• Journal of Periodontal and Implant Science
• /
• 제48권5호
• /
• pp.295-304
• /
• 2018

Purpose: This study was undertaken to evaluate the clinical and microbiological effects of an erythritol powder air-polishing device (EPAP) as a supplement to scaling and root planing (SRP) therapy in patients with moderate chronic periodontitis. Methods: Clinical and microbiological evaluations were performed at 21 sites treated with SRP (control) and 21 sites treated with SRP+EPAP (test). All examinations were performed before treatment, 1 month after treatment, and 3 months after treatment. Results: There were no significant clinical differences between the test group and the control group. Microbiological analysis revealed that the relative expression level of Porphyromonas gingivalis was significantly lower in the test group than in the control group at 1 month after treatment. Clinical and microbiological results showed improvements at 1 month compared to baseline; in contrast, the results at 3 months after treatment were worse than those at 1 month after treatment. Conclusions: In this study, both SRP and SRP+EPAP were clinically and microbiologically effective as non-surgical periodontal treatments. In particular, the SRP+EPAP group showed an antimicrobial effect on P. gingivalis, a keystone bacterium associated with the onset of chronic periodontitis, in a short-term period. Periodic periodontal therapy, at intervals of at least every 3 months, is important for sustaining the microbiological effects of this treatment.

• Journal of Periodontal and Implant Science
• /
• 제43권2호
• /
• pp.96-100
• /
• 2013

Purpose: Chronic periodontitis (CP) seems to be associated with stress and depression, but little information on this possible association is available in the literature. Thus, the objective of this study was to evaluate the association among stress, the salivary cortisol level (SCL), and CP. Methods: Seventy systemically healthy subjects were included in the study from January to September 2011. Full medical and dental histories were obtained, and the following measurements were recorded: 1) probing depth; 2) clinical attachment level; 3) bleeding on probing; and 4) tooth mobility. Saliva samples were collected for the evaluation of SCL (via a highly sensitive electrochemiluminescence immunoassay), and all subjects also answered a questionnaire (i.e., the Zung Self-rating Depression Scale). The odds ratio (OR) with a 95% confidence interval (CI) was calculated, and one way analysis of variance and the Tukey-Kramer method were performed. Results: A total of 36 subjects with CP (51.4%) and 34 without CP were evaluated. Of them, all of the subjects with CP and one periodontally healthy subject were diagnosed with depression. Subjects with moderate CP had statistically significantly higher levels of SCL than subjects with a diagnosis of slight CP (P=0.006). Also, subjects with severe CP showed the same outcome when compared to those with slight CP (P=0.012). In addition, 46 subjects presented high SCL whereas 24 had a normal level. CP was found to be correlated with the SCL, with an OR of 4.14 (95% CI, 1.43 to 12.01). Conclusions: Subjects with a high SCL and depression may show an increased risk for CP.

• Journal of Periodontal and Implant Science
• /
• 제36권1호
• /
• pp.69-84
• /
• 2006

Reports on the comparison of clinical effect between non-surgical and surgical therapy, and the change of the clinical parameters during maintenance phase have been rarely presented in Korea. This study was to observe the clinical changes during maintenance phase of 6 months in patients with chronic periodontitis treated by non-surgical or surgical therapy in Department of Periodontics, Chonnam National University Hospital. Among the systemically healthy and non-smoking patients with moderate to severe chronic periodontitis, twenty eight patients (mean age: 47.5 years) treated by non-surgical therapy (scaling and root planning) and nineteen patients (mean age: 47.3 years) treated by surgical therapy (flap surgery) were included in this study. The periodontal supportive therapy including recall check and oral hygiene reinforcement was started as maintenance phase since 1 month of healing after treatment. Probing depth, gingival recession. clinical attachment level and tooth mobility were recorded at initial, baseline and 1, 2, 3 and 6 month of maintenance phase. The clinical parameters were compared between the non-surgical and surgical therapies using Student t-test and repeated measure ANOVA by initial probing depth and surfaces. Surgical therapy resulted in greater change in clinical parameters than non-surgical therapy. During the maintenance phase of 6 months, the clinical effects after treatment had been changed in different pattern according to initial probing depth and tooth surface. During maintenance phase, probing depth increased more and gingival recession increased less after surgical therapy, compared to non-surgical therapy. The sites of initial probing depth less than 3 mm lost more clinical attachment level, and the sites of initial probing depth more than 7 mm gained clinical attachment level during maintenance phase after non-surgical therapy, compared to surgical therapy. Non-surgical therapy resulted in greater reduction of tooth mobility than surgical therapy during maintenance phase. These results indicate that the clinical effects of non-surgical or surgical therapy may be different and may change during the maintenance phase.

• Journal of Periodontal and Implant Science
• /
• 제51권2호
• /
• pp.124-134
• /
• 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.

• 대한치위생과학회지
• /
• 제7권1호
• /
• pp.69-81
• /
• 2024

연구의 배경 및 목적: 본 연구는 한국 성인을 대표하는 표본을 대상으로 우울증에 따른 신체활동과 치주염의 연관성을 조사하고자 하였다. 한국 성인의 우울 증상에 따라 신체활동과 치주염 간 연관성에 차이가 있는지 파악하고자 하며, 이를 통하여 우울증 환자의 구강건강 증진 및 유지관리를 위하여 신체활동을 포함한 건강행동에 대한 기초자료를 제공하는데 근거가 되고자 한다. 연구 방법: 제7기 국민건강영양조사(2016~2018년)에 참여한 총 12,689명의 대상자를 조사하였다. 우울증은 PHQ-9 ≥ 10으로 정의했다. 치주 상태는 지역 사회 치주지수(CPI)를 사용하였다. 치주염은 코드 3 이상으로 설정했다. 구강검사는 조사지역 중 일부를 추출하여 검사를 진행하여 제 7기로 통합되어 별도 가중치가 사용되었다. 개별가중치 요인이 사용되었고, 자료 분석은 복합표본설계(Complex sampling design)를 통해 분산값을 계산했다. 신체활동은 일과 여가, 장소이동과 관련된 신체활동으로 구분되며, 본 연구에서는 일과 여가에서 약간 숨이 차거나 심장이 약간 빠르게 뛰는 활동 이상을 하는 경우와 장소이동 신체활동을 모두 포함하는 총신체활동량으로 정의하였다. 총신체활동량은 신체활동 실천 일수와 시간을 고려하여 강도에 따라 가중치를 부여하여 산출하였고, 산출된 값의 분포를 고려하여 총신체활동을 하는 집단과 하지 않는 집단으로 나누었다. 다변량 로지스틱회귀분석을 실시하고자, 사회인구학적 변수(연령, 성별, 교육수준 및 가구소득), 구강 및 건강행동(치실 및 치간칫솔 사용, 현재 흡연), 전신건강상태(당뇨병 및 고혈압) 변수를 보정하였다. 우울증 여부에 따라 층화분석을 실시하여 신체활동과 치주염 간 연관성 차이를 분석하였다. 결과: 다변수 로지스틱회귀모형에서 우울증이 있는 대상자 중 신체활동을 하지 않는 집단은 신체활동을 하는 집단보다 치주질환의 위험성이 2.65배(오즈비 = 2.65, 95% 신뢰구간 = 1.17-6.01) 높은 것으로 나타났다. 결론: 우울증이 있는 경우 신체활동은 치주염과 유의하게 관련이 있는 것으로 나타났다.

• Journal of Periodontal and Implant Science
• /
• 제29권2호
• /
• pp.371-387
• /
• 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
• /
• 제28권4호
• /
• pp.531-545
• /
• 1998

The objective of the present study was to evaluate the clinical and microbiological effects of scaling and root planing combined with local application of 2% minocycline gel to patients with moderate to advanced chronic adult periodontitis. 27 healthy patients with moderate to advanced chronic adult periodontitis were enrolled in the study. 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 splitmouth design. All patients received standardized oral hygiene instructions at the beginning of the study. Subsequently scaling and root plaining was performed on all remaining teeth until 0 week. The 2% minocycline gel was applied to periodontal pocket at 0, 1, 2, 3week in the test side. The normal saline was irrigated subgingivally for about 30 seconds in the control side. The clinical and microbiological analysis was carried out at 0, 4, 8, and 12weeks. The results of this st udy were as follows; 1.2% minocycline gel delivered subgingivally as an adjunct to scaling and root planing provided benefit in reducing sulcular bleeding index and pocket depth than the use of normal saline. 2. The relative proportion of cocci and non-motile bacteria was increased in the test and control groups with time, and there was no statistically significantdifference between two groups. 3. The proportion of spirochetes was slowly reduced in the control group, but, inthe test group, they were remarkably reduced from the 4th week, and there was a statistically significant difference between two groups. 4. In both groups, the relative proportion of motile rods was notably decreasedat the beginning of the study, and remained until 12th week in the test group,but, in the control group, they were slowly increased from the 4th weekand finally similar to that of the initial examination. In conclusion, local application of 2% minocycline gel may be effective in the clinical and microbiological aspects as an adjunct to scaling and root planing in periodontal disease sites.

• Journal of Periodontal and Implant Science
• /
• 제50권2호
• /
• pp.74-82
• /
• 2020

Purpose: The aim of this cross-sectional study was to investigate the effect of scaling and root planing (SRP) on the expression of anti-inflammatory cytokines (interleukin [IL]-4, IL-9, IL-10, and IL-13) in the gingival crevicular fluid (GCF) of electronic cigarette users and non-smokers with moderate chronic periodontitis (CP). Methods: Electronic cigarette users and non-smokers with CP were included in the study. Full-mouth plaque and gingival indices, probing depth (PD), clinical attachment loss (CAL), and marginal bone loss (MBL) were assessed. The GCF was collected, and its volume and levels of IL-4, IL-9, IL-10, and IL-13 were assessed. These parameters were evaluated at baseline and 3 months after SRP. The sample size was estimated, and comparisons between groups were performed. P<0.05 was considered to indicate statistical significance. Results: Thirty-six electronic cigarette users (47.7±5.8 years old) and 35 non-smokers (46.5±3.4 years old) with CP were included. At baseline, there were no differences in plaque index (PI), PD, CAL, MBL, and GCF IL-4, IL-9, IL-10, and IL-13 between electronic cigarette users and nonsmokers. At the 3-month follow-up, there were no significant differences in PI, gingival index (GI), PD, CAL, and MBL in electronic cigarette users compared to baseline, while there were significant reductions in PI, GI, and PD among non-smokers. At the 3-month follow-up, GCF IL-4, IL-9, IL-10, and IL-13 levels were significantly elevated in both groups (P<0.05) compared to baseline. The increases in GCF IL-4, IL-9, IL-10, and IL-13 levels were significantly higher in non-smokers (P<0.05) than in electronic cigarette users at the 3-month follow-up. Conclusions: Levels of GCF IL-4, IL-9, IL-10, and IL-13 increased after SRP in electronic cigarette users and non-smokers with CP; however, the anti-inflammatory effect of SRP was more profound in non-smokers than in electronic cigarette users.

• Journal of Periodontal and Implant Science
• /
• 제43권4호
• /
• pp.183-190
• /
• 2013

Purpose: At present, information regarding periodontal disease in geriatric patients is scarce. The purpose of this study was to quantify the periodontal pathogens present in the saliva of Korean geriatric patients and assess the relationship between the bacterial levels and the periodontal condition. Methods: Six putative periodontal pathogens were quantified by using a real-time polymerase chain reaction assay in geriatric patient groups (>60 years) with mild chronic periodontitis (MCP), moderate chronic periodontitis (MoCP), and severe chronic periodontitis (SCP). The copy numbers of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Prevotella intermedia were measured. Results: It was found that the bacterial copy numbers increased as the severity of the disease increased from MCP to SCP, except for P. intermedia. For P. intermedia, it was found that samples in the MCP group yielded the largest amount. It was also found that the quantities of P. gingivalis, T. forsythia, and T. denticola, the so-called "red complex" bacteria, were lower than those of F. nucleatum, A. actinomycetemcomitans, and P. intermedia in all of the samples. Conclusions: Collectively, the results of this study suggest that the levels of P. gingivalis, T. forsythia, F. nucleatum, and T. denticola present in saliva are associated with the severity of periodontal disease in geriatric patients.

• 치위생과학회지
• /
• 제15권2호
• /
• pp.202-208
• /
• 2015

본 연구는 후향적 연구로서, 대상자의 치주 건강 상태에 따라 그들의 치면세균막의 산 생성 능력에 차이가 있는지를 Cariview 검사법을 활용하여 평가하였다. 치과에 내원한 만 20세 이상의 성인 68명의 치면세균막을 채취하여 Cariview 검사를 시행하였고, 방사선 사진 및 QLF-D 사진을 통해 얻은 데이터를 분석하여 다음과 같은 결과를 얻었다. 치주 건강 상태에 따라 대상자의 나이, 치조골 소실 치아 수, 임플란트 수에서는 유의한 차이를 확인하였다(p<0.001). 그러나 치은염, 경도 치주염, 중등도 치주염, 고도 치주염으로 치은 건강상태의 분류에 따라 평균적인 Cariview 점수에는 차이가 있었으나 통계적으로 유의한 차이는 확인되지 않았다(p=0.12).