• The Journal of Korean Academy of Prosthodontics
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• v.54 no.4
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• pp.401-406
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• 2016

Implant overdenture exhibits higher retention, masticatory function, and patient's satisfaction compared to conventional dentures. Particularly, in treatment of severe alveolar bone resorption, implant overdenture can be considered as the first treatment option. The types of attachments used for implant overdenture can be classified into solitary type, which implants are not connected to each other, and bar type in which implants are connected. In the case of solitary type commonly used in clinical practice, parallel relationship is important. When it is not established, there is a higher risk of attachment wear, retention loss, and frequent visits for maintenance. In this case, satisfactory results have been obtained with implant overdentures using milled bar on two unparallel implants placed on the mandible.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.187-198
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• 2002

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Recently, bioactive glass that has been utilized in plastic surgery is being investigated for application in dental practice. But, there has not been any long-term assessment of bioactive glass when used in periodontal intrabony defects. The present study evaluates the long-term effects of bioactive glass on the periodontal regeneration in intrabony defects of human and the effect of plaqu control on long term treatment results after dividing patients into those who underwent 3-month regular check-up and those who didn't under go regular check-up The clinical effect on 74sites from 17 infrabony pockets of 11 patients were analyzed 36months after treatment. 51 sites which underwent regular check up were classified as the Follow-up group(F/U group), and 23 sites which did not undergo regular check up were classified as Non Follow-up group(Non F/U group). After comparing the probing depth, attachment loss, bone probing depth before and 36months after treatment, the following results could be concluded. 1. The changes of probing pocket depth showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.79${\pm}$0.68mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(0.61${\pm}$0.54mm) (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.44${\pm}$0.74mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(1.18${\pm}$1.54) (P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after baseline and 36 months after treatment in both F/U(1.35${\pm}$0.28) and Non F/U group(0.78${\pm}$0.55mm) (P<0.05). The results suggest that treatment of infrabony defects with bioactive glass resulted in significan reduction of attachment loss and bone probing depth 36months after the treatment. The use of bioactive glass in infrabony defects, combined with regular check-up and proper plaque control generally shows favorable clinical results. This measn that bioactive glass could be a useful bone substitute.

• Journal of Periodontal and Implant Science
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• v.44 no.4
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• pp.201-206
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• 2014

Purpose: Aggressive periodontitis, especially in its severe form, was traditionally considered to have an unfavourable prognosis. It required a complex treatment and its stabilization was often achieved by surgical therapy. The aim of this study was to investigate the results of nonsurgical periodontal treatment in severe generalized forms of aggressive periodontitis. Methods: Patients with advanced generalized aggressive periodontitis were included in the study. Probing depth (PD) of pockets ${\geq}7mm$ and clinical attachment level (CAL) of sites with attachment loss ${\geq}5mm$ were measured at baseline before nonsurgical periodontal treatment, at re-evaluation, and after treatment. The following other parameters were recorded: resolution of inflammation and bone fill. We compared the baseline values with re-evaluation and posttreatment values using the Friedman test. The Wilcoxon test with the Bonferroni correction was used for both re-evaluation and posttreatment values. Results: Seven patients with 266 periodontal sites were examined. A significant difference was found between values, reported as medians with interquartile ranges, for PD at baseline (7.94 [7.33-8.19] mm) and both re-evaluation (4.33 [3.63-5.08] mm) and posttreatment (3.54 [3.33-4.11] mm) values (P=0.002). A significant difference was also found between values for CAL at baseline (9.02 [7.5-9.2] mm) and both re-evaluation (6.55 [6.30-6.87] mm) and posttreatment (6.45 [5.70-6.61] mm) (P=0.002). Inflammation was resolved and angular bone defects were repaired in all cases. Conclusions: These therapeutic results suggest that this form of periodontitis could have positive outcomes after nonsurgical periodontal treatment. The reparative potential of tissue affected by severe aggressive periodontitis should encourage clinicians to save apparently hopeless teeth in cases of this form of periodontitis.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.25-32
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• 2014

Purpose: Periodontitis is an infectious disease caused predominantly by gram-negative anerobes. The host inflammatory response to these bacteria causes alveolar bone loss that is characterized as periodontitis. Omega-3 fatty acids (${\omega}$-3 FAs) have anti-inflammatory properties, thus have been used to treat some chronic inflammatory diseases such as cardiovascular disease and rheumatoid arthritis. We aimed to evaluate the effect of dietary supplementation with ${\omega}$-3 FAs as a host modulating agent in patients with chronic periodontitis. Methods: Sixty otherwise healthy subjects with moderate and severe chronic periodontitis were enrolled in our randomised, double-blind, placebo-controlled trial. The control group (CG, n=30) was treated with scaling and root planing (SRP) and given a placebo; the treatment group (TG, n=30) was treated with SRP and dietary supplementation of ${\omega}$-3 FAs (one 300 mg tablet daily for 12 weeks). Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated in all patients at baseline, a 6-week and 12-week period after treatment. Results: A significant reduction in the gingival index, sulcus bleeding index, pocket depth, and clinical attachment level was found in the TG compared to the CG at a 12-week period. However, no statistically significant changes in serum CRP levels were found. Conclusions: Our findings suggest that ${\omega}$-3 FAs can successfully reduce gingival inflammation, pocket depth, and attachment level gain. Dietary supplementation with ${\omega}$-3 FAs may have potential benefits as a host modulatory agent in the prevention and/or C management of chronic periodontitis.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.17-26
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• 2009

Purpose: The non-carious cervical lesion(NCCL) is a loss of tooth structure at the neck of affected teeth that is unrelated to tooth caries. The reported prevalence of NCCL varies from 5% to 85%. Prevalence and severity of lesions have been found to increase with age. They are becoming more significant as people live longer and become more aware of the importance of oral health. The purposes of this study were first, to examine the periodontal conditions associated with NCCL, and second, to investigate the clinical effects of class V restorations of NCCL on periodontal tissues. Materials and methods: The sample size was 982 teeth of 50 subjects(25 male, mean age $52{\pm}7$) who were seen at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, clinical periodontal parameters were measured. After the initial examination, 24 patients who were absent from hypersensitivity were selected. The teeth with NCCL were randomly divided into the test and control groups. The teeth in the test group were restored with flowable resin; the control teeth were not restored. Six months later, the clinical examinations were repeated. The data were analyzed using the SPSS program. Results: The results were as follows: 1) NCCL occurred on 45.8% of examined teeth. The percentage of affected teeth was higher in maxillary and premolar teeth. 2) The shallow saucer type was the most common. 3) Teeth with NCCL had more gingival recession, lower attachment level, and higher incidences of bleeding on probing(BOP) and plaque than NCCL-free teeth. 4) Six months later, gingival recession, attachment level, the percentages of BOP and plaque in the test group were lower than in the control group(p<0.05). Conclusion: NCCLs were more found in maxillary teeth, especially in premolar teeth. The results suggest that the restoration of NCCL could affect some periodontal parameters favorably.

• Journal of Periodontal and Implant Science
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• v.51 no.2
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• pp.124-134
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• 2021

Purpose: The aim of this study was to assess the association between the clinical status of rheumatoid arthritis (RA) and periodontitis (PD) in patients diagnosed with PD and to evaluate the impact of RA treatment on the severity of PD. Methods: The study included 148 participants with PD, of whom 64 were also diagnosed with RA (PD+RA group), while 84 age-matched participants were rheumatologically healthy (PD-only group). PD severity was assessed by the following periodontal parameters: clinical attachment loss, probing pocket depth (PPD), bleeding on probing (BOP), alveolar bone loss, and number of missing teeth. RA disease characteristics and impact of disease were evaluated by the Disease Activity Score 28 using C-reactive protein, disease duration, RA treatment, the RA Impact of Disease tool, and the Health Assessment Questionnaire. Outcome variables were compared using parametric and non-parametric tests and associations were evaluated using regression analysis with the calculation of odds ratios (ORs). Results: Participants in the PD+RA group had higher mean PPD values (2.81 ± 0.59 mm vs. 2.58 ± 0.49 mm, P=0.009) and number of missing teeth (6.27±4.79 vs. 3.93±4.08, P=0.001) than those in the PD-only group. A significant association was found between mean PPD and RA (OR, 2.22; 95% CI, 1.16-4.31; P=0.016). Within the PD+RA group, moderate to severe periodontal disease was significantly more prevalent among participants with higher RA disease activity (P=0.042). The use of biologic disease-modifying antirheumatic drugs (bDMARDs) was associated with a lower BOP percentage (P=0.016). Conclusions: In patients with PD, RA was associated with a higher mean PPD and number of missing teeth. The severity of PD was affected by the RA disease clinical activity and by treatment with bDMARDs, which were associated with a significantly lower mean BOP percentage.

• The Journal of Advanced Prosthodontics
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• v.4 no.4
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• pp.254-258
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• 2012

Implant-supported overdenture is a reliable treatment option for the patients with edentulous mandible when they have difficulty in using complete dentures. Several options have been used for implant-supported overdenture attachments. Among these, bar attachment system has greater retention and better maintainability than others. SFI-Bar$^{(R)}$ is prefabricated and can be adjustable at chairside. Therefore, laboratory procedures such as soldering and welding are unnecessary, which leads to fewer errors and lower costs. A 67-year-old female patient presented, complaining of mobility of lower anterior teeth with old denture. She had been wearing complete denture in the maxilla and removable partial denture in the mandible with severe bone loss. After extracting the teeth, two implants were placed in front of mental foramen, and SFI-Bar$^{(R)}$ was connected. A tube bar was seated to two adapters through large ball joints and fixation screws, connecting each implant. The length of the tube bar was adjusted according to inter-implant distance. Then, a female part was attached to the bar beneath the new denture. This clinical report describes two-implant-supported overdenture using the SFI-Bar$^{(R)}$ system in a mandibular edentulous patient.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.1
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• pp.50-58
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• 2000

The purpose of this study was to investigate the causes of food impaction and to explore solutions as well. For this study, 39 patients with food impaction were selected. 77 contact areas in these patients were investigated mobility, tightness of contact area, gingival index, plaque index, attachment loss, alveolar bone loss, proximal caries, marginal ridge distance and occlusal relationships. The results were as follows ; 1. Teeth without distal support were found to be the most frequent site of food impaction (41.6%). Food impaction was found to be more frequent in the upper teeth (65.2%) than the lower teeth (33.8%). 2. Food impaction was found in tight contact cases (71.4%). Alveolar bone loss was not found in the early stage of food impaction (83.1%) 3. The distance between the marginal ridges of food impaction sites (mean=0.48mm) was short-er than that of the control group. (mean=0.77mm) (p<0.001) 4. In 18.2% of the cases, proximal carries were found at the food impaction site. 5. Food impaction affected patient's occlusion with the following frequencies, cusp to marginal ridge relationship (72.7%), cusp to fossa relationship (3.9%) and stepped relationship (23.4%).

• The Journal of the Korean dental association
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• v.55 no.1
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• pp.30-41
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• 2017

Inadequate keratinized mucosa around dental implants can lead to more plaque accumulation, tissue inflammation, marginal recession and attachment loss. We evaluated the effects of free gingival and extracellular matrix membrane grafts performed to increase the insufficient width of keratinized tissue around dental implants in the posterior mandible. A 47-year-old female patient presented with discomfort due to swelling of the lower right second premolar area. Due to severe destruction of alveolar bone, the tooth was extracted. After 3 months, a guided bone regeneration (GBR) procedure was performed and then a dental implant was placed 6 months later. During the second-stage implant surgery, free gingival grafting was performed to increase the width of the keratinized tissue. After 12 months, a clinical evaluation was performed. A 64-year-old female patient had a missing tooth area of bilateral lower molar region with narrow zone of keratinized gingiva and horizontal alveolar bone loss. Simultaneous implant placement and GBR were performed. Five months after the first-stage implant surgery, a gingival augmentation procedure was performed with an extracellular matrix membrane graft to improve the width of the keratinized tissue in the second-stage implant surgery. After 12 months, a clinical evaluation was performed. In these two clinical cases, 12 months of follow-up, revealed that the increased width of the keratinized tissue and the deepened oral vestibule was well maintained. A patient showed a good oral hygiene status. In conclusion, increased width of keratinized tissue around dental implants could improve oral hygiene and could have positive effects on the long-term stability and survival rate of dental implants. When planning a keratinized tissue augmentation procedure, clinicians should consider patient-reported outcomes.

• The Journal of Advanced Prosthodontics
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• v.6 no.4
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• pp.245-252
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• 2014

PURPOSE. To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS. Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS. Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION. In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.