• Journal of Periodontal and Implant Science
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• v.43 no.6
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• pp.276-282
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• 2013

Purpose: The aim of this study was to explore root shape abnormalities, to investigate the influence of root form abnormalities on periodontal attachment loss, and to gather basic data to assist in the diagnosis and treatment of aggressive periodontitis. Methods: From January 2010 to June 2012, a survey was conducted of all 3,284 periodontitis patients who visited the Department of Periodontology, Daejeon Dental Hospital, Wonkwang University School of Dentistry. Clinical parameters (probing depth, periodontal attachment loss, missing teeth) were measured and a radiographic examination was performed at the baseline. We classified the root shape abnormality of bicuspids and molars based on Meng classification. Results: The periodontal attachment loss was the highest at the maxillary first molar (6.03 mm). The loss of the second molar was prominent. Type V deformity was shown to be the most common in the second maxillary and mandibular molars (P<0.05). Type V root shape was associated with the highest attachment loss (P=0.01). Conclusions: Considering the small population and limited design of this study, definitive conclusions cannot be drawn. We suggest larger scale, methodologically more sophisticated studies that include normal controls and chronic periodontitis patients to clarify whether root form abnormalities are a potential risk factor for aggressive periodontitis.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.61-68
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• 2006

The factors influencing long-term prognosis of teeth must be carefully considered. Among these, attachment level is strongly associated with tooth loss. The purpose of the present study was to estimate pattern of attachment loss based on attachment area in extracted teeth. 197 satisfied the criteria for assessment after staining. The protocol described by Waerhaug(l975) was performed. An indir ect method, based on digital image abstracted from digital camera and digital imaging software program, was used to calculate the root surface area and the attachment loss area. The data were analysed using SPSS. Except maxillary central incisior and mandibular canine, no statistical significant differences between each root surfaces were observed in anterior teeth. In posterior teeth, statistical significant differences in palatal surface of maxillary molar and mandibular molar compared with others were observed. Statistical significant difference in buccal surface compared with others was lowly observed in single and multi rooted. This study did not reveal progressive loss pattern of attachment area in each root surface but clarified root surface that has relative high loss rate of attachment area at extraction. Thus understanding this pattern of attachment loss is helpful for dentist to treat the periodontitis.

• Journal of Periodontal and Implant Science
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• v.41 no.3
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• pp.143-148
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• 2011

Purpose: Few epidemiologic studies have investigated aggressive periodontitis in Koreans, but such studies of disease prevalence and other clinical characteristics would be invaluable in providing proper treatment. The aim of this study was to assess the prevalence of aggressive periodontitis and to measure the extent of associated periodontal breakdown. Methods: The study population consisted of 1,692 patients who visited the Department of Periodontology, Wonkwang Daejeon Dental Hospital from January to December, 2010. Clinical parameters (probing depth, gingival recession, periodontal attachment loss) were measured by a single examiner, and radiographic examination was performed at the baseline. Results: Twenty-eight (1.65%) patients showed clinical features of aggressive periodontitis, of which 27 patients exhibited the generalized form, and 1 exhibited the localized form. There was no significant difference between the percentage of male and female patients. The probing pocket depth of the maxillary first molar was deeper than that of the other teeth and gingival recession was also the most serious at the maxillary first molar. The periodontal attachment loss was the highest at the maxillary first molar. The average number of missing teeth was 1.29 per subject. Loss of the second molar was prominent. Conclusions: Within the limitations of this study, the periodontal breakdown evaluated by attachment loss was found to be most severe at the first molars of aggressive periodontitis patients. However, further large scale multicenter studies are necessary to access more precise data, including prevalence.

• Journal of Periodontal and Implant Science
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• v.41 no.2
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• pp.92-97
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• 2011

Purpose: The present study was performed to compare the treatment outcomes of non-surgical periodontal treatment according to the distribution of attachment loss of a given patient. Methods: Forty-five patients with moderate to severe periodontitis were divided in two subgroups; Group I patients with teeth manifesting attachment loss of ${\geq}$ 6 mm at one or more sites on the buccal/labial aspect while maintaining an attachment level ${\leq}$ 5 mm at the lingual/palatal aspect, Group II patients with teeth manifesting an attachment level ${\geq}$ 6 mm at more than one site on the lingual/palatal aspect while maintaining an attachment level ${\leq}$ 5 mm at the buccal/labial aspect. The probing pocket depth, probing attachment level, tooth mobility, and chewing discomfort were recorded at baseline and 6 months examinations following non-surgical periodontal therapy. Results: The buccal/ abial surfaces of teeth with moderate to severe periodontitis in Group I patients demonstrated a greater amount of pocket reduction, gain of attachment level, and tooth mobility reduction than the lingual/palatal aspects of teeth examined in Group II patients. Conclusions: Within the limits of the present study, the patients demonstrating attachment loss ${\geq}$ 6 mm at buccal/labial surfaces responded better to the nonsurgical periodontal therapy than those demonstrating comparable attachment loss at lingual/ palatal surfaces.

• Journal of Periodontal and Implant Science
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• v.38 no.1
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• pp.15-22
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• 2008

Purpose: The attachment level is strongly associated with tooth loss and provides useful information on patterns of destruction of the periodontium. The presence of horizontal attachment loss would not be detected in clinical measurement. Therefore, the purpose of the present study was to estimate the patterns of periodontal destruction based on the attachment area and horizontal attachment loss in extracted teeth due to severe periodontitis. Materials and Methods: 307 teeth satisfied the criteria for assessment. An indirect method, based on digital images obtained from a digital camera and an image analysis program, was used to calculate the area of root surface and attachment loss and the extent of horizontal attachment loss. The data were analysed using SPSS. Results: No statistically significant differences among root surfaces were observed in anterior teeth on the loss of attachment area. However, in posterior teeth statistically significant differences in palatal surfaces of maxillary and mandibular premolar and molar surfaces compared with buccal surfaces were observed. Horizontal attachment loss was observed in 21.5% of the teeth examined. Frequency of horizontal attachment loss was highest in the maxillary first premolar (34.8%), followed by the maxillary second premolar (27.3%) and maxillary canine (25%). The mean length of horizontal attachment loss was 1.5mm. Conclusion: More meticulous examination will be needed of the palatal surfaces of maxillary and mandibular premolar and molar teeth. The percentage of teeth with horizontal attachment loss greater than 2.1 mm was 5.2%. Considering the length of curette blades, about 5.2% of teeth were not properly debrided. Therefore, Additional supportive therapy such as local drug delivery has to be considered in treatment of the first maxillary, second premolar and canine due to the high prevalence of horizontal attachment loss.

• The Journal of the Korean dental association
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• v.55 no.1
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• pp.22-29
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• 2017

Purpose : Preservation of the periodontal health of the treated patient requires supportive periodontal therapy for the elimination of periodontal disease. After Phase I therapy is completed, patients are placed on a schedule of periodic recall visits for maintenance care to prevent recurrence of the disease. The amount of tooth loss would be the most relevant criterion in an evaluation of the effect of periodontal treatment, but this would require studies with extremely long follow-up periods. Thus the most commonly used outcome criteria in clinical research have been clinical attachment level change, reduction of pocket depth and bleeding frequency. The purpose of this case study is to identify the effect of supportive periodontal therapy after periodontal flap surgery. Materials & Methods : Following routine hygienic phase of treatment, patients with chronic periodontitis received surgical periodontal treatment. Bleeding on probing, pocket depth and clinical attachment level were measured at baseline, pre-operation and 1 year follow up. All procedures were performed by one operator. Results : One year a total of 28 patients (58sites) to recheck remained, when conducted maintenance program after periodontal flap surgery was observed reduction of bleeding frequency, pocket depth and improvement of clinical attachment level. Conclusion : The results from this study indicate that supportive periodontal therapy after periodontal flap surgery is effective for reduction of bleeding frequency, pocket depth and gain of clinical attachment level.

• Oral Biology Research
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• v.42 no.4
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• pp.248-253
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• 2018

Cemental tears are uncommon form of root fracture that can lead to rapid localized periodontal attachment loss. Studies have described periodontal breakdown as being associated with the separation of the cementum from the underlying tooth structure. The aim of this case report is to assess the outcome of treatment of cemental tear with several surgical treatment regimens. Three patients with cemental tear were treated with different surgical method. In all three cases, the cemental tear occurred on maxillary right central incisors. In each case, the root fragment were removed, the localized defect was treated using different surgical methods including guided tissue regeneration and bone graft followed by scaling and root planting. In all three cases, symptoms subsided after the treatment and clinical attachment level was improved up to 2 mm at 3 month after surgery. Both conventional and regenerative periodontal surgery could achieve successful outcomes.

• Journal of Periodontal and Implant Science
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• v.43 no.3
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• pp.136-140
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• 2013

Purpose: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Methods: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Results: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. Conclusions: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.

• Journal of Periodontal and Implant Science
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• v.23 no.2
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• pp.331-344
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• 1993

The purpose of this study was to investigate the change of tooth mobility and bite force according to periodontal disease severity. Tooth mobility and biting force due to change of viscoelastic property of periodontium were influenced by inflammation of periodontal tissue. 30 patients participated in this study, the periodontal disease severity is evaluated with SBI and attachment loss. SBI and attachment loss were examined by periodontal probe. Tooth mobility was tested two times to each tooth using periotest (Siemens Co, Germany) and bite force was evaluated with MPM-3000 (Nihon Kohden Co, Japan). Statistical analysis was applied to correlation ($r^2$) and regression analysis. The obtained results were as follows : 1. As the attachment loss increased, tooth mobility increased with significance, and they had highly positive correlation ($r^2=0.68$) on entire dentition. 2. As the SBI increased, tooth mobility increased with significance, and they had positive correlation ($r^2=0.37$) on entire dentition. 3. As the attachment loss increased, bite force decreased with significance, and they had highly negative correlation ($r^2=0.42$) on maxillary anterior dentition but low negative correlation ($r^2=0.20$) on the other portion of dentition. 4. As the SBI increased, bite force decreased with significance, and they had highly negative correlation ($r^2=0.31$) on maxillary anterior dentition but low negative correlation ($r^2=0.16$) on the other portion of dentition. 5. As tooth mobility increased, bite force decreased with significance, and they had highly negative correlation ($r^2=0.32$) on maxillary anterior dentition but low negative correlation ($r^2=0.16$) on the other portion of dentition.

• Journal of Periodontal and Implant Science
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• v.49 no.2
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• pp.60-75
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• 2019

The primary aim of this systematic review was to assess the evidence on periodontal disease progression after treatment in patients receiving supportive periodontal therapy (SPT) and to identify predictors of clinical attachment level (CAL) loss. A protocol was developed to answer the following focused question: In adult patients treated for periodontitis, what is the disease progression in terms of CAL loss after surgical or non-surgical treatment? Randomized controlled clinical trials, prospective cohort studies, and longitudinal observational human studies with a minimum of 5 years of follow-up after surgical or non-surgical treatment that reported CAL and probing depth changes were selected. Seventeen publications reporting data from 14 investigations were included. Data from 964 patients with a follow-up range of 5-15 years was evaluated. When the CAL at the latest follow-up was compared to the CAL after active periodontal therapy, 10 of the included studies reported an overall mean CAL loss of ${\leq}0.5mm$, 3 studies reported a mean CAL loss of 0.5-1 mm, and 4 studies reported a mean CAL loss of >1 mm. Based on 7 publications, the percentage of sites showing a CAL loss of ${\geq}2mm$ varied from 3% to 20%, and a high percentage of sites with CAL loss was associated with poor oral hygiene, smoking, and poor compliance with SPT. The outcomes after periodontal therapy remained stable over time. Disease progression occurred in a reduced number of sites and patients, mostly associated with poor oral hygiene, poor compliance with SPT, and smoking.