• Journal of Periodontal and Implant Science
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• v.40 no.4
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• pp.164-171
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• 2010

Purpose: This study compared the total antioxidant status (TAS) and superoxide dismutase (SOD) activity in the saliva of periodontally compromised patients before and after scaling and root planing (SRP) to assess their diagnostic utility. Methods: Severe chronic periodontitis patient (test group) and subjects with no attachment loss, sites showing a 3 mm or more probing depth and a sulcus bleeding index < 10% (control group) were enrolled in this study. Saliva sampling and clinical examination were performed at one week, one month and 3 months after SRP. The TAS and SOD activity in each patient's saliva was measured for the comparative analysis between the groups. Results: In the test group, the TAS decreased directly after SRP. With time, it increased slightly and was relatively unchanged compared to the baseline. In the control group, the TAS also decreased immediately after SRP but increased gradually with time until 3 months. The SOD activity in the test and control subjects decreased immediately after SRP until 1 month. At 3 months, the SOD activity had increased. Both groups had a similar profile of SOD activity. However, the SOD activity of the control group was significantly higher than that of the test group at each point in time (P < 0.05). Conclusions: There was a significant difference in the total salivary antioxidant level between the periodontitis and healthy or gingivitis (control) group during the experiment period. The total antioxidant level in the saliva was higher in the patients with severe chronic periodontitis than the healthy or gingivitis control before SRP. The SOD activity of the periodontitis patients was lower than the control at each time point. These findings conclusively reveal the possible use of saliva as a diagnostic tool for periodontal health.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.79-86
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• 2013

Purpose: The purpose of study was to compare glycemic control using glycated hemoglobin levels ($HbA_{1c}$) in diabetic patients with chronic generalized periodontitis (CGP) undergoing scaling and root planing (SRP) with and without systemic doxycycline. Methods: Fifty subjects with type 2 diabetes mellitus ($T_2DM$) and CGP receiving antidiabetic therapy were selected for study. The selected subjects were randomly assigned to two groups (test group [TG] and control group [CG]) comprising 25 patients each. The TG received SRP followed by systemic doxycycline. The CG received treatment with SRP only. The periodontal parameters were recorded at baseline (day zero), and every 1 month for 4 months and included probing depth, clinical attachment level, plaque index, gingival index, and $HbA_{1c}$ level were recorded at baseline (day zero) and at the end of 4 months. Results: A statistically significant effect was demonstrated for the periodontal parameters for both the TG and CG. $HbA_{1c}$ values did not show a statistically significant difference in the treatment group as compared to the CG. Conclusions: The authors concluded that nonsurgical periodontal therapy improved glycemic control in patients with $T_2DM$ in both groups, but no statistical difference was observed with adjunctive systemic doxycycline therapy. A further study with a larger sample size is required.

• Journal of dental hygiene science
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• v.18 no.3
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• pp.137-146
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• 2018

This systematic review aimed to investigate the effects of periodontal treatment on glycated hemoglobin A (HbA1c) levels in patients with type 2 diabetes who develop periodontal disease. The search of the MEDLINE, Embase, CINAHL, and Cochrane Library databases was completed on April 8, 2018. The study design was based on randomized clinical trials. Scaling and root planing was performed for the test group, whereas no periodontal treatment or simple oral training was performed for the control group. The main outcome variable was the change in HbA1c levels. We used the Review Manager statistical analysis software for the quantitative analysis of selected documents. Meta-analysis was performed using the inverse variance estimation method of the fixed-effect model to estimate the effects of periodontal treatment on HbA1c levels in patients with type 2 diabetes. A total of 1,011 documents were searched using search strategies, and 10 documents were included in the meta-analysis. The meta-analysis of the selected literature showed that periodontal treatment significantly reduced the HbA1c levels in patients with type 2 diabetes who develop periodontal disease (mean difference, -0.34; 95% confidence interval, -0.43 to -0.26; p<0.001). This study aimed to investigate the effects of periodontal treatment on HbA1c levels, which can be used as a basis for the increasing management of diabetic complications. To improve the quality of life and reduce the burden of medical expenses for patients with diabetes, periodontal disease management through nonsurgical periodontal treatment, such as scaling and root planing, is necessary.

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.1109-1116
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• 2005

The purpose of this study was to observe the effects of periodontal therapy, including nonsurgical periodontal therapy with azithromycin, surgical therapy, and maintenace therapy on the drug-induced gingival enlargement, by means of measuring gingival thickness. The test group of 18 patients with drug-induced gingival enlargement received scaling, root planing with azithromycin for 5 days, with or without surgical periodontal treatment. The control group of 18 patients who had not taken any medication, received scaling and root planing, with or without surgical periodontal treatment. Both groups received supportive periodontal therapy every 3 months for 2 years. The mean period of total treatment is 32 months in the test group and 31 months in the control group. The thickness of the buccal gingiva was measured using an ultrasonic device of $SDM^{(R)}$(Krupp Corp., Essen, Germany). The results revealed that the test $group(1.21{\pm}0.51mm)$ showed statistically thicker buccal gingiva than the control $group(1.01{\pm}0.3mm)$. In the test group, the buccal gingiva was thickest on 2nd molars and was thinnest on canines of both dental arches. In the control group, the buccal gingiva was thickest on central incisors in the maxilla and 2nd molars in the mandible, while the thinnest areas were on canines in the maxilla and 1st premolars in the mandible. It would be concluded that the periodontal treatment with azithromycin aids in decreasing the degree of the gingival enlargement but cannot prevent the recurrence completely.

• Journal of Periodontal and Implant Science
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• v.38 no.1
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• pp.23-30
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• 2008

Purpose: The purpose of this study was to investigate the incidence of curet fracture and its contributing factors. Material and Methods: Fifty-eight periodontal curets which were broken during periodontal treatment in Kangnung National University Dental Hospital for 1 year were used as study materials. The blade thickness of new curets and broken ones was measured using a digital micrometer. Types of treatment procedures, clinical experience of operators, point of breakage, and method of removal of broken fragments were recorded for each broken curet. Results: The incidence of curet fracture in root planing (16.4 curets per 1,000 procedures) was higher than those in flap surgery (7.5) or supragingival scaling (2.7). No curet was broken during supportive periodontal treatment. The incidence of fracture did not seem to be related with clinical experience of operators. The most frequent breakage point of the curets were upper 1/3 of blades. Fifty-six of 58 broken fragments were removed by non-surgical methods. Two broken tips which could not removed non-surgically were left in the pockets, and proved to be removed spontaneously 1 week later. Conclusion: Root planing showed higher incidence of curet fracture than any other type of periodontal treatment. Most of the fractured fragments were removed by non-surgical method. Further study is needed to develop methods of removal of the fragments which can not be removed non-surgically.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.2
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• pp.195-202
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• 2013

The relationship between occlusion and periodontal health has been studied extensively. Despite this, there are few reports on the effects of intentional passive eruption (IPE) using an occlusal reduction. The aim of this clinical report was to present the favorable long-term results of IPE using an occlusal reduction combined with scaling and root planing. After periodontal examination, teeth were diagnosed as moderate chronic periodontitis with intrabony defects and mobility. IPE was performed using periodic occlusal reduction combined with initial periodontal therapy. All teeth examined healed uneventfully and the patients did not complain of discomfort. It has been clinically well maintained during 8 years after completion of IPE. Overall, these results suggest that the IPE would be helpful in improving periodontal health.

• Journal of Periodontal and Implant Science
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• v.27 no.3
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• pp.585-595
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• 1997

Removal of subgingival calculus is essential for the success in periodontal treatment. Subgingival instrumentation is used for the removal of all bacterial plaque and calculus. In this study, two types of anterior curet were used on ant. teeth to conduct subgingival scaling and root planing. The remaining amount of calculus was evaluated according to type of instrument, depth of pocket, and tooth surface. 24 teeth extracted from patients being treated at Dan Kook University dept. Perio. were used. 4 surfaces per tooth a total of 96 areas were evaluated. 12 teeth treated with Gracey No. 1-2 was used as the control group and 12 teeth treated with Mini-five curet No. 1-2 was the experimental group. The 4 surfaces of the teeth {buccal, mesial, lingual or palatal, distal) were observed under a stereomicroscope and the images were captured 3 times per surfaced with a CCD. The image were observed on the monitor using a $10{\times]10$ grid produced with the Microsoft power point. The amount of calculus remaining was evaluated 3 times per surface. The results were as follows. 1. There was no significant difference in remaining calculus according to the pre-treatment pocket depth, and tooth position{Mx. or Mn). 2. The Mini-five curet showed better results than the Gracey curet but there was no statistically significant difference. 3. In both Gracey curet group and Mini-five curet group the lingual(or palatal) surface showed significant difference compared to the other surfaces(p<0.05). From the results above, it is thought that when treating ant. teeth consideration of the tooth surface is more important than the choice of instrument.

• Journal of Periodontal and Implant Science
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• v.52 no.2
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• pp.116-126
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• 2022

Purpose: This study evaluated the efficacy of treating periodontitis using subgingival nano-hydroxyapatite powder with an air abrasion device (NHAPA) combined with scaling and root planing (SRP). Methods: A total of 28 patients with stage III periodontitis (grade B) were included in this study, although 1 was lost during follow-up and 3 used antibiotics. The patients were divided into a test group and a control group. All patients first received whole-mouth SRP using hand instruments, and a split-mouth approach was used for the second treatment. In the test group, the teeth were treated with NHAPA for 15 seconds at 70% power per pocket. Subgingival plaque samples were obtained from the 2 deepest pockets at the test and control sites before treatment (baseline) and 3 months after treatment. The full-mouth plaque index (PI), gingival index (GI), papillary bleeding index (PBI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and at 1- and 3-month post-treatment. Real-time polymerase chain reaction was used to determine the colonisation of Treponema denticola (Td), Porphyromonas gingivalis (Pg), and Aggregatibacter actinomycetemcomitans in the subgingival plaque. Results: From baseline to the first month, the test group showed significantly larger changes in BOP and CAL (43.705%±27.495% and 1.160±0.747 mm, respectively) than the control group (36.311%±27.599% and 0.947±0.635 mm, respectively). Periodontal parameters had improved in both groups at 3 months. The reductions of PI, GI, BOP, PD, and CAL in the test group at 3 months were greater and statistically significant. The total bacterial count and Td and Pg species had decreased significantly by the third month in both groups (P<0.05). Conclusions: Applying NHAPA in addition to SRP improves clinical periodontal parameters more than SRP alone. Subgingival NHAPA may encourage clot adhesion to tooth surfaces by increasing surface wettability.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.847-863
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• 1999

The present study was performed to evaluate the effect of EDTA on diseased root surfaces with regard to the removal of the smear layer, exposure of dentinal tubule openings, and demineralization of the peritubular dentin. 20 periodontally involved single rooted teeth were used. After scaling and root planing, root conditioning was carried out with 3%, 17%, and 24% EDTA solution for 20 sec., 3 min., and 5 min. respectively. Then, the specimens were rinsed with tap water for 5 min. and processed for scanning electron microscopic observation. The following results were obtained. 1. In control group which was conditioned with cotton pellets soaked with saline for 3 min., the surface showed an amorphous irregular coating. The tubule orifices seemed to be com-pressed in the direction of the curette strokes. 2. In test group which was conditioned with EDTA solution, the number of opening dentinal tubules and the extent of the dentinal tubule opening increased with time irrespective of the concentration of EDTA solution. 3. In the group which was conditioned with EDTA solution for 20 sec., the smear layer was not completely removed. 4. If the time of root conditioning is above 3 min., collagen-like fibers covering the circum tubular dentin surface were shown even in the group which was conditioned with 3% EDTA solution. In conclusion, EDTA solution was a very effective root conditioning agent like low pH root conditioning agents which had various disadvantages. Therefore, using EDTA solution, more successful periodontal regeneration could be obtained.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.561-578
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• 1999

The goal of periodontal therapy is the periodontal regeneration by the removal of microorganisms and their toxic products from the periodontally diseased root surface. To achieve periodontal regeneration, root conditioning as an adjunct to root planing has been done. There are low pH etchants such as citric acid, tetracycline-HCl, and EDTA solution which is a neutral chelating agent. The purpose of present study was to examine the effect of root conditioning by citric acid, tetracycline HCl, and EDTA. Total 35 root specimens(6${\times}$3${\times}$2mm) were prepared from the periodontally diseased teeth, scaled and root planed. The specimens were treated with normal saline for 1 minute, saturated citric acid(pH 1) for 3 minutes, 50mg/ml tetracycline-HCl(pH 2) for 5 minutes, 15% EDTA(pH 7) for 5 minutes using rubbing technique. The specimens were examined under scanning electron microscopy at 1000, and 3000 magnification. On the microphotographs taken at 1000 magnification, the numbers of opened and patent dentinal tubules per unit area(10,640${\mu}m^2$) were counted. And the diameters of opened dentinal tubules per unit are (10,640${\mu}m^2$) were measured. The differences of number and diameter among all groups were statistically analyzed by Kruskal Wallis Test. The results were as follows; 1. In the specimens applied with normal saline(control group), the root surface was finely cracked, and was covered by irregular smear layer. Neither exposed dentinal tubules nor any patent dentinal tubules could be seen. 2. In the specimens applied with saturated citric acid(experimental 1 group), the globular collagen fibers were exposed around the peritubular space, and many dentinal tubules were revealed. 3. In the specimens applied with tetracycline-HCl(experimental 2 group), the process-like collagen fibers were exposed around the peritubular space, and some dentinal tubules were revealed. 4. In the specimens applied with 15% EDTA(experimental 3 group), the root surface was covered by the collagenous fibrillar network, and many dentinal tubules were revealed. 5. The numbers of opened and patent dentinal tubules were significantly more in exp. 1 group and exp. 3 group than in exp. 2 group(P<0.05). But there was no significant difference between exp. 1 group and exp. 3 group. In control group, the number of opened and patent dentinal tubules could not be counted because any dentinal tubules couldn't be seen. 6 . The diameter of opened dentinal tubules was significantly smaller in exp. 1 group and exp. 3 group than in exp. 2 group(P<0.05). But there was no significant difference between exp. 1 group and exp. 3 group. In control group, the diameter of opened dentinal tubules could not be measured because any dentinal tubules couldn't be seen. The results demonstrate that root conditioning with citric acid, tetracycline- HCl, and EDTA is more effective in periodontal healing than only root planing, and 15% EDTA solution can replace low pH etching agents such as citric acid, tetracycline-HCl for root conditioning.