• The Journal of the Korean dental association
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• v.51 no.9
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• pp.501-510
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• 2013

This paper reviews a current view regarding the association between periodontitis and atherosclerotic cardiovascular diseases (ACVD). Many evidences have suggested that there exist biological mechanisms by which periodontitis can lead to ACVD. Periodontal infection can lead to direct bacterial invasion into endothelial tissues through the blood stream, then the bacteria can activate the host inflammatory response followed by atheroma formation, maturation and exacerbation. Also, chronic periodontal infections may indirectly induce endothelial activation or dysfunction through a state of systemic inflammation as evidenced by elevated plasma acute proteins, IL-6 and fibrinogen as well. There is moderate evidence that periodontal treatment can reduce systemic inflammation and improvement of both clinical surrogate markers. But there is no periodontal intervention study available on primary ACVD prevention. There is consistent and strong epidemiologic evidence, including in vitro, animal and clinical studies, that periodontitis imparts increased risk for future ACVD. However, evidences from intervention trials to date are not sufficient to confirm the multi directional causality of periodontitis in ACVD etiology. Well-designed intervention trials on the impact of periodontal treatment on the prevention of ACVD outcomes are needed.

• Journal of Periodontal and Implant Science
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• v.43 no.6
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• pp.276-282
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• 2013

Purpose: The aim of this study was to explore root shape abnormalities, to investigate the influence of root form abnormalities on periodontal attachment loss, and to gather basic data to assist in the diagnosis and treatment of aggressive periodontitis. Methods: From January 2010 to June 2012, a survey was conducted of all 3,284 periodontitis patients who visited the Department of Periodontology, Daejeon Dental Hospital, Wonkwang University School of Dentistry. Clinical parameters (probing depth, periodontal attachment loss, missing teeth) were measured and a radiographic examination was performed at the baseline. We classified the root shape abnormality of bicuspids and molars based on Meng classification. Results: The periodontal attachment loss was the highest at the maxillary first molar (6.03 mm). The loss of the second molar was prominent. Type V deformity was shown to be the most common in the second maxillary and mandibular molars (P<0.05). Type V root shape was associated with the highest attachment loss (P=0.01). Conclusions: Considering the small population and limited design of this study, definitive conclusions cannot be drawn. We suggest larger scale, methodologically more sophisticated studies that include normal controls and chronic periodontitis patients to clarify whether root form abnormalities are a potential risk factor for aggressive periodontitis.

• Journal of Periodontal and Implant Science
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• v.34 no.4
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• pp.723-731
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• 2004

Helicobacter pylori(H. pylori) has been associated with the cause of chronic gastritis, peptic ulcers and gastric cancer. Although it may be transmitted through the oral cavity, it is unknown whether the oral cavity acts as a reservoir of H. pylori. The purpose of this study was to investigate the mode of detection of H. pylori in oral cavity of adult periodontitis patients with plaque and periodontal pocket which atmosphere is grown well H. pylori. We analysed detection rate of H. pylori in saliva and subgingival plaques of 17 adult periodontitis patients without symptoms of gastroduodenal disease by nested PCR. Samples tested comprised saliva and subgingival plaques from central incisor, 1st premolar and 1st molar. H. pylori DNA was not identified in saliva from all patients. The detection rate in subgingival plaque from incisors, premolars and molars was 5.9%, 5.9% and 17.7%, respectively. In conclusion, the dental plaque and periodontal pocket (especially, of molars) in adult periodontitis can be favorable reservoir of H. pylori and may be the source of infection and transmission of H. pylori.

• International Journal of Oral Biology
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• v.47 no.2
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• pp.25-31
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• 2022

Lysophosphatidic acid (LPA) is a bioactive lipid messenger involved in the pathogenesis of chronic inflammation and various diseases. Recent studies have shown an association between periodontitis and neuroinflammatory diseases such as Alzheimer's disease, stroke, and multiple sclerosis. However, the mechanistic relationship between periodontitis and neuroinflammatory diseases remains unclear. The current study found that lysophosphatidic acid receptors 1 (LPAR1) and 6 (LPAR6) exhibited increased expression in primary microglia and astrocytes. The primary astrocytes were then treated using medium conditioned to mimic periodontitis through addition of Porphyromonas gingivalis lipopolysaccharides, and an increased nitric oxide (NO) production was observed. Application of conditioned medium from human periodontal ligament stem cells with or without LPAR1 knockdown showed a decrease in the production of NO and expression of inducible nitric oxide synthase and interleukin 1 beta. These findings may contribute to our understanding of the mechanistic link between periodontitis and neuroinflammatory diseases.

• Journal of Periodontal and Implant Science
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• v.53 no.3
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• pp.173-183
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• 2023

Purpose: Treatment for periodontitis has evolved over the years as new technologies have become available. Currently, lasers seem attractive as a treatment modality, but their effectiveness needs to be verified. The purpose of this project was to evaluate Laser Assisted New Attachment Procedure^® (LANAP^®) surgery as a single treatment modality. Methods: As part of a mandatory training program for periodontists and other dentists, 22 consecutive patients diagnosed with moderate to severe periodontitis (probing depth [PD] up to 11 mm) were treated with the LANAP^® surgical approach using a 1064-nm Nd:YAG laser as part of a multi-step protocol. Following single-session active therapy, they were entered into a maintenance program. Their clinical status was re-evaluated at 12-18 months following surgery. Results: All 22 patients completed the 12- to 18-month follow-up. PD, clinical attachment level, and furcation (FURC) showed substantial improvement. Recession was minimal (mean, 0.1 mm), while 93.5% of PD measurements were 3 mm or less at re-evaluation. Furthermore, 40% of grade 2 FURC closed clinically. Conclusions: Within the limits of this case series, LANAP^® was found to be an effective, minimally invasive, laser surgical therapy for moderate to advanced periodontitis.

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.216-222
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• 2015

Purpose: After extraction, the alveolar bone tends to undergo atrophy in three-dimensions. The amount of alveolar bone loss in the horizontal dimension has been reported to be greater than the amount of bone loss in the vertical dimension, and is most pronounced in the buccal aspect. The aim of this study was to monitor the predictive alveolar bone level following the extraction of anterior teeth seriously involved with advanced chronic periodontitis. Methods: This study included 25 patients with advanced chronic periodontitis, whose maxillary anterior teeth had been extracted due to extensive attachment loss more than one year before the study. Periapical radiographs were analyzed to assess the vertical level of alveolar bone surrounding the edentulous area. An imaginary line connecting the mesial and the distal ends of the alveolar crest facing the adjacent tooth was arbitrarily created. Several representative coordinates were established in the horizontal direction, and the vertical distance from the imaginary line to the alveolar crest was measured at each coordinate for each patient using image analysis software. Regression functions predicting the vertical level of the alveolar bone in the maxillary anterior edentulous area were identified for each patient. Results: The regression functions demonstrated a tendency to converge to parabolic shapes. The predicted maximum distance between the imaginary line and the alveolar bone calculated using the regression function was $1.43{\pm}0.65mm$. No significant differences were found between the expected and actual maximum distances. Likewise, the predicted and actual maximum horizontal distances did not show any significant differences. The distance from the alveolar bone crest to the imaginary lines was not influenced by the mesio-distal spans of the edentulous area. Conclusions: After extraction, the vertical level of the alveolar ridge increased to become closer to the reference line connecting the mesial and distal alveolar crests.

• Journal of Periodontal and Implant Science
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• v.40 no.4
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• pp.164-171
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• 2010

Purpose: This study compared the total antioxidant status (TAS) and superoxide dismutase (SOD) activity in the saliva of periodontally compromised patients before and after scaling and root planing (SRP) to assess their diagnostic utility. Methods: Severe chronic periodontitis patient (test group) and subjects with no attachment loss, sites showing a 3 mm or more probing depth and a sulcus bleeding index < 10% (control group) were enrolled in this study. Saliva sampling and clinical examination were performed at one week, one month and 3 months after SRP. The TAS and SOD activity in each patient's saliva was measured for the comparative analysis between the groups. Results: In the test group, the TAS decreased directly after SRP. With time, it increased slightly and was relatively unchanged compared to the baseline. In the control group, the TAS also decreased immediately after SRP but increased gradually with time until 3 months. The SOD activity in the test and control subjects decreased immediately after SRP until 1 month. At 3 months, the SOD activity had increased. Both groups had a similar profile of SOD activity. However, the SOD activity of the control group was significantly higher than that of the test group at each point in time (P < 0.05). Conclusions: There was a significant difference in the total salivary antioxidant level between the periodontitis and healthy or gingivitis (control) group during the experiment period. The total antioxidant level in the saliva was higher in the patients with severe chronic periodontitis than the healthy or gingivitis control before SRP. The SOD activity of the periodontitis patients was lower than the control at each time point. These findings conclusively reveal the possible use of saliva as a diagnostic tool for periodontal health.

• Journal of Periodontal and Implant Science
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• v.26 no.3
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• pp.753-761
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• 1996

The purpose of present study is to assess the effects of capsaicin topically applicated to the chronic periodontal pain suffering area. In the First study, twenty patients with chronic pain caused by mild periodontal disease were selected, and periodontal pack containing capsaicin(PPC) was attached to these patients gingiva around pain suffering area. Then the presence of discomfort had been recorded every ten minutes for the first 1 hour. After 1 hour again, It had been recorded according to the presence of pack and to the existence of pain. In the second study, twenty moderate periodontitis patients were selected. After subgingival curettage of two quadrant area, non-euginol periodontal pack or PPC were attached to the curetted gingival margins of them (Non-euginol pack bearing area and capsaicin pack bearing area is supposed to control group and test group respectively.), and the degrees of pain with time had been recorded eight times with 1 hour interval (at that day) or recorded once in a day (from the next day to the next appointment day). The results are as follows : 1. PPC has caused discomfort accompanied by burning sensation to the mild periodontitis patients with chronic pain. 2. PPC has given little effects to improve the pain after subgingival curettage of moderate periodontitis patients.

• The Journal of the Korean dental association
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• v.57 no.12
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• pp.736-746
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• 2019

Supportive periodontal therapy(SPT) is essential for the long-term success of periodontal treatment. A patient's compliance with SPT is one of the most important factors affecting periodontal status. There are few studies quantifying compliance with SPT. The aim of this study is to quantify patient's compliance using new method and evaluate tooth loss depending on patient's supportive periodontal treatment compliance index(SPTCI) with SPT. This study included subjects diagnosed with generalized moderate to severe chronic periodontitis, who had completed active periodontal treatment and had SPT over 5 years in Wonkwang university dental hospital. Chart review and radiography analysis were performed. To quantify compliance, SPTCI representing average of gap between recommended schedules and actual visits has been used and evaluated with tooth loss. Mean period of SPT was 8.9 years and mean SPTCI was about 120. In statical analysis, patients who have higher SPTCI with SPT are more likely to have higher rate of tooth loss. Under SPTCI of 120, there were no significant co-relation between SPTCI and tooth loss. Patients diagnosed with moderate chronic periodontitis have significant co-relation between SPTCI and tooth loss, whereas patients diagnosed with severe chronic periodontitis have no co-relation. SPTCI, new method of quantifying compliance in this study, affected to tooth loss. This study suggests that using SPTCI could be helpful for prediction of tooth loss and be used to determine the interval of visit.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.79-86
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• 2013

Purpose: The purpose of study was to compare glycemic control using glycated hemoglobin levels ($HbA_{1c}$) in diabetic patients with chronic generalized periodontitis (CGP) undergoing scaling and root planing (SRP) with and without systemic doxycycline. Methods: Fifty subjects with type 2 diabetes mellitus ($T_2DM$) and CGP receiving antidiabetic therapy were selected for study. The selected subjects were randomly assigned to two groups (test group [TG] and control group [CG]) comprising 25 patients each. The TG received SRP followed by systemic doxycycline. The CG received treatment with SRP only. The periodontal parameters were recorded at baseline (day zero), and every 1 month for 4 months and included probing depth, clinical attachment level, plaque index, gingival index, and $HbA_{1c}$ level were recorded at baseline (day zero) and at the end of 4 months. Results: A statistically significant effect was demonstrated for the periodontal parameters for both the TG and CG. $HbA_{1c}$ values did not show a statistically significant difference in the treatment group as compared to the CG. Conclusions: The authors concluded that nonsurgical periodontal therapy improved glycemic control in patients with $T_2DM$ in both groups, but no statistical difference was observed with adjunctive systemic doxycycline therapy. A further study with a larger sample size is required.