• Journal of Periodontal and Implant Science
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• v.49 no.2
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• pp.90-104
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• 2019

Purpose: The aim of this study was to evaluate clinical and radiographic changes and the survival rate after periodontal surgery using deproteinized bovine bone mineral (DBBM) with 10% collagen or DBBM with a collagen membrane in endo-periodontal lesions. Methods: A total of 52 cases (41 patients) with at least 5 years of follow-up were included in this study. After scaling and root planing with or without endodontic treatment, periodontal regenerative procedures with DBBM with 10% collagen alone or DBBM with a collagen membrane were performed, yielding the DBBM + 10% collagen and DBBM + collagen membrane groups, respectively. Changes in clinical parameters including the plaque index, bleeding on probing, probing pocket depth, gingival recession, relative clinical attachment level, mobility, and radiographic bone gains were evaluated immediately before periodontal surgical procedures and at a 12-month follow-up. Results: At the 12-month follow-up after regenerative procedures, improvements in clinical parameters and radiographic bone gains were observed in both treatment groups. The DBBM + 10% collagen group showed greater probing pocket depth reduction ($4.52{\pm}1.06mm$) than the DBBM + collagen membrane group ($4.04{\pm}0.82mm$). However, there were no significant differences between the groups. Additionally, the radiographic bone gain in the DBBM + 10% collagen group ($5.15{\pm}1.54mm$) was comparable to that of the DBBM + collagen membrane group ($5.35{\pm}1.84mm$). The 5-year survival rate of the teeth with endo-periodontal lesions after periodontal regenerative procedures was 92.31%. Conclusions: This study showed that regenerative procedures using DBBM with 10% collagen alone improved the clinical attachment level and radiographic bone level in endo-periodontal lesions. Successful maintenance of the results after regenerative procedures in endo-periodontal lesions can be obtained by repeated oral hygiene education within strict supportive periodontal treatment.

• Journal of Periodontal and Implant Science
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• v.54 no.2
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• pp.85-95
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• 2024

Purpose: Developmental endothelial locus-1 (DEL-1) plays a role in regulating neutrophil migration within the periodontium. The objective of this study was to evaluate the levels of DEL-1 in saliva and gingival crevicular fluid (GCF), as well as the number of neutrophils in patients with periodontitis. Methods: Forty systemically healthy, non-smoking periodontitis patients participated in this study. Clinical periodontal parameters, including the plaque index, probing pocket depth (PPD), clinical attachment level, bleeding on probing, modified sulcular bleeding index, and marginal bone level, were measured. Levels of DEL-1, interleukin (IL)-1β, IL-6, and IL-8 in unstimulated saliva samples, as well as DEL-1 in the GCF of 3 teeth from each participant, were assessed. Neutrophil counts in oral rinse and GCF samples were recorded. Spearman correlation coefficients were used to examine the correlation between protein levels, clinical parameters, and neutrophil quantities. Participants were divided into 2 age groups (those under 50 years and those 50 years or older) in order to investigate potential age-related differences. Results: DEL-1 levels in the GCF showed a negative relationship with PPD (sum). Neutrophils in oral rinse samples were positively correlated with PPD, IL-8, and IL-1β levels. Neutrophils in GCF exhibited a positive correlation with PPD (sum). Salivary DEL-1 levels showed correlations with IL-8 and IL-1β, but not with the clinical parameters of periodontitis. Conclusions: The negative relationship observed between PPD and GCF DEL-1 levels is consistent with the proposed protective role of DEL-1.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.737-744
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• 2008

Purpose: In advanced case of periodontitis, surgical treatment without bone contouring may result in residual pockets inaccessible to proper cleaning during post-treatment maintenance. This problem can be avoided or reduced by applying guided tissue regeneration. Materials and Methods: All of 3 patients had deep periodontal pocket depth and bleeding on probing, and radiograph revealed osseous defect, so we planned guided tissue regeneration using resorbable membrane with or without xenograft. Result: 6 months later, periodontal pocket depth and bleeding on probing was improved and gingiva was stable. Conclusion: Guided tissue regeneration using resorbable membrane with or without xenograft in osseous defect is predictable.

• Journal of Periodontal and Implant Science
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• v.43 no.3
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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.

• Journal of Periodontal and Implant Science
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• v.41 no.3
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• pp.143-148
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• 2011

Purpose: Few epidemiologic studies have investigated aggressive periodontitis in Koreans, but such studies of disease prevalence and other clinical characteristics would be invaluable in providing proper treatment. The aim of this study was to assess the prevalence of aggressive periodontitis and to measure the extent of associated periodontal breakdown. Methods: The study population consisted of 1,692 patients who visited the Department of Periodontology, Wonkwang Daejeon Dental Hospital from January to December, 2010. Clinical parameters (probing depth, gingival recession, periodontal attachment loss) were measured by a single examiner, and radiographic examination was performed at the baseline. Results: Twenty-eight (1.65%) patients showed clinical features of aggressive periodontitis, of which 27 patients exhibited the generalized form, and 1 exhibited the localized form. There was no significant difference between the percentage of male and female patients. The probing pocket depth of the maxillary first molar was deeper than that of the other teeth and gingival recession was also the most serious at the maxillary first molar. The periodontal attachment loss was the highest at the maxillary first molar. The average number of missing teeth was 1.29 per subject. Loss of the second molar was prominent. Conclusions: Within the limitations of this study, the periodontal breakdown evaluated by attachment loss was found to be most severe at the first molars of aggressive periodontitis patients. However, further large scale multicenter studies are necessary to access more precise data, including prevalence.

• Journal of Periodontal and Implant Science
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• v.42 no.6
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• pp.237-242
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• 2012

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.

• Journal of Korean Clinical Health Science
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• v.8 no.2
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• pp.1436-1443
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• 2020

Purpose: The purpose of this study was to differences in the expression rate of Porphyromonas gingivalis according to smoking status, smoking amount and period of smoking. Methods: At the time of investigation, 30 smokers and non-smokers were recruited among patients with periodontitis with a probing pocket depth(PPD) of 4 mm or more. General information was collected using a self-questionnaire, and the average value was used by a dentist to measure the probing pocket depth of three times each for the first or second molar. Plaque collection and analysis were performed by collecting only subgingival plaque using a conventional method, and the expression rate of P. gingivalis was confirmed using polymerase chain reaction (PCR). For statistical analysis, the SPSS Ver 25.0 program was used. Results: Smoking did not have a significant effect on the expression of P. gingivalis, but it did affect the expression of more type II genotypes (p<0.05). In addition, smokers had more slight periodontal pocket, and the amount and duration of smoking did not affect the expression of P. gingivalis. Conclusions: In the future, it is necessary to reinforce the group of smokers and non-smokers with healthy oral conditions, and to investigate the quantitative difference in the expression rate and genotype of P. gingivalis over time of harmful substances in smoking.

• International Journal of Oral Biology
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• v.40 no.2
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• pp.93-101
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• 2015

The efficacy of air-polishing on subgingival debridement, as compared to scaling and root planning (SRP), was evaluated clinically and microbiologically. Fifteen patients diagnosed as chronic periodontitis, and having single-root tooth over 5 mm of pocket depth symmetrically in the left and right quadrant, were investigated. Subgingival debridement was performed by SRP and air-polishing. The results were evaluated and compared clinically and microbiologically. Probing pocket depth (PPD), bleeding on probing (BOP), relative attachment level (RAL) and change of gingival crevicular fluid (GCF) were assessed before treatment, and at 14 and 60 days after treatment. Microbial analysis was done pre-treatment, post-treatment, and at 14 and 60 days after treatment. Results of air polishing showed that post treatment, the PPD and BOP decreased, and attachment gain was observed. There was no clinical difference when compared to SRP. The volume of GCF decreased at 14 days, and increased again at 60 days. Compared to SRP, there was a statistical significance of the volume of GCF at 60 days in air-polishing. In the microbial analysis, high-risk bacteria that cause periodontal disease were remarkably reduced. They decreased immediately after treatment, but increased again with the passage of time. Thus, our results show that subgingival debridement by air-polishing was effective for decrease of pocket depth, attachment gain, decrease of GCF and inhibition of pathogens. Further studies are required to compare air-polishing and SRP, considering factors such as degree of pocket depth and calculus existence.

• The Journal of the Korean dental association
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• v.57 no.12
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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.

• The Journal of the Korean dental association
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• v.55 no.6
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• pp.388-399
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• 2017

Generalized aggressive periodontitis cause intrabony pocket, loss of teeth, and severe alveolar bone defect. As a result, pathologic tooth migration occurs and esthetic problem happens according to this, especially on the anterior teeth of maxilla. The purpose of this study was to assess the multidisciplinary treatment including periodontics, orthodontics and prosthetics of a patient caused by generalized aggressive periodontitis. This study presents a case using full mouth periodontal treatment, immediate orthodontic treatment for 5 months, implantation with guided bone regeneration and free gingival graft, and prosthetic treatment. Treatments took totally 14 months. Periodontal indicators such as probing pocket depth, bleeding on probing, tooth mobility improved. Also, the patient was satisfied with the esthetic and functional improvement.