• Journal of Periodontal and Implant Science
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• 제32권2호
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• pp.303-314
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• 2002

This study was performed to evaluate the usability of Er:YAG laser for periodontal therapy. Forty dental root slabs ($5{\times}5{\times}2mm^3$) were prepared from human periodontally diseased extracted teeth and grouped into 4 groups: 1) control (root planing only), 2) root planing and irradiated with laser at 30mJ, 3) root planing and irradiated with laser at 60mJ, and 4) root planing and irradiated with laser at 100mJ. The root slabs were embedded in resin block before laser treatment. Er:YAG laser was irradiated under water irrigation with the tip held perpendicular to the root surface in contact mode. After Er:YAG laser irradiation or planing on the root surface, morphological changes have been observed under SEM, and the micro-hardness and Ca/P ratio were compared. 1. In the Control group, the root surface showed the directional change caused by root planing instrumentation, and the presence of smear layer, and no exposure of dentinal tubule was observed. Laser irradiated group showed surface changes with rough dentin surface of niche and depression and dentinal tubule exposure by the elimination of smear layer. 2. The micro-hardness of root surface in the laser irradiated group was higher than the control group. The higher energy output was applied, the higher micro-hardness on root surface was resulted. 3. The higher energy output was applied, the higher Ca/P ratio was observed. The higher Ca/P ratio in 60mJ group and 100mJ group was statistically significantly compared to the control group and the 30mJ group. These results suggest that Er:YAG laser irradiation on the periodontally diseased root surface could remove smear layer and increase the micro-hardness on root surface and Ca/P ratio which contribute to enhance the acid resistance of periodontally treated root surface.

• 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 Dental Anesthesia and Pain Medicine
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• 제18권1호
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• pp.65-69
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• 2018

Local anesthesia is administered to control pain, but it may induce fear and anxiety. Root planing is a non-surgical periodontal therapy; however, when it is performed in an extensive manner, some tissue removal is inevitable. Notably, this removal may be so painful that local anesthesia is required to be administered to the area scheduled for the treatment. Although patients tend to accept root planing easily, they frequently express a fear of local anesthesia. Intraosseous anesthesia (IA) is an intraosseous injection technique, whereby local anesthetic is injected into the cancellous bone supporting the teeth. A computer-controlled IA system (CIAS) exhibits multiple benefits, such as less painful anesthesia, reduced soft tissue numbness, and the provision of palatal or lingual, as well as buccal, anesthesia via single needle penetration. In this report, we present two cases of root planing that were performed under local anesthesia, using a CIAS.

• Journal of Periodontal and Implant Science
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• 제28권2호
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• pp.351-372
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• 1998

The purpose of this study was to evaluate in vitro effects of the loss of tooth substance and root surface changes following root planing with various periodontal instruments. The 39 extracted human teeth due to severe periodontal disease were included. The total 50 root surfaces of 30 teeth were root planed with following instruments : Group 1, with Gracey curette, Group 2, with ultrasonic scaler, Group 3, with rotating root planing bur, Group 4, with Gracey curette plus rubber cup polishing, and Group 5, with ultrasonic scaler plus rubber cup polishing. Following root planing, the amount of tooth substance loss was evaluated by measuring the weight of the removed tooth substance and then 5 specimens ($5{\times}5{\times}2mm$) were randomly selected from the each group for roughness measurement. Root planed areas of each specimen were subjected to five measurements using the Profilometer and an average surface roughness values(Ra) for each group was obtained. Statistical difference for roughness values of each group was analyzed using oneway ANOVA and student t-test. For scanning electron microscopic(SEM) examination of root surface changes following root planing, 15 root surfaces of remaining 9 teeth were root planed and 3 specimens were randomly selected. The mean loss of tooth substance removed was Group 1, $7.0{\pm}1.09mg$, Group 2, $1.3{\pm}1.00mg$, Group 3, $5.8{\pm}1.72mg$, Group 4, $8.7{\pm}1.34mg$, and Group 5, $4.5{\pm}1.68mg$ following root palning, respectively. These results indicate that curette is effective instrument in the respect of diseased root substance removal. The average surface roughness values are following results : Group 1 and Group 4 were the smoothest surface ($Ra=0.34{\pm}0.06{\mu}m$, $Ra=0.34{\pm}0.04{\mu}m$, respectively) and Group 2 was the roughest surface ($Ra=2.09{\pm}0.06{\mu}m$). Statistical analysis of roughness values demonstrated a highly significant difference (P<0.05) between each experimental groups. However, no statistically significant difference in roughness values were observed between the Group 1 and Group 4. The results in this study suggest that curette and/or polishing procedure should be done after root planing with ultrasonic scaler and caution should be used with dia-mond-coated bur during routine root planing procedure.

• Journal of Periodontal and Implant Science
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• 제27권3호
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• pp.575-584
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• 1997

The quality of periodontal instrument cutting edge is a basic element of effective root planing procedure. Using instruments, the sharp edge is changed into blunt or beveled edge. With the blunt instrument, the periodontal treatment can't be carried into accuracy and effective. The study on the wear of periodontal curet is insufficient, there are few publications about the change of sharpness of cutting egde after using instrument and a certen reports were published on the study of scanning electron microscope(SEM) examination. In this study, to declare the number of strokes for sharpening of instruments, the changes of cutting edge is measured by the clinical methods, tactile sensitivity examination and refraction light-white line test after scaling strokes and root planing strokes. SEM test was added for defined the changes of cutting edges. The 7/8 Gracey curets that have been never used was tested. Maxillary molars which were extracted from the School of Dental Medicine, Dankook University was used. Subjected teeth had attachment loss more than 6 mm in bucca-lingual surface and sufficient calculus of a band type in cervical area. The strokes of curet were executed 3, 5, 7, 9, 11, 13 times on scaling stroke and 10, 15, 20, 25, 30, 35 times on root planing stroke. A resident has periodontal experience over 3 years carried out the clinical examinations those tactile sensitivity examination and refraction light-white line test 5 times. The case there being tactile sensitivity certenly is 2, the case being felt tactile sensitivity is 1, and the case there not being tactile sensitivity is 0. The visual examination was recorded as following. The case that refracted white line is not recognised is 2, the case that uncerten is 1, and the case that acknowledged is 0. The results were obtained as follows. 1. After scaling strokes, the tactile sensitivity was reduced after 11 strokes and disappeared in 13 strokes. 2. In tactile sensitivity after root planing procedures, sensitivity was reduced after 25 strokes and disappeared in 35 strokes. 3. In case of visual examination, the detection of refracted white line was increased after 9 strokes of scaling procedures and the accuracy of wear wasn't showed after root planing procedures. 4. In SEM, metal projection was observed on new periodontal curet cutting edge and it was disappeared after scaling procedures. 5. In SEM, the cutting edge was showed changing linear into an aspect of the surface after 5 strokes of scaling procedures and 10 strokes of root planing procedures and showed beveled edge in 11 strokes of scaling procedures, 25 strokes of root planing procedures. The results of 3-type examination indicated that the sharpening of curet should be performed after 11 strokes of scaling procedures and 25 strokes of root planing procedures.

• Journal of Periodontal and Implant Science
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• 제28권2호
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• pp.371-376
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• 1998

This study presents an evaluation of the effectiveness of nonsurgical subgingival scaling and root planing related to initial pocket depth, type of teeth, and individual root surfaces. A total of 110 teeth designated for periodontal surgery in 67 patients with marginal periodontitis were selected and received thorough scaling and root planing with standard rigid Gracey curettes. After a healing period of 4 to 8 weeks, residual calculus was assessed at the time of periodontal surgery following the reflection of mucoperiosteal flap. The results demonstrated a high correlation between the percentage of residual calculus and initial pocket depth. It was further noted that tooth type and involved root surface also influenced the rate of calculus remnant. The results of this study suggest that complete removal of subgingival calculus utilizing conventional instrumentation via closed approach is rare.

• Restorative Dentistry and Endodontics
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• 제17권2호
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• pp.413-420
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• 1992

The purpose of this study was to compare the effectiveness of hand instrumentation with K - file and ultrasonic instrumentation and irrigation system in removing pulpal debris and canal wall planing. 20 mandibular molar teeth were instrumented to size 30 K - file and 20 teeth were instrumented with ultrasonic Suprasson. And Normal Saline and 2.5% NaOCl were used as irrigation solution. All specimens were viewed at the coronal, middle, and apical third of the root canals for the evaluation of the cleaning effect under the multiview microscope. The result were as follows : 1. All of the technique and irrigation solution was effecient in the debris removal and canal wall planing at the cervical and middle thirds of the root canal. 2. All of the techniques and irrigation solutions was less efficient in the debris removal and canal planing at the apical third of the root canal. 3. The debris removal and canal wall planing was depended more on the anatomical variations of the root canal than on the techniques and irrigation solutions.

• Journal of Periodontal and Implant Science
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• 제25권1호
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• pp.24-34
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• 1995

The purpose of this study was to compare effects of demineralization of citric acid and tetracycline HCI on periodontally involved root surface. Twelve periodontally involved single rooted teeth were used. After scaling and root planing, root conditioning with citric acid and tetracycline HCI were carried and the teeth were processed scanning electron microscopic observation.The results were as follows: The scaled root surface was covered by much debris and calculus. The effect of demineralization of citric acid and tetracycline HCI was more reduced on scaling group than root planing group, because of hypermineralization of cementum surface and demineralization effect on root surface of tetracycline HCI showed tendency to reduction. The root planed group displayed more smooth root surface than scaling group, the surface was covered by smear layer, thus no exposure of dentinal tubule opening and collagen fiber, especially after root planing, citric acid and tetracycline HCl treated group showed exposure of dentinal tubule and collagen fiber, thus it was thought that new connective tissue attachment could be acquired.

• Journal of Periodontal and Implant Science
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• 제35권3호
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• pp.719-730
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• 2005

The purpose of this study was to compare the effect of tetracycline HCL, Citric acid and PrefGel applied on the root surfaces that planed with periodontal curret with Roto bur. In this study, 20 extracted teeth with advanced periodontal disease were used. The teeth were root planing with periodontal curette and Roto bur. Following root planing, each agents was burnished on the prepared root surface for 3 minutes to find opened dentinal tubules. And then, each specimens were investigated using scanning electron microscope. Amount of remained cementum by loss of tooth substance index and the number of opened dentinal tubules were evaluated to each specimens The results were as follows. 1. Groups treated with periodontal curette were almost seemed no removed. Other groups treated with Roto bur showed partially opened dentinal tubule orifices. 2. Loss of tooth substance index were compared between groups. There was no statistically difference between periodontal curette groups. Between Roto bur groups was alike. But there were statistically differences between periodontal curette and Roto bur groups. 3. At comparing with various root conditioning agents, Tetracycline HCL group took statistically higher than Citric acid and PrefGel in opened dentinal tubules. On the other hand, there was no statistically difference between Citric acid group and PrefGel group. As a result of this study, groups treated with Roto bur showed more cementum removed than groups treated with periodontal curette. In a treatment for regeneration of periodontal tissue, it was regarded that Roto bur should be used and that Tetracycline HCL would be more effective as chemical root conditioning agent.

• Journal of Periodontal and Implant Science
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• 제24권3호
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• pp.483-492
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• 1994

The purpose of this study was to assess the recolonization of the subgingival microflora following scaling and root planing on single and multiroot teeth with periodontal pockets which were above 5mm. 7 patients with deep pockets were selected for this study. They had not taken antibiotics for 6 months and no history of dental treatment for 6 months before the study. After initial clinical(plaque index, gingival index, probing pocket depth), microbiological and BANA test were determined, each subject received a single session of scaling and root planing, but they were not received oral hygiene instructions. Clinical indices, microbial parameters and BANA test were reassessed 1, 2, and 4 weeks after treatment. The results were as follows : 1. Plaue index, gingival index and pocket depth were not significantly when compared single root group with multiroot group, both groups were siginficantly reduced at 2weeks in plaque index and 2, 4 weeks in gingival index(P<0.05), probing pocket depth was siginificantly changed at 2, 4weeks in multiroot teeth group and 4 weeks in single root teeth group(P<0.05). 2. Percentage of cocci was significantly increased at 4weeks in single root teeth group(P<0.05), motile rod was significantly changed at 4weeks in both group(P<0.05), spirochetes and nonmotile rods were not significantly changed. 3. BANA test was significantly reduced at 1 and 2 weeks (P<0.05) in single root teeth group, multiroot teeth group was not significantly all weeks. This results were suggested that clinical and microbiological effect following scaling and root planing on periodontal disease.