• 대한치과의사협회지
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• 제50권8호
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• pp.474-481
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• 2012

The periodontal flap surgery is the most widely utilized surgical procedure to reduce the pocket depth and to access the subgingival root surfaces for scaling and root planing. The diagnosis of the periodontal lesion and the objective of the surgery will dictate the type of flap procedure which will be utilized to obtain the best result. The incisions, type of flap and the selection of suturing design must be planned and executed to fit the problem. Periodontal flaps are designed to preserve gingival integrity and to gain access to root surfaces for residual calculus removal and to thoroughly remove granulation tissue so bone defects can be visualized and treated. Gentle and efficient procedures result in optimum healing and minimal postoperative pain. When flaps need to be repositioned apically or less often, coronally, then the flaps must sit passively at the appropriate level before suturing. To ensure this, buccal and lingual flaps need to be elevated beyond the mucogingival junction so the elasticity of the mucosa allows for flap mobility. Sometimes it may be necessary to extend the flap elevation apically with a split incision approach to minimize the effect of the less elastic periosteum. Vertical incisions can aid in flap positioning by allow ing the clinician to suture the flap at a different level to the adjacent untreated gingiva. In osseous periodontal surgery, flaps are apically positioned to minimize postoperative pocket depth. In regenerative periodontal surgery including implant surgery, soft tissue cove rage of bony defects, graft materials, membranes, and bio logic agents is important so sulcular incisions and light suturing techniques are crucial.

• 치위생과학회지
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• 제13권4호
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• pp.418-425
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• 2013

본 연구는 생활습관과 치주건강상태의 관련성을 파악하여 올바른 생활습관을 통한 치주질환의 예방 및 유지를 위한 기초자료를 제공하기 위하여 실시되었다. 연구대상은 일부지역 치과의원에 내원한 40~50대 성인 남녀 총 326명을 대상으로 하여 구조화된 설문지와 치주건강상태를 측정하여 조사 분석하였다. 수집된 자료는 IBM SPSS Statistics 19.0 통계프로그램을 이용하여 분석한 결과는 다음과 같다. 1. 흡연여부는 치은염 지수(p<0.01), 치주낭 깊이(p<0.001), 임상적 부착소실(p<0.001)에 따라 통계적으로 유의한 차이를 보였다. 2. 일일 흡연량은 치은염 지수(p<0.05), 치주낭 깊이(p<0.01), 임상적 부착소실(p<0.001)에 따라 통계적으로 유의한 차이를 보였다. 3. 흡연기간은 치은염 지수(p<0.05), 치주낭 깊이(p<0.01), 임상적 부착소실(p<0.001)에 따라 통계적으로 유의한 차이를 보였다. 4. 음주주기는 치은염 지수(p<0.05), 임상적 부착소실(p<0.05)에 따라 통계적으로 유의한 차이를 보였다. 5. 흡연을 하는 경우(p<0.05) 임상적 부착소실에 영향을 미치는 것으로 조사되었다. 이상의 결과에서 치과진료기관은 환자들에게 건강한 치주상태를 예방 및 유지하기 위해서는 과도한 흡연과 음주는 치주건강상태에 영향을 미친다는 사실을 인식시킬 필요가 있으며 더불어 체계적인 금연과 절주를 위한 교육프로그램 개발이 마련되어야 할 것이다.

• Journal of Periodontal and Implant Science
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• 제43권3호
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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.

• 대한치과의사협회지
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• 제57권12호
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• pp.758-767
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• 2019

The classification of periodontal disease in 1999 has been widely used for determining a diagnosis, establishing a treatment plan, and evaluating the prognosis of the patient with periodontal disease. However, scientific evidence from many studies indicates the need for a new classification system for periodontal and peri-implant disease. Summary at 2017 world workshop as follows: 1) Periodontal health and peri-implant health was defined; 2) Chronic periodontitis and aggressive periodontitis were unified as periodontitis; 3) Periodontitis was further classified by staging and grading to reflect disease severity and management complexity, rate of disease progression, respectively; 4) Periodontal disease as manifestation of systemic disease is based on the International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) code; 5) Periodontal biotype and biologic width was replaced to periodontal phenotype and supracrestal tissue attachment, respectively; 6) The excessive occlusal force was replaced by a traumatic occlusal force; 7) ≥3 mm of radiographic bone loss, ≥6 mm of pocket probing depth and bleeding on probing indicates peri-implantitis in the absence of radiograph at final prosthesis delivery.

• Journal of Periodontal and Implant Science
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• 제41권2호
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• pp.92-97
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• 2011

Purpose: The present study was performed to compare the treatment outcomes of non-surgical periodontal treatment according to the distribution of attachment loss of a given patient. Methods: Forty-five patients with moderate to severe periodontitis were divided in two subgroups; Group I patients with teeth manifesting attachment loss of ${\geq}$ 6 mm at one or more sites on the buccal/labial aspect while maintaining an attachment level ${\leq}$ 5 mm at the lingual/palatal aspect, Group II patients with teeth manifesting an attachment level ${\geq}$ 6 mm at more than one site on the lingual/palatal aspect while maintaining an attachment level ${\leq}$ 5 mm at the buccal/labial aspect. The probing pocket depth, probing attachment level, tooth mobility, and chewing discomfort were recorded at baseline and 6 months examinations following non-surgical periodontal therapy. Results: The buccal/ abial surfaces of teeth with moderate to severe periodontitis in Group I patients demonstrated a greater amount of pocket reduction, gain of attachment level, and tooth mobility reduction than the lingual/palatal aspects of teeth examined in Group II patients. Conclusions: Within the limits of the present study, the patients demonstrating attachment loss ${\geq}$ 6 mm at buccal/labial surfaces responded better to the nonsurgical periodontal therapy than those demonstrating comparable attachment loss at lingual/ palatal surfaces.

• Journal of Periodontal and Implant Science
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• 제34권3호
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• pp.499-508
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• 2004

Regeneration of Periodontium with PRP does not only improve regeneration rate and density of bone but have a possibility to estimate faster healing process for soft tissue. And also, autogenous bone and xenogenic bone graft are effective on regeneration of periodontium. The purpose of this study is to evaluate the effectiveness of autogenous bone and xenogenic bone $(BBP^{(R)})$ grafts with the PRP technique on regeneration of periodontium. 52 Generally healthy Pt. who had pocket depth 5mm at any of 6 surfaces of the teeth were in the study at Dept. of Perio. in Dankook Dental Hospital. Open Flap was treated for 18 infra-bony pockets as control group, autogenous bone with PRP was inserted for 25 infrabony pockets as first test group, and $(BBP^{(R)})$ with PRP was inserted for 22 infrabony pockets as 2nd test group. Then evaluation was made after 3 and 6 months 1. There were significant differences between average probing pocket depth and clinical attachment level of 3, 6 months and minimal and maximal attachment level after 6 months each other. 2. There were significant differences in average probing pocket depth of control group and 2nd experimental group between 1 and 6 months. For clinical attachment level and minimal and maximal proving attachment level, there was a significant difference after 6 month of surgery. 3. There was no significant difference between two test groups for average probing depth, clinical attachment level, and minimal and maximal probing attachment level. As the result, PRP with bone graft could be very effective for regeneration of periodontium and there was no difference between xenogenic bone and autogenous bone.

• Journal of Periodontal and Implant Science
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• 제31권3호
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• pp.501-511
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• 2001

Several indices have been developed that use bleeding and color changes as indicators of early gingival pathology. In the presence of gingivitis, vascular proliferation and reduction of keratinization owing to increase redness in gingiva. Descriptions of healthy gingiva are numerous, ranging from pale pink and coral pink to deep red and violet. This terms are not objective. Because of perception of color depends on a lot of factors such as light source, object, observer and so on. It is difficult to make an objective expression. Therefore the using of mechanical equipment is recommended to exclude these variables and observer's vias. The purpose of this study was to evaluate gingival color change after scaling & subgingival root planing. The other purpose of this study was to research the correlation of pocket depth, P.B.I. score and gingival color change. After photo-taking and storaging the image of gingival color into a computer, color change was examine with an image analysis program. Results were as follow; 1. Color of healed gingiva after scaling & subgingival root planing was significantly differ from color of inflamed gingiva(p<0.01). 2. Color of healed gingiva after scaling was similar to color of healed gingiva after subgingival root planing(p<0.05). 3. There was statistically significant correlation between color change of red component and pocket depth after scaling & subgingival root planing(p<0.01). 4. There was no correlation between color change of green, blue component and pocket depth after scaling & subgingival root planing(p<0.01). 5. There was statistically significant correlation between between color change of red component and P.B.I. score after scaling & subgingival root planing(p<0.01). 6. There was no correlation between color changes of green, blue component and P.B.I. score after scaling & subgingival root planing(p<0.01). 7. Increase of pocket depth and P.B.I. score were significantly correlated to the amount of color change(p<0.01). 8. P.B.I. score had a higher correlation with color change than pocket depth(p<0.01).

• Journal of Periodontal and Implant Science
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• 제24권1호
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• pp.120-130
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• 1994

The purpose of the present investigation was to compare the effectiveness of porous hydroxyapatite (PHA) and coralline based porous calcium carbonate(PCC) as implant materials in human periodontal osseous defects. 10 adult patients having periodontitis and 2 similar angular osseous defects ${\ge}$5mm as verified by radiographic analysis and clinical probing depth ${\ge}$4mm were selected. The measurements were recorded just before surgery and after 6 month. Clinical parameters used in this study included gingival recession, pocket depth, probing attachment level, Sulcus Bleeding Index, Plaque Index, tooth mobility and bone defect depth measurements. After initial therapy, patients were treated with mucoperiosteal flap surgery. The contralateral bony defects in each patient randomly assigned to either bone graft material, one with PHA(Interpore 200) and the other with coralline based calcium carbonate(Biocoral). After 6 month both groups showed statistically significant reduction of pocket depth, Sulcus Bleeding Index, Plaque Index and significant improvement in probing attachment level. No statistically significant differences were found between the groups. There were 3.0mm or 68% of bone repair with PHA and 3.1mm, 61% with PCC. These values were likewise not significantly different. The data and clinical impression strongly suggest that both PHA and PCC are alloplastic implants with clinically apparent acceptance by the soft and hard tissue and that they can be used as bone graft materials successfully.

• Journal of Periodontal and Implant Science
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• 제33권3호
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• pp.407-414
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• 2003

The aim of this study was to investigate the effect of third molar extraction on the periodontal status of the adjacent second molar. A total of 61 second molars in 31 adult periodontitis patients were examined. Among them, 27 second molars without adjacent third molars were included in the test group, and 34 second molars with third molar were included in the control group. Clinical parameters including plaque index, gingival index, and pocket depth and radiographic bone loss were measured around the second molar both in test and control group. The result showed that: (1) the mean plaque index and gingival index of control group were higher than these of the test group but the difference was not statistically significant, (2) the mean pocket depth of the control group was higher than the test group significantly at distal and buccal surface, (3) radiographic hone loss was greater in control group than test group significantly, (4) in Pearson correlation analysis between the age of extraction and radiographic bone loss in the test group, a positive relationship was shown(p<0.01). Within limitation of this study, it may be concluded that third molar extraction in periodontitis patients showed an improvement in periodontal status in contrast the patients group having third molar, therefore earlier a removal of third molar may minimize radiographic hone loss of the adjacent second molar.

• Journal of Periodontal and Implant Science
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• 제28권3호
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• pp.465-475
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• 1998

The purpose of this study was to investigate the comparative effects of subgingival irrigation using some oral mouth rinses on early healing process of periodontal inflammation. The study population consisted of 13 patients with periodontal inflammation and distributed into 4 groups. Oral hygiene instruction, delicate scaling and root planing were done and then irrigated per 3 days during 2 weeks in situ with 1 of 4 solutions ; normal saline, C31G, Benzotonium chloride and tetracycline. Examination regarding probing pocket depth, plaque index, sulcular bleeding index, gingival index, gingival recession and leukocytes differential count was performed. Evaluation was made at the baseline and 2 weeks after non-surgical periodontal therapy. The results were as follows : 1. Clinical indices including probing pocket depth, plaque index, sulcular bleeding index, gingival index and gingival recession were significantly improved from baseline to 2 weeks. But there was no significant differences among 4 groups. 2. PMNs percent on leukocytes differential count was significantly decreased from baseline to 2 weeks on all groups. Those of tetracycline and C31G were significantly decreased than those of normal saline group. These results suggest that clinical indices were not different, but the decrease of inflammation were significantly different among some mouth rinses.