• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.6
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• pp.445-453
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• 2021

Objectives: Periodontitis is the most common chronic disease that causes tooth loss and is related to systemic diseases such as cardiovascular disease and diabetes. An objective indicator of the current activity of periodontitis is necessary. Soluble forms of the receptor for advanced glycation end products (sRAGE) are markers that reflect the status of inflammatory diseases. In this study, the relationship between sRAGE and periodontitis was analyzed to determine whether it can be used to diagnose the current state of periodontitis. Patients and Methods: Eighty-four patients without any systemic diseases were diagnosed with periodontitis using three classifications of periodontitis. Demographics and oral examination data such as plaque index (PI), bleeding on probing (BOP) index, and probing pocket depth (PPD) were analyzed according to each classification. In addition, correlation and partial correlation between sRAGE and the values indicating periodontitis were analyzed. Results: In each classification, the level of sRAGE tended to decrease if periodontitis was present or severe, but this change was not statistically significant. sRAGE and periodontitis-related variables exhibited a weak correlation, among which the BOP index showed a relatively strong negative correlation (ρ=-0.20). Based on this, on analyzing the correlation between the BOP index and sRAGE in the group with more severe periodontitis (PPD≥5 mm group, severe group of AAP/CDC [American Academy of Periodontology/Centers for Disease Control and Prevention], periodontitis group of López), the correlation further increased (ρ=-0.23, -0.40, -0.50). Partial correlation analysis of the sRAGE and BOP index showed a stronger negative correlation (ρ=-0.36, -0.55, -0.45). Conclusion: sRAGE demonstrated a tendency to decrease upon increased severity of periodontitis according to the classifications used. Above all, the correlation with the BOP index, which reflects the current state of periodontitis, was higher in the group with severe periodontitis. This indicates that the current status of periodontitis can be diagnosed through sRAGE.

• Journal of Periodontal and Implant Science
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• v.53 no.2
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• pp.120-134
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• 2023

Purpose: We investigated whether repeated irradiation with light-emitting diodes (LEDs) at a combination of 470 nm and 525 nm could suppress the progression of experimental periodontitis. Methods: A experimental periodontitis model was established in the second, third, and fourth premolars of the mandible in beagle dogs for 2 months. The spontaneous progression of periodontitis was monitored under the specified treatment regimen for 3 months. During this period, the animals were subjected to treatments of either plaque control only (control) or plaque control with LED application (test) at 2-week intervals. The clinical parameters included the probing pocket depth (PPD), gingival recession (GR), and the clinical attachment level (CAL). Histomorphometric analysis was performed using measurements of the length of the junctional epithelium, connective tissue (CT) zone, and total soft tissue (ST). Results: There were significant differences in PPD between the control and test groups at baseline and 12 weeks. When the change in PPD was stratified based on time intervals, it was shown that greater differences occurred in the test group, with statistical significance for baseline to 12 weeks, 6 to 12 weeks, and baseline to 6 weeks. There was no significant difference in GR between the control and test groups at any time points. Likewise, no statistically significant differences were found in GR at any time intervals. CAL showed a statistically significant difference between the control and test groups at baseline only, although significant differences in CAL were observed between baseline and 12 weeks and between 6 and 12 weeks. The proportion of CT to ST was smaller for both buccal and lingual areas in the control group than in the test group. Conclusions: Repeated LED irradiation with a combination of 470-nm and 525-nm wavelengths may help suppress the progression of periodontal disease.

• Journal of Periodontal and Implant Science
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• v.54 no.1
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• pp.13-24
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• 2024

Purpose: This study investigated the adjunctive effect of light-emitting diodes (LEDs) in the treatment of experimental periodontitis. Methods: Experimental periodontitis was induced by placing ligatures around the mandibular second, third, and fourth premolars of 6 beagles for 3 months. After ligature removal, periodontitis progressed spontaneously for 2 months. The animals' hemimandibles were allocated among the following 3 groups: 1) no treatment (control), 2) scaling and root planing (SRP), and 3) SRP with LED irradiation at 470-nm and 630-nm wavelengths (SRP/LED). The probing pocket depth (PPD) and gingival recession (GR) were measured at baseline, 6 weeks, and 12 weeks. The clinical attachment level (CAL) was calculated. After 12 weeks, histological and histomorphometric assessments were performed. The distances from the gingival margin to the apical extent of the junctional epithelium (E) and to the connective tissue (CT) attachment were measured, as was the total length of soft tissue (ST). Results: PPD and CAL increased at 12 weeks compared with baseline in the control group (6.31±0.43 mm to 6.93±0.50 mm, and 6.46±0.60 mm to 7.61±0.78 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP group (6.01±0.59 to 4.81±0.65 mm, and 6.51±0.98 to 5.39±0.93 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP/LED group (6.03±0.39 to 4.46±0.47 mm, and 6.11±0.47 to 4.78±0.57 mm, respectively). The E/ST and CT/ST ratios significantly differed among the 3 groups (P<0.05). The clinical parameters and histologic findings demonstrated that 470-nm and 630-nm wavelength LED irradiation accompanying SRP could improve treatment results. Conclusions: Within the study limitations, 470 nm and 630 nm wavelength LED irradiation might provide additional benefits for periodontitis treatment.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.1-14
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• 1999

Ursodeoxycholic acid(UDCA) is a hydrophilic gall bladder acid and has been used as a effective drug for liver disease related to in1munity. This drug inhibits secretions of IL-2, IL-4, and $IFN-{\gamma}$ from T-cells and production of immunoglobulin from B-cells. Also it has been reported that UDCA inhibits production of IL-1 related to the progression of periodontal disease and activation of collagenases. The purpose of the present study was to elucidate the effects of UDCA on inhibition of periodontal disease progression using clinical, microbiological and histometrical parameters. Twelve pure bred, 16 month-old-beagle dogs were used in the study. After ligature-induced periodontal diseases were formed, experimental drugs were applied twice a day and then the results of clinical, microbiological, and histometrical parameters were measured at baselie(initiation of experiment) , 4weeks and 8weeks. The gel with UDCA(concentration 0.5%, 5% 3 dogs in each) was applied to experimental group, chlorhexidine to positive control group(3dogs) and the gel without UDCA(base) to negative control group. After induction of general anesthesia, the maxillary 2nd, 3rd premolars and 1st molar and the mandibular 2nd, 3rd, 4th premolars and 1st molar were ligated in one side selected randomly and were not ligated in the opposite side. The plaque index(PI), gingival index(GI), pocket depth(PD) and gingival crevicular fluid(GCF) volum were measured clinically. The PI and GI were measured at 3 buccal points of all experimental teeth and the GCF was measured only at the 3rd premolar in the maxilla and the 4th premolar in the mandible. In the microbiological study, the samples extracted from the 3rd premolar of the maxilla and the 4th premolar of the mandible at the center of buccal surface were analyzed aerobics, anaerobics and Streptococcus colony forming units, After clinical and microbiological examination at 8weeks, the dogs were sacrificed by carotid artery perfusion. The samples were fixed and sectioned including interproximal area, and the distance from cementoenamel junction(CEJ) to alveolar crest was measured. The results were that PI, GI and PD increased until 4 weeks and decreased at 8 weeks in three groups but the differences between all the groups were not significant. The 0.5% UDCA in non-ligated group showed remarkable decrease of GCF. The experimental group applied 5% UDCA decreased the number of aerobics and anaerobics. The distance from CEJ to alveolar crest was greater in the negative control group on both ligated and non-ligated sides, but the differences were not significant stastically.

• The Journal of the Korean Society for Microbiology
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• v.21 no.4
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• pp.503-513
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• 1986

Previous studies have developed the technique of topical application of tetracycline(TC) into the periodontal pockets and examined the change of clinical parameters and subgingival microbial morphotypes. The purpose of this study was to longitudinally examine the clinical and microbiological effects of topically applied TC in a double-blind and split-mouth design. Thirteen patients with moderate periodontitis, who were treated with or without TC application and scaling treatment, were examined. TC gel(3%) was used to apply into the selected periodontal pockets twice a week for 2 weeks. During the experiment, clinical parameters and subgingival microbial morphotypes were examined, and for isolation of black-pigmented Bacteroides(BPB) and streptococci, an anaerobic sample culturing was done at week 0, 2, and 7. In clinical observation the TC-scaled group exhibited a significant decrease of Gingival Inflammatory Index, Plaque Index, Sulcus Bleeding Index, pocket depth, and gingival crevicular fluid when compared to the TC-unsealed, placebo-scaled, and placebo-unsealed groups. The result of microbial morphotype observation showed a significant increase of coccal form and a decrease of spirochetes in the TC-scaled, TC-unscaled, and placebo-scaled groups. The culture study of streptococci revealed that TC with scaling treatment resulted in a significant increase of S. sanguis I at week 2, but its proportion had returned to the base line level. The anaerobic culture study showed that BPB was significantly reduced in the TC-scaled and TC-unsealed groups at week 7. Among BPB species, B. intermedius declined significantly with time treatment(week 2 and 7) in the TC-scaled and TC-unsealed groups. These results suggest that the settled pathogenic microflora can be succeeded by nonpathogenic microflora in periodontal pockets after TC treatment.

• Journal of Periodontal and Implant Science
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• v.29 no.2
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• pp.433-447
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• 1999

The objective of this study was to evaluate the effect a chewable tablet containing sodium flouride and lauroyl sodium sulfate on removing plaque and inhibiting gingival inflammation. A randomized parallel study was designed. 100 voluteers participated in the study. There were two test groups each with 30 subject. Test group A was instructed to brush once in the morning, and to use the tablet once in the afternoon and once in the evening. Test group B was instructed to use the tablet three times a day without brushing. There were two control groups each with 20 subjects. Control group A was instructed to brush once in the morning only. Control group B was instructed not to brush all. Two weeks before the test period, the subjects received through tooth cleaning and polishing. At baseline, GI, PI, BOP, and GCF of the Ramfjord teeth were measured in all groups. Bacteria culture was done with the plaque sampled from tooth with the deepest pocket. After 5 days, clinical indices were measured and the bacterial culture was repeated. Control group B was dropped from the study after this period. All the other groups remained and the indices and the culture was repeated after 2 weeks, and 3weeks. Also whether the oral mucosa showed signs of irritation was monitored throughout the test period. Test group A showed less PI, GI, BOP, probing depth, GCF than test group B or control group A. Especially, PI and the BOP was significantly less than that of the group that was instructed to brush once a day. This implies that the added use of this tablet aids in plaque removal in people who brush just once a day. Test group A showed increase of cocci, decrease of motile rods, and decrease of spirochetes after 14-21 days. And this was significantly different from the control group A. At no time of the test period did any of the subjects show signs of irritation of the oral mucosa or adverse reactions. Following conclusions could be obtained from this study. This chewable tablet for enhanced oral hygiene could be used as an adjunct to oral hygiene in people who do not brush adequately. The use of this tablet decreased the number of subgingival bacteria, and this could be effective in plaque removal and for prevention of gingival inflammation.

• Journal of Periodontal and Implant Science
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• v.51 no.5
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• pp.342-351
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• 2021

Purpose: The aim of this study was to compare the inflammatory and lipid profile of patients with and without peri-implantitis. Methods: A cross-sectional biochemical study was carried out in which blood samples were collected from 16 patients with peri-implantitis and from 31 subjects with healthy implants. Clinical peri-implant parameters were obtained from all subjects. Levels of tumor necrosis factor-alpha and interleukin-10 (IL-10) were measured in serum. Lipid fractions, glucose and creatinine levels, and complete blood count were also assessed. Results: After controlling for a history of periodontitis, statistically significant differences between peri-implantitis patients and controls were found for total cholesterol (estimated adjusted mean difference, 76.4 mg/dL; 95% confidence interval [CI], 39.6, 113.2 mg/dL; P<0.001), low-density lipoprotein (LDL) cholesterol (estimated adjusted mean difference, 57.7 mg/dL; 95% CI, 23.8, 91.6 mg/dL; P<0.001), white blood cells (WBC) (estimated adjusted mean difference, 2.8×10³/µL; 95% CI, 1.6, 4.0×10³/µL; P<0.001) and IL-10 (estimated adjusted mean difference, -10.4 pg/mL; 95% CI, -15.8, -5.0 pg/mL; P<0.001). The peri-implant probing pocket depth (PPD) was modestly positively correlated with total cholesterol (r=0.512; P<0.001), LDL cholesterol (r=0.463; P=0.001), and WBC (r=0.519; P<0.001). A moderate negative correlation was observed between IL-10 and PPD (r=0.609; P<0.001). Conclusions: Otherwise healthy individuals with peri-implantitis showed increased low-grade systemic inflammation and dyslipidemia.

• Journal of Korean Academy of Dental Administration
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• v.8 no.1
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• pp.15-23
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• 2020

The aim of this study is to identify future-oriented tasks for Korean dental hygienists based on a literature review. A literature search is performed using 14 keywords related to tasks carried out by dental hygienists, and included articles published from 2000 to 2019 in the databases KISS, RISS, DBpia, NDSL, Papersearch, Pubmed, and Google Scholar. Six reviewers assessed the titles and abstracts of articles, and an article was selected if the study was considered to cover future-oriented tasks for Korean dental hygienists. Based on the results six local studies and two foreign studies were used for literature review and data extraction. In total, 38 tasks were classified as future-oriented tasks of dental hygienists according to the following criteria: 1) tasks that were specifically referred to as future-oriented tasks, and 2) tasks that could be classified as future-oriented tasks although no specific reference was made. Of these, the most frequently mentioned tasks were measuring periodontal pocket depth, dental hygiene assessment, providing dietary advice, infiltration anesthesia, and root planing. These were extracted from five of the eight studies, including both local and foreign studies. Dental hygiene planning, emergency, emergency management, and smoking cessation were the next most common tasks based on four studies. Even though some of these future-oriented tasks for Korean dental hygienists are included in the dentistry curriculum, and are currently performed as clinical practice for dental hygienists. Nonetheless, the reference to the legal scope is unclear. It is necessary to reconsider the scope of tasks of dental hygienists to reflect changes in domestic and foreign dental care delivery, thereby contributing to the oral health promotion of the public, where safety is guaranteed under legal protection.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.125-137
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• 2006

1. 목적 흡연은 치주질환의 주요한 위험 인자 중의 하나이다. 일반적으로 흡연자는 비흡연자보다 비외과적 및 외과적 치주치료에 대한 반응이 덜 효과적인 것으로 알려져 있다. 이 연구에서는 중등도의 만성 치주염이 존재하는 한국인 흡연자와 비흡연자를 대상으로 하여, 비외과적 치주치료인 치석 제거술과 치근 활택술을 시행한 후 6개윌 동안의 임상적 치유 반응을 비교해 보고자 하였다. 2. 방법 20명의 중등도 만성 치주염 환자(흡연자 10명, 비흡연자 10명)를 대상으로 치주낭 깊이(Probing Pocket Depth, PPD), 치은퇴축(GR), 치주탐침시 출혈유무(BOP), #16, 12, 24, 32, 36, 44의 치태지수(Plaque Index, Silness & $L{\"{o}}e$ 1964)를 임상변수로 측정하였다. 치주낭 깊이 (PD)와 치은퇴축(GR)은 전자 탐침(Florida $Probe^{(R)}$ Co. Gainesville, FL)을 이용하여 각 치아당 6군데를 측정하였다. 임상적 부착 수준(CAL)은 치주낭 깊이(PD)와 치은퇴축(GR)의 합으로 계산하였다. 초진시에 전악 임상 검사를 시행하였고, 초진시의 치주낭 깊이에 따라 조사 대상이 되는 치아 부위를 선정하였다. 치주적으로 건강한 부위 $(PD{\leq}3mm)$를 대조군인 1군으로 하고 치주낭 깊이가 4 mm를 초과하고 5 mm 미만인 부위를 2군, 5 mm 이상의 치주낭 깊이를 가지는 부위를 3군으로 설정하였다. 비외과적 치주치료인 치석 제거술, 치근 활택술과 구강위생 교육을 시행하였고 2개월(T1), 4개윌(T2), 6개윌(T3)에 선정된 해당 치아 부위에 대해 임상 재검사를 시행하였다. 3. 결과 BOP와 Plaque Index는 초진, 2, 4, 6개월에 흡연자와 비흡연자 간에 유의할 만한 차이가 없었으나 전반적으로 감소하는 경향이 나타났다. 대조군인 l군에 서는 흡연자와 비흡연자 간에 모든 시기에서 PD, GR, CAL에 유의할 만한 차이가 없었다. 치주낭 깊이가 4 mm를 초과하고 5 mm 미만인 2군에서는 비흡연자에서 6개월에 유의할 만한 치주낭 깊이 감소가 나타났으며, 4개월과 6개윌에 유의할 만한 부착수준의 증가가 관찰되었다(p<0.05). 치주낭 깊이가 5 mm이상인 3군에서는 비흡연자에서 치주낭 깊이 감소가 일관되게 더 많이 나타났으나 통계학적으로 유의할 만한 차이는 6개월째에서만 관찰되었다. 2군과 유사하게 치주낭 갚이 감소는 흡연자보다 비흡연자에서 0.6 mm 더 크게 나타났다. 부착수준의 획득은 2군에서는 4, 6개월째에, 3군에서는 6개월째에 비흡연자에서 유의하게 더 많이 일어났다. 초진시의 치주낭 깊이와 각 시기별 ${\Delta}PD$ 간의 상관관계에서는 치주낭 갚이가 5mm 이상인 3군에서 비흡연자의 경우 6개월째에 가장 강한 상관성이 나타났다($r_s=0.43$, p<0.05). 흡연자에서는 3군에서 어떠한 유의한 상관관계도 나타나지 않았다. 결론적으로 중등도 만성 치주염 환자를 대상으로 한 6개윌의 단기간 연구에서 비외과적 치주치료 후 흡연자에서 비흡연자보다 치주낭 깊이 감소의 개선과 부착수준의 획득이 더 적게 나타나 임상적 치유반응이 좋지 않음을 확인하였다. 이는 흡연이 숙주의 치유반응 부정적인 영향을 주기 때문으로 생각된다.