• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.1
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• pp.37-46
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• 2012

The ultimate goal of periodontal therapy is the regeneration of supporting tissues. It is recommended to avoid probing until 6~9 months following the regenerative therapy because the probing may jeopardize the newly formed tissues. We can measure tooth mobility objectively using Periotest. The purpose of this study is to investigate whether Periotest can be used to evaluate the treatment results alternatively, and whether there are the correlations between the changes of Periotest value (PTV) and other clinical parameters. Regenerative treatments have been performed on 29 teeth of twenty five patients, at Department of Periodontology, Pusan National University Hospital. We measured the tooth mobility by Periotest and other parameters at the baseline, 6 and 12 months after regenerative treatment. Compared to the baseline, there were the statistically significant improvements in all the parameters at 6 months and 12 months. There were statistically significant correlations among the probing depth, attachment level, gingival recession and PTV at baseline, 6 months, and 12 months. Also there was the correlation between changes in PTV and in the attachment level at each time of observation period. We may conclude that regenerative therapy would improve the clinical parameters and periodontal status and PTV would be an alternative index to evaluate the healing process after regenerative surgery.

• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.179-189
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• 1997

Teeth mobility is an important part of a periodontal examination, because it represents a function of the persisting height of the alveolar bone and the width of the periodontal ligament. The purpose of this study was to evaluate clinical difference in teeth mobility after treatment with the modified Widman flap and the undisplaced flap in humans. Twenty males with moderate periodontal disease were selected. The severity of periodontal disease was evaluated with sulcular bleeding index, pocket depth and attachment level and tooth mobility was measured with Periotest(Siemens Co., Germany) at the initial examination, 1, 2, 4, 6, 8 and 12 weeks following the modified Widman flap and the undisplaced flap operation using the split-mouth technique. The relation of mobility to clinical parameters was statistically analyzed by multiple regression and the change of teeth mobility according to healing process by independent t-test using SPSS program. The results were as follows: 1. There was a strong relationship between the Periotest value(PTV) and attachment level. 2. The change of teeth mobility in both flap procedures was increased significantly at 1 week post-op. and was decreased to preoperative level at 4 weeks post-op, in modified Widman flap and at 6 weeks post-op. in undisplaced flap. 3. The change of teeth mobility in premolar teeth group in undisplaced flap compared to modified Widman flap was generally increased but these changes were not statistically significant. The changes of teeth mobility in molar teeth group in undisplaced flap was increased significantly at 2 weeks post-op.. 4. The change of teeth mobility following undisplaced flap was increased significantly compared to that of modified Widman flap at 2 weeks post-op.

• 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.

• International Journal of Oral Biology
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• v.40 no.2
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• pp.93-101
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• 2015

The efficacy of air-polishing on subgingival debridement, as compared to scaling and root planning (SRP), was evaluated clinically and microbiologically. Fifteen patients diagnosed as chronic periodontitis, and having single-root tooth over 5 mm of pocket depth symmetrically in the left and right quadrant, were investigated. Subgingival debridement was performed by SRP and air-polishing. The results were evaluated and compared clinically and microbiologically. Probing pocket depth (PPD), bleeding on probing (BOP), relative attachment level (RAL) and change of gingival crevicular fluid (GCF) were assessed before treatment, and at 14 and 60 days after treatment. Microbial analysis was done pre-treatment, post-treatment, and at 14 and 60 days after treatment. Results of air polishing showed that post treatment, the PPD and BOP decreased, and attachment gain was observed. There was no clinical difference when compared to SRP. The volume of GCF decreased at 14 days, and increased again at 60 days. Compared to SRP, there was a statistical significance of the volume of GCF at 60 days in air-polishing. In the microbial analysis, high-risk bacteria that cause periodontal disease were remarkably reduced. They decreased immediately after treatment, but increased again with the passage of time. Thus, our results show that subgingival debridement by air-polishing was effective for decrease of pocket depth, attachment gain, decrease of GCF and inhibition of pathogens. Further studies are required to compare air-polishing and SRP, considering factors such as degree of pocket depth and calculus existence.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.359-373
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• 1993

The ultimate objective of periodontal therapy is not only stopping the progression of periodontal disease, but also promoting the regeneration of lost periodontal tissue. Guided Tissue Regeneration, which is based on the principle that the goal of periodontal regeneration can be achieved by preventing apical migration of gingival epithelium and blocking cells originating from connective tissue, has been developed and used as a clinical procedure, and although it has shown excellent results in connective tissue healing, there have not been many studies showing its effect on the regeneration of alveolar bone loss due to periodontal disease. The objectives of this study are to investigate the result of 12 months-long treatment following guided tissue regeneration using expanded polytetrafluoroehylene membrane, and to observe the presence of regenerated alveolar bone. Forty-one teeth from 28 patients with clinical diagnosis of periodontitis has been selected. In fifteen of those interproximal intrabony defects, only flap operation had been carried out, and designated as the control group. Twenty-six intrabony defects received e-PTFE membrane following flap operation, and designated as the experimental group. Eleven teeth whose membrane had been exposed were excluded from the experiment. Various measurements including probing depth, loss of attachment, probing bone level and gingival recession have been recorded at 6th month and 12th month, and the significance of the changes has been analyzed. The results are as follows: 1. Probing depth at 6th and 12th month has shown a significant decrease in both groups (p<0.01), but significantly higher decrease was found in the experimental group compared to the control at the month(p<0.05). 2. Loss of attachment at 6th and 12th month has shown a significant decrease in both groups, but significantly higher decrease was found in the experimental group compared to the control (p<0.05). 3. Probing bone level at 6th and 12th month has shown a insignificant decrease in the control group and significant decrease in the experimental group (p<0.01). Significantly higher decrease in probing bone level was found in the experimental group (p<0.05). 4. Gingival recession at 6th and 12th month has shown a statistically significant increase (p<0.05), and the control group showed higher increase compared to the experimental group although no statistical significance was found. As these results have shown, the use of e-PTFE membrane in intrabony pockets results in marked decrease in the loss of attachment and probing bone level. This seems to indicate that e-PTFE membrane may play a role in alveolar bone regeneration in intrabony defects.

• Journal of Periodontal and Implant Science
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• v.23 no.1
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• pp.27-36
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• 1993

The purpose of the this study was to research the interrelationship of periodontal status and patient's age between diabetic group and non-diabetic group and compare that of periodontal status according to the blood sugar level and duration of diabetics. The participants of this study were 52 diabetic patients and 51 non-diabetic patients. The diabetic group and non-diabetic group were further divided into four subgroups according to the age(under 35 years old, 36 - 45 years old, 46 - 55 years old, over 56 years old) and the diabetic group was further divided into three subgroups according to the duration of diabetics (under 5 years, 6 - 10 years, over 11 years) and blood sugar level(under 140mg/100ml, 140-200mg/100ml, over 200mg /100ml), respectively. Author evaluated such periodontal status as plaque index and calculus index, gingival lndex, loss of attachment, papillary bleeding index, tooth mobility and missing teeth, and then data was statistically analyzed by SPSS/PC+ using ANOVA, respectively. The results were as follows: 1. The mean value of plaque index, gingival index, loss of attachment, papillary bleeding index, tooth mobility and missing teeth of diabetic patients were significantly higher than that of non-diabetic patients, respectively(p <0.01, p<0.01, p<0.01, p<0.01, p<0.001, p<0.001), but there was no significant difference between diabetic group and non-diabetic group in calculus index(P>0.05). 2. According to the increase of age, loss of attachment and missing teeth were increased in both group, and correlation of each subgroup was statistically significant, respectively(p<0.05, p<0.001). 3. According to the elevation of blood sugar level of diabetics, plaque index, gingival index, loss of attachment, papillary bleeding index, tooth mobility and missing teeth were increased in diabetic group, and correlation of each subgroup was statistically significant, respectively (p<0.05, p<0.05, p<0.05, p<0.05, p<0.001, p<0.001). 4. According to the duration of diabetics, plaque index, gingival index, loss of attachment, papillary bleeding index, tooth mobility and missing teeth were increased in diabetic group, and correlation of each subgroup was statistically significant, respectively(p<0.05, p<0.05, p<0.05, p<0.05, p<0.001, p<0.001).

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.103-116
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• 1996

This study was performed to observe the bacterial adhesion and penetration to e-PTFE membrane following guided tissue regeneration(GTR) procedure and to evaluate the association of the membrane exposure and bacterial contamination with the clinical outcome. For the study, ten infrabony defects in 9 patient were treated by mucoperiosteal flap operation including placement of the e-PTFE membrane. The treated teeth were monitored weekly for the membrane exposure, gingival recession and gingival inflammation. The membranes were retrieved after 4 to 6 weeks, examined by SEM for bacterial contamination and adherent connective tisue elements, and observed under LM for the bacterial penetration into membrane. Three months postsurgery, the defect sites were clinically reexamined for the changes in attachment level and probing depth. Comparison of the ultrastuctural findings and clinical outcome revealed that extent of membrane exposure and bacterial contamination of the membrane was inversely associated with clinical attachment gain. From this finding, the extent of membrane exposure and the bacterial contamination on the apical portion of the e-PTFE membrane at the time of removal seemed to be a critical determinant on the clinical outcome of GTR and the membrane exposure needs to be controlled for optimal results.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.893-914
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• 1999

Tooth mobility may be the decisive factor that determines whether dental treatment of any kind is undertaken. Although tooth mobility in isolation says little in itself, the finding of increased tooth mobility is of both diagnostic and prognostic importance. Only the detection of an increase or decrease in mobility makes an evaluation possible. Thus prior to treatment, we must understand the pathologic process causing the observed the tooth mobility and decide whether the pattern and degree of observed tooth mobility is reversible or irreversible. And then it must be decided whether retention and treatment or extraction and replacement. The purpose of this study was to compare tooth mobility at different time period during root planing and flap operation and to relate changes in mobility to each treatment method. Twenty-one patients (287 teeth) with chronic adult periodontitis were treated with root planing(control group) and flap operation(experimental group), and each group was divided 3 subgroups based upon initial probing pocket depth (1-3mm, 4-6mm, 7mm and more). Tooth mobility was measured with $Periotest^{(R)}$ at the day of operation, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 8 weeks, 12 weeks after each treatment. Tooth mobility, attachment loss, radiographic bone loss, and bleeding on probing were measured at the day of operation, 4 weeks, 8 weeks and 12 weeks after treatment. 1. In group initial probing depth was 1-3mm, tooth mobility had no significant difference after root planing and flap operation. 2 . In group initial probing depth was 4-6mm, 7mm and more, tooth mobility had decreased in 12 weeks after root planing(p<0.01). And the mobility had increased after flap operation(p<0.01) and was at peak in 1 week, and decreased at initial level in 4 weeks, below the initial level in 12 weeks(p<0.01). 3. In 1 week, significant difference in tooth mobility between control and experimental group was found(p<0.01) but, in 12 weeks no difference between two groups was found. 4. Change of immediate tooth mobility after treatment was more larger in deep pocket than in shallow one. In group with the same probing pocket depth, the change of tooth mobility in molar group was greater than that of premolar group. 5. Tooth mobility before treatment was more strongly correlated with radiographic bone loss (r=0.5325) than probing depth, attachment loss and bleeding on probing, in 12 weeks after treatment, was more strongly correlated with attachment loss($r^2$=0.4761) than probing depth and bleeding on probing. Evaluation of the treatment effect and the prognosis after root planing and flap operation were meaningful on tooth initial probing depth 4mm and more. After flap operation, evaluation of the prognosis should be performed at least in 4 weeks and in 12 weeks after treatment, no difference in tooth mobility between two groups was observed. Radiographic bone loss and attachment loss were good clinical indicators to evaluate tooth mobility.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.597-608
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• 2005

The aim of this study is to determine whether full-mouth disinfection therapy(FMT) in our clinical setting would show better improvement of clinical parameters than partial mouth disinfection therapy(PMT) in chronic periodontitis and aggressive periodontitis patients. Among 12 patients, 6 were treated FMT and other 6 were treated PMT. Clinical parameters were calculated 3 months and 6 months after initial therapy. 1. There were no statistically significant differences between FMT and PMT in the reduction rate of bleeding on probing after 3 months, 6 months 2. Initial probing depth was 4-6mm, the mean probing depth after 3 months was 2.2mm vs 2.5mm(FMT vs PMT), after 6 months was 2.4mm vs 2.8mm. This was significantly lower in the FMT groups. 3. Initial probing depth was ${\geqq}$ 7mm, the reduction rate of mean probing depth during first 3 months was 4.8mm vs 4.1mm(FMT vs PMT), and 3 to 6 months was 0.5mm vs 0.3mm. This was significantly larger in the FMT groups. 4. Initial probing depth was 4-6mm, the mean clinical attachment level after 3 months was 2.3mm vs 2.7mm(FMT vs PMT), after 6 months was 2.7mm vs 3.0mm. This was significantly lower in the FMT groups. 5. Initial probing depth was ${\geqq}$ 7mm, the reduction rate of mean probing depth during first 3 months was 4.0mm vs 3.0mm(FMT vs PMT), and 3 to 6 months was 0mm vs -0.1mm. This was significantly larger in the FMT groups. Although the results provided us with succeccful clinical improvement in aggressive periodontitis, further research is needed to prove its additional benefit in the treatment of chronic periodontitis

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.877-889
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• 2005

This study was designed to compare the effects of treatment using chitosan membrane $(Nanogide-C^{(R)})$ resorbable barrier with control treated by polylactic acid/polylacticglycolic acid membrane(PLA/PLGA membrane, $Biomesh^{(R)}$). 44 furcation defecs from 44 patients with class 2 furcation degree were used for this study, 22 sites of them were treated by chitosan membrane as experimental group and 22 site were treated by PLA/PLGA membrane as control group. Clinical parameters including probing depth, gingival recession, attachment level and radiographic examination were evlauated at base line, 1 month, 2 month and 3 month. after surgery. Statistical test used to analyze these data included paired t-test, one way ANOVA. The results are as follows : 1. Probing depth was significanlly decreased in the two group and there were significant differences between groups(p<0.05). 2. Gingival recession was not significanlly increased in the two group and there were no significant differences between groups(p<0.05). 3. Loss of attachment was statistically decreased in the two group and there were no significant differences between groups(p<0.05). 4. Horizontal bone level was significanlly increased in the two group and there were significant differences between groups(p<0.05). On the basis of these results, chitoans resorbable membrane has similar potential to PLA/PLGA membrane in GTR for furcation defect.