• International Journal of Oral Biology
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• v.30 no.3
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• pp.105-110
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• 2005

Periodontitis is a chronic infectious disease that leads to the destruction, one of the major cause of tooth loss in human. Osteoclast Differentiation Factor(ODF), also called as Receptor activator of NF-${\kappa}B$ ligand(RANKL), a surface-associated ligand on bone marrow stromal cells and osteoblasts, activates its cognate receptor RANK on osteoclast progenitor cells, which leads to differentiation of these mononucleated precursor cells. Osteoprotegerin(OPG), a decoy receptor, is released from stromal cells and osteoblasts to inhibit the interaction between RANKL and RANK. The experiment for the effect of pregnancy on gingival health showed greater gingival inflammation and edema during pregnancy, despite similar plaque index. There should be many factors affecting the periodontal health in pregnancy. In this experiment, we examined the direct effects of sex hormones(estrogen and progesterone) on the ODF/OPG expression in human gingival fibroblasts and periodontal ligament cells at the serum concentration of pregnancy. The ratio was high in the 1st trimester of pregnancy by estrogen and in the late 2nd trimester by progesterone. Therefore, the local periodontal destruction might be accelerated by these hormonal effect on the periodontal cells.

• Journal of Periodontal and Implant Science
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• v.51 no.1
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• pp.30-39
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• 2021

Purpose: The present study was undertaken to examine whether periodontal probe visibility (PV) accurately reflects gingival thickness (GT) and to identify factors affecting PV using cluster and multivariate analyses. Methods: The clinical characteristics of the maxillary central incisors (n=90 subjects) were examined. Clinical photographs, sex, PV, probing depth, gingival width, papilla height, GT as measured with an ultrasonic device, and the ratio of crown width to crown length were recorded. Multivariate analysis, using multinomial baseline-category logistic regression, was used to identify factors predictive of PV. Cluster analysis was used to identify gingival biotypes. Results: In the multivariate analysis, sex was the only significant predictor of PV (odds ratio, 6.48). Two clusters of subjects were created based on morphometric parameters. The mean GT among cluster A subjects was significantly lower than that among cluster B subjects (P=0.015). No significant difference was found between cluster A and B subjects in terms of PV score (P=0.583). Conclusions: Periodontal PV was not associated with GT as measured directly using an ultrasonic device. Sex was a highly significant predictor of periodontal PV. GT was found to be correlated with morphological characteristics of the periodontium.

• Journal of Korean Academy of Nursing
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• v.46 no.5
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• pp.653-662
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• 2016

Purpose: The purpose of this study was to identify the influences of oral health behaviors, depression, and stress on periodontal disease in pregnant women. Methods: The participants in this study were 129 pregnant women. Data were collected using questionnaires which included individual characteristics, oral health care behaviors, the Center for Epidemiological Studies-Depression scale (CES-D), a global measure of perceived stress, and pregnancy stress. A dentist measured periodontal probing depth and classified stages of periodontal disease according to the Community Periodontal Index (CPI). Data were analyzed using descriptive statistics, Pearson correlation, and multiple regression. Results: Periodontal disease had significant correlations with oral health care behaviors (r=-.56, p <.001), perceived stress (r=.44 p <.001), pregnancy stress (r=.37 p <.001), diet (r=-.33, p <.001) and depression (r=.18 p =.046). Factors influencing periodontal disease for these pregnant women were being in the 2nd (${\beta}=.27$, p <.001) or 3rd trimester (${\beta}=.45$, p <.001), having a pregnancy induced disease (${\beta}=.20$, p =.002), performing higher oral health behaviors (${\beta}=-.30$, p <.001), and having higher perceived stress (${\beta}=.17$, p =.028). The explanation power of this regression model was 61.6% (F=15.52, p <.001). Conclusion: The findings of this study indicated that periodic assessment of periodontal disease is essential for pregnant women who are in 2nd or 3rd trimester and have pregnancy induced diseases. Enhancing oral health care behaviors and reducing perceived stress are indicated as effective strategies to reduce periodontal disease in pregnant women.

• Journal of Periodontal and Implant Science
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• v.50 no.6
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• pp.358-367
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• 2020

Purpose: The aim of this study was to investigate the efficacy and validity of subgingival bacterial sampling using a retraction cord, and to evaluate how well this sampling method reflected changes in periodontal conditions after periodontal therapy. Methods: Based on clinical examinations, 87 subjects were divided into a healthy group (n=40) and a periodontitis group (n=47). Clinical measurements were obtained from all subjects including periodontal probing depth (PD), bleeding on probing (BOP), clinical attachment loss (CAL), and the plaque index. Saliva and gingival crevicular fluid (GCF) as a subgingival bacterial sample were sampled before and 3 months after periodontal therapy. The salivary and subgingival bacterial samples were analyzed by reverse-transcription polymerase chain reaction to quantify the following 11 periodontal pathogens: Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythus (Tf), Treponema denticola (Td), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn), Pavimonas micra (Pm), Campylobacter rectus (Cr), Prevotella nigrescens (Pn), Eikenella corrodens (Ec), and Eubacterium nodatum (En). Results: Non-surgical periodontal therapy resulted in significant decreases in PD (P<0.01), CAL (P<0.01), and BOP (P<0.05) after 3 months. Four species (Pg, Tf, Pi, and Pm) were significantly more abundant in both types of samples in the periodontitis group than in the healthy group. After periodontal therapy, Cr was the only bacterium that showed a statistically significant decrease in saliva, whereas statistically significant decreases in Cr, Pg, and Pn were found in GCF. Conclusions: Salivary and subgingival bacterial sampling with a gingival retraction cord were found to be equivalent in terms of their accuracy for differentiating periodontitis, but GCF reflected changes in bacterial abundance after periodontal therapy more sensitively than saliva.

• Journal of dental hygiene science
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• v.14 no.2
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• pp.107-113
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• 2014

This study was conducted to evaluate the association between periodontal disease and diabetes mellitus. The final analysis population of this study was composed of 4,830 adults with diabetes mellitus or periodontal disease and aged 19 years or older, based on the third-edition data of the 4th Korea National Health and Nutrition Examination Survey (KNHANES) (in 2009). Diabetic status and potential confounders were used in questionnaire materials and physical examination materials, and the presence of periodontal disease was used in the materials for oral health examination by a dentist. For diabetic status, fasting plasma glucose (FPG) levels <100 mg/dl were subcategorized into normal group and FPG levels ${\geq}100mg/dl$ into impaired fasting glucose group; glycosylated hemoglobin (HbA1c) levels <7% into normal group and HbA1c ${\geq}7%$ into diabetes group, on the basis of the American Diabetes Association. According to the 2009 Korea Health Statistics, the case where the pocket depth is 3 mm or more was defined as periodontal disease. The association between the two diseases was evaluated through $x^2$-test and logistic regression analysis using R-commander 2.14. In impaired fasting glucose group, community periodontal index (CPI) groups 3 to 4 had higher risks for periodontal disease 1.23 times (95% confidence interval, 1.07~1.42) than those of CPI groups CPI 0~2, even after adjustment for several confounders. In addition, periodontal disease and diabetes mellitus showed statistically significant differences depending on age, sex, income level, educational background, smoking status, alcohol consumption, and snack intake. The analyses of the third-edition data of the 4th KNHANES showed that there was a statistically significant association between periodontal disease and diabetes mellitus as examined by means of CPI in this study.

• Journal of Korean society of Dental Hygiene
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• v.7 no.4
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• pp.553-567
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• 2007

Migrant Worker are rapidly increasing in Korea since 1990. They are nowadays main sources of laborer groups engaging in medium-sized factories. The purpose of this study is to provide the basic information to establish proper oral health policy. Dental caries and periodontal disese are the most common disease that occur in the mouth. Periodontal disease is the most common disease in humans and the biggest reason for the loss of the teeth in the adult population. The CPITIN has been developed jontly by the international Dental Federation and the World Health Organization. CPITN is now an established index of level, of periodontal condition in populations for which specific intervention might be considered. This study was conducted to obtain the information regarding to CPITN of migrant workers located in Daegu, Questionaire survey was carried out for 289 workers from July 9 to August 8, 2006. Total survey was 289, 224 males and 65 females. The result was as follows: First, The number of nationality was 14. The first majority was China as 31.8% Among 14 nationalities were Cambodia 18.0%, Vietnam 12.8%, Sri Lanka 12.1%, Indonesia 7.3%, Nepal 4.2%, the other 13.8%, those who are aged from 20 to 29 were 43.9%, and salary from 1,000,000 won to 1,490,000 won 51.2%.(as for their residence, those who resided) over 3 years were 42.6% and not insured reached 68.5%. Second, more than 93.4% of the subjects need periodontal treatment, only 4.9% of non-smoker was health periodontal states, four times frequency of tooth brushing per a day was 16.7%. Third, 28.7% of migrant workers had experienced visit of dental clinic, and 22.9% had received treatment of decayed tooth. Fourth, It is difficult for them 65.1% of them to visit dental clinic in korea, the First was a communication problem and the second was time. Fifth, Most of them didn't have a oral health education but 85.1% of them said that they wish they attend oral health education. We conclude that the situation of migrant workers was very bad considering their working conditions, circumstances, and health condition. According to this study, more than 93.4% of the people need periodontal treatment. Besides they didn't have accurate knowledge about prevention of periodontal disease. Therefor our considering these facts, the policy of dental health by government should be established for migrant workers.

• Journal of Periodontal and Implant Science
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• v.31 no.4
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• pp.661-668
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• 2001

Anti-P. gingivalis immune sera were obtained from mice immunized with either P. gingivalis alone, or F. nucleaturm followed by P. gingivalis. Two groups of immune sera were examined for binding capacity to P. gingivalis biofilm by confocal laser scanning microscope, Antibody avidity index was also determined for each immune sera. The results indicated that prior immunization of mice with F. nucleaturm impaired P. gingivalis-specific immune sera in binding capacity to biofilm and antibody avidity to P. gingivalis. Elevated antibody responses in patients with destructive periodontal disease has often been related to suboptimal level of protective antibody $(opsonophagocytosis)^{1-3)}$ while post-immune sera obtained with experimental animals using a single periodontal pathogen demonstrated satisfactory levels of protective function against the homologous bacterial $challenge^{4,5)}$.The reason is unclear why elevated IgG responses in periodontal patients to periodontal pathogens do not necessarily reflect their protective function. Such an immune deviation might be derived from the fact that destructive periodontal disease is cumulative result of immunopathologic processes responding to an array of different colonizing microorganisms sequentially infecting in the subgingival environmental niche. Fusobacterium nucleaturm is one of the key pathogens in gingivitis, in the transitional phase of conversion of gingivitis into destructive periodontitk, and in adult $periodontitis^{6-8)}$. It also plays a central role in coaggregation with other important microbial species in subgingival $area^{6,9,10)}$ as well as in $biofilm^{11)}$, especially with Porphyromonas gingjvalis in synergism of virulence in human periodontal disease or in animal $models^{12-14)}$. This organism has also been reported to have immune modulating activity for secondary immune response to Actinobacillus $actinomycetemcomitans^{15)}$. It is presumed that sequential colonization and intermicrobial coaggregation between intermediate and late colonizers could potentially modulate the immune responses and development of specific T cell phenotypes in periodontal lesions. We have recently demonstrated the skewed polarization of P. gingivalis-specific helper T cell clones in mice immunized with F. nucleaturm followed by P. $gingivalis.^{16)}$. Consequently F. nucleaturm may initially prime the immune cells and modify their responses to the successive organism, P. gingivalis. This could explain why one frequently observes non-protective serum antibodies to P. gingivalis in periodontal patients in contrast with those obtained from animals that were immunized with $P.gingivalis\;alone^{17)}$. The present study was performed to investigate the immune modulating effect of F. nucleatum on serum binding to experimental biofilms and the avidity of anti-P. gingivalis antibody.

• Journal of Periodontal and Implant Science
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• v.36 no.3
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• pp.693-703
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• 2006

The purpose of this study was to evaluate the efficacy of the Sonicare $Elite^{(R)}$ power toothbrush in plaque removal and reduction of gingivitis from hard-to-reach sites of the moderate periodontitis compared to regular manual toothbrush in 12 week follow-up. 82 subjects with incipient to moderate periodontitis were randomly assigned to use either the manual or sonic brush, instructed in its use, and asked to brush 2 times a day for 2 minutes. Plaque scores were taken at baseline, 1, 4, 12 weeks using Silness & $L\ddot{o}e$ plaque index and gingival inflammation was assessed by the $L\ddot{o}e$ & Silness gingival index. The results were as follows. 1. The Sonicare $Elite^{(R)}$ power toothbrush showed a significant reduction(p<0.0001) of the plaque(Silness & $L\ddot{o}e$) and gingival inflammation(Loe & Silness). 2. The Sonicare $Elite^{(R)}$ power toothbrush showed a significant better reduction of plaque and gingivitis(p<0.05) than the manual toothbrush after 1, 4, and 12 weeks. 3. The Sonicare $Elite^{(R)}$ power toothbrush demonstrated a significant reduction(p<0.0001) of the plaque in interproximal sites(p<0.0001), buccal sites(p<0.0001) and the lingual sites(p=0.00l8) of the teeth. 4. The Sonicare $Elite^{(R)}$ power toothbrush demonstrated a significant reduction(p<0.0001) of the gingival inflammation in the interproximal sites(p<0.0001), the buccal sites(p<0.0001) and the lingual sites(p<0.0001) of the teeth. The results of this study support the findings that Sonicare $Elite^{(R)}$ power toothbrush has a great potential to remove the plaque and resolve the gingival inflammation during the period of 12 week.

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.71-78
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• 2014

Purpose: Host modulatory therapy has been proposed as a treatment for periodontal diseases. A class of herbal medicines, known to be immunomodulators, alters the activity of immune function through the regulation of informational molecules such as cytokines. In the current study, we tested the hypothesis that herbal immunomodulator drugs act as an adjuvant to scaling and root planing (SRP) in alleviating periodontal inflammation by improving clinical and biochemical parameters. Methods: Sixty healthy subjects (30 in each group) with moderate and severe chronic periodontitis were enrolled in a double-blind, placebo-controlled, double-masked randomised controlled trial. The control group was treated with SRP and a placebo, whereas the test group was treated with SRP followed by dietary supplementation of Septilin for 3 weeks. Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated for all patients at the baseline, 3 weeks, and 6 weeks. Results: Improved gingival index scores found in the test group as compared to the control group were found to be statistically significant only after 3 weeks (P<0.001). In contrast, the decrease in the sulcus bleeding index and pocket depth scores was statistically highly significant in the test group as compared to the control group after 3 weeks and 6 weeks (P<0.001). However, reduced clinical attachment level and CRP scores, as reflected in the test group as compared to the control group, were not found to be statistically significant after both 3 weeks (P>0.05) and 6 weeks (P>0.05). Conclusions: The results of this clinical-biochemical study suggest that dietary supplementation with herbal immunomodulatory agents may be a promising adjunct to SRP and may aid in improving periodontal treatment outcomes.

• Journal of Periodontal and Implant Science
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• v.48 no.2
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• pp.92-102
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• 2018

Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.