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.
This study was perfomed to investigate the prosthodontic and periodontal status of the abutment teeth in distally extending bridges(DEBs) (78 cases) and removable partial dentures(RPDs) (43 cases) for 122 patients (55 males and 57 females) visiting department of Periodontology, Seoul National University Hospital. The average wearing periods were 67.8 months for DEBs and 66.4 months for RPDs. 38.4% of the patients in DEBs and 35.9% in RPDs complainted of chewing discomfort and 22.6% and 24.4% were not chewing on the prosthodontically - treated sides, respectively. In DEBs, when the restoration for 2nd molar supported by 1st molar & 2nd premolar was grouped to type 1, 1st molar supported by 1st & 2nd premolars was type 2, and 1st & 2nd molars supported by 1st & 2nd premolars was type 3, there was a significant differences only in the tooth mobility score among clinical parameters (type 2>type 1>type 3). In RPDs, when bilateral free-end case was grouped to type 1, and unilateral case was type 2, there was a significant difference in the Gingival index (type 1>type 2). In DEBs, 62.8% of restoration were overcontoured, 72% had interproximal space closures, 30.5% overextended pontics and 86.6% overhanging margins. In RPDs, 24.4% of the restorations were overcontoured, 45.5% had interproxinal space closures and 58.3% overhanging margins. From these results of this study, periodontal problems caused by prosthodontic defects were considered to be contributing factors in chewing discomfort.
Purpose: Systemic health has a profound effect on dental treatment. The aim of this study was to evaluate peri-implant bone loss and health screening data to discover factors that may influence peri-implant diseases. Methods: This study analyzed the panoramic X-rays of patients undergoing health screenings at the Health Promotion Center at Seoul St. Mary's Hospital in 2018, to investigate the relationship between laboratory test results and dental data. The patients' physical data, such as height, weight, blood pressure, hematological and urine analysis data, smoking habits, number of remaining teeth, alveolar bone level, number of implants, and degree of bone loss around the implant, were analyzed for correlations. Their associations with glycated hemoglobin, glucose, blood urea nitrogen (BUN), creatinine, and severity of periodontitis were evaluated using univariate and multivariate regression analysis. Results: In total, 2,264 patients opted in for dental health examinations, of whom 752 (33.2%) had undergone dental implant treatment. These 752 patients had a total of 2,658 implants, and 129 (17.1%) had 1 or more implants with peri-implant bone loss of 2 mm or more. The number of these implants was 204 (7%). Body mass index and smoking were not correlated with peri-implant bone loss. Stepwise multivariate regression analysis revealed that the severity of periodontal bone loss (moderate bone loss: odds ratio [OR], 3.154; 95% confidence interval [CI], 1.175-8.475 and severe bone loss: OR, 7.751; 95% CI, 3.003-20) and BUN (OR, 1.082; 95% CI, 1.027-1.141) showed statistically significant predictive value. The severity of periodontitis showed greater predictive value than the biochemical parameters of blood glucose, renal function, and liver function. Conclusions: The results of this study showed that periodontal bone loss was a predictor of peri-implant bone loss, suggesting that periodontal disease should be controlled before dental treatment. Diligent maintenance care is recommended for patients with moderate to severe periodontal bone loss.
Jung Soo Park;Yeek Herr;Jong-Hyuk Chung;Seung-Il Shin;Hyun-Chang Lim
Journal of Periodontal and Implant Science
/
v.53
no.2
/
pp.145-156
/
2023
Purpose: The significance of keratinized tissue for peri-implant health has been emphasized. However, there is an absence of clinical evidence for the use of a xenogeneic collagen matrix (XCM) to manage peri-implant mucositis and peri-implantitis. Therefore, the purpose of this study was to investigate outcomes after keratinized tissue augmentation using an XCM for the management of peri-implant diseases. Methods: Twelve implants (5 with peri-implant mucositis and 7 with peri-implantitis) in 10 patients were included in this study. Non-surgical treatments were first performed, but inflammation persisted in all implant sites. The implant sites all showed a lack of keratinized mucosa (KM) and vestibular depth (VD). Apically positioned flaps with XCM application were performed. Bone augmentation was simultaneously performed on peri-implantitis sites with an intrabony defect (>3 mm). The following clinical parameters were measured: the probing pocket depth (PPD), modified sulcular bleeding index (mSBI), suppuration (SUP), keratinized mucosal height (KMH), and VD. Results: There were no adverse healing events during the follow-up visits (18±4.6 months). The final KMHs and VDs were 4.34±0.86 mm and 8.0±4.05 mm, respectively, for the sites with peri-implant mucositis and 3.29±0.86 mm and 6.5±1.91 mm, respectively, for the sites with peri-implantitis. Additionally, the PPD and mSBI significantly decreased, and none of the implants presented with SUP. Conclusions: Keratinized tissue augmentation using an XCM for sites with peri-implant mucositis and peri-implantitis was effective for increasing the KMH and VD and decreasing peri-implant inflammation.
Purpose: The aim of this study was to clinically and radiographically evaluate and compare treatment of intrabony defects with the use of decalcified freeze-dried bone allograft in combination with a calcium sulphate barrier to collagen membrane. Methods: Twelve patients having chronic periodontal disease aged 20 to 50 years and with a probing depth >6 mm were selected. Classification of patient defects into experimental and control groups was made randomly. In the test group, a calcium sulphate barrier membrane, and in control group, a collagen membrane, was used in conjunction with decalcified freeze-dried bone graft in both sides. Ancillary parameters as well as soft tissue parameters along with radiographs were taken at baseline and after 6 months of surgery. Parameters assessed were plaque index, modified gingival index, probing depth, relative attachment level, and location of the gingival margin. A Student's t-test was done for intragroup and a paired t-test for intergroup analysis. Results: Intragroup analysis revealed statistically significant improvement in all the ancillary parameters and soft tissue parameters with no statistically significant difference in intergroup analysis. Conclusions: The study concluded that a calcium sulphate barrier was comparable to collagen membrane in achieving clinical benefits and hence it can be used as an economical alternative to collagen membrane.
Park, Jeong-Cheol;Song, Ji-Eun;Gwon, Yeong-Jin;Sin, Yong-Mok;Hwang, Jae-Gwan;Kim, Jong-Gwan
The Journal of the Korean dental association
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v.46
no.5
/
pp.315-322
/
2008
The purpose of the present study was to determine the effect of a chewing gum containing 70% xylitol and 0.23% Curcuma xanthorrhiza extract to remove dental plaque and reduce gingivitis when used as a supplement to daily toothbrushing for 3 weeks. The study group consisted of 75 adults with moderate gingvitis. Participants were divided into 3 groups(contol 1 group - Gum base, contol 2 group - 70% Xylitol, experiment group - 70% xylitol and 0.23% xanthorrhizol) and instructed to chew the study gum for 3 times daily for 3 weeks in addition to regular daily toothbrushing. Chewing xylitol/xanthorrhizol gum significantly reduced plaque index with significant difference by week 3(p<0.01). Gingival index and bleeding on probing were decreased in xy/ Curcuma xanthorrhiza extract group by 35.9% and 31.65% each in the same period. No adverse effects on the oral tissues were observed in any of the participants for the duration of the study. In conclusion, regular use of a chewing gum containing 70% xylitol and 0.23% Curcuma xanthorrhiza extract appears safe and effective for the removal of dental plaque and reduction of gingivitis when used in conjunction with daily toothbrushing.
Objective: To compare computer-aided design and computer-aided manufacturing (CAD/CAM) customized nitinol retainers with standard stainless-steel fixed retainers over a 12-month study period. Methods: This randomized controlled trial (RCT) was conducted on 62 patients randomly allocated to a control group that received stainless-steel retainers or a test group that received customized CAD/CAM nickel-titanium retainers. Four time points were defined: retainer placement (T0) and 1-month (T1), 6-month (T2), and 12-month (T3) follow-up appointments. At each time point, Little's irregularity index (LII) (primary endpoint) and dental stability measurements such as intercanine width were recorded in addition to assessment of periodontal parameters. Radiological measurements such as the incisor mandibular plane angle (IMPA) were recorded at T0 and T3. Failure events (wire integrity or debonding) were assessed at each time point. Results: From T0 to T3, LII and other dental measurements showed no significant differences between the two groups. The data for periodontal parameters remained stable over the study period, except for the gingival index, which was slightly, but significantly, higher in the test group at T3 (p = 0.039). The IMPA angle showed no intergroup difference. The two groups showed no significant difference in debonding events. Conclusions: This RCT conducted over a 12-month period demonstrated no significant difference between customized CAD/CAM nickel-titanium lingual retainers and standard stainless-steel lingual retainers in terms of dental anterior stability and retainer survival. Both retainers eventually appeared to be equally effective in maintaining periodontal health.
Purpose: The aim of this study was to compare the clinical outcome of open flap debridement (OFD) with a biphasic calcium phosphate (BCP) graft to that of OFD without BCP graft for the treatment of intrabony periodontal defects (IBDs). Methods: The study included 25 subjects that had at least one intrabony defect of 2- or 3-wall morphology and an intrabony component ${\geq}4$ mm as detected radiographically. Subjects were randomly assigned to treatment with (BCP group, n=14) or without BCP (OFD group, n=11). Clinical parameters were recorded at baseline and 6 months after surgery and included the plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), and gingival recession (REC). A stringent plaque control regimen was enforced for all of the patients during the 6-month observation period. Results: In all of the treatment groups, significant PD reductions and CAL gains occurred during the study period (P<0.01). At 6 months, patients in the BCP group exhibited a mean PD reduction of $3.7{\pm}1.2$ mm and a mean CAL gain of $3.0{\pm}1.1$ mm compared to the baseline. Corresponding values for the patients treated with OFD were $2.5{\pm}0.8$ mm and $1.4{\pm}1.0$ mm, respectively. Compared to OFD group, the additional CAL gain was significantly greater in the patients in BCP group (P=0.028). The additional PD reduction was significant for the BCP group (P=0.048). The REC showed a significant increase in both groups, and the amount of recession was significantly smaller in the BCP group than OFD group (P=0.023). In radiographic evaluation, the height of the bone fill in the BCP group was significantly greater than OFD group. Conclusions: The clinical benefits of BCP found in this study indicate that BCP may be an appropriate alternative to conventional graft materials.
The present study was performed to evaluate the clinical effects following local application of 30% minocycline strip(polycaprolactone), 2% minocycline gel(hydrocarbon gel) and 12% minocycline strip(polylactide, Minodent) to augment scaling and root planing in patients with chronic adult periodontitis. Forty teeth with periodontitis were enrolled in the study anddistributed into 4 groups including control group. All patients performed standardized oral hygiene instructions and mechanical debridement at the beginning of the study and then each local delivery drugs were inserted into periodontal pocket in each groups. Examinations regarding plaque index(PI), papillary bleeding index (PBI), probing pocket depth (PPD) were carried out at 0, 2, 4 weeks. All experimental groups showed statistically significant differences between baseline and 2 and 4 weeks in every clinical indices. Especially, 30%minocycline strip and Minodent group showed a significant improvement in PBI at 2 weeks and in PPD at 2 and 4 weeks. In conclusion, highly bio-resorbable Minodent delivered subgingivally as an adjunct to scaling and root planing induces better clinical effects for periodontal health than 2% minocycline gel and control group.
Objective: This systematic review aimed to evaluate periodontal parameters in orthodontically tractioned teeth compared with the respective non-tractioned contralateral teeth. Methods: Search strategies were developed for six electronic databases and gray literature. Random-effects meta-analyses were performed for the outcomes of interest. Furthermore, the certainty of the evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool. Results: Overall, 2,082 articles were identified, of which 24 were selected for the qualitative synthesis. A significant difference was observed between the impacted and contralateral teeth (mean difference [MD] = 0.25; 95% confidence interval [CI] = 0.10-0.40; I2 = 0%) when the gingival index was evaluated. Additionally, impacted teeth showed a greater probing depth, with a significant mean difference between the groups (MD = 0.14; 95% CI = 0.07-0.20; I2 = 6%). Most studies had a low risk of bias; however, the certainty of the evidence was very low owing to the design of existing studies. Conclusions: The evidence in the literature indicated that tractioned teeth might show worsening of periodontal parameters related to the gingival index and probing depth; however, the evidence remains uncertain about this outcome. Furthermore, probing depth should be considered regarding its clinical significance because of the small effect size observed.
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