• 대한치과보철학회지
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• 제52권1호
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• pp.27-33
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• 2014

연구 목적: 본 연구는 임플란트 보철물과 인접치 사이의 식편압입을 호소하는 환자를 대상으로 각종 임상 자료를 분석하여 식편압입의 임상적 발현 양상을 알아보고자 하였다. 연구 재료 및 방법: 식편압입을 주소로 내원한 보철물 장착이 완료된 임플란트 환자 51명을 대상으로 설문조사와 구강검사를 시행하고 방사선 사진과 모형을 채득하여 식편압입과 관련이 있는 요소를 분석한 결과 다음과 같은 결과를 얻었다. 결과: 1. 식편압입은 하악(39.2%)보다 상악(60.7%)에서 많이 나타났다. 2. 식편압입은 자연치아가 임플란트 보철물의 원심 부위(13.7%)에 있는 경우보다 근심 부위(86.2%)에 있는 경우에 많이 나타났다. 3. 식편압입이 나타난 임플란트 보철물과 그 인접치 사이의 접촉점은 긴밀하지 않은 경우(94.2%)가 대부분이었다. 결론: 임플란트 보철물과 인접치 사이에 식편압입이 일어나지 않기 위해서는 임플란트 보철물과 인접치아가 적절한 긴밀도를 가지고 있어야 하겠다.

• Journal of Periodontal and Implant Science
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• 제35권1호
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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.

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.225-234
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• 2002

The purpose of this study was to evaluate the relationship between the osteoporotic condition and periodontal condition in postmenopausal women with periodontitis. Forty three female postmenopausal patients with no systemic disease were grouped into 3 groups by their periodontal conditions; 12 mild periodontitis, 11 moderate periodontitis and 20 advanced periodontitis. From each patient, age of menopause was taken, alkaline phosphatase(ALP) and osteocalcin (OC) in blood and deoxypyridinoline (DPD) in urine were measured. Bone mineral density (BMD) of lumbar spine (L2-L4) was measured by dual energy X-ray absorptiometry. Periodontal and osteoporotic parameters were compared among the groups and correlation coefficient between them was evaluated. The blood ALP and OC levels were similar among the groups with different periodontal condition, whereas the urine DPD level and BMD were significantly lower in advanced periodontitis group than the other groups(p<0.01). Probing depth was negatively related with BMD (r=-0.5, p<0.01) and positively related with patient age and the duration of menopause (r= 0.32 and 0.35 respectively, p<0.05). Clinical attachment loss was negatively related with BMD (r=-0.66, p<0.01), and positively related with urine DPD (r= 0.37, p<0.05). These results showed that postmenopausal women with advanced periodontitis had significantly decreased bone mineral density and suggests that decreased bone mineral density in postmenopausal women could be associated with periodontal tissue breakdown.

• Journal of Periodontal and Implant Science
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• 제49권2호
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• pp.105-113
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• 2019

Purpose: An unresolved inflammatory state contributes to the pathogenesis of periodontal disease and metabolic syndrome (MetS). Therefore, the purpose of this study was to evaluate the role of lipoxin A4 (LXA4), a proresolving lipid mediator, in the association between periodontal disease and MetS. Methods: Sixty-seven patients with MetS and 65 patients without MetS were included in the study. Sociodemographic information was obtained via a questionnaire, and detailed medical diagnoses were made. Periodontal parameters (plaque index [PI], gingival index [GI], probing pocket depth [PD], and clinical attachment level [CAL]) and metabolic parameters were measured, and serum LXA4 levels were determined. The associations among MetS, periodontal parameters, and serum LX levels were evaluated by adjusted multivariate linear regression analyses. Results: Patients with MetS were older and had a higher body mass index than patients without MetS. Periodontal parameters (PI, GI, PD, and CAL) were higher in patients with MetS than in those without MetS. Serum LXA4 levels were higher in patients without MetS. Multivariate linear regression analysis indicated a positive association between MetS and periodontal parameters (PD and CAL). Negative associations were established between MetS and LXA4 levels, and between LXA4 and periodontal parameters (PI, PD, and CAL). Conclusions: The presence of higher values of periodontal parameters in patients with MetS and the negative relationship of LXA4 with MetS and periodontal disease may support the protective role of proresolving lipid mediators in the association between periodontal disease and MetS.

• Journal of Yeungnam Medical Science
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• 제39권4호
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• pp.322-331
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• 2022

Background: The combined use of biomaterials for regeneration may have great biological relevance. This study aimed to compare the regenerative potential of biphasic calcium phosphate (BCP) alone and with growth factor enamel matrix derivatives (EMDs) for the regeneration of intrabony defects at 1 year. Methods: This randomized controlled trial included 40 sites in 29 patients with stage II/III periodontitis and 2/3 wall intrabony defects that were treated with BCP alone (control group) or a combination of BCP and EMD (test group). BCP alloplastic bone grafts provide better bio-absorbability and accelerate bone formation. EMDs are commercially available amelogenins. Mean values and standard deviations were calculated for the following parameters: plaque index (PI), papillary bleeding index (PBI), vertical probing pocket depth (V-PPD), vertical clinical attachment level (V-CAL), and radiographic defect depth (RDD). Student paired and unpaired t-tests were used to compare the data from baseline to 12 months for each group and between the groups, respectively. The results were considered statistically significant at p<0.05. Results: At 12 months, the PI and PBI scores of the control and test groups were not significantly different (p>0.05). The mean V-PPD difference, V-CAL gain, and RDD difference were statistically significant in both groups at 12 months (p<0.001 for all parameters). Intergroup comparisons showed that the mean V-PPD reduction (2.13±1.35 mm), V-CAL gain (2.53±1.2 mm), and RDD fill (1.33±1.0 mm) were statistically significant between the groups at 12 months (p<0.001 for all parameters). Conclusion: BCP and EMDs combination is a promising modality for the regeneration of intrabony defects.

• Journal of Periodontal and Implant Science
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• 제33권3호
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• pp.485-497
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• 2003

Grapefruit seed extract has been reported to have antimicrobial effect. The purpose of this study was to evaluate the antimicrobial and anti-gingivitis effect of chewing gum containing grapefruit seed extract and xylitol. 40 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in the experimental group chewed gum containing grapefruit seed extract and xylitol while subjects in the control group chewed gum containing only xylitol. All subjects received scaling and tooth brushing instruction. 1 week after scaling was set as baseline. Gingival index and plaque index were scored at baseline, 1 week, 2 week, 3 week and 4 week. Bleeding index, probing pocket depth and clinical attachment level were scored at baseline, 2 week and 4 week. The number of total bacteria and Streptococcus mutans in unstimulated saliva of experimental group were counted at 1 week, 2 week, 3 week and 4 week. Gingival indices of experimental group and control group at baseline, 1 week, 2 week, 3 week and 4 week were 0.850${\pm}$0.298, 0.575${\pm}$0.345, 0.533${\pm}$0.332, 0.459${\pm}$0.311, 0.408${\pm}$0.224 and 0.758${\pm}$0.379, 0.592${\pm}$0.276, 0.563${\pm}$0.281, 0.454${\pm}$0.194, 0.413${\pm}$0.199 (mean${\pm}$SD), respectively. Plaque indices of experimental group and control group at baseline, 1 week. 2 week, 3 week and 4 week were 0.497${\pm}$0.500, 0.375${\pm}$0.484, 0.332${\pm}$0.471, 0,286${\pm}$0.452, 0.210${\pm}$0.407 and 0.411${\pm}$0.492, 0.375${\pm}$0.484, 0.354${\pm}$0.479, 0.313${\pm}$0.463, 0.193${\pm}$0.395, respectively. Bleeding indices of experimental group and control group at baseline, 2 week and 4 week were 0.377${\pm}$0.177, 0.298${\pm}$0.152, 0.192${\pm}$0.108 and 0.383${\pm}$0.124, 0.318${\pm}$0.153, 0.225${\pm}$0.126, respectively. Probing pocket depth of experimental group and control group at baseline, 2 week and 4 week were 2.56${\pm}$1.00, 2.40${\pm}$0.65, 2.23${\pm}$0.64 and 2.45${\pm}$0.682.37${\pm}$0.57, 2.19${\pm}$0.57, respectively. Clinical attachment level of experimental group and control group at baseline, 2 week and 4 week were 2.58${\pm}$1.01, 2.43${\pm}$0.67, 2.26${\pm}$0.65 and 2.49${\pm}$0.70, 2.40${\pm}$0.59, 2.22${\pm}$0.62, respectively. The % of reduction of total bacteria in saliva of experimental group at 2 week, 3 week and 4 week were 46 ${\pm}$ 53%, 53 ${\pm}$ 5% and 69 ${\pm}$ 33%. The % of reduction of Streptococcus mutans count in saliva of experimental group at 2 week, 3 week and 4 week were 52${\pm}$69%, 88${\pm}$30% and 89${\pm}$17%. From these findings, it can be concluded that regular use of grapefruit seed extract /xylitol chewing gum may be effective to control and prevent gingivitis and may have caries-preventive effect.

• Journal of Periodontal and Implant Science
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• 제46권6호
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• pp.382-395
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• 2016

Purpose: Alendronate has been proposed as a local and systemic drug treatment used as an adjunct to scaling and root planing (SRP) for the treatment of periodontitis. However, its effectiveness has yet to be conclusively established. The purpose of the present meta-analysis was to assess the effectiveness of SRP with alendronate on periodontitis compared to SRP alone. Methods: Five electronic databases were used by 2 independent reviewers to identify relevant articles from the earliest records up to September 2016. Randomized controlled trials (RCTs) comparing SRP with alendronate to SRP with placebo in the treatment of periodontitis were included. The outcome measures were changes in bone defect fill, probing depth (PD), and clinical attachment level (CAL) from baseline to 6 months. A fixed-effect or random-effect model was used to pool the extracted data, as appropriate. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Cochrane ${\chi}^2$ and $I^2$ tests. Results: After the selection process, 8 articles were included in the meta-analysis. Compared with SRP alone, the adjunctive mean benefits of locally delivered alendronate were 38.25% for bone defect fill increase (95% CI=33.05%-43.45%; P<0.001; $I^2=94.0%$), 2.29 mm for PD reduction (95% CI=2.07-2.52 mm; P<0.001; $I^2=0.0%$) and 1.92 mm for CAL gain (95% CI=1.55-2.30 mm; P<0.001; $I^2=66.0%$). In addition, systemically administered alendronate with SRP significantly reduced PD by 0.36 mm (95% CI=0.18-0.55 mm; P<0.001; $I^2=0.0%$) and increased CAL by 0.39 mm (95% CI=0.11-0.68 mm; P=0.006; $I^2=6.0%$). Conclusions: The collective evidence regarding the adjunctive use of alendronate locally and systemically with SRP indicates that the combined treatment can improve the efficacy of non-surgical periodontal therapy on increasing CAL and bone defect fill and reducing PD. However, precautions must be exercised in interpreting these results, and multicenter studies evaluating this specific application should be carried out.

• Journal of Periodontal and Implant Science
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• 제48권6호
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• pp.347-359
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• 2018

Purpose: Periodontitis and rheumatoid arthritis (RA) share a similar inflammatory pathogenesis. Porphyromonas gingivalis (Pg) can induce anticyclic-citrullinated peptide autoantibodies (anti-CCP antibodies), a key factor in the development of RA. This study aimed at evaluating the relationships between the 2 diseases and identifying the clinical implications thereof, with a focus on periodontal pathogens in Korean adults. Methods: A total of 260 RA patients and 86 age- and sex-matched control patients without arthritis were enrolled in this prospective cross-sectional study. Periodontal indices and the prevalence and amount of periodontal pathogens were compared between the groups. Correlations between periodontal and RA indices were examined, as were correlations between 9 periodontal pathogens and RA indices. Results: The RA group had significantly higher values than the control group for all investigated periodontal indices (P<0.05) except the number of teeth. The gingival index (GI) was correlated with the disease activity score 28 (DAS28) (r=0.125, P=0.049), RA disease duration (r=0.253, P<0.001), erythrocyte sedimentation rate (ESR) (r=0.162, P=0.010), and anti-CCP antibody titer (r=0.205, P=0.004). Probing pocket depth (PPD) was correlated with ESR (r=0.139, P=0.027) and anti-Pg antibody titer (r=0.203, P=0.001). Bleeding on probing (BOP) was correlated with DAS28 (r=0.137, P=0.030), RA disease duration (r=0.202, P=0.001), ESR (r=0.136, P=0.030), anti-Pg antibody titer (r=0.177, P=0.005), and anti-CCP antibody titer (r=0.188, P=0.007). Clinical attachment level (CAL) and periodontitis severity were correlated with anti-Pg antibody titer (the former r=0.201, P=0.002; the latter r=0.175, P=0.006). The quantity of Pg was positively correlated with the serum anti-Pg antibody titer (r=0.148, P=0.020). Conclusions: The GI, BOP, and PPD showed positive relationships with several RA indices. The anti-Pg antibody titer had positive relationships with PPD, BOP, CAL, and periodontitis severity. Thus, increasing values of periodontal indices could be used as a risk indicator of disease development in RA patients, and an increasing anti-Pg antibody titer could be considered as a warning sign in RA patients suffering with periodontitis.

• Journal of Periodontal and Implant Science
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• 제53권2호
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• pp.120-134
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• 2023

Purpose: We investigated whether repeated irradiation with light-emitting diodes (LEDs) at a combination of 470 nm and 525 nm could suppress the progression of experimental periodontitis. Methods: A experimental periodontitis model was established in the second, third, and fourth premolars of the mandible in beagle dogs for 2 months. The spontaneous progression of periodontitis was monitored under the specified treatment regimen for 3 months. During this period, the animals were subjected to treatments of either plaque control only (control) or plaque control with LED application (test) at 2-week intervals. The clinical parameters included the probing pocket depth (PPD), gingival recession (GR), and the clinical attachment level (CAL). Histomorphometric analysis was performed using measurements of the length of the junctional epithelium, connective tissue (CT) zone, and total soft tissue (ST). Results: There were significant differences in PPD between the control and test groups at baseline and 12 weeks. When the change in PPD was stratified based on time intervals, it was shown that greater differences occurred in the test group, with statistical significance for baseline to 12 weeks, 6 to 12 weeks, and baseline to 6 weeks. There was no significant difference in GR between the control and test groups at any time points. Likewise, no statistically significant differences were found in GR at any time intervals. CAL showed a statistically significant difference between the control and test groups at baseline only, although significant differences in CAL were observed between baseline and 12 weeks and between 6 and 12 weeks. The proportion of CT to ST was smaller for both buccal and lingual areas in the control group than in the test group. Conclusions: Repeated LED irradiation with a combination of 470-nm and 525-nm wavelengths may help suppress the progression of periodontal disease.

• Journal of Periodontal and Implant Science
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• 제44권4호
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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.