. Radiographic analysis was performed at baseline, 1 week and 3 months after surgery. Results: Membrane exposure was not observed in any cases. Significant probing depth reduction, attachment-level gain and bone fill were observed for both test and control groups compared to baseline at 3 months after surgery (P<0.05). However, there were no statistically significant differences in clinical improvement and radiographic bone fill between treatment protocols (P>0.05). Conclusions: Within the limitations of this study, the results suggest that both NC and BC were comparable in terms of clinical and radiographic outcomes for the treatment of periodontal intrabony defects in human subjects.

• Journal of Periodontal and Implant Science
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• v.52 no.4
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• pp.298-311
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• 2022

Purpose: The aim of this study was to evaluate the clinical outcomes of periodontal granulation tissue preservation (PGTP) in access flap periodontal surgery. Methods: Twenty patients (stage III-IV periodontitis) with 42 deep periodontal pockets that did not resolve after non-surgical treatment were consecutively recruited. Access flap periodontal surgery was modified using PGTP. The clinical periodontal parameters were evaluated at 9 months. The differences in the amount of granulation tissue width (GTw) preserved were evaluated and the influence of smoking was analyzed. Results: GTw >1 mm was observed in 97.6% of interproximal defects, and the granulation tissue extended above the bone peak in 71.4% of defects. At 9 months, probing pocket depth reduction (4.33±1.43 mm) and clinical attachment gain (CAG; 4.10±1.75 mm) were statistically significant (P<0.001). The residual probing depth was 3.2±0.89 mm. When GTw extended above the interproximal bone peak (i.e., the interproximal supra-alveolar granulation tissue thickness [iSUPRA-GT] was greater than 0 mm), a significant CAG was recorded in the supra-alveolar component (1.67±1.32 mm, P<0.001). Interproximal gingival recession (iGR) was significant (P<0.05) only in smokers, with a reduction in the interdental papillary tissue height of 0.93±0.76 mm. In non-smokers, there was no increase in the iGR when the iSUPRA-GT was >0 mm. The clinical results in smokers were significantly worse. Conclusions: PGTP was used to modify access flap periodontal surgery by preserving affected tissues with the potential for recovery. The results show that preserving periodontal granulation tissue is an effective and conservative procedure in the surgical treatment of periodontal disease.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.39-47
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• 2014

Purpose: Peri-implantitis, a clinical term describing the inflammatory process that affects the soft and hard tissues around an osseointegrated implant, may lead to peri-implant pocket formation and loss of supporting bone. However, this imprecise definition has resulted in a wide variation of the reported prevalence; ${\geq}10%$ of implants and 20% of patients over a 5- to 10-year period after implantation has been reported. The individual reporting of bone loss, bleeding on probing, pocket probing depth and inconsistent recording of results has led to this variation in the prevalence. Thus, a specific definition of peri-implantitis is needed. This paper describes the vast variation existing in the definition of peri-implantitis and suggests a logical way to record the degree and prevalence of the condition. The evaluation of bone loss must be made within the concept of natural physiological bony remodelling according to the initial peri-implant hard and soft tissue damage and actual definitive load of the implant. Therefore, the reason for bone loss must be determined as either a result of the individual osseous remodelling process or a response to infection. Methods: The most current Papers and Consensus of Opinion describing peri-implantitis are presented to illustrate the dilemma that periodontologists and implant surgeons are faced with when diagnosing the degree of the disease process and the necessary treatment regime that will be required. Results: The treatment of peri-implantitis should be determined by its severity. A case of advanced peri-implantitis is at risk of extreme implant exposure that results in a loss of soft tissue morphology and keratinized gingival tissue. Conclusions: Loss of bone at the implant surface may lead to loss of bone at any adjacent natural teeth or implants. Thus, if early detection of peri-implantitis has not occurred and the disease process progresses to advanced peri-implantitis, the compromised hard and soft tissues will require extensive, skill-sensitive regenerative procedures, including implantotomy, established periodontal regenerative techniques and alternative osteotomy sites.