• Journal of Periodontal and Implant Science
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• 제50권4호
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• pp.268-277
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• 2020

Purpose: Many home care treatments can be used to promote the health and longevity of dental implants; however, few studies are available to support the concept that self-performed oral hygiene behaviors are an essential tool for improving and maintaining oral health. We investigated age-stratified associations between dental health behaviors related to tooth brushing (TB) and oral hygiene product use in Korean adults with implants. Methods: A total of 1,911 subjects over 19 years of age who had 1 or more implants and who participated in the 2013 to 2015 Korea National Health and Nutrition Examination Survey were reviewed. Periodontal status was assessed using Community Periodontal Index (CPI) scores, and periodontitis was defined as a CPI greater than or equal to 3. The complex sampling design of the survey was utilized to obtain the variance and individual weight of each analyzed factor. A high CPI was the outcome variable, and the main explanatory variables were oral hygiene behaviors, such as TB, dental floss (DF), interproximal brushing, and mouth rinsing. Results: Almost all individuals with a lower CPI brushed their teeth twice or more per day, in contrast to those with a higher CPI, and were likely to use DF. The adjusted odds ratio of not using DF for a higher CPI was 1.83 (95% confidence interval, 1.35-2.49). Conclusions: TB was implemented more than twice a day by patients with good oral health, and the combination of TB and DF significantly reduced the prevalence of a higher CPI. Self-performed oral hygiene practices combining TB and DF were significantly related to a low prevalence of periodontitis in implant patients.

• Journal of Periodontal and Implant Science
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• 제54권2호
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• pp.85-95
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• 2024

Purpose: Developmental endothelial locus-1 (DEL-1) plays a role in regulating neutrophil migration within the periodontium. The objective of this study was to evaluate the levels of DEL-1 in saliva and gingival crevicular fluid (GCF), as well as the number of neutrophils in patients with periodontitis. Methods: Forty systemically healthy, non-smoking periodontitis patients participated in this study. Clinical periodontal parameters, including the plaque index, probing pocket depth (PPD), clinical attachment level, bleeding on probing, modified sulcular bleeding index, and marginal bone level, were measured. Levels of DEL-1, interleukin (IL)-1β, IL-6, and IL-8 in unstimulated saliva samples, as well as DEL-1 in the GCF of 3 teeth from each participant, were assessed. Neutrophil counts in oral rinse and GCF samples were recorded. Spearman correlation coefficients were used to examine the correlation between protein levels, clinical parameters, and neutrophil quantities. Participants were divided into 2 age groups (those under 50 years and those 50 years or older) in order to investigate potential age-related differences. Results: DEL-1 levels in the GCF showed a negative relationship with PPD (sum). Neutrophils in oral rinse samples were positively correlated with PPD, IL-8, and IL-1β levels. Neutrophils in GCF exhibited a positive correlation with PPD (sum). Salivary DEL-1 levels showed correlations with IL-8 and IL-1β, but not with the clinical parameters of periodontitis. Conclusions: The negative relationship observed between PPD and GCF DEL-1 levels is consistent with the proposed protective role of DEL-1.

• 한국융합학회논문지
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• 제10권11호
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• pp.233-239
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• 2019

본 연구는 국민건강영양조사 제6기(2013년~2015년) 자료를 토대로 건강행태 및 심혈관질환과 치주질환의 영향요인을 분석하고자 하였다. 연구대상은 심혈관질환(고혈압, 협심증, 심근경색증, 뇌졸중), 치주질환이 있는 만 19세 이상을 대상자로 선정하였고, SPSS(SPSS 23.0 for Windows)를 사용하여 14,940명을 분석하였다. 교차분석(chi-quare test) 및 복합표본 로지스틱 회귀분석을 사용하여 인구사회경제학적 특성, 건강행태 및 심혈관질환과 치주질환의 유무를 분석하였다. 결과로는 고혈압, 협심증, 심근경색증, 뇌졸중과 관련성이 있었다. 영향요인은 고혈압이 없을 경우 치주질환 유병률이 0.684배 낮았고, 남자, 연령, 학력, 교육수준, 흡연, 잠자기 전 칫솔질, 치실 치간칫솔 사용이 통계적으로 유의하였다. 결과로는 건강행태 개선과 두 질환의 체계적 관리가 요구되고, 향후 질환 간의 예방교육 프로그램 개발에 도움을 주고자 한다.

• Journal of Periodontal and Implant Science
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• 제31권1호
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• pp.243-258
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• 2001

Gingival recession is exposure of the root surface with apical shift in the position of gingiva. The incidence of gingival recession is 8% in children and 100% after the age of 50. Recession tends to be found in patients with healthy gingiva, but more frequentely found in patients with periodontal disease, and it often causes mucogingival defects. Buccal surface of premolar is the area not only for severe gingival recession and cervical abrasion, but also the area of numbers of buccal frenum and less keratinized gingiva. Threrfore, the goal of this study was to observe the patients with periodontitis and examine whether there are clinical relations between gingival recession and cervical abrasion of premolar and other factors related with the condition of periodontal health. Generally healthy 218 patients who had periodontitis, aged between 18 and 78, were examined for depth of periodontal poket, width of attached gingival, gingival recession, cervical abrasion, and frenum of mid-buccal surface of premolar at the Department of Periodontics in Dankook University Dental Hospital and following is the result. 1. The average gingival recession and cervical abrasion of premolar with periodontal disease was 0.76mm and 0.29mm and each has 43% and 14% of incidence. Also the width of attached gingiva of mid-buccal surface was 1.77mm. the average periodontal pocket depth is 2.0mm and 47% of frequently seen was narrow single shaped frenum, and the interdistance of the frenum was mostly over 4mm. 2. With statistical significance(P<0.05), the incidence of gingival recession increased with age and was related much more with female than male, the first premolar than the second premolar, and with narrow attached gingiva and frenum. 3. With statistical significance(p<0.05), the incidence of cervical abrasion increased with age and was related with the area of the first premolar and narrow attached gingiva, but the sexual and frenum differences were not statistically significant (p>0.05). 4. The severity of gingival recession increased with age and was more related with female than male, the first premolar than the second premolar. And the area of narrow attached gingiva and frenum showed more gingival recession and the distance of frenum was more highly related than shape, and they were statistically significant (p<0.05). 5. With statistical significance(p<0.05), the severity of cervical abrasion increase with age and was observed at the first premolar and narrow attached gingiva. But the sexual and frenum differences were not statistically significant (p>0.05).

• 치위생과학회지
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• 제23권3호
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• pp.225-235
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• 2023

Background: This study aimed to analyze the effects of periodontal treatment and individual- and tooth-related factors on tooth extraction in people with disabilities. Methods: The Korea National Health Insurance claims data of individuals with disabilities aged 40~64 years with chronic periodontitis in 2008 were obtained. Of these, data on the disabled who underwent scaling/root plaining, subgingival curettage/periodontal surgery, or non-periodontal treatments, and data on their teeth were selected. The extraction of 716,688 teeth from 39,097 patients was tracked until 2018, and the patient- and tooth-level factors related to tooth loss were identified using a mixed-effect logistic regression analysis. Results: Data from approximately 17% of the teeth were extracted during a follow-up period of approximately 11 years. Among the tooth-level variables, scaling/root planing treatment at baseline and periodontal treatment during the follow-up period were associated with a lower risk of tooth loss (odds ratio=0.692 and 0.769, respectively, p<0.001). Non-vital teeth increased the risk of tooth loss by 3.159 times (p<0.001). Among the patient-level variables, females were less likely to have lost their teeth than males, and those with orthopedic impairment or brain lesions/mental disabilities, a higher age group, lower income level, or residents in medium/small cities or rural areas were more likely to have lost their teeth (p<0.001). Conclusion: Through approximately 11 years of follow-up, scaling or root planing, experience with periodontal treatment at least once, female sex, older age, lower income, smaller residential areas, type of disability, and pulp vitality were found to be associated with tooth loss in individuals with disabilities aged 40~64 years with chronic periodontitis. To prevent tooth loss in individuals with disabilities, it is necessary to establish a dental treatment plan that considers the timing of periodontal treatment and the characteristics of the patient and teeth.

• International Journal of Clinical Preventive Dentistry
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• 제14권4호
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• pp.256-263
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• 2018

Objective: This study aimed to investigate the factors associated with masticatory performance, as measured with a chewing gum containing spherical resinous microparticles, and to evaluate the method by examining the relationship with self-reported masticatory status. Methods: The participants in this study comprised 903 industrial workers (mean age, $42.2{\pm}11.6years$). A questionnaire was administered to assess self-reported masticatory status. The masticatory performance score was calculated by counting the number of particles in the chewing gum. Clinical oral examinations were administered. Multiple linear regression analysis was conducted on the masticatory performance scores to examine the related factors. Analysis of covariance was conducted to investigate the association between the masticatory performance score and the self-reported masticatory status. Results: Significant predictors of the masticatory performance score were sex (p<0.001), age (p<0.001), decayed teeth (p=0.009), total-functional tooth units (p<0.001), periodontitis (p=0.003), and malocclusion (p=0.011). The relationship between the masticatory performance score and the self-reported masticatory status was attenuated after controlling for confounding factors. Conclusion: The masticatory performance increased with age and decreased as the oral health status worsened. Using this chewing gum method partly, but not comprehensively, reflects masticatory performance. Therefore, various masticatory performance-related indexes should be employed to measure masticatory performance accurately.

• 한국치위생학회지
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• 제20권5호
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• pp.743-752
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• 2020

Objectives: The objectives of this study were to investigate the distribution and level of periodontopathic bacteria with the general characteristics and oral health condition of the elderly. Methods: A total of 335 elderly individuals aged 65 years or older who lived in Ganghwa-gun, Incheon, were included in the study. Oral examination, investigation through a questionnaire, and collection of saliva were carried out. The collected saliva was analyzed for the distribution and levels of bacteria (red and orange complex bacteria) by real-time polymerase chain reaction. Statistical analyses were performed using chi-square test, t-test, one-way analysis of variance, and Pearson's correlation coefficient with SAS statistical software version 9.4. Results: Among the general characteristics, there were significant differences in the distribution of Porphyromonas gingivalis, Treponema denticola, and Parvimonas micra depending on sex, age, and dental visits (p<0.05). The number of remaining teeth and denture use were related to the distribution of periodontopathic bacteria, except T. denticola (p<0.05). Additionally, periodontitis was related to the distribution of P. gingivalis (p<0.05). As the number of remaining teeth increased, the copy number of red and orange complex bacteria also increased (p<0.05). Those individuals who did not use dentures and had periodontal disease had more periodontopathic bacteria (p<0.05). Conclusions: The distribution and copy number of periodontopathic bacteria in the elderly were more related to oral health condition than to general characteristics. In particular, the distribution and copy number of periodontopathic bacteria were higher in subjects with multiple remaining teeth, no dentures, and periodontal disease.

• Journal of Periodontal and Implant Science
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• 제38권4호
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• pp.629-638
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• 2008

Purpose: The purposes of this study were to compare and quantify the expression of Stromelysin-1 and MT-MMP-1 in the gingival tissues of patients with type 2 diabetes mellitus(DM) and healthy adults with chronic periodontitis. Materials and Methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was devided into three groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2 (n=8) is inflammed gingiva from patients with chronic periodontitis. Group 3 (n=8) is inflammed gingiva from patients with chronic periodontitis associated with type 2 DM. Tissue samples were prepared and analyzed by Western blotting. The quantification of Stromelysin-1 and MT-MMP-1 were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. Results: In the analysis of expression levels, Stromelysin-1 and MT-MMP-1 expressions were similar in group 1 and 2. Stromelysin-1 and MT-MMP-1 expressions was more increased in group 3 than group 1, 2. The difference between group 3 and group 1, 2 was statistically significant. Also, in the interrelationship of Stromelysin-1 and MT-MMP-1 expressions, expressions of Stromelysin-1 and MT-MMP-1 showed increasing tendency in chronic periodontitis associated with type 2 DM and it seems that the MT-MMP-1 expressions were increasing in proportion to Stromelysin-1 expressions. Conclusion: It is suggested that Stromelysin-1 and MT-MMP-1 may be partly involved in the progression of periodontal inflammation associated with type 2 DM, as related to a metabolism of other factors, such as AGE, plasmin and other inflammatory mediators. Therefore, the expression levels of Stromelysin-1 and MT-MMP-1 can be inflammatory markers of periodontal inflammed tissue with type 2 DM.

• Journal of Periodontal and Implant Science
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• 제47권2호
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• pp.96-105
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• 2017

Purpose: The National Health Insurance Service-National Sample Cohort and medical checkup data from 2002 to 2013 were used to evaluate the association between periodontal surgery for the treatment of periodontitis (PSTP) and vasculogenic erectile dysfunction (VED). Methods: Bivariate and multivariate logistic regression analyses were applied to a longitudinal retrospective database to assess the association between PSTP and VED while adjusting for the potential confounding effects of sociodemographic factors (age, household income, insurance status, health status, residence area, and smoking status) and comorbidities (diabetes mellitus, angina pectoris, cerebral infarction, and myocardial infarction). Results: Among the 7,148 PSTP within the 268,296 recruited subjects, the overall prevalence of VED in PSTP was 1.43% (n=102). The bivariate analysis showed that VED was significantly related to PSTP (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.38-2.06; P<0.001), and this was confirmed in the multivariate analysis after adjusting for sociodemographic factors and comorbidities (OR, 1.29; 95% CI, 1.06-1.58; P=0.002). Conclusions: Subjects with a history of periodontal flap surgery had a significantly higher risk of VED, after adjusting for potential confounding factors. Further studies are required to identify the key mechanisms underlying the association between severe periodontal disease and VED.

• Journal of Periodontal and Implant Science
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• 제34권3호
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• pp.607-622
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• 2004

Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of $PGE_2$ was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood $PGE_2$. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15% vs. 3.3%, OR 5.118,p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.