• 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 Periodontal and Implant Science
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• v.26 no.2
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• pp.522-530
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• 1996

Most dentists are very interested in laser therapy on the intraoral soft tissue lesions because they want to accomplish the analgesic and aseptic surgery with little or no bleeding. In order to determine the difference of pain threshold according to different gingival tissues with or without inflammation, 25 patients with inflammatory periodontal disease and 10 volunteers with good general and oral health were selected as the inflamed group and the normal group, respectively. Interdental papilla, marginal gingiva, attached gingiva, and alveolar mucosa were irradiated by the contact delivery($300{\mu]m$ fiber optic, for 5 seconds) of a pulsed Nd:YAG laser(EN.EL.EN06O, Italy). And the laser power was gradually increased from 0.5W by the increment of 0.1W. The highest laser power was recorded as the first painful power when the painful gesture was recognized at first. The difference of the first painful power of laser according to different gingival tissues with or without inflammation was statistically analyzed by paired t-test in MICROSTAT program. Following results were obtained: 1. In the comparison related with the inflammation, the first painful power was significantly lower in the inflamed group than in the normal group, regardless of interdental papilla and marginal gingiva(p<0.05). 2. In the comparison related with the tissue structure, the first painful. power was significantly lower in alveolar mucosa than in attached gingiva(p<0.05). The results suggest that, for the painless therapy by a pulsed-Nd:YAG laser irradiation, the laser surgery over 2.0W of power should be necessarily accomplished under the local anethesia, and the local anesthesia should be considered according to the degree of inflammation, the tissue structure, and the purpose of laser therapy.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.471-482
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• 2000

Recent studies have demonstrated that smoking may be one of the most significant risk factors in the development and progression of periodontal disease. Reports have indicated that smoking causes gingival blood flow to be decreased. However, studies on the effects of smoking on gingival blood flow have yielded contradictory results. The purpose of the present study was to determine the effect of smoking on gingival blood flow. One hundred volunteers(fifty non-smokers and fifty smokers) with good general and periodontal health, aged twenties(non-smoker : 22-29 years, mean=25.36, smoker : 23-29 years, mean=26.64) were selected. Laser Doppler flowmetry (floLAB, Moor Instruments Ltd., England) was applied to measure the gingival blood flow of interdental papilla, marginal gingiva, attached gingiva and alveolar mucosa of left and right upper lateral incisors. In smokers, following an overnight abstinence from smoking, gingival blood flow was measured before smoking, immediately after smoking, 1-, 2-, 3-, 4-, 5- and 6- hour after smoking from 9 a.m. to 3:30 p.m. The difference of blood flow in each tissue of non-smokers and that of each measuring time and each tissue of smokers were statistically analyzed by one way ANOVA and Tukey test. And the difference of blood flow between smokers and nonsmokers in each tissue was statistically analyzed by t-test. The results were as follows : 1. Mean blood flow was highest in alveolar mucosa, followed by interdental papilla, attached gingiva and marginal gingiva in both smokers and nonsmokers. There was a statistically significant difference in each tissue(p<0.05) . 2. There was no consistent result between mean blood flow before smoking in smokers and that of nonsmokers in each tissue. 3. There was a statistically significant difference between gingival blood flow at measuring time point and gingival blood flow of smokers in each tissue(p<0.05). The present study suggested that smoking could alter the gingival blood flow, thus might be partly contributed to periodontal destruction.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.3
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• pp.230-237
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• 2017

Regenerative therapy in an interproximal intrabony defect is a challenge due to unaesthetic appearance after surgery. In this article, we introduce a case series of additional use of autogenous periosteal barrier membrane combined with bovine bone mineral and enamel matrix derivative (EMD) in interproximal periodontal intrabony defects to overcome an aforementioned shortcoming. During the periodontal regenerative surgery, autogenous periosteal membrane was additionally adopted besides xenograft material and EMD. Clinical and radiographic examinations were performed before surgery and 6 months after surgical treatment. All clinical parameters were improved and the intrabony defects were resolved on the radiography 6 months after surgery. Moreover, soft tissue esthetics such as the contour of interdental papilla was better than that of conventional regenerative therapy. Periodontal regenerative therapy using several graft materials and bioactive materials was effective in the treatment of periodontal intrabony defect. Moreover, using of autogenous periosteal barrier membrane combined with xenograft and EMD has additional effect for the treatment of an interproximal intrabony defect in terms of augmentation of interdental soft tissue volume.

• Journal of Periodontal and Implant Science
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• v.42 no.3
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• pp.105-109
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• 2012

Purpose: Soft tissue recessions frequently cause esthetic disharmony and dissatisfaction. Compared with soft tissue coverage around a tooth, the coverage of an implant site is obviously unpredictable. Particularly in the cases of thin mucosa, a significant greater amount of recession takes place compared to thick mucosa. To overcome this problem, this case report demonstrates a two-step mucosal dehiscence coverage technique for an endosseous implant. Methods: A 33-year-old female visited us with the chief complaint of dissatisfaction with the esthetics of an exposed implant in the maxillary left cental incisor region. A partial-thickness pouch was constructed around the dehiscence. A subepithelial connective tissue graft was positioned in the apical site of the implant and covered by a mucosal flap with normal tension. At 12 months after surgery, the recipient site was partially covered by keratinized mucosa. However, the buccal interdental papilla between implant on maxillary left central incisor region and adjacent lateral incisor was concave in shape. To resolve the mucosal recession after the first graft, a second graft was performed with the same technique. Results: An esthetically satisfactory result was achieved and the marginal soft tissue level was stable 9 months after the second graft. Conclusions: The second graft was able to resolve the mucosal recession after first graft. This two-step approach has the potential to improve the certainty of esthetic results.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.1
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• pp.50-59
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• 2015

It is hard to restore and manage anterior teeth esthetically and functionally; because of peri-implantitis, not only hard and soft tissue problem such as alveolar bone resorption and interdental papilla loss but also esthetic problem caused by metal abutment exposure can occur. This case presents patients using customized abutment made of Co-Cr alloy that can be made by conventional casting and compensate the shortcomings of prefabricated titanium abutments, and cement-retained prosthesis.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.4
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• pp.276-284
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• 2023

After tooth extraction, alveolar bone is resorbed over time. Loss of alveolar bone and reduction of upper soft tissue poses difficulties in future implant placement and long-term survival of the implant. This case report focuses on increasing the soft and hard tissues at the implant placement site by using alveolar ridge augmentation and a xenogeneic collagen matrix as a soft tissue substitute in an extraction socket affected by periodontal disease. In each case, the width of the alveolar bone increased to 6 mm, 8 mm, and 4 mm, and regeneration of the interdental papilla around the implant was shown, as well as buccal keratinized gingiva of 4 mm, 6 mm, and 4 mm, respectively. Enlarged alveolar bone facilitates implant surgery, and interdental papillae and keratinized gingiva enable aesthetic prosthesis. This study performed alveolar ridge augmentation on patients with extraction sockets affected by periodontal disease and additionally used soft tissue substitutes to provide a better environment for implant placement and have positive effects for aesthetic and predictive implant surgery.

• Journal of Korean society of Dental Hygiene
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• v.11 no.2
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• pp.293-301
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• 2011

Objectives : The aim of the trial was to study the effect of plaque control(tooth brushing instruction) for oral health improvement on periodontitis patients. Methods : 30 patients(35~65 years) with advanced periodontal disease were subjected to a baseline examination including assessment of oral hygiene status(O'leary index), gingival condition(bleeding). the assessment were repeated after 2, 4, 6 weeks. cognitive, behavioral and clinical outcomes were assessed in the primary care setting by questionnaire and clinical oral examination. Results : The oral hygiene status expressed as the individual mean percentage of tooth surfaces with plaque 59.3% at baseline and 21.2% after 6 weeks(p<0.001). The gingival bleeding status expressed as the individual mean point of interdental papilla 3.8 at baseline and 1.9 after 6 weeks(p<0.001). Also, the patients self-assessment about correct tooth brushing behavior was 3.9(5-point likert scales), satisfaction of plan practices 4.1(5-point likert scales), efficacy of tooth brushing instruction 8.7(10-point likert scales). Patients wanted to continuous participation. Conclusions : A verification of effect after individualized oral health instruction and repeated dental plaque control represented to significance on plaque control score, oral care practice and oral health recognition. The important oral care step against periodontal disease is to establish good oral health habits. Also, oral health behavior recognition is more important for the practice of oral health. Therefore professional plaque control and tooth brushing instruction absolutely need in improving oral health.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.19-28
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• 2004

Tooth is the most important element in esthetic consideration on facial area. Tooth alignment which is in harmony with gingiva, lips, and face is also key element. The purpose of this study was to give a clinical discipline for restoration of gingival contour, which contains a ratio of maxillary 6 anterior teeth, research for gingival contour etc., in case of rehabilitation of maxillary anterior teeth. 300 Dankook university dental school students ,who is their twenties and free from periodontitis, participate in this study. The result was from each 70 males and females who had normal occlusion and tooth alignment. Length, width and length/width ratio of maxillary 6 anterior teeth were 0.74-0.81 in male, 0.81-0.84 in female. There was significant difference between male and female. The most deepest position of gingiva in maxillary central incisor and canine was located in distal part of teeth and maxillary lateral incisor was middle portion. In maxillary central incisors, gingival line of the most deepest point appeared significant difference between male and female (p<0.01) whereas there was no difference in lateral incisors and canines. Distance between interdental papilla apex and the most deepest portion appeared significant difference between male and female. Distance of the deepest position of gingiva is statistically significant except maxillary central incisors and lateral incisors. Standard deviation and mean of the width of labio-lingual were measured in cervical area and there was a significant difference both male and female.(p<0.01) From this result, we could get the mean of maxillary anterior gingival line and these results have great value in clinical guidance in studying maxillary anterior teeth.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.1
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• pp.80-86
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• 2011

When a tooth adjacent to implant has coronal damages caused by severe dental caries or fracture, the clinical crown lengthening by forced eruption makes it possible to get esthetic restoration due to the prevention of alveolar crestal bone resorption and loss of interdental papilla. A 54-years-old male patient wanted prosthetic treatment because his anterior 3 unit bridges had fallen out. A right maxillary central incisor showed mild dental caries but a right maxillary canine lost most clinical crowns. Forced eruption combined with a gingival fiberotomy of a right maxillary canine was performed for 1 month after the dental implant had been simultaneously placed with bone grafts on a right maxillary lateral incisor. About 5 months after implant placement, 2nd surgical operation was performed. The provisional restorations were adjusted to make esthetic gingival contour for 8 weeks. The porcelain fused gold restorations were fabricated and set. The patient was satisfied with the final restorations in esthetic and functional aspect.