• Journal of Periodontal and Implant Science
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• v.43 no.3
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• pp.121-129
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• 2013

Purpose: The present study has two aims; firstly, it attempts to verify the presence of oxidative stress by estimating the reactive oxygen species (ROS) levels in periodontal pockets ${\geq}5$ mm as compared to controls. The second aim is to evaluate the effect of lycopene as a locally delivered antioxidant gel on periodontal health and on the gingival crevicular fluid (GCF) levels of 8-hydroxydeoxyguanosine (8-OHdG), a marker of oxidative injury. Methods: Thirty-one subjects participated in this study. In the pretreatment phase, the ROS levels in pockets ${\geq}5$ mm were measured by flow cytometry. Three sites in each subject were randomly assigned into each of the following experimental groups: sham group, only scaling and root planing (SRP) was done; placebo group, local delivery of placebo gel after SRP; and lycopene group, local delivery of lycopene gel after SRP. Clinical parameters included recording site-specific measures of GCF 8-OHdG, plaque, gingivitis, probing depth, and clinical attachment level. Results: The gel, when delivered to the sites with oxidative stress, was effective in increasing clinical attachment and in reducing gingival inflammation, probing depth, and 8-OHdG levels as compared to the placebo and sham sites. Conclusions: From this trial conducted over a period of 6 months, it was found that locally delivered lycopene seems to be effective in reducing the measures of oxidative stress and periodontal disease.

• Journal of Periodontal and Implant Science
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• v.27 no.2
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• pp.411-424
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• 1997

The purpose of this study was to evaluate in vitro the effects during subgingival calculus removal using Nd:YAG laser. The study group was consisted of 30 teeth with advanced periodontal disease extracted before the start of periodontal therapy. The specimens were divided into 8 different groups : 1) untreated control 2) scaling and root planing only 3) laser treated using 150mJ/pulse, 1sec, 5sec, contact mode 4) laser treated using 200mJ/pulse, 5sec, contact mode 5) laser treated using 150mJ/pulse, 1sec, non-contact mode 6) laser treated using 200mJ/pulse, 5sec, non-contact mode 7) laser treated using l5OmJ/pulse, 1sec, contact mode with water irrigation 8) laser treated using 200mJ/pulse, 5sec, contact mode with water irrigation. All specimens were prepared for evaluation by scanning electron microscopy(SEM). Specimens from Group 2 exhibited a smear layer of scale like texture with parallel instrument tracks resulting from curet use. Specimens treated by contact mode, Group 3 and 4 featured surface changes not observed· in controls such as charring, randomly distributed pitting and crater formation, and melting down of the tooth material and calculus. Specimens treated by noncontact mode, Group 5 and 6 featured similar surface changes observed in contact mode. However, the differences between contact and non-contact groups not significant. Specimens treated by contact mode with water irrigation, Group 7 and 8 featured slight surface change compared to other groups. The results suggested that Nd: YAG laser did not completely remove the subgingival calculus but was possible the application as adjunctive method.

• Journal of Periodontal and Implant Science
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• v.27 no.4
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• pp.701-722
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• 1997

It was reported that low dose doxycycline(LDD) regimen could inhibit pathologically elevated collagenase activity in the gingival crevicular fluid of petients with adult periodontitis without producing typical antibiotic side effects. The purpose of this study was to evaluate the effects of LDD regimen(20mg) administered during non-surgical therapy on clinical index and gingival crevicular fluid enzyme activity in diabetics who are at high risk for periodontal disease. Forty-nine subjects having at least two sites with probing pocket depths greater than 4mm were selected. In this double-blind, placebo-controlled study, the patients were administered 20 mg doxycycline capsule or placebo capsule b.i.d. for 2 weeks. Clinical parameters of dental plaque, gingival inflammation, probing pocket depth and probing attachment level were assessed at week 0, 2, 4, and 8. Gingival crevicular fluid samples were collected at the same time to evaluate the activities of collagenase and elastase. Clinical parameters and elastase activity were significantly reduced in all groups compared to the baseline value after treatment. Significantly greater reduction in pocket depth and gain in attachment level was shown in the LDD-administered group compared to placebo group in both adult periodontitis and diabetic patients. Total collagenase activity was also reduced significantly in all groups after treatment, but the greater reduction was seen in the LDD-administered diabetics group compared to relevant placebo group(at 4, 8week). Significantly greater reduction in active collagenase activity was also seen in the LDD-administered group compared to placebo group in diabetic patients(at 2, 4, 8week). These results indicated that use of low dose doxycycline could be aueseful adjunct to instrumentation therapy in the management of diabetic patient with periodontitis as well as adult periodontitis patient.

• Journal of Periodontal and Implant Science
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• v.27 no.4
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• pp.723-737
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• 1997

본 연구의 목적은 조직유도재생술의 초기치유시에 구강양치액으로 사용되어지는 0.1% 클로르헥시딘과 0.2% 클로르헥시딘을 사용했을 경우, 양치액을 사용하지 않았을 경우의 세균감염 정도를 비교하는 것이다. 30명의 성인형 치주염에 이환되어진 사람을 대상으로 하였다. 초기치료(Scaling/Root planing/Oral hygiene instruction)를 시행한 후에 한 사람에 한 군데씩 선정하여 2급이나 3급의 치근이개부를 가지고 임상적으로 혹은 방사선학적으로 치간골내낭을 보이지 않는 치아에 통법에 따라 Gore-TexTM를 위치시켰다. 술후 5일간 항생제 (UnasynTM 375mg tablet p.o.tid)를 투여하고 차폐막을 제거할 때까지(4주 혹은 6주) 10명의 환자에게는 0.1% 클로르헥시딘을, 다른 10명의 환자에게는 0.2% 클로르헥시딘으로 구강양치를 하게 하고, 또 다른 10명의 환자에게는 구강양치액을 사용하지 않도록 하였다. 또 1주일에 한번씩 전문가구강위생술식을 실시하였다. 4주나 6주 후에 차폐막을 제거하고 주사전자현미경, 혐기성 세균배양을 이용하여 세균감염정도를 비교하였다. 1. 주사전자현미경으로 관찰시에 0.1% 클로르헥시딘을 사용했을 경우와 0.2% 클로르헥시딘을 사용했을 경우, 클로르헥시딘을 사용하지 않은 경우에 별 차이를 발견할 수 없었다. 2. 혐기성 세균배양시에 0.2% 클로르헥시딘을 사용했을 경우, 0.1%클로르헥시딘을 사용했을 경우보다 적은 수의 세균 수를 보였으나 통계적으로 유의할 만한 차이는 보이지 않았다. 클로르헥시딘을 사용하지 않은 경우에는 다른 두 경우에 비해 통계적으로 유의할 만한 차이를 보였다.(P<0.05) 3. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia를 인지한 경우에는 세 경우 모두 비슷한 비율로 발견되었다.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.80-88
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• 1996

The aim of the present investigation was to see the effect of combined use of PDGF BB and IGF -1 on the guided tissue regeneration(GTR) using barrier membrane in the treatment of human furcation involvement. Twelve patients with initially diagnosed as having moderate to advanced adult periodontitis with mandibular class II buccal furcation defects have been wer selected. Initial scaling and root planing has been performed and baseline data consisting of probing depths and attachment levels have been recorded prior to surgical procedures. The GTR procedures using either barrier membrane(control : ePTFE) alone or together with the application of PDGF - BB and IGF -l(experimental : ePTFE+PDGF/IGF) have been done under the routine guidelines. During the surgery, the distance from CEJ either to the bottom of the bone defects(CEJ - BD) or to the bone crest(CEJ-BC) were measured. Horizontal distance to the deepest area in the furcal defects were measured from the reference line connection the most prominent bony walls of the two buccal roots. 6 months following the GTR therapy, all the measurements were made repeatedly. The probing attachment gain of the experimental and the control grous were 2.14mm and l.07mm, respectively with no statically significnant difference. Amont of vertical bone fill in the experimental and the control groups were 2.43mm and 2.29mm, rexpectively. Amonut of horizontal bone fill were 2.86mm in the experimental group and 2.17mm in the control group, respectively. However, there were no significant differences in the amount of bone fill(both vertical and horizontal)between the two groups.

• Journal of Periodontal and Implant Science
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• v.28 no.1
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• pp.187-191
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• 1998

Aplastic anemia is a disease characterized by general lack of bone marrow activity; It may affect not only the red blood cells but also the white blood cells and platelets, resulting in pancytopenia. Spontaneous gingival hemorrhage is present in some cases and it is related to the blood platelet deficiency. This case report presents the periodontal treatment of a patient with aplastic anemia. A 43-year-old female was referred for continuous gingival bleeding after periodontal treatment. Periodontal findings revealed generalized gingival imflammation, oozing of blood from gingival crevice, and it was diagnosed as adult periodontitis. Root planing and extraction of the upper left third molar with poor prognosis were put into operation after elevation of the platelet count with platelet transfusion. The extraction socket was sutured with 3-0 silk. Bleeding continued even after digital compression at the upper right second premolar, second molar, and left canine areas, which presented severe inflammation. Although platelets were transfused repeatedly, platelet count did not stay elevated since survival rate of the transfused platelets were low due to alloimmunization. Thrombin gauze packing was not effective. Bleeding ceased 3 days after treatment with transfusion of donor platelets. 20 days after the treatment, the gingiva was generally healthy except upper right second premolar and lateral incisor areas. The result of periodontal treatment was good, but bleeding control after treatment was troublesome. In the periodontal treatment of patient with aplastic anemia, elevation of the platelet count with platelet transfusion seems to be the best method for hemorrhage control.

• Journal of Periodontal and Implant Science
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• v.44 no.6
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• pp.280-287
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• 2014

Purpose: The purpose of this randomized single-blind controlled trial was to elucidate the clinical and antimicrobial effects of daily phototherapy (PT) as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis. Methods: The study was conducted from December 2013 to May 2014 at Ewha Womans University Mokdong Hospital, Seoul, Korea. Forty-one patients with mild to moderate chronic periodontitis were randomly divided into two therapeutic groups in a 1:1 ratio: SRP+PT and SRP (control) groups. All participants underwent full-mouth SRP. PT was performed thrice a day for a month by using electric toothbrushes with embedded light-emitting diodes. Plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing were assessed before (baseline) and four weeks after (follow-up) the treatment. Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum, Parvimonas micra, Campylobacter rectus, Eikenella corrodens, Streptococcus mutans, and Streptococcus sobrinus levels were detected by a real-time polymerase chain reaction at the same points in time. Results: The clinical parameters improved in both the groups. At the follow-up assessment, PPD was significantly decreased in the SRP+PT group (P=0.00). Further, PPD and CAL showed significantly greater changes in the SRP+PT group than in the SRP group (PPD, P=0.03; CAL, P=0.04). P. gingivalis and T. forsythia levels decreased in this group, but no significant intergroup differences were noted. Conclusions: Adjunctive PT seems to have clinical benefits, but evidence of its antimicrobial effects is not sufficient. Long-term studies are necessary to develop the most effective PT protocol and compare the effectiveness of PT with and without exogenous photosensitizers.

• Journal of Periodontal and Implant Science
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• v.41 no.3
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• pp.117-122
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• 2011

Purpose: The purpose of the present randomized controlled clinical study was to evaluate the short-term outcomes of micro-current electrical neuromuscular stimulation (MENS) as an adjunct method to nonsurgical periodontal therapy. Methods: Twenty patients with moderate to severe chronic periodontitis were recruited into the study and randomly treated with either nonsurgical periodontal therapy followed by 5 MENS treatments with a micro current device or by nonsurgical periodontal therapy alone. Periodontal parameters were measured at baseline and 6 weeks following therapy, and included the plaque index, bleeding on probing, probing depth, and clinical attachment level (CAL). Results: All measured values were reduced at the time of re-evaluation. The amount of inflammation was significantly reduced in both the test (P=0.002) and control group (P=0.015). The test group demonstrated a significant CAL gain at 6 weeks following therapy, including non-molar (P=0.009) and molar teeth (P=0.028). In comparison with the control group, the test group showed statistically significant differences in the CAL on both molar (P=0.027) and non-molar teeth (P=0.031). Conclusions: In conclusion, the short-term results of the study indicate that MENS could be a suitable adjunctive method in the treatment of chronic periodontitis.

• Journal of Periodontal and Implant Science
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• v.48 no.1
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• pp.47-59
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• 2018

Purpose: To evaluate the clinical and microbiological effects of the local use of egg yolk immunoglobulin against Porphyromonas gingivalis (anti-P.g. IgY) as an adjunct to scaling and root planing (SRP) in the treatment of moderate to severe chronic periodontitis. Methods: This was a randomized, placebo-controlled, double-blind trial involving 60 systematically healthy patients with moderate to severe chronic periodontitis. Subjects (n=20/group) were randomly assigned to receive SRP combined with subgingival irrigation of anti-P.g. IgY and anti-P.g. IgY mouthwash, subgingival irrigation of 0.2% chlorhexidine and 0.2% chlorhexidine mouthwash, or subgingival irrigation of placebo and placebo mouthwash for 4 weeks. Probing pocket depth, clinical attachment level, bleeding on probing, and the plaque index were evaluated at baseline and at 4 weeks. Subgingival plaque, gingival crevicular fluid, and saliva were simultaneously collected for microbiological analysis. Results: Our results showed that anti-P.g. IgY mouthwash was as effective as chlorhexidine at improving clinical parameters over a 4-week period. All the groups showed a significant reduction in levels of P.g. at 4 weeks. No significant difference was observed in the test group when compared to placebo regarding the reduction in the levels of P.g. Anti-P.g. IgY significantly suppressed the numbers of red complex bacteria (RCB) in subgingival plaque and saliva in comparison with placebo. No adverse effects were reported in any of the subjects. Conclusions: Within the limitations of the study, the present investigation showed that passive immunization with anti-P.g. IgY may prove to be effective in the treatment of chronic periodontitis due to its ability to improve clinical parameters and to reduce RCB. No significant differences were found between the anti-P.g. IgY and placebo groups in the reduction of P.g.

• Journal of Periodontal and Implant Science
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• v.30 no.1
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• pp.203-212
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• 2000

Putrefactive activity within the oral cavity is the principal cause of halitosis. The most common intraoral sites of oral malodor production are tongue, interdental and subgingival areas. The other foci may include faulty restorations, sites of food impaction and abscesses. Periodontal disease frequently involves pathological oral malodor, which is caused mainly by volatile sulfur compounds(VSC), such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. The purpose of this study is to evaluate the association between oral malodor and periodontal status. Volatile sulfur compounds in mouth air were estimated by portable sulfide monitor($Halimeter^{TM}$). The results were as follows : 1. The levels of volatile sulfur compounds were significantly greater in a periodontitis group than in a control group(P<0.01). The amounts of VSC in mouth air from patients with periodontal involvement were four times greater than those of the control group. 2. The significant positive correlation was found between VSC concentrations and the number of pocket depth above 4mm(P<0.01), but correlation between VSC concentrations and plaque score was not statistically significant(P>0.05). 3. In the periodontitis group, VSC concentrations of pre-treatment significantly decreased after scaling and root planing(P<0.01). 4. No statistically significant correlation was found between VSC concentrations and sex / age in the periodontitis group. The above results indicate that periodontal disease may play a role as an important factor of oral malodor and deep periodontal pockets are a source of volatile sulfur compounds.