• 대한치과교정학회지
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• 제33권2호
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• pp.113-120
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• 2003

본 연구는 불화나트륨과 자일리톨 성분으로 구성된 구강 청정용 저작성 정제 (덴포정, 하미 즐, 부천, 경기 )가 교정치료 중인 환자의 구강위생 상태에 미치는 영향을 알아보기 위해 시행되었다. 교정치료 중인 18세 이상의 성인 환자 30명을 대상으로 약제사용 전, 2주 후, 4주 후에 피험자의 상악과 하악 전치 부위 및 구치 부위에서 각각 치은 지수, 치은 출혈 지수, 치태 지수를 측정하여 다음과 같은 결과를 얻었다. 1. 상하악 전치부와 구치부 모두에서 치태 지수가 약제사용 전에 비해 사용 2주 후와 4주 후 유의성 있게 감소하였다. (p<0.05).또한, 적용 2주 후와 4주 후의 지수를 비교하였을 때 4주 후에 좀 더 개선된 경향을 보였으나, 통계적 유의성은 나타나지 않았다(p>0.05). 2. 치은 지수, 치은 출혈 지수도 상하악 전치부와 구치부 모두에서 적용 전에 비하여 2주 후와 4주 후 유의성 있게 감소하였다(p<0.05).적용 2주 후와 4주 후의 지수의 비교 검증에서 통계학적으로 유의할 만한 차이는 보이지 않아 구강위생 상태의 개선이 계속 유지됨을 보였다. 본 연구의 결과는 치태 지수, 치은 지수, 치은 출혈 지수가 실험 정제 적용 후에 감소하여 구강위생 상태가 개선되었음을 보였다. 이러한 결과를 통해 덴포정을 교정치료 중인 한자에서 부가적으로 사용하였을 경우 치주조직의 건강을 증진시키는데 도움을 줄 수 있으리라고 생각된다.

• 치위생과학회지
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• 제14권3호
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• pp.287-294
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• 2014

본 연구는 구강 건강 개선을 위해 효과적인 구강 보건 교육방법을 모색하고자 동기면담이라는 새로운 상담기법을 적용한 구강 관리 프로그램을 진행하였다. 동기면담의 효과를 검증하고, 구강 관리 프로그램 개발의 기초자료로 제시하고자 대학생 98명을 대상으로 구강 관리 프로그램을 시행하였다. 첫 방문 날짜를 기준으로 실험군 32명과 대조군 66명으로 배정하였으며, 실험군에게는 총 3회의 동기면담을 시행한 결과 다음과 같은 결과를 얻었다. 1. 중재 유무에 따라 프로그램 참여 전후의 구강 상태를 비교한 결과 실험군에서 유의한 차이를 나타냈다. 치주상태를 평가하는 PSR, 치은 지수, 치석 지수, 치면세균막 지수, QLF-D 측정값인 SPS 모두 중재 전보다 중재 후에 측정값이 유의하게 감소하였다(p<0.05). 2. 구강 관리 프로그램 시행 기간 총 3회 동안 치면세균막지수값을 측정한 결과 두 집단 간의 차이는 통계적으로 유의하지 않았으나(p>0.05), 3회의 치면세균막 측정 시점 간의 차이는 통계적으로 유의하였으며 집단과 측정 시점간의 교호작용도 유의한 차이를 나타냈다(p<0.05). 3. 구강 관리 프로그램 참여 기간 동안 재방문 준수도는 실험군의 방문 준수도가 높게 나타났다. 또한 프로그램 재방문에 영향을 미치는 요인을 분석한 결과 동기면담을 시행한 집단이 시행하지 않은 집단보다 재방문할 가능성이 23.89배 높았으며, 구강 양치액을 사용하는 사람이 사용하지 않는 사람보다 21.73배, 치주상태 측정값 PSR이 큰사람이 12.19배 재방문할 가능성이 높은 것으로 나타났다(p<0.05). 이상의 결과를 종합해 보면, 동기면담의 시행은 구강 상태를 개선하며 그 가운데 치면세균막 감소에 높은 영향력이 있음을 확인할 수 있다. 또한 동기면담을 적용한 집단은 치면세균막 지수가 점차 감소하는 반면 중재를 시행하지 않는 집단은 다시 증가하는 양상을 나타내어 동기면담의 시행이 행동 유지에 관련이 있음을 알 수 있다. 동기면담 시행 집단이 재방문율이 높고, 재방문 준수에 동기면담의 영향력이 있는 것을 확인하였으므로 동기면담은 구강 관리 프로그램에 적용 가능하며 구강건강개선에 영향력 있는 중재로 이용될 것으로 생각된다.

• Journal of Periodontal and Implant Science
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• 제23권1호
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• pp.109-126
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• 1993

Refractory periodontitis manifest progressive attachment loss in a rapid and unrelenting manner regardless of the type or frequency of therapy applied. The purpose of this study was ta evaluate the relation between the level of cytokines in GCF and periodontopathic microflora with disease activity of refractory periodontitis. Selection of patients with refractory periodontitis (7 males, 3 females) were made by long term clinical observation including conventional clinical history and parameters. Teeth that showed pocket depth greater than 6mm were selected as sample teeth. Subjects were examined at baseline and after 3 months. Prior to baseline test, individual acrylic stent was fabricated. Reference grooves were made on each sample tooth site. Pocket depth and attachment loss were measured by Florida Probe. Gingival index was measured at 4 sites each sample teeth. Disease activity was defined as attachment loss of ${\ge}$ 2.1mm, as determined by sequential probing and tolerance method. The pattern and amount of alveolar bone resorption was observed with quantitative digital subtraction image processing radiography. Morphological analysis of subgingival bacteria was taken by phase contrast microscopy. Predominant cultivable bacterial distribution and frequency were compared between disease-active and disease-inactive site using immunofluorescence microscopy and selective microbial culturing. Levels of $interleukin-l{\beta}$, 2, 4, 6 and $TNF-{\alpha}$ in GCF and blood serum sample were quantified by ELISA. In active sites, P. intermedia was significantly increased to compare with inactive site. $IL-1{\beta}$, IL-2, IL-6 and $TNF-{\alpha}$ in GCF were increased in active sites and IL-2 in serum was increased in active patients significantly. Alveolar bone loss in active site was correlated with $IL-1{\beta}$, IL-2 in GCF. And loss of attachment in active site was correlated with IL-2 in GCF. These results demonstrate that IL-2 in serum, $IL-1{\beta}$, IL-2, IL-6 and $TNF-{\alpha}$ in GCF, P, intermedia might be used as possible predictors of disease activity in refractory periodontitis before it is clinically expressed as attachment loss and quantitative alveolar bone change.

• Journal of Periodontal and Implant Science
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• 제44권2호
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• pp.57-64
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• 2014

Purpose: Both chronic periodontitis (CP) and iron deficiency anemia (IDA) induce oxidative stress in the body and cause an imbalance between reactive oxygen species and antioxidants, such as superoxide dismutase (SOD). This study explored the SOD enzyme activity of saliva and serum in CP patients with and without IDA and analyzed the impact of IDA on CP. Methods: A total of 82 patients were divided into four groups: control group (CG, 22), periodontally healthy IDA patients (IDA-PH, 20), CP patients (CP, 20), and IDA patients with CP (IDA-CP, 20). After clinical measurements and samplings, serum and salivary SOD levels were determined using an SOD assay kit. Results: IDA-CP patients exhibited a higher gingival index, bleeding on probing, probing pocket depth, and percentage (%) of sites with a clinical attachment loss (CAL) of ${\geq}6mm$ (P<0.008) than CP patients. The mean salivary and serum SOD levels were significantly lower in the IDA-PH, CP, and IDA-CP patients than in the CG group (P<0.008). A significant positive correlation between salivary and serum SOD activity was observed in IDA (P<0.05). Furthermore, serum and salivary SOD levels were significantly and negatively correlated with all periodontal parameters including the percentage of sites with CAL of 4-5 and ${\geq}6mm$ (P<0.05) except the significant correlation between salivary SOD activity and mean CAL and the percentage of sites with CAL of 4-5 mm (P>0.05) in these patients. Conclusions: Within the limits of this study, it may be suggested that IDA patients with chronic periodontitis have more periodontal breakdowns than patients with chronic periodontitis. Serum and salivary SOD activity levels were lower in the IDA-PH, CP and IDA-CP groups than in the CG. Iron deficiency anemia influenced the serum SOD activity but did not seem to affect the salivary SOD activity in these patients.

• Journal of Periodontal and Implant Science
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• 제48권3호
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• pp.136-151
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• 2018

Purpose: The decontamination procedure is a challenging aspect of surgical regenerative therapy (SRT) of peri-implantitis that affects its success. The purpose of the present study was to determine the impact of additional topical gaseous ozone therapy on the decontamination of implant surfaces in SRT of peri-implantitis. Methods: A total of 41 patients (22 males, 19 females; mean age, $53.55{\pm}8.98years$) with moderate or advanced peri-implantitis were randomly allocated to the test group (ozone group) with the use of sterile saline with additional ozone therapy or the control group with sterile saline alone for decontamination of the implant surfaces in SRT of peri-implantitis. Clinical and radiographic outcomes were evaluated over a period of 12 months. Results: At the 12-month follow-up, the plaque and gingival index values were significantly better in the ozone group (P<0.05). Probing depth decreased from $6.27{\pm}1.42mm$ and $5.73{\pm}1.11mm$ at baseline to $2.75{\pm}0.7mm$ and $3.34{\pm}0.85mm$ at the end of the 12-month observation period in the ozone and control groups, respectively. Similarly, the clinical attachment level values changed from $6.39{\pm}1.23mm$ and $5.89{\pm}1.23mm$ at baseline to $3.23{\pm}1.24mm$ and $3.91{\pm}1.36mm$ at the 12-month follow-up in the ozone and control groups, respectively. According to the radiographic evidence, the defect fill between baseline and 12 months postoperatively was $2.32{\pm}1.28mm$ in the ozone group and $1.17{\pm}0.77mm$ in the control group, which was a statistically significant between-group difference (P<0.05). Conclusions: Implant surface decontamination with the additional use of ozone therapy in SRT of peri-implantitis showed clinically and radiographically significant. Trial registry at ClinicalTrials.gov, NCT03018795.

• Journal of Periodontal and Implant Science
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• 제37권1호
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• pp.91-102
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• 2007

The long term success of periodontal treatment is dependent upon the effectiveness of the main-tenance care program after active treatment. The purpose of this study was to evaluate whether nutraceutical containing PRF-K2 as natural product from plant and seaweed has beneficial effects on clinical parameters, gingival crevicular fluid (GCF) volume and GCF cytokine levels during main- tenance phase after periodontal treatment. Among the generally healthy and non-smoking. moderate to severe chronic periodontitis patients during maintenance phase in Department of Periodontics, Chonnam National University Hospital, twenty eight patients took nutraceutical containing PRF-K2 (Oscotec Inc. Cheonan, Korea) for 3 months as experimental group and sixteen patients received only maintenance care as control group. Clinical examination and GCF collection were performed at baseline, 1, 2 and 3 months of experiment. Total amounts and concentrations of GCF IL-1{\beta}, IL-1ra and $PGE_2$ were evaluated using ELISA kit. In probing pocket depth, experimental group showed the tendency of more reduction than control group after 3 months of experiment. Sulcus bleeding index (SBI) and GCF volume were significantly decreased in experimental group(p<0.05), whereas they were increased in control group. GCF IL-1{\beta} level tended to decrease in both experimental and control group and IL-1ra concentration tended to increase in experimental group and to decrease in control group. IL-1ra/IL-1{\beta} ratio tended to increase in experimental group and to decrease in control group during experimental period. GCF $PGE_2$ amount did not show any change in experimental group and tended to increase in control group. These results suggest that nutraceutical supplement which contain PRF-K2 could improve perio-dontal condition during maintenance phase after periodontal therapy.

• 구강회복응용과학지
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• 제28권1호
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• pp.37-46
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• 2012

치주치료의 궁극적 목표는 치주질환으로 상실된 치주조직의 재생이라고 볼 수 있다. 치주재생술식 후 회복을 평가하는 단계에서, 탐침과정이 초기 회복기의 신생조직에 위해한 영향을 줄 수 있다. 치아동요도는 치주조직이 치아를 지지하고 있는 상태를 평가하는 중요한 지표로 사용된다. 이에 본 연구에서는 치아동요도와 다른 임상지표간의 상관관계를 조사하고, 치아동요도를 측정하는 Periotest$^{(R)}$가 재생술식 후 초기 회복기에 탐침의 필요성을 배제할 수 있는지를 조사하고자 하는 것이다. 치주재생수술을 받은 25명의 환자, 29개의 치아를 대상으로 하였다. 부착수준, 치주낭 심도, 치아동요도 (Periotest$^{(R)}$ value PTV)등의 임상지표를 연구시작단계, 시술 후 6개월, 12개월에 측정하였다. 재생수술 후 모든 임상지표들이 개선되었고 (p<0.05), 각각의 시기에 부착수준, 탐침깊이, 치은퇴축과 PTV 사이의 통계적으로 유의한 상관관계가 관찰되었다. 또한 각 시기 사이의 임상지표와 PTV변화량의 상관관계에서 치주낭깊이와 부착수준이 상관관계가 있는 것으로 관찰되었다. 이상의 결과들로 치주재생술식 이후 임상지표들의 개선을 기대할 수 있으며, 재생술식 이후 회복기에 임상지표의 측정에 PTV가 보조적 역할을 할 수 있을 것으로 사료된다.

• 대한예방한의학회지
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• 제18권1호
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• pp.125-138
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• 2014

Objective : Polycan, exopolymers purified from Aureobasidium pullulans SM-2001 and calcium gluconate have been showed favorable inhibitory effects on the periodontitis and related alveolar bone losses through antioxidant and anti-inflammatory activities, respectively. In the present study, we intended to observe the possible synergic effects of mixed formula consisted of Polycan and calcium gluconate on ligation-induced experimental periodontitis and related alveolar bone losses in rats, and to select the fittest compositions for further developing as effective agents to ameliorate periodontal diseases. Method : Experiments were conducted as two separated two tests - first is synergic effects of Polycan and calcium gluconate 1:1, 1:9 and 9:1 mixtures, and second is 1:99, 2:98, 4:96, 8:92 and 1:9 mixtures. Experimental periodontal diseases were induced by ligature placed around the cervix of upper left incisior teeth of rats. One day after ligation placements, 200mg/kg of each single or mixed formulas of Polycan or/and calcium gluconate were orally administered for 10 days. The changes on the alveolar bone loss index and maxillary bone mineral density (BMD) were observed for detecting alveolar bone losses, and for anti-inflammatory effects, myeloperoxidase (MPO) activities and proinflammatory cytokine (tumor necrosis factor; TNF-${\alpha}$) contents were also evaluated in gingival tissues around ligature placed incisior teeth. The results of mixtures were compared with those of singe Polycan and calcium gluconate treated rat. Results : Each single or mixed formulas of Polycan or/and calcium gluconate favorably and significantly inhibited the inflammatory changes. The inhibitory effects of mixed formula consisted of Polycan and calcium gluconate 1:9 showed against periodontitis and related alveolar bone losses as compared with those of each Polycan and calcium gluconate single formula (p<0.05). In second experiment, Polycan and calcium gluconate 2:98, 4:96, 8:92 and 1:9 mixed formulas also showed significant increased anti-inflammatory and inhibitory effects against alveolar bone losses as compared with those of each single formula. Among them, Polycan and calcium gluconate 2:98 showed the highest efficacy against to ligation-induced experimental periodontitis and related alveolar bone losses. Conclusion : The results obtained in this study suggest that appropriated mixtures of Polycan and calcium gluconate showed synergic inhibitory effects against ligation-induced experimental periodontitis and related alveolar bone losses in rats. Moreover, Polycan and calcium gluconate 2:98 showed the highest efficacies in this experiment, suggesting the fittest composition for further developing as effective agents to ameliorate periodontal diseases.

• 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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• 제51권1호
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• pp.53-62
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• 2021

Purpose: This study aimed to evaluate the clinical and microbiological efficacy of adjunctive local delivery of minocycline (Periocline^®) in patients receiving supportive periodontal therapy (SPT) after initial treatment. Methods: The participants were 16 men and 8 women (age, 20-65 years) who had at least 15 natural teeth, underwent SPT for more than 1 year due to chronic periodontitis, had 4 or more periodontal pocket sites deeper than 5 mm, and showed >25% gingival bleeding on probing (BoP). They were randomly assigned to the test and control groups. In the test group, mechanical debridement and local antibiotic delivery were performed for all periodontal sulci/pockets; in the control group, mechanical debridement and saline irrigation were performed. In patients who underwent SPT for more than 1 year, clinical and microbiological examinations were performed at baseline and 1 and 3 months after SPT. The clinical examination included an assessment of the periodontal pocket depth, clinical attachment level, plaque index, and BoP. Microbial tests were performed using real-time polymerase chain reaction; the relative ratios of Porphyromonas gingivalis and Fusobacterium nucleatum were determined. Results: Both groups showed significant improvements in clinical parameters at 1 and 3 months from baseline; there were no significant changes between months 1 and 3. Intergroup differences were insignificant. The microbiological analysis revealed no significant differences in P. gingivalis and F. nucleatum ratios across time points. While intergroup differences were insignificant, there was a tendency for the P. gingivalis and F. nucleatum ratios to decrease in the test group. Conclusions: Mechanical debridement in patients receiving maintenance therapy resulted in clinically significant improvement; the effectiveness of additional local delivery of antibiotics was not significant. The ratios of P. gingivalis and F. nucleatum showed a tendency to decrease in the test group, although it was not significant.