• Journal of Periodontal and Implant Science
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• v.44 no.3
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• pp.118-125
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• 2014

Purpose: The present split mouth study evaluates the effect of nonsurgical periodontal treatment on the gingival crevicular fluid (GCF) leptin level in chronic periodontitis. Methods: Ninety sites from 30 nonobese chronic periodontitis patients were selected and divided as follows: group I, 30 healthy sites receiving no treatment; group II, 30 periodontitis sites receiving scaling and root planing (SRP); and group III, 30 periodontitis sites receiving SRP with tetracycline local drug delivery. At baseline, after GCF sampling and clinical parameter recording, the assigned treatment was performed for the study groups. During recall visits, GCF sampling followed by clinical parameter recording was done for groups II and III. Results: Reductions in the probing depth and the clinical attachment level (CAL) were highly significant at different time intervals (except between day 0 and 45) in both groups II and III. Upon comparison, group III showed significant gain in CAL between day 0 and 15 and between day 0 and 45. After treatment, the reduction in the GCF leptin level was more significant in group III than in group II at day 15 but re-elevated almost to the pretreatment levels at day 45. Conclusions: Nonsurgical periodontal therapies were not effective in maintaining stable reduction in the GCF leptin level during the study period.

• Journal of Periodontal and Implant Science
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• v.30 no.1
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• pp.157-168
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• 2000

Periodontal surgery can be directed to remove the irritants from the tooth surface and reduce the periodontal pocket. The purpose of this study is to compare the clinical effects after between modified Widman flap and modified flap in periodontal patients. Ninety six molar area teeth of 9 patients were used. One of sextants performed a modified Widman flap, while the other side performed a modified flap. After initial periodontal therapy, the following measurements prior to surgery(baseline) were taken : pocket depth, gingival recession, clinical attachment level, tooth mobility, bleeding on probing. Also these measurements were taken at 4 weeks, 8weeks, and 12 weeks after surgery. Significant decrease of pocket depth was shown in both techniques, and the degree of decrease was significant in modified flap than modified Widman flap at 12 weeks. Significant increase of gingival recession was shown in both techniques, and the degree of increase was significant in modified Widman flap than modified flap at 4 weeks, 8 weeks, and 12 weeks. Significant attachment gain was shown in both techniques, and the degree of increase was significant in modified flap than modified Widman flap at 4 weeks, 8 weeks, and 12 weeks. Significant increase of tooth mobility was shown in both techniques at 4 weeks, but the decrease of tooth mobility was shown at 12 weeks. Greater decrease of bleeding on probing was shown in both techniques at 4 weeks. Modified flap was better than modified Widman flap in the decrease of gingival recession and the attachment gain. These results indicate that modified flap operation is better than modified Widman flap operation in the effect of periodontal treatment.

• Journal of Periodontal and Implant Science
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• v.32 no.4
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• pp.847-855
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• 2002

It has been reported that Magnoliae cortex extract has antibacterial and antimicrobial activity against pathogenic microbes and Zea Mays L. extract is effective for improving gingival tissue health. The purpose of this study was to examine the anti-inflammatory and antimicrobial effects of Zea Mays L. and Magnoliac cortex extract mixtures through experimental peridontitis induced beagle dog model. Nine beagle dogs with experimentally induced periodontitis were selected. Baseline clinical indices which includes plaque index, gingival index, probing pocket depth, clinical attachment level, gingival fluid flow rate were recorded and microbial assays were done. Magnoliac cortex and Zea Mays L., mixed at 2:l ratio in 105mg capsular dosage, were taken by 3 capsule (Group I) or 6 capsule dosages (Group II) three times a day. After 4,8,12 weeks, clinical indices were recorded. All data of clinical indices were compared through one-way ANOVA with 95% confidence level. Clinical indices of group I and II showed significantly better results than those of control group. There were no significant differences between group I and II. In conclusion, it was confirmed that mixture of Magnoliae cortex and Zea May L. (mix ratio 2:1) possessed clinical improving effects to periodontitis.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.25-32
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• 2014

Purpose: Periodontitis is an infectious disease caused predominantly by gram-negative anerobes. The host inflammatory response to these bacteria causes alveolar bone loss that is characterized as periodontitis. Omega-3 fatty acids (${\omega}$-3 FAs) have anti-inflammatory properties, thus have been used to treat some chronic inflammatory diseases such as cardiovascular disease and rheumatoid arthritis. We aimed to evaluate the effect of dietary supplementation with ${\omega}$-3 FAs as a host modulating agent in patients with chronic periodontitis. Methods: Sixty otherwise healthy subjects with moderate and severe chronic periodontitis were enrolled in our randomised, double-blind, placebo-controlled trial. The control group (CG, n=30) was treated with scaling and root planing (SRP) and given a placebo; the treatment group (TG, n=30) was treated with SRP and dietary supplementation of ${\omega}$-3 FAs (one 300 mg tablet daily for 12 weeks). Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated in all patients at baseline, a 6-week and 12-week period after treatment. Results: A significant reduction in the gingival index, sulcus bleeding index, pocket depth, and clinical attachment level was found in the TG compared to the CG at a 12-week period. However, no statistically significant changes in serum CRP levels were found. Conclusions: Our findings suggest that ${\omega}$-3 FAs can successfully reduce gingival inflammation, pocket depth, and attachment level gain. Dietary supplementation with ${\omega}$-3 FAs may have potential benefits as a host modulatory agent in the prevention and/or C management of chronic periodontitis.

• Journal of Periodontal and Implant Science
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• v.27 no.4
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• pp.701-722
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• 1997

It was reported that low dose doxycycline(LDD) regimen could inhibit pathologically elevated collagenase activity in the gingival crevicular fluid of petients with adult periodontitis without producing typical antibiotic side effects. The purpose of this study was to evaluate the effects of LDD regimen(20mg) administered during non-surgical therapy on clinical index and gingival crevicular fluid enzyme activity in diabetics who are at high risk for periodontal disease. Forty-nine subjects having at least two sites with probing pocket depths greater than 4mm were selected. In this double-blind, placebo-controlled study, the patients were administered 20 mg doxycycline capsule or placebo capsule b.i.d. for 2 weeks. Clinical parameters of dental plaque, gingival inflammation, probing pocket depth and probing attachment level were assessed at week 0, 2, 4, and 8. Gingival crevicular fluid samples were collected at the same time to evaluate the activities of collagenase and elastase. Clinical parameters and elastase activity were significantly reduced in all groups compared to the baseline value after treatment. Significantly greater reduction in pocket depth and gain in attachment level was shown in the LDD-administered group compared to placebo group in both adult periodontitis and diabetic patients. Total collagenase activity was also reduced significantly in all groups after treatment, but the greater reduction was seen in the LDD-administered diabetics group compared to relevant placebo group(at 4, 8week). Significantly greater reduction in active collagenase activity was also seen in the LDD-administered group compared to placebo group in diabetic patients(at 2, 4, 8week). These results indicated that use of low dose doxycycline could be aueseful adjunct to instrumentation therapy in the management of diabetic patient with periodontitis as well as adult periodontitis patient.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.659-669
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• 2004

The aim of this study was to evaluate the clinical efficacy of mouthrinses prepared by sterilized water-generating $device(Purister^{(R)})$ on the control of gingivitis and incipient periodontitis when it was used as a adjunctives to the mechanical plaque control. 40 healthy patients with gingivitis or incipient periodontitis were divided into two groups. Patients in the experimental group use mouthrinses prepared by sterilized water-generating $device(Purister^{(R)})$ after tooth brushing while patients in the control group do only tooth brushing for plaque control. All patients received scaling and tooth brushing instruction. 1 week after scaling was set as baseline. Probing pocket depth, clinical attachment level, and bleeding on probing were scored at baseline, 4 weeks. Gingival index and plaque index were scored at baseline, 2 weeks, and 4 weeks. The results were as follows: 1. In the experimental group, gingival index, plaque index, probing pocket depth, and clinical attachment level showed statistically significant decrease, but in the control group, significant increase(p<0.05). 2. There was no significant difference between the experimental and the control group in bleeding on probing, but significant decrease in the experimental group and Significant increase in the control group In a time-dependent manner(p <0.05). From these results, it can be concluded that regular use of mouthrinses prepared by sterilized water-generating $device(Purister^{(R)})$ as adjunctives of mechanical plaque control, may be effective to prevent and treat gingivitis and incipient periodontitis.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.17-26
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• 2009

Purpose: The non-carious cervical lesion(NCCL) is a loss of tooth structure at the neck of affected teeth that is unrelated to tooth caries. The reported prevalence of NCCL varies from 5% to 85%. Prevalence and severity of lesions have been found to increase with age. They are becoming more significant as people live longer and become more aware of the importance of oral health. The purposes of this study were first, to examine the periodontal conditions associated with NCCL, and second, to investigate the clinical effects of class V restorations of NCCL on periodontal tissues. Materials and methods: The sample size was 982 teeth of 50 subjects(25 male, mean age $52{\pm}7$) who were seen at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, clinical periodontal parameters were measured. After the initial examination, 24 patients who were absent from hypersensitivity were selected. The teeth with NCCL were randomly divided into the test and control groups. The teeth in the test group were restored with flowable resin; the control teeth were not restored. Six months later, the clinical examinations were repeated. The data were analyzed using the SPSS program. Results: The results were as follows: 1) NCCL occurred on 45.8% of examined teeth. The percentage of affected teeth was higher in maxillary and premolar teeth. 2) The shallow saucer type was the most common. 3) Teeth with NCCL had more gingival recession, lower attachment level, and higher incidences of bleeding on probing(BOP) and plaque than NCCL-free teeth. 4) Six months later, gingival recession, attachment level, the percentages of BOP and plaque in the test group were lower than in the control group(p<0.05). Conclusion: NCCLs were more found in maxillary teeth, especially in premolar teeth. The results suggest that the restoration of NCCL could affect some periodontal parameters favorably.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.103-115
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• 1999

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. Various periodontal procedures have been used throughout the years in an attempt to reestablish attachment of periodontal tissues to root surfaces affected by periodontitis. Flap debridement surgery has been demonstrated to be a successful procedure in gaining the probing attachment level and reducing probing depth. A tendency towards impaired wound healing following periodontal procedures in smokers has been clinically documented. But, previous clinical studies on healing response in smokers are based on a retrospective design. The purpose of this study was to evaluate the treatment outcome following flap debridement surgery in smokers compared to nonsmokers. 25 patients with moderate to advanced periodontitis were included for study. Among these patients, 13 patients were smokers, and 12 patients were nonsmokers. Mucoperiosteal flap was raised with the sulcular incision. No antibiotic treatment was administered postsurgery. The patients was recalled at monthly intervals during a period of 6 months following the surgery. The patients were received supragingival scaling and oral hygiene reinforcement. All the recordings, including modified O' Leary plaque control record, bleeding on probing, probing pocket depth, probing attachment level,were recorded, presurgery and 6 months postsurgery. The changes of all the recordings at 6 months after flap debridement surgery revealed the following results: 1. PI on all the dentitions and surgical sites showed no statistical significance between smokers and nonsmokers at presurgery. But, smokers demonstrated a significantly lower % of PI than nonsmokers at 6 months postsurgery. 2. Smokers demonstrated a greater % of BOP sites than nonsmokers on the surgical sites and all the dentitions, presurgery and 6 months postsurgery. But, there was no statistical significance between two groups. 3. Smokers exhibited significantly less reduction of probing depth in the 3 mm or less probing pocket depth(PPD) group, 6mm or more PPD group and total PPD group when compared to nonsmokers at 6 months postsurgery. 4. Smokers exhibited significantly less gain of probing attachment level(PAL) in the 3mm or less PPD group, 6 mm or more PPD group and total PPD group when compared to nonsmokers at 6 months postsurgery.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.1
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• pp.7-18
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• 2017

Purpose: Nonsteroidal anti-inflammatory drugs that prohibit biosynthesis of arachidonic acid metabolites have been considered potent host modulation agents. The aim of this review was to determine the effect of nonsteroidal anti-inflammatory drugs adjunctive with nonsurgical periodontal treatment in patients with periodontal disease. Materials and Methods: Three electronic databases were searched to identify relevant studies. The methodological quality and mean differences of the change in clinical attachment level and probing depth were analyzed according to Cochrane review methods. Results: Twelve studies were included in the methodological assessment and nine studies were suitable for inclusion in the meta-analysis. The mean difference in the clinical attachment level gain did not differ significantly between the nonsteroidal anti-inflammatory drugs and control groups at any observation time. The highest mean difference in clinical attachment level gain was 0.30 mm at 4 weeks (95% confidence interval = -0.37 to 0.97). There was a significant mean difference in the probing depth reduction, of 0.34 mm (95% confidence interval = 0.29 to 0.40) at 6 weeks. Conclusion: Therefore, nonsteroidal anti-inflammatory drugs have additional therapeutic effect when administrated with nonsurgical periodontal treatment.

• Journal of Periodontal and Implant Science
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• v.24 no.3
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• pp.618-632
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• 1994

The ultimate goal of periodontal therapy is promoting the regeneration of lost periodontal tissue. The purpose of this study is to evaluate the effect of treatment using decalcified freeze dried bone allograft as a bone graft material. 47 intrabony defects from 27 patients with clinical diagnosis of chronic periodontitis were selected among those 24 defects were treated via flap operation only and designated as the control group, the other 23 defects were treated with decalcified freeze dired bone allografting via flap operation and designated as the experimental group. Clinical parameters including probing depth, loss of attachment, probing bone level and gingival recession have been recorded at 6th months, and the significance of the changes has been analyzed. The results are as follows : 1. Probing depths were reduced significantly in both control group($2.75{\pm}0.99mm$) and experimental group($3.69{\pm}0.97mm$) postoperatively(p<0.01). Experimental group showed significantly higher decrease compared to the control group(p]0.01). 2. Loss of attachment showed statistically significant decrease in both control group($1.77{\pm}1.08mm$) and experimental group postoperatively($2.70{\pm}1.55mm$). Experimental group showed significantly higher decrease compared to the control group(p]0.05). 3. Probing bone levels were reduced with statistically significance in both control group($1.08{\pm}0.97mm$) and experimental group($4.00{\pm}1.41mm$) postoperatively(p<0.01). Experimental group showed significantly higher decrease compared to the control group(p<0.01). 4. Gingival recession showed statistically significant increase in the control group($1.21{\pm}0.72mm$) and experimental group($1.00{\pm}1.09mm$) postoperatively(p<0.01). There was no statistical significance between the control group and the experimental group. On the basis of these results, treatment using allogenic decalcified freeze dried bone is effective in reducing probing depth, loss of attachment and probing bone level. Therefore allogenic decalcified freeze dried bone is an effective bone graft material in periodontal regeneration.