• Journal of Periodontal and Implant Science
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• v.52 no.1
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• pp.77-87
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• 2022

Purpose: This pilot study assessed the immediate in vivo effect of high peak pulse power neodymium-doped yttrium aluminum garnet (Nd:YAG) laser monotherapy on selected red/orange complex periodontal pathogens in deep human periodontal pockets. Methods: Twelve adults with severe periodontitis were treated with the Laser-Assisted New Attachment Procedure (LANAP®) surgical protocol, wherein a free-running, digitally pulsed, Nd:YAG dental laser was used as the initial therapeutic step before mechanical root debridement. Using a flexible optical fiber in a handpiece, Nd:YAG laser energy, at a density of 196 J/cm² and a high peak pulse power of 1,333 W/pulse, was directed parallel to untreated tooth root surfaces in sequential coronal-apical passes to clinical periodontal probing depths, for a total applied energy dose of approximately 8-12 joules per millimeter of periodontal probing depth at each periodontal site. Subgingival biofilm specimens were collected from each patient before and immediately after Nd:YAG laser monotherapy from periodontal pockets exhibiting ≥6 mm probing depths and bleeding on probing. Selected red/orange complex periodontal pathogens (Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia/nigrescens, Fusobacterium nucleatum, Parvimonas micra, and Campylobacter species) were quantified in the subgingival samples using established anaerobic culture techniques. Results: All immediate post-treatment subgingival biofilm specimens continued to yield microbial growth after Nd:YAG laser monotherapy. The mean levels of total cultivable red/orange complex periodontal pathogens per patient significantly decreased from 12.0% pretreatment to 4.9% (a 59.2% decrease) immediately after Nd:YAG laser monotherapy, with 3 (25%) patients rendered culture-negative for all evaluated red/orange complex periodontal pathogens. Conclusions: High peak pulse power Nd:YAG laser monotherapy, used as the initial step in the LANAP® surgical protocol on mature subgingival biofilms, immediately induced significant reductions of nearly 60% in the mean total cultivable red/orange complex periodontal pathogen proportions per patient prior to mechanical root instrumentation and the rest of the LANAP® surgical protocol.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.187-197
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• 2005

The aim of this study was to investigate the influence of peri-implant soft tissue and bone thickness on the early dimensional change of peri-implant soft tissue. Seventy-seven non-submerged implants of 39 patients which had been loaded more than 6 months were selected for the study. Following clinical parameters were measured; bucco-lingual bone width of the alveolar bone for implant placement before implant surgery; distance between implant shoulder and the first bone/implant contact at the surgery; presence of plaque, probing depth, bleeding on probing, width of keratinized mucosa, mucosa thickness, distance between implant shoulder and peri-implant mucosa, crown margin location at follow-up examination. The results showed that distance between implant shoulder and peri-implant mucosa (DIM) was correlated with probing depth and width of keratinized mucosa (p < 0.05). In addition, mucosa thickness was also correlated with probing depth (p<0.05). However, the bone width of alveolar bone and soft tissue thickness were not found to be correlated with DIM. It is important to understand the meaning of peri-implant tissue dimension in relation to dimensional changes of peri-implant soft tissue which designates appearance of implant-supported restorations. Future study is needed to elucidate the significance of the buccal bone thickness and soft tissue thickness with respect to the change of peri-implant soft tissue margin with the use of an instrument capable of measuring buccal bone thickness directly.

• Journal of Periodontal and Implant Science
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• v.19 no.1
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• pp.130.2-130.2
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• 1989

• Journal of Periodontal and Implant Science
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• v.29 no.2
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• pp.371-387
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• 1999

The present study was performed to assess and compare the clinical and microbiological effects following local application of 2% minocycline gel or 0.1% chlorhexidine subgingival irrigation to augment scaling and root planing in patients with moderate to advanced chronic adult periodontitis. 32 healthy patients with moderate to advanced chronic adult periodontitis were enrolled in the study. In each patient, the quadrants that had 2 or more teeth with $5{\sim}8mm$ probing pocket depth and radiographic evidence of alveolar bone loss were selected and divided into test side and control side according to the split-mouth design. All patients received standardized oral hygiene instructions at the beginning of the study and all remaining teeth received scaling and root planing until 0 week. The 2% minocycline gel was applied to periodontal pocket at 0, 1, 2, 3 week in the test side. The 0.1% chlorhexidine solution and the normal saline were irrigated subgingivally for about 30 seconds in the positive control side and negative control side respectively. The clinical and microbiological analysis carried out at 0, 4, 8, and 12 weeks . The results of this study were as follows; 1. In saline irrigation group, there was no adjunctive effects in probing pocket depth reduction, sulcular bleeding index and no significant changes in relative proportions of subgingival bacteria. 2. The chlorhexidine irrigation as an adjunct to scaling and root planing results in reduction in the plaque index and sulcular bleeding index, but there was not statistically significant. The relative proportion of spirochetes was significantly reduced, but the proportion of motile rods was no significant reduction. 3. The minocycline gel delivered subgingivally as an adjunct to scaling and root planing provide significant benefit in reducing probing depths and sulcular bleeding index compared to saline and chlorhexidine irrigation groups. 4. The relative proportions of spirochetes and motile rods were significantly reduced and the proportions of cocci and non-motile bacteria were correspondingly increased in the minocycline gel group. In conclusion, minocycline gel delivered subgingivally as an adjunct to scaling and root planing induces clinical and microbial responses more favorable for periodontal health than saline and chlorhexidine subgingival irrigation.

• Journal of Periodontal and Implant Science
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• v.28 no.3
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• pp.465-475
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• 1998

The purpose of this study was to investigate the comparative effects of subgingival irrigation using some oral mouth rinses on early healing process of periodontal inflammation. The study population consisted of 13 patients with periodontal inflammation and distributed into 4 groups. Oral hygiene instruction, delicate scaling and root planing were done and then irrigated per 3 days during 2 weeks in situ with 1 of 4 solutions ; normal saline, C31G, Benzotonium chloride and tetracycline. Examination regarding probing pocket depth, plaque index, sulcular bleeding index, gingival index, gingival recession and leukocytes differential count was performed. Evaluation was made at the baseline and 2 weeks after non-surgical periodontal therapy. The results were as follows : 1. Clinical indices including probing pocket depth, plaque index, sulcular bleeding index, gingival index and gingival recession were significantly improved from baseline to 2 weeks. But there was no significant differences among 4 groups. 2. PMNs percent on leukocytes differential count was significantly decreased from baseline to 2 weeks on all groups. Those of tetracycline and C31G were significantly decreased than those of normal saline group. These results suggest that clinical indices were not different, but the decrease of inflammation were significantly different among some mouth rinses.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.131-139
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• 1999

The present study investigate the effect of newly designed toothbrush(Chess tip : experimental group), conventional toothbrush(control group) on plaque control, gingivitis, and periodontitis. The results of 4weeks post-research by clinical comparison between the two groups are as follows. 1. In analysis of plaque index between groups there was Significant difference in the experimental group at 2,4 week. 2. In analysis of gingival index between groups there was significant difference in the experimental group at 1,2,4 week. 3. Both experimental group and control group showed decrease in periodontal pocket depth after 4week, but there was significant difference in the experimental group at 4 week. 4. Both experimental group and control group showed decrease in bleeding on probing after 4week, but there was significant difference in the experimental group at 4 week. These results indicate that newly designed toothbrush has beneficial effects as additional aid of mechanical treatment at the point of periodontal pocket, plaque control, and bleeding on probing.

• Journal of Periodontal and Implant Science
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• v.42 no.1
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• pp.3-12
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• 2012

Purpose: Anti-rheumatic agents target common molecular pathways of inflammation in rheumatoid arthritis (RA) and periodontitis. The purpose of this study was to determine the relative effect of anti-rheumatic agents on the levels of inflammatory biomarkers and periodontal inflammation in RA patients with periodontitis. Methods: A systematic review and meta-analysis were conducted of studies comparing periodontal parameters of inflammation, such as bleeding on probing, and biomarkers of inflammation in RA patients with periodontitis and healthy adults with and without periodontitis. The search included the electronic databases MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar, inclusive through October 2011, with no language restrictions. Hand searches were conducted of the bibliographies of related journals and systematic reviews. Observational and interventional studies assessing the effects of antirheumatic therapy qualified for inclusion. Two reviewers performed independent data extraction and risk-of-bias assessment. Of the 187 identified publications, 13 studies fulfilled the inclusion criteria. Results: When compared to healthy adults without periodontitis, RA subjects were found to have significantly higher levels of bleeding on probing and limited evidence of higher levels of interleukin-$1{\beta}$ and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in gingival crevicular fluid and saliva. No consistent differences were found in periodontal parameters and inflammatory biomarkers between RA subjects and adults with periodontitis. Studies evaluating the effect of anti-TNF-${\alpha}$ therapy in RA subjects with periodontitis have yielded inconsistent results. Conclusions: There are limited data, however, to suggest that anti-TNF-${\alpha}$ agents can reduce local production of inflammatory cytokines and periodontal inflammation in RA patients with periodontitis.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.325-332
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• 2014

PURPOSE. The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS. A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS. Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION. For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.

• Journal of Periodontal and Implant Science
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• v.30 no.1
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• pp.157-168
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• 2000

Periodontal surgery can be directed to remove the irritants from the tooth surface and reduce the periodontal pocket. The purpose of this study is to compare the clinical effects after between modified Widman flap and modified flap in periodontal patients. Ninety six molar area teeth of 9 patients were used. One of sextants performed a modified Widman flap, while the other side performed a modified flap. After initial periodontal therapy, the following measurements prior to surgery(baseline) were taken : pocket depth, gingival recession, clinical attachment level, tooth mobility, bleeding on probing. Also these measurements were taken at 4 weeks, 8weeks, and 12 weeks after surgery. Significant decrease of pocket depth was shown in both techniques, and the degree of decrease was significant in modified flap than modified Widman flap at 12 weeks. Significant increase of gingival recession was shown in both techniques, and the degree of increase was significant in modified Widman flap than modified flap at 4 weeks, 8 weeks, and 12 weeks. Significant attachment gain was shown in both techniques, and the degree of increase was significant in modified flap than modified Widman flap at 4 weeks, 8 weeks, and 12 weeks. Significant increase of tooth mobility was shown in both techniques at 4 weeks, but the decrease of tooth mobility was shown at 12 weeks. Greater decrease of bleeding on probing was shown in both techniques at 4 weeks. Modified flap was better than modified Widman flap in the decrease of gingival recession and the attachment gain. These results indicate that modified flap operation is better than modified Widman flap operation in the effect of periodontal treatment.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.111-121
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• 2005

Coronary heart disease is the leading cause of mortality in adult population. Whereas the association between periodontal disease and coronary heart disease (CHD) are controversial, recent studies reported the association between periodontal disease and acute myocardial infarction or prognosis of CHD. This study was aimed to investigate the relationship between periodontal disease and angiographically defined CHD, and acute myocardial infarction, and the prognosis of treated CHD. Patients under the age of 60 who had undergone the 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=20) without stenosis. After recording the number of missing teeth, periodontal disease status was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), Positive CHD subjects were classified into acute myocardial infarction group (AMI), and non-AMI with angina pectoris and old myocardial infarction. Six months postoperatively, positive CHD subjects were followed and had undergone the coronary angiography again. Even though there was no significant difference in the periodontal parameters and status between positive CHD and negative CHD, some periodontal parameters, such as mean probing depth and proportion of sites with probing depth greater than 4mm or 6mm were significantly different between AMI and Non-AMI(p<0.05). There was no significant difference in the periodontal parameters according to in angiographically follow-up status. These results indicate that periodontal disease may be associated with the occurrence of acute myocardial infarction.