• Journal of Periodontal and Implant Science
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• v.24 no.3
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• pp.483-492
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• 1994

The purpose of this study was to assess the recolonization of the subgingival microflora following scaling and root planing on single and multiroot teeth with periodontal pockets which were above 5mm. 7 patients with deep pockets were selected for this study. They had not taken antibiotics for 6 months and no history of dental treatment for 6 months before the study. After initial clinical(plaque index, gingival index, probing pocket depth), microbiological and BANA test were determined, each subject received a single session of scaling and root planing, but they were not received oral hygiene instructions. Clinical indices, microbial parameters and BANA test were reassessed 1, 2, and 4 weeks after treatment. The results were as follows : 1. Plaue index, gingival index and pocket depth were not significantly when compared single root group with multiroot group, both groups were siginficantly reduced at 2weeks in plaque index and 2, 4 weeks in gingival index(P<0.05), probing pocket depth was siginificantly changed at 2, 4weeks in multiroot teeth group and 4 weeks in single root teeth group(P<0.05). 2. Percentage of cocci was significantly increased at 4weeks in single root teeth group(P<0.05), motile rod was significantly changed at 4weeks in both group(P<0.05), spirochetes and nonmotile rods were not significantly changed. 3. BANA test was significantly reduced at 1 and 2 weeks (P<0.05) in single root teeth group, multiroot teeth group was not significantly all weeks. This results were suggested that clinical and microbiological effect following scaling and root planing on periodontal disease.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.714-719
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• 2009

Purpose: Recurrent ischial pressure sore is troublesome for adequate soft tissue coverage, because usually its pocket has a very large deep space and adjacent donor tissue have been scarred in the previous surgery. However, the conventional reconstructive methods are very difficult to overcome them. Modified gluteus maximus myocutaneous V - Y advancement flap from buttock can be successfully used in these circumstances. Methods: From February 2007 to October 2008, modified gluteus maximus myocutaneous V - Y advancement flaps were perfomed in 10 paraplegic patients with recurrent ischial pressure sore. The myocutaneous flap based on the inferior gluteal artery was designed in V - shaped pattern toward the superolateral aspect of buttock and was elevated from adjacent tissue. Furthermore, when additional muscular bulk was required to obliterate dead space, the flap dissection was extended to the inferolateral aspect which can included the adequate amount of the gluteal muscle. After the advanced flap was located in sore pocket, donor defect was repaired primarily. Results: The patients' mean age was 46.9 and the average follow - up period was 12.4 months. The immediate postoperative course was uneventful. But, two patients were treated through readvancement of previous flap due to wound dehiscence or recurrence after 6 months. The long - term results were satisfied in proper soft tissue bulk and low recurrence rate. Conclusions: The modified gluteus maximus myocutaneous V - Y advancement flap may be a reliable method in reconstruction of recurrent ischial pressure sore, which were surrounded by scarred tissue because of its repetitive surgeries and were required to provide sufficient volume of soft tissue to fill the large pocket.

• The Journal of the Korean dental association
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• v.57 no.9
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• pp.496-503
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• 2019

A dental implant has been covered by National Health Insurance (NHI) in Korea since 2014. Every year the age group covered was extended and the out-of-pocket payment was decreased. This study analyzed the dental implant utilization rate by the National Health Insurance customized DB during the last 5 years. As a result, the utilization rate has been rapidly increasing steeply. The differences by age and sex in the utilization rate of dental implants were explored. The inclusion of a dental implant in the NHI system contributed to improving the dental accessibility of the elderly in Korea. However, a deep discussion is needed whether it is appropriately provided to necessary patients. The utilization rate will increase further in the future. Therefore, continuous monitoring and critical policy review should be continued.

• The Journal of the Korean dental association
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• v.57 no.7
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• pp.403-411
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• 2019

A cracked tooth is defined as an incomplete fracture initiated from the crown and extending subgingivally and usually directed mesiodistally. Cracked teeth were most frequently involved in mandibular and maxillary molars at the age of 50s. Cracks occurred mainly in nonbonded restorations such as gold and amalgam, and majority of cracks were found in intact teeth. A pulpal and periapical diagnosis is dependent on the extent of the crack and duration of the symptom. The pulp of a cracked tooth might become inflamed because of microleakage, which induces thermal sensitivity. Once the crack has extended and exposed the pulp, severe pulp and periapical pathosis will likely be present. In addition, the extended crack can cause a bony dehiscence with a resulting narrow and deep periodontal pocket. Therefore, early diagnosis of the cracked tooth and proper treatment planning are important for clinician.

• Journal of Periodontal and Implant Science
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• v.51 no.4
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• pp.276-284
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• 2021

Purpose: The aim of this randomized clinical trial was to assess whether chemical cleansing using a sulfonic/sulfuric acid gel solution (HBX) as an adjunct to scaling and root planing (SRP) resulted in a decrease in residual plaque and calculus in deep periodontal pockets compared to SRP alone. Methods: Fifty-six patients with 56 hopeless posterior teeth, scheduled for extraction due to severe periodontitis, were enrolled in this study. Each tooth was randomly assigned to 1 of the 2 experimental procedures. The test teeth were subjected to the irrigation of the subgingival area with HBX for 2 minutes, followed by SRP with hand and ultrasonic instruments for 14 minutes, and then extracted. The control teeth received only mechanical instrumentation before extraction. Residual biofilm was evaluated on photographs and measured as total area and percentage of root surface covered by remaining plaque (RP) or calculus (RC) after treatment. Results: The initial pocket depth (PD) and total subgingival root surface area were similar between the 2 treatment groups. After treatment, the total subgingival root area covered by RP and RC was statistically significantly larger (P<0.001) in the control group than in the test group. The test teeth showed a lower percentage of RP, but a higher percentage of RC than the control teeth (both P<0.001). Complete calculus removal was achieved in 42% of the control teeth surfaces and in 25% of the test teeth surfaces for a PD of 4 mm. Conclusions: The additional chemical cleansing with HBX resulted in a statistically significant improvement in bacterial plaque removal during SRP of deep pockets, but it was not effective in reducing calculus deposits.

• Journal of Periodontal and Implant Science
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• v.43 no.6
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• pp.283-290
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• 2013

Purpose: The concept of gingival biotype has been used as a predictor of periodontal therapy outcomes since the 1980s. In the present study, prospective and controlled experiments were performed to compare periodontal pocket depth (PPD) reduction and gingival shrinkage (GSH) after scaling and root planing (SRP) according to gingival biotype. Methods: Twenty-five patients diagnosed with chronic periodontitis participated in the present study. The PPD and GSH of the labial side of the maxillary anterior teeth (from the right canine to the left canine) were evaluated at baseline and 3 months after SRP. Changes in the PPD following SRP were classified into 4 groups according to the gingival thickness and initial PPD. Two more groups representing normal gingival crevices were added in evaluation of the GSH. The results were statistically analyzed using the independent t-test. Results: In the end, 16 patients participated in the present study. With regard to PPD reduction, there were no significant differences according to gingival biotype (P>0.05). Likewise, sites with a PPD of over 3 mm failed to show any significant differences in the GSH (P>0.05). However, among the sites with a PPD of under 3 mm, those with the thin gingival biotype showed more GSH (P<0.05). Conclusions: PPD changes after SRP were not affected by gingival biotype with either shallow or deep periodontal pockets. GSH also showed equal outcomes in all the groups without normal gingival crevices. The results of SRP seem not to differ according to gingival biotype.

• Journal of Periodontal and Implant Science
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• v.25 no.2
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• pp.397-406
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• 1995

The purpose of this study was to evaluate the changes of interproximal bone density by means of videodensitometer and to examine the clinical applicability of videodentitometer to assess the periodontal disease activity.Twelve interproximal sites, with periodontal pockets deeper than 5mm and vertical loss of bone on standard dental radiograph, were treated by subgingival curettage. The papilla bleeding index, the plaque index, the degree of mobility, the depth of pockets, and the level of attachment were measured. Standardized reproducible radiographs were taken by using the occlusal stent with parallelling film holder. The density of the interdental bone was measured on the radiographs by a videodensitometer at three levels: the most 'superficial' level; the 'deep' level, arbitrarily 1.5mm below: and the 'apical' level, where no bony changes were to be expected. The clinical parameter and the radiographical change were measured at initial, and 1 month, 3 months, and 6 months after treatment.The results were as follows :1. The papilla bleeding index and the degree of mobility decreased significantly until 3 months after subgingival curettage and showed the Same level in the remaining experimental periods. 2. The pocket depth mainly decreased due to the gingival recession until 1 month after treatment, but to the attachment gain after 1 month. 3. The density of the interdental bone did not show a significance increase until 1 month after treatment, but showed a steady increase throughout the 6 months of observation. 4. The close relationships were shown between the decrease in pocket depth and the gain of attachment and the improvement of bone density at 6 months after treatment.

• Journal of Veterinary Clinics
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• v.37 no.3
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• pp.149-152
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• 2020

One-year-old male Cocker Spaniel dog was referred for the third eyelid enlargement and inflammation in the left eye (OS). It gradually swelled for 2 weeks after the cherry eye repair by conjunctival mucosa pocket procedure at a private animal clinic. Routine ophthalmic examinations including neuro-ophthalmic examination, Schirmer tear test, intraocular pressure and corneal fluorescein staining were all normal. No lesions were found on slit lamp biomicroscopy and indirect ophthalmoscopy except for third eyelid swelling in the OS. Ultrasonography revealed cystic structure within the OS nictitating membrane. Fluid from the cyst was aspirated and there were no microorganisms or neoplastic changes. Surgical intervention was performed under general anesthesia. On the day of the surgery, there was a deep corneal ulcer in the OS, which had not existed before. Ventral palpebral surface of the third eyelid was incised horizontally to the shaft of the T-shaped hyaline cartilage. And then, a full thickness of the cystic wall was incised and marsupialized. Additionally, a direct suture was performed on the ulcerated cornea. Topical and systemic antibiotics and anti-inflammatory drugs were prescribed. One month after the surgery, the third eyelid swelling and the discharge were improved. Marsupialization of the nictitating membrane cyst relieved the swelling of the third eyelid and inflammation. It could be a simple but effective surgical intervention for the cystic complication of conjunctival mucosa pocket procedure in dogs.

• 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.48 no.5
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• pp.326-333
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• 2018

Purpose: The present study investigated the outcomes of a newly-developed, simple, and practical nonsurgical treatment modality suitable for most forms of intrabony defects around failing dental implants using intrasulcular delivery of chlorhexidine solution and minocycline hydrochloride (HCl). Methods: Forty-five dental implants in 20 patients diagnosed with peri-implantitis were included. At baseline and the study endpoint, the probing pocket depth (PPD), clinical attachment level (CAL), and the presence of bleeding on probing (BOP) at 6 sites around each implant were recorded. The radiographic osseous defect morphology at the mesial or distal proximal aspect of each implant was classified as 1) narrow or wide and 2) shallow or deep. For a comparative analysis of bone changes according to the defect morphology, the distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) at the mesial and distal aspects of each implant was measured at baseline and the endpoint. Patients were scheduled to visit the clinic every 2-4 weeks for intrasulcular irrigation of chlorhexidine and delivery of minocycline HCl. Results: We observed statistically significant decreases in PPD, CAL, and BOP after treatment. At the endpoint, bone levels increased in all defects, regardless of the osseous morphology of the intrabony defect. The mean DIB change in deep defects was significantly greater than that in shallow defects. Although the mean bone gain in narrow defects was greater than in wide defects, the difference was not statistically significant. Conclusions: We propose that significant and sustainable improvements in both clinical and radiographic parameters can be expected when intrabony defects around dental implants are managed through a simple nonsurgical approach involving combined intrasulcular chlorhexidine irrigation and local delivery of minocycline HCl.