• Journal of Periodontal and Implant Science
• /
• v.32 no.1
• /
• pp.13-23
• /
• 2002

The ultimate goal of periodontal therapy is directed to arresting the progression of the disease, and regenerating the fibrous attachment. In order to achieve such treatment aim, the plaque and calculus must be eliminated and the physiological conditions of the root surface must be changed to facilitate the attachment and migration of the new fibroblasts, The method of changing the proper root surface conditions to promote the healing of periodontal tissue involves mechanical procedures, such as scaling and root planing, and chemical procedures such as tetracycline-HCl. However, the formation of a long junctional epithelium was most frequently observed type of healing. Thus, the aim of this study was to examine in vitro the influence of surface conditioning of dentin by TC-HCl on human gingival epithelial cell attachment. Human gingival epithelial cells were obtained from healthy retromolar pad area(under the age 23 years). Seventy two teeth extracted from severe periodontitis were used as study material. To evaluate the epithelial cell attachment to dentin, the prepared specimen was divided to four groups. For the control group, only scaling and root planing were carried out, and for the test group, 1 to 3, the concentration of the TC-HCl was 50, 125 and 250mg/ml respectively. After cell cultivation time of 1-, 3-. 24 hour, for the indirect quantitative assessment of gingival epithelial cell attached to dentin sample, the absorbance of epithelial cell unattached to dentin was measured. The results were as follows; 1. There was no statistically significant difference between scaling and root planing group and TC-HCl 50mg/ml 125mg/ml and 250mg/ml group about absorbance of unattached epithelial cell to dentin sample(p>0.5). 2. As time passes, the absorbance of unattached gingival epithelial cell to dentin sample was decreased statistically significant(p<0.05). 3. There was no statistically significant difference among the TC-HCl group(p>0.05) We concluded that there was similar effect on gingival epithelial cell attachment between TC-HCl conditioning on root surface and only scaling and root planing treatment

• Journal of Periodontal and Implant Science
• /
• v.28 no.2
• /
• pp.351-372
• /
• 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
• /
• v.27 no.3
• /
• pp.495-514
• /
• 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.

• Journal of Periodontal and Implant Science
• /
• v.24 no.1
• /
• pp.64-86
• /
• 1994

The authors have transplanted periodontally involved roots which had been root planed into healthy and periodontally involved extraction sockets, and studied the root resorption patterns as well as its effect on new bone formation and wound healing. Alveolar bone around mandibular premolars of 6 adult dogs has been surgically removed, followed by ligation of orthodontic elastic wires for 8 weeks inducing chronic periodontal disease. After removing the crown portions, roots were extracted, and notches were made on the root surfaces discriminating healthy and periodontally involved areas using burs. Controls and experimental groups were divided as follows. Control I : Transplantation of periodontally involved root into healthy extraction sockets. Control II : Transplantation of periodontally involved root into diseased extraction sockets. Experimental group I : Transplantation of root planed roots into healthy extraction sockets. Experimental group II : Transplantation of root planed roots into diseased extraction sockets. Extraction sockets were sutured after transplantations, completely submerging the roots. Healing progress was histologically observed at 2nd, 8th, 12th, and 20th weeks, and the results were as follows ; 1. No inflammation or infection within the extraction sockets had been observed in all groups throughout the experimental period. 2. Reversal lines were observed at week 2 in all groups, clearly discriminating socket walls and new bone, and numerous blood vessels were observed in the new bone trabeculae. 3. Experimental groups showed markedly less root resorption compared to the controls at week 2, but as time progressed, severe resorptions were present in all groups. 4. Localized areas of new bone ankylosis were observed, and the rest of the areas showed collagen fiber insertion with new bone formation at its periphery. 5. No clear differences were found in healing and alveolar bone regeneration between healthy and diseased extraction sockets. 6. The amount of root resorption and ankylosis had increased up to week 8 and 12, showing ankylosis of new bone and the roots. However, no further increase in ankylosis was observed at week 20. 7. Most of the cementum on healthy roots was directly ankylosed to new bone at week, 2, and were gradually resorbed and replaced by new bone thereafter. These results appear to indicate that root planing may inhibit early root resorption of transplanted roots, but gradual replacement by alveolar bone and collagen fibers eventually occur. Condition of the roots or presence of disease in extraction sockets do not appear to make marked differences in alveolar bone regeneration process.

• Journal of Periodontal and Implant Science
• /
• v.44 no.1
• /
• pp.33-38
• /
• 2014

Purpose: Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts. Methods: Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the alveolar process with the indication of reconstruction procedures to allow rehabilitation with dental implants; and the absence of systemic disease, local infection, or inflammation. The patients were randomly divided into two groups based on whether they received a perforated (inner surface) or nonperforated graft. After a 6-month healing period, a biopsy was performed and osseointegrated implants were installed in the same procedure. Results: Fibrous connective tissue was evident at the interface in patients who received nonperforated grafts. However, full union between the graft and host bed was visible in those who had received a perforated graft. Conclusions: We found that cortical inner side perforations at donor sites increased the surface area and opened the medullary cavity. Our results indicate an increased rate of graft incorporation in patients who received such perforated grafts.

• Journal of dental hygiene science
• /
• v.15 no.2
• /
• pp.238-245
• /
• 2015

Dentinal hypersensitivity is a type of dental pain that occurs when various stimuli are applied to exposed dentin lesions. If the symptoms of dentinal hypersensitivity continue, the dentin is exposed and the hypersensitivity may become a periodontal disease or root caries due to bacterial infection. Therefore, the clinical goal of the present study is to reduce the pain of the patient suffering from dentinal hypersensitivity by developing antimicrobial hypersensitivity treatments and to improve oral hygiene. We prepared chlorhexidine, tetracycline, cetylpyridinium chloride, gallic acid loaded desensitizer by adding 0.1%, 0.5%, 1.0%, and 2.0% chlorhexidine, tetracycline, cetylpyridinium chloride, gallic acid to desensitizer (Micro Prime; Denville and Hurri Seal; Beutlich), and antibacterial effect, and cytotoxicity. The antibacterial test by using Staphylococcus aureus (SA. ATCC 6538, FDA 209) showed that the antibacterial effect of all experimental groups was significantly higher than that of control group (p<0.05). Cytotoxicity test by using agar diffusion assay indicated that Micro Prime showed mild toxicity, Hurri Seal showed severe toxicity and this cytotoxicity is supposed to be caused by one of desensitizer components showing weak antibacterial effect.

• Restorative Dentistry and Endodontics
• /
• v.32 no.6
• /
• pp.483-490
• /
• 2007

This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice. but combined endodontic-peri-odontic treatment allowed the tooth to be saved.

• Journal of Periodontal and Implant Science
• /
• v.52 no.1
• /
• pp.65-76
• /
• 2022

Purpose: The present study measured changes in arteriolar and venular capillary flow and structure in the gingival tissues during the development of plaque-induced gingival inflammation by combining dynamic optical coherence tomography (OCT), laser perfusion, and capillaroscopic video imaging. Methods: Gingival inflammation was induced in 21 healthy volunteers over a 3-week period. Gingival blood flow and capillary morphology were measured by dynamic OCT, laser perfusion imaging, and capillaroscopy, including a baseline assessment of capillary glycocalyx thickness. Venular capillary flow was estimated by analysis of the perfusion images and mean blood velocity/acceleration in the capillaroscopic images. Readings were recorded at baseline and weekly over the 3 weeks of plaque accumulation and 2 weeks after brushing was resumed. Results: Perfusion imaging demonstrated a significant reduction of gingival blood flow after 1 and 2 weeks of plaque accumulation (P<0.05), but by 3 weeks of plaque accumulation there was a more mixed picture, with reduced flow in some participants and increased flow in others. Participants with reduced flux at 3 weeks also demonstrated venular-type flow as determined by perfusion images and evidence of the development of venular capillaries as assessed by the velocity/acceleration ratio in capillaroscopic images. After brushing resumed, these venular capillaries were broken down and replaced by arteriolar capillaries. Conclusions: After 3 weeks of plaque accumulation, there was wide variation in microvascular reactions between the participants. Reduced capillary flow was associated with the development of venular capillaries in some individuals. This is noteworthy, as an early increase in venous capillaries is a key vascular feature of cardiovascular disease, psoriasis, Sjögren syndrome, and rheumatoid arthritis-diseases with a significant association with the development of severe gingival inflammation, which leads to periodontitis. Future investigations of microvascular changes in gingival inflammation might benefit from accurate capillary flow velocity measurements to assess the development of venular capillaries.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.43 no.4
• /
• pp.354-364
• /
• 2016

To evaluate the oral health status and to assess the resultant dental treatment needs in adolescents, 2,062 adolescents aged 14-17 years attending middle and high schools in Yangsan were surveyed by clinical examination and questionnaires. The obtained results were as follows. In the dental caries examination based on WHO criteria, the treatment needs of 66.7% of the subjects were determined. Assessment of dental erosion by the VEDE system indicated the treatment needs in 27.8% of the subjects, while MIH examination based on EAPD criteria indicated the treatment needs in 14.7%. Assessment of malocclusion using the occlusal index showed good occlusion in 67.8%, no need for treatment in 19.7%, slight need for treatment in 6.8%, definite need for treatment in 4.5%, and worst occlusion in 1.1% of the subjects, showing 12.5% of average treatment need. The prevalence and treatment need for periodontal disease was found to be 71.2% by CPITN assessments. The assessment of temporomandibular disorders by Helkimo's anamnestic index showed no symptoms in 67.1%, mild symptoms in 13.4%, and severe symptoms in 19.5% of the examinees. The overall treatment need of TMD was 20.6%. Periodontal diseases were ranked the highest in treatment need, followed by dental caries, dental erosion, MIH, TMD, and malocclusion in order. The results of this study indicated the overall status of adolescents'oral health and dental treatment needs. These might hopefully provide fundamental data and contribute to establishing promotional projects for adolescent oral health in Korea.

• The Journal of Korean Academy of Prosthodontics
• /
• v.53 no.1
• /
• pp.51-57
• /
• 2015

When an implant-supported maxillary full-arch fixed prosthesis is planned for patients with the horizontal and vertical bone resorption induced by periodontal disease, it is necessary to consider the masticatory function, esthetics and phonetics when placing implants. For this reason, thorough clinical and radiological diagnosis is necessary. Extensive bone and soft tissue grafting may be required as well. Since there is no clear guideline for proper number of implants, segment or splinting of substructure and method of retaining prosthesis, these should be considered during diagnostic process. This clinical report describes a patient who has experienced several tooth extractions and periodontal treatment due to severe periodontitis on maxilla and mandible. With bone and soft tissue graft before dental implant placement, the patient have satisfactory result in esthetic and functional aspect with the implant-supported maxillary full-arch fixed prosthesis opposing mandibular natural dentition.