• Journal of Korean Dental Science
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• v.9 no.2
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• pp.81-89
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• 2016

Necrotizing periodontal diseases, especially acute necrotizing ulcerative gingivitis (ANUG), it should be noted, occur abruptly and progress rapidly, eventually causing severe soft-tissue and alveolar bone loss. This report presents the cases of two ANUG patients and provides a brief treatment protocol for easy and effective clinical management. After proper diagnosis, sequential treatment with cessation of mechanical brushing, along with a prescription of systemic antibiotics and chlorhexidine as a mouth rinse, scaling, root planing, and supportive periodontal therapy, was utilized. In all cases discussed in this report, there was marked improvement in a few days. ANUG, though an uncommon disease, can be efficiently managed with proper diagnosis and immediate treatment.

• Journal of Oral Medicine and Pain
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• v.46 no.2
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• pp.63-68
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• 2021

Mucous membrane pemphigoid (MMP) is a heterogeneous group of chronic, autoimmune subepithelial blistering diseases, predominantly involving oral mucosal membrane. Because of its pathophysiology of autoimmune reaction, MMP-related gingivitis would not respond to conventional periodontal treatments. We present a case of a 65-year-old female with a chief complaint of chronic generalized buccal gingivitis, unimproved after periodontal treatment for four months. Based on the clinical findings, histological examination, and direct immunofluorescence microscopy, it was diagnosed as MMP. The symptoms were relieved with immunomodulatory therapy using corticosteroids and the supportive management of professional plaque control. MMP can cause pathological involvement throughout the oral and other mucosae of the body, thus leading to functional impairment through repeated inflammatory cascades. Therefore, accurate diagnosis is essential to properly manage local and possible systemic complications of MMP.

• Journal of Periodontal and Implant Science
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• v.47 no.4
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• pp.240-250
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• 2017

Purpose: The aim of this study was to analyze the prevalence and risk indicators of peri-implantitis in Korean patients with history of periodontal disease. Methods: A total of 444 patients with 1,485 implants were selected from patients who had been treated at the Department of Periodontology, Chonbuk National University Dental Hospital between July 2014 and June 2015. A group with a history of peri-implantitis (HP) (370 patients with 1,189 implants) and a group with a current peri-implantitis (CP) (318 patients with 1,004 implants) were created based on the radiographic and clinical assessments of implants. The prevalence of peri-implantitis was calculated at both the patient and implant levels. The influence of risk variables on the occurrence of peri-implantitis was analyzed using generalized estimating equations analysis. Results: The prevalence of peri-implantitis in the HP and CP groups ranged from 6.7% to 19.7%. The cumulative peri-implantitis rate in the HP group estimated with the Kaplan-Meier method was higher than that in the CP group over the follow-up period. Among the patient-related risk variables, supportive periodontal therapy (SPT) was the only significant risk indicator for the occurrence of peri-implantitis in both groups. In the analysis of implant-related variables, implants supporting fixed dental prosthesis (FDP) and implants with subjective discomfort was associated with a higher prevalence of peri-implantitis than single implants and implants without subjective discomfort in the HP group. The presence of subjective discomfort was the only significant implant-related variable predictive of peri-implantitis in the CP group. Conclusions: Within the limitations of this study, the prevalence of peri-implantitis in Korean patients with a history of periodontal disease was similar to that reported in other population samples. Regular SPT was important for preventing peri-implantitis. Single implants were found to be less susceptible to peri-implantitis than those supporting FDP. Patients' subjective discomfort was found to be a strong risk indicator for peri-implantitis.

• The Journal of the Korean dental association
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• v.57 no.11
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• pp.644-653
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• 2019

Since 2013, adults aged over 20 can receive national health insurance scaling once a year in South Korea. In this study, we analyzed the usage status of national health insurance care service for periodontal disease in 2010-2018 by using Healthcare big data of the Health Insurance Review and Assessment Service. The increase rate of the dental care users was very high at 7.8 and 11.2% in 2013 and 2014, respectively. These are higher than the increase rate of all medical institution users, which is between -1.7 and 3.7%. In 2017, the rate of dental use was 44.4%, which has increased more than 10% compared to 2012. Percent receiver of national health insurance scaling was 19.5% in 2017. The 20s had the highest rate of 23.2%. The rate decreased with age. Based on these results, it can be evaluated that the expansion of national health insurance coverage for scaling improves accessibility to dental care. A more long-term assessment of the effect of periodic dental examination and scaling on reducing the prevalence of periodontal disease is needed. National health insurance coverage should be extended to oral hygiene education and supportive periodontal therapy in order to prevent periodontal disease.

• Journal of Periodontal and Implant Science
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• v.51 no.3
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• pp.147-162
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• 2021

Purpose: This systematic review and meta-analysis was conducted to assess the effects of glycine powder air-polishing (GPAP) in patients during supportive periodontal therapy (SPT) compared to hand instrumentation and ultrasonic scaling. Methods: The authors searched for randomized clinical trials in 8 electronic databases for relevant studies through November 15, 2019. The eligibility criteria were as follows: population, patients with chronic periodontitis undergoing SPT; intervention and comparison, patients treated by GPAP with a standard/nozzle type jet or mechanical instrumentation; and outcomes, bleeding on probing (BOP), patient discomfort/pain (assessed by a visual analogue scale [VAS]), probing depth (PD), gingival recession (Rec), plaque index (PI), clinical attachment level (CAL), gingival epithelium score, and subgingival bacteria count. After extracting the data and assessing the risk of bias, the authors performed the meta-analysis. Results: In total, 17 studies were included in this study. The difference of means for BOP in patients who received GPAP was lower (difference of means: -8.02%; 95% confidence interval [CI], -12.10% to -3.95%; P<0.00001; I²=10%) than that in patients treated with hand instrumentation. The results of patient discomfort/pain measured by a VAS (difference of means: -1.48, 95% CI, -1.90 to -1.06; P<0.001; I²=83%) indicated that treatment with GPAP might be less painful than ultrasonic scaling. The results of PD, Rec, PI, and CAL showed that GPAP had no advantage over hand instrumentation or ultrasonic scaling. Conclusions: The findings of this study suggest that GPAP may alleviate gingival inflammation more effectively and be less painful than traditional methods, which makes it a promising alternative for dental clinical use. With regards to PD, Rec, PI, and CAL, there was insufficient evidence to support a difference among GPAP, hand instrumentation, and ultrasonic scaling. Higher-quality studies are still needed to assess the effects of GPAP.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.211-221
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• 2006

The aim of present study was to evaluate the influence of periodontal status of adjacent tooth and loading time to the prevalence of red complex of implant sulcus. In 97 patients, partially edentulous subjects with endosseous root-form implants were selected. All subjects were medically healthy and had not taken systemic antibiotics and professional plaque control 3 months before sampling. The number was as follows: clinically healthy implants:161, clinically unhealthy implants:22, clinically healthy adjacent teeth:73, clinically unhealthy adjacent teeth:38. All teeth and implants of each patient were examined probing depth(PD), modified sulcus bleeding index(mSBI), and modified plaque index(mPI), and samples of subgingival plaque were obtained at each site with sterile curet or fine paper points, then the plaque transferred to PBS. Obtained samples were examined for the presence of P. gingivalis, T. forsythensis, and T. denticola by the polymerase chain reaction (PCR). The relationship among clinical parameters and the colonizations by the 3 bacterial species from adjacent teeth and implants region were analyzed by student t-test (p<0.05). The results of this study were as follows: 1. mPI and mSBI of implant increased with increasing of same indices of adjacent tooth(p=0.03,0.001), but not in the PD . 2. The mPI, mBI, PD of implants was higher when red complex exist. 3. The prevalence of red complex was higher when the periodontal condition is unhealthy. 4. The prevalence of red complex of implants has no significant relation to the probing depth of adjacent tooth. 5. Prevalence of P. gingivalis, T. forsythensis of implants increased with loading time. (p=0.02,0.018) These results shows the importance of oral hygiene and supportive periodontal therapy.

• The Journal of the Korean dental association
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• v.53 no.5
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• pp.318-325
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• 2015

Peri-implantitis is defined as an inflammatory process affecting the tissues around an osseointegrated implant, resulting in the loss of the supporting bone. Microbial adherence and colonization appear to play a major role in the pathogenesis of periimplantitis. The decision regarding treatment strategies is based on the diagnosis. The severity of the peri-implant lesion and the treatment strategies must include mechanical cleaning (infection control) procedures. Mechanical instrumentation is widely used for the debridement of dental implants, but this may alter the titanium's surface properties. Therefore, selection of the type of instrumentation should be made depending on the type of surface to be debrided. Also, patients with dental implants must always be enrolled in a supportive therapy program.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.503-513
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• 2006

The purpose of this study was to determine the distribution, prevalence and relationship of the localized periodontitis of root fusion in maxillary and mandibular molars. One hundred patients who had eight maxillary and mandibular molars(third molars excluded) were consecutively selected for the study subjects. The subjects provided a total of 800 molars, i. e., 400 maxillary and 400 mandibular molars. A decision about root fusion was made on the radiographic examination. Probing depth, plaque index, gingival index and mobility were measured. The results were as follows. 1. 15.9% of the molars had a fused root. 22% of the maxillary molars and 9.8% of the mandibular molars had a fused molars. 2. In maxillary molars, the results of probing depth, plaque index, gingival index, mobility are more higher in test group than in control group, and there was a significantly difference except plaque index of maxillary first molars group(p<0.01). 3. In mandibular molars, the results of probing depth, plaque index, gingival index, mobility are more higher in test group than in control group, and there was a significantly difference(p<0.01). As a result of this study, it can be concluded that, in management of molars with a root fusion, we should detect the molars through the precise radiographic examination, early periodontal treatment and systematic treatment plan should be chosen. And postoperative continuing supportive periodontal therapy is needed.

• Journal of Periodontal and Implant Science
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• v.38 no.1
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• pp.15-22
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• 2008

Purpose: The attachment level is strongly associated with tooth loss and provides useful information on patterns of destruction of the periodontium. The presence of horizontal attachment loss would not be detected in clinical measurement. Therefore, the purpose of the present study was to estimate the patterns of periodontal destruction based on the attachment area and horizontal attachment loss in extracted teeth due to severe periodontitis. Materials and Methods: 307 teeth satisfied the criteria for assessment. An indirect method, based on digital images obtained from a digital camera and an image analysis program, was used to calculate the area of root surface and attachment loss and the extent of horizontal attachment loss. The data were analysed using SPSS. Results: No statistically significant differences among root surfaces were observed in anterior teeth on the loss of attachment area. However, in posterior teeth statistically significant differences in palatal surfaces of maxillary and mandibular premolar and molar surfaces compared with buccal surfaces were observed. Horizontal attachment loss was observed in 21.5% of the teeth examined. Frequency of horizontal attachment loss was highest in the maxillary first premolar (34.8%), followed by the maxillary second premolar (27.3%) and maxillary canine (25%). The mean length of horizontal attachment loss was 1.5mm. Conclusion: More meticulous examination will be needed of the palatal surfaces of maxillary and mandibular premolar and molar teeth. The percentage of teeth with horizontal attachment loss greater than 2.1 mm was 5.2%. Considering the length of curette blades, about 5.2% of teeth were not properly debrided. Therefore, Additional supportive therapy such as local drug delivery has to be considered in treatment of the first maxillary, second premolar and canine due to the high prevalence of horizontal attachment loss.

• Journal of Periodontal and Implant Science
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• v.51 no.2
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• pp.135-143
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• 2021

Purpose: To investigate factors affecting the antagonistic and adjacent teeth in patients after implant restoration and prosthetic rehabilitation. Methods: In total, 160 patients who visited Kyungpook National University Dental Hospital for implant surgery, prosthesis placement, and supportive periodontal therapy (SPT) were included in this study. The average follow-up period was 88.06 months, and the maximum was 175 months. Patients' history of smoking, diabetes, hypertension, and osteoporosis was investigated, and panoramic radiographs were taken after surgery and prosthetic treatment. During the follow-up period, extraction and prosthetic/endodontic treatments of the antagonistic and adjacent teeth were analyzed. The statistical analyses were performed using descriptive statistics, the chi-square test, the Fisher exact test, and multiple logistic regression analyses. Results: Treatment was performed on 29.4% of the studied antagonistic teeth with extraction performed in 20.0% and prosthetic treatment in 10.0%. Furthermore, 19.4% of the studied adjacent teeth underwent treatment, of which extraction was performed in 12.5% and prosthetic treatment in 7.5%. The treatment rate for adjacent teeth was 25.3% in smokers, which was higher than that of non-smokers (12.3%) (P=0.039). Patients who were non-adherent to SPT showed a significantly higher rate (19.6%) of antagonistic prosthetic treatment than did those who were adherent (5.5%) (P=0.006). Conclusions: Implant restoration can affect the adjacent and antagonistic teeth. Smoking, osteoporosis history, and absence of SPT may be risk factors for the treatment of the adjacent and antagonistic teeth.