• Journal of Periodontal and Implant Science
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• v.25 no.3
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• pp.668-678
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• 1995

In order to evaluate the therapeutic effect of argon laser irradiation on hypersensitive root, 60 mandibular premolars that had been extracted due to periodontal disease were treated by thorough scaling, root planing and root conditioning with tetracycline HCI(100mg/ml, 5 min.) for induction of hypersensitive root. Within middle one third of root mesial surface(30) or distal surface(30) was randomly irradiated by 0.5W-, 0.75W- and 1.0W-power for 2 minutes argon laser(HGM Inc., USA) with or without topical application of 1.23% acidulated phosphate fluoride gel(Pascal, USA). After all teeth were maintained in 2% methylene blue solution for 48 hours and cross-sectioned through irradiated surface of dried roots, methylene blue stained area was compared between irradiated side and nonirradiated side. Following results were obtained : 1. Methylene blue stained area was significantly less in the laser irradiated group than control group(p<0.05). 2. There was no significant difference in methylene blue stained area between 0.5W-power and 0.75W-power group(p>0.1) and between 0.75W-power and 1.0W-power group(p>0.1), but there was significant difference between 0.5W-power and 1.0W-power group(p<0.05). 3. There was no significant difference in methylene blue stained area between two groups with and without topical application of 0.12% acidulated phosphate fluoride gel(p>0.1). The results suggest that argon laser irradiation on hypersensitive root may reduce the hypersensitivity by obstruction of dentinal tubules.

• Journal of Periodontal and Implant Science
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• v.24 no.1
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• pp.87-97
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• 1994

The ultimate goal of periodontal therapy is to fully reconstruct the periodontal attachment apparatus. Commonly used techniques for treatment of infrabony defects include a combination of root planing, curettage and root treatment. To prevent the apical migration of epithelial cells, the technique of guided tissue regeneration is used. The aim of this study is to compare the effects of root treatment with Citric acid & Tetracycline and Guided tissue regeneration in dogs. Experimental periodontitis was induced by the ligation of orthodontic elastic threads in the upper right and left premolars 3, 4 of five adult dogs for 6 weeks. 4 types of procedures were performed as follows; 1) Control graup : Mucoperiosteal flap 2) Experinental I : GTR used Gore-tex(R) membrane 3) Experinental II : Root treatment with citric acid (PHl) 4) Experinental III : Root treatment with tetracycline HCl (50mg/ml) There after, dogs were serially sacrificed at the 1, 2, 4, 5, 8 weeks, and the specimens were prepared, and stained with hematoxylin-eosin for the light microscopic evaluation. The results of this study were as follows; 1. Junctional epithelium reached to the notch through the furcation area in control group at 8 weeks. 2. In the aspects of the inflammatory cell infiltration, control group showed severe aggregation than experimental group I, II, III through the experimental period 3. New cementum was observed over the notch from 5 weeks in experimental group II 4. In the aspects of the amount of new bone formation, experimental group was better than control group, but there was not significant differences among the experimental group, I, II, III

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.315-324
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• 2002

The purpose of this in vitro study was to evaluate the efficiency of Er:YAG laser on calculus removal and the morphologic changes and hardness of the irradiated surface at different power settings. This experiment used human teeth which were extracted due to periodontal disease and had a band of calculus. Forty root slabs ($5{\times}5mm$) were made and divided into control group and irradiated groups. Experimental groups were as follows; Control group (root planing), Group1 (irradiated with laser at 30mJ), Group2 (irradiated with laser at 60mJ), Group3 (irradiated with laser at 100mJ). Twelve root slab embedded in resin block were used in each group. Er:YAG laser was applied under water irrigation with the tip held perpendicular to the root surface in contact mode. The treatment time was measured until the calculus was removed completely under naked eyes. The efficiency of calculus removal was evaluated by the time for removal. Morphological changes of laser irradiated site were observed under SEM and the surface hardness was measured using a VH tester. The results were as follows; 1. The efficiency of laser scaling was increased with increasing the energy level of irradiation(p<0.05). 2. The morphological changes such as carbonization, crater and scale-like defects in the irradiated root surface were frequently observed with increasing the energy level. 3. The surface hardness tended to increase at 60mJ and 100mJ irradiated groups than that of control group. From the results evaluting on the efficiency, morphological change and surface hardness, lower energy level was suggested for the clinical application of the Er:YAG laser in scaling.

• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.191-203
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• 1997

Recently, alteration on chemical treatment on the root and removal of pathologic bacteria, which is the main reason for periodontal disease, by complete removal of infected cementum layer was been emphasied In this study, teeth extracted due to periodontal disease were root planed using periodontal curette and roto bur. Then they were treated with different concentration of Tetracycline HCI at different time. The state of root surface and change in the pre and post treatment was observed. The results were as follows. 1. The group treatment with periodontal curette and saline showed remaining plaque, debris and irregular surface and no dentianl tubule orifice could be seen. 2. The group treatment with periodontal curette and tetracycline HCI showed process compoed with decacified material and there was concanity seemed to be a lacunae of cementocyte. 3. The group treatment with roto bur and saline, there was no remaning plaque and partial dentinal tubule orifice could be seen but smear layer covering them.4. The group treatment with roto bur and tetracycline HCI showed various shape and size dentinal tubule orifice could be seen. From the results, roto bur showed cleaner surfaces than treatment with periodontal curette. But still smear layer existed. Thus for regeneration of periodontal tissue, chemical treatment using tetracycline HCI should follow roto bur treatment. And it is considered that the treatment time is more important than the concentration of tetracycline HCl.

• Journal of Periodontal and Implant Science
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• v.44 no.4
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• pp.158-168
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• 2014

Purpose: The present study was conducted to evaluate the impact of scaling and root planing (SRP) on the C-reactive protein (CRP) levels of gingival crevicular fluid (GCF) and serum in chronic periodontitis patients with type 2 diabetes mellitus (T2DM-CP) or without type 2 diabetes mellitus (NDM-CP). Methods: Forty-eight human participants were divided into two groups: an experimental (T2DM-CP) group (group I, n=24) comprising chronic periodontitis patients with random blood sugar ${\geq}200mg/dL$ and type 2 diabetes mellitus, and control (NDM-CP) group (group II, n=24) of those with chronic periodontitis and random blood sugar <200 without T2DM for the study. All subjects underwent nonsurgical periodontal therapy (NSPT) including complete SRP and subgingival debridement. Periodontal health parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), GCF volume (GCF vol), GCF-CRP, random blood glucose (RBS), glycated hemoglobin, and systemic inflammatory markers, serum CRP, total leukocyte count (TLC), neutrophil count (Neutr) and lymphocyte count (Lymph), were evaluated at baseline, 1 month, and 3 months after SRP. Results: NSPT resulted in statistically significant improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum as well as GCF of both groups I and II. The mean improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum and GCF was greater in group I than group II after NSPT. There was nonsignificant increase in GCF-CRP, TLC, Lymph, and RBS, and a significant increase in Neutr and Serum CRP in group II at 1 month. The Serum CRP level of 20 out of 24 group II patients had also increased at 1 month. Conclusions: The CRP levels in both GCF and serum were higher in T2DM-CP patients than in NDM-CP patients. Although there was a significant improvement in both the groups, greater improvement was observed in both GCF and serum samples of T2DM-CP patients.

• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.249-262
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• 1997

The present study investigates the effects of calcium sulfate graft on the periodontal healing in intrabony periodontal defects of dogs. Following the general anesthesia with 30mg/kg pentobarbital injected intravenously, the first premolar was extracted and full-thickness periodontal flap was elevated from the second premolar to the fourth premolar. The portion of premolars coronal to the alveolar crest was removed and mesial and distal roots were separated. Exposed root canals were sealed with Caviton and covered completely with flaps sutured. Following the healing period of 12 weeks, the surgical sited were uncovered and $4{\times}4mm$ intrabony defects were surgically created. Those defects with calcium sulfate graft following the root planing was designated as the test sites and those with flap surgery-only were designated as control sites. The animals were sacrificed after 8 weeks and the healing was histologically analyzed. The results were as follows. 1. No foreign body reaction or inflammation were observed in either groups. Calcium sulfate was completely resorbed in the test sites. 2. New cementum was observed coronal to the notch in both groups. Connective tissue fibers were oriented parallel to the root surface in the controls. Connective tissues were formed in large amount in the sites. 3. Test sites showed marked amount of new bone formation while the control sites showed minimal bone gain. 4. Root resorption was observed in coronal portions of th control Sites. The results suggest that calcium sulfate is a biocompatible graft material with a potential for new bone and cementum formation.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.564-576
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• 1993

The purpose of this study was to evaluate the effects of Nd:YAG laser treatment on removal of smear layer and exposure of dentinal tubules. The experimental specimens were obtained from root planed surface of 30 human teeth which were extracted due to severe periodontal disease. The specimens were assigned randomly of three groups: root planed group, Tetracycline HCl(100mg/ml, 5min) group, and Nd:YAG laser ($Laser-35^{TM}$, U.S.A. 5 seconds )group. Nd:YAG laser group was divided into 4 subgroups according to 3.0W, 3.5W, 4.0W, 4.5W of power. The surface change of specimens were evaluated by scanning electron microscopy. The number of exposed dentinal tubules and percentage of area occupied by dentinal tubule orifices per unit area between each group was statistically analyzed by paired Student t-test. The results were as follows: 1. By root planing only, dentinal tubule was not exposed, but scale-like smear layer and parallel instrument tracks were resulted. 2. Tetracycline HCl treated surfaces exhibited the small number of partially exposed dentinal tubules with long orifices. The number($3.80{\pm}0.79$) of exposed dentinal tubules on Tetracycline HCl group was significantly less than that in laser groups above 3.5W of power(P<0.001), and the percentage ($0.68{\pm}0.19$) of area occufied by dentinal tubule orifices per unit area($192\;{\mu}m^2$) was significantly lower than that of any laser group(P<0.001). 3. The laser group irradiated with 4.5W of power showed both the most number($10.60{\pm}0.97$) of exposed dentinal tubules among the experimental groups, and the highest percentage($3.75{\pm}0.55\;%$) of area occupied by dentinal tubule orifices. 4. Energy Surge during laser pulsing and overlapping passes of the fiber resulted in melted and resolidified surface textures with lava-like appearance.

• Journal of Periodontal and Implant Science
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• v.48 no.6
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• pp.395-404
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• 2018

Purpose: The purpose of this study was to propose a technique for periodontal biotype modification through thickening of the entire facial aspect using a volume-stable collagen matrix and autogenous subepithelial connective tissue graft (CTG) for the treatment of gingival recession. Methods: Four systemically healthy patients showing Miller class I or class II gingival recession in the mandibular incisor area were included in this study. Full-mouth scaling and root planing procedures were performed at least 4 weeks prior to periodontal plastic surgery. A split-thickness flap with a horizontal intrasulcular incision and 2 vertical incisions was used in cases 1-3, and the modified tunnel technique was used in case 4 for coronal advancement of the mucogingival complex. After the exposed root surfaces were debrided thoroughly, double-layered volume-stable collagen matrix was placed on the apical part of the recession and a subepithelial CTG harvested from the palatal area was placed on the coronal part. The amount of root coverage at 3 months postoperatively was evaluated in cases 1-3, and facio-lingual volumetric changes were analyzed in cases 1 and 2. Results: Healing was uneventful in all 4 cases and complete root coverage was shown in cases 1-3. In case 4, reduction of gingival recession was observed at 3 months after surgery. In cases 1 and 2, a comparison of stereolithographic files from the preoperative and postoperative time points demonstrated that the entire facio-lingual volume had increased. Conclusions: The surgical technique suggested herein, using a volume-stable collagen matrix and autogenous subepithelial CTG, may be an effective method for periodontal biotype modification through thickening of the entire facial aspect for the treatment of gingival recession.

• Journal of Periodontal and Implant Science
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• v.27 no.4
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• pp.819-828
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• 1997

The purpose of this study was to evaluate the abrasion-resistance of root surface after NaF iontophoresis, Nd:YAG laser irradiation and combined treatment 50 anterior teeth with flat interproximal root surface that had been extracted due to periodontal destruction were selected. All teeth were treated by the same procedure as conventional periodontal root treatment, such as scaling and root planing, root conditioning with tetracycline HCI(lOOmg/ml, 5min). The pre-treatment weight of each tooth was measured by a dial scale(SHIMADEU Co, LIBROR EB-220HU, capacity 220.000 g, Japan). All teeth were divided into 5 groups as follows: Nd:YAG laser irradiation(group 1, 1 W, 100 mJ, 10Hz, fiberoptic-root surface distance=5mm, $10\;sec.{\times}6times$, EL.EN.EN060, Italy): NaF iontophoresis(group 2, $150{\mu}A$, 4 min}: Nd:YAG laser irradiation following NaF iontophoresis(group 3): NaF iontophoresis following Nd:YAG laser irradiation(group 4): No treatment(control group). Electric toothbrushing (Oral-B, Brown Co, Germany) was conducted during 1 hour($lO\;min.{\times}6\;times$). Subsequently post-treatment weight was remeasured by the same method as pre-treatment weight measurement. The difference of abrasion rate among all groups was statistically analyzed by ANOVA(SAS program). Following results were obtained: 1. The abrasion rate was significantly lower in Nd:YAG laser irradiation group than NaF iontophoresis group(p < 0.001). 2. The abrasion rate was significantly lower in combined groups of Nd:YAG laser irradiation and NaF iontophoresis than either Nd:YAG laser irradiation group or NaF iontophoresis group(p < 0.001). 3. There was no significant difference in abrasion rate according to application order in the combined groups(p > 0.05). 4. The abrasion rate was significantly lower in all experimental groups than control group(p < 0.001). The results suggest that combined treatment of Nd:YAG laser irradiation and NaF iontophoresis on exposed root surface after periodontal therapy can enhance the abrasion-resistance of root surface and may inhibit the root caries development.

• Journal of Periodontal and Implant Science
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• v.27 no.3
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• pp.495-514
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• 1997

The purpose of this study was to evaluate the in vitro effects of Nd:YAG laser irradiation on removal of a root surface smear layer after root planing in comparison with Tetracycline HCl. The 60 extracted human teeth due to severe periodontal disease were vigorously scaled and root planed with Gracey curet. Thirty specimen($5{\times}5{\times}2mm$) were obtained from root planed surface of 30 human teeth and assigned randomly to one of three groups : root planed group(5 specimen), Tetracycline HCI group(5 specimen, burnished for 5 minutes), and Nd:YAG laser group(25 specimen, German Dental Laser, Fotona Twinlight). Nd:YAG laser group was divided into 4 subgroups according to power of 1W, 1.5W, 2W, 3W at frequency to 10Hz. The specimen were then fixed, and examed by Scanning electron microscopic study. 30 of 60 human teeth used to measurement of the intrapulpal temperature rise during laser irradiation. Laser-irradiated surface exhibited various surface texture from relative flat surface to irregular surface with patent dentinal tubules of various shape and size. In some area, the root surface alteration which are carbonization, pit and crater formation and melting and resolidification were observed. The number of exposed dentinal tubules per unit($100_{\mu}m^2$) on tetracycline HCI group was more than that in the laser group below 1.5W of power(150mJ/pulse) and was significantly less than that in laser group above 2W of power(200mJ/pulse)(P<0.OOl). As power increased the intrapulpal temperature rise also increased. The result suggested that the parameter which effectively remove root surface smear layer than tetracycline HCI may cause thermal damage to pulp and root surface alteration result from laser exposure would indicate need for additional instrumentation. Thus, Nd:YAG laser irradiation in these parameter may not be appropriate for clinical use as adjunct to conventional periodontal therapy.