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.
Gingival recession is one of the common mucogingival problems during the orthodontic treatment. The causes of the gingival recession are similar to gingival recession in patients with periodontal diseases. Accumulation of bacterial deposits around the natural teeth induces the gingival inflammation and gingival recession occurs in the teeth with the lack of the supporting bone. However, malpositioned teeth which are labially positioned teeth or rotated teeth are more risky for gingival recession. Once root is exposed to oral cavity due to gingival recession, the orthodontic tooth movement is compromised and esthetic problems appeared. In addition, excessive gingival recession over the mucogingival junction jeopardizes the oral hygiene control, which has a risk of further gingival recession and bone loss around the tooth. To cover exposed root or to prevent further gingival recession, mucogingival surgery with gingival graft is recommended for the patients under orthodontic treatment. This case report aimed to present the mucogingival treatments of gingival recession observed during orthodontic treatment. Case I had had initial slight gingival recession before the orthodontic treatment. However, during the retraction phases, the gingival recession progressed and the periodontal treatment was referred. In case II, miller Class III gingival recession was occurred after correction of rotation. Both cases were treated by coronally advanced flap with free gingival grafts and recovered to the level of adjacent teeth despite of complete root coverage was not achieved in Case II. After periodontal treatment, orthodontic treatment was successfully completed. In conclusion, mucogingival surgery during the orthodontic treatment is recommended for the successful orthodontic treatment as well as periodontal health.
Many references report that abnormal diastema except temporary diastema existing in mixed dentition period is caused by maxilary heavy labial frenum, malocclusion, progressive periodontal disease, and loss of posterior teeth. We can diagnose patient as diastema caused by periodontal disease, especially, in case of accompanying progressively destructed anterior maxillary alveolar bone defect, and interseptal bone defect. We report Multiple disciplinary approach for diastema associated with periodontal disease. Periodontal treatment(Guided Tissue -Regeneration, alveoloplasty, bone graft), or thodontic treatment (space closure, redistribution), and the final proshodontic restoration for retention were used.
The purpose of this study was to determine the association between drinking behaviors and the need for periodontal treatment. The data of 5,995 adults from the 2012 Korea National Health and Nutrition Examination Survey were categorized into young adulthood (19~39 years), middle age (40~64 years), and old age (${\geq}65$ years) and analyzed. Chi-square test was performed to determine those who needed periodontal treatment by the respondents' general characteristics and drinking behaviors, and logistic regression analysis was carried out to determine the impact of each drinking behavior on the need for periodontal treatment. The results of this study have confirmed that alcohol intake is a factor adversely affecting periodontal status; therefore, patients should know the fact that excessive alcohol intake and increased frequency of drinking may affect the prevalence rate of periodontal diseases. Moreover, moderate-drinking programs that can reinforce prevention of drinking so that dental hygienists can provide good oral health care should be developed. A systematic oral health promotion program should be introduced for constant prevention with the objective of activating oral health education that focused on middle-aged and young-adult people in pursuit of healthy aging society.
Kim, Sangmin;Lee, Jaemin;Kang, Dae-Young;Shin, Hyun-Seung
Journal of Dental Rehabilitation and Applied Science
/
v.37
no.4
/
pp.294-300
/
2021
Necrotizing periodontal disease caused by plaque bacteria is showed clinical findings including pseudo-membrane, interproximal necrosis of the affected area, pain on palpation and gingiva bleeding. Microbiological examination is showed that patients have fusospirochetal bacteria. Two patients who were provisionally diagnosed as necrotizing periodontal disease received nonsurgical periodontal treatments in conjunction with dressing using 3% hydrogen peroxide and local antibiotic delivery. Before and 3 - 5 days after initial treatment, the levels of periodontal bacteria in gingival crevicular fluid obtained using quantitative PCR were compared. After treatment, patients recovered normal gingiva. The number of periodontal diseases related bacterial species decreased from seven or eight to one. As a result, periodontium of patients with necrotizing periodontal disease was recovered to normal periodontium by nonsurgical periodontal treatments.
Purpose: The aim of this study was to evaluate the clinical outcomes of periodontal granulation tissue preservation (PGTP) in access flap periodontal surgery. Methods: Twenty patients (stage III-IV periodontitis) with 42 deep periodontal pockets that did not resolve after non-surgical treatment were consecutively recruited. Access flap periodontal surgery was modified using PGTP. The clinical periodontal parameters were evaluated at 9 months. The differences in the amount of granulation tissue width (GTw) preserved were evaluated and the influence of smoking was analyzed. Results: GTw >1 mm was observed in 97.6% of interproximal defects, and the granulation tissue extended above the bone peak in 71.4% of defects. At 9 months, probing pocket depth reduction (4.33±1.43 mm) and clinical attachment gain (CAG; 4.10±1.75 mm) were statistically significant (P<0.001). The residual probing depth was 3.2±0.89 mm. When GTw extended above the interproximal bone peak (i.e., the interproximal supra-alveolar granulation tissue thickness [iSUPRA-GT] was greater than 0 mm), a significant CAG was recorded in the supra-alveolar component (1.67±1.32 mm, P<0.001). Interproximal gingival recession (iGR) was significant (P<0.05) only in smokers, with a reduction in the interdental papillary tissue height of 0.93±0.76 mm. In non-smokers, there was no increase in the iGR when the iSUPRA-GT was >0 mm. The clinical results in smokers were significantly worse. Conclusions: PGTP was used to modify access flap periodontal surgery by preserving affected tissues with the potential for recovery. The results show that preserving periodontal granulation tissue is an effective and conservative procedure in the surgical treatment of periodontal disease.
Objectives: The purpose of this study was to compare the dental treatment needs of workers depending on their shifts and working patterns. Methods: Only workers aged 15 or older according to the $6^{th}$ Korea National Health and Nutrition Examination Survey (2013-2015) were considered eligible. A total of 9,092 people who responded to health surveys and completed oral examinations and interviews were selected for the study. Statistical analysis was carried out by the complex samples general linear model. Results: As the daytime workers' age increased, the requirement for restorative treatment decreased. In contrast, the requirement for tooth extraction caused by dental caries and periodontal disease increased. As the evening shift workers' age increased, the requirement for restorative treatment decreased. In the case of shift workers, the requirement for restorative treatment was lowest in those aged 50-64 years and highest in those aged 30-49 years. In the case of smokers; the daytime workers required a higher amount of restorative treatment, pulpal treatment, and tooth extraction due to dental caries and periodontal disease; the night shift workers required a higher amount of restorative treatment; and the shift workers required a higher amount of tooth extraction caused by periodontal disease. The results of comparing the dental treatment needs depending on working patterns were: the need for restorative treatment was higher in night shift workers (0.377) than in shift workers (0.245); the requirement for pulpal and restorative treatment was higher in daytime workers (0.055) than in night shift workers (0.010); requirement for tooth extraction due to periodontal disease was higher in night shift workers (0.060) than in evening shift workers (0.012). Conclusions: There are differences in dental treatment needs depending on the workers' working patterns. Collective oral health care is needed at workplaces to promote the workers' oral health.
Lee, Jae Young;Choi, Yoon Young;Choi, Youngnim;Jin, Bo Hyoung
Journal of Periodontal and Implant Science
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v.50
no.2
/
pp.83-96
/
2020
Purpose: The present study aimed to evaluate the clinical benefit of additional toothbrushing accompanying non-surgical periodontal treatment on oral and general health in patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a doubled-blind randomized controlled trial in 60 T2DM patients between June 2013 and June 2014. The patients were randomly assigned to the scaling and root planing (SRP) group; the scaling and root planing with additional toothbrushing (SRPAT) group, in which additional toothbrushing was performed by toothpick methods; or the control group. Microbiological and oral examinations were performed for up to 12 weeks following treatment. Non-surgical treatment was conducted in the experimental groups. The SRP group received scaling and root planing and the SRPAT group received additional toothbrushing with the Watanabe method once a week from the first visit through the fifth visit. The primary outcomes were changes in haemoglobin A1c (or glycated haemoglobin; HbA1c) levels, serum endotoxin levels, and interleukin-1 beta levels. Periodontal health status was measured by periodontal pocket depth, the calculus index, and bleeding on probing (BOP). Results: Both the SRP and SRPAT groups showed improvements in periodontal health and HbA1c, but the SRPAT group showed significantly less BOP than the SRP group. Furthermore, only the SRPAT group showed a statistically significant decrease in serum endotoxin levels. Conclusions: Non-surgical periodontal treatment was effective in improving HbA1c and serum endotoxin levels in T2DM patients. Furthermore, non-surgical treatment with additional tooth brushing had a more favourable effect on gingival bleeding management. Trial RegistrationClinical Research Information Service Identifier: KCT000416.
Kim, Young-Taek;Lee, Jae-Hong;Kweon, Helen Hye-In;Lee, Jung-Seok;Choi, Jung-Kyu;Kim, Dong-Wook;Choi, Seong-Ho
The Journal of the Korean dental association
/
v.54
no.8
/
pp.604-612
/
2016
The aim of this study was to evaluate the effect of national health insurance coverage of periodontal scaling using the National Health Insurance Service-National Sample Cohort for 2009-2013. After the enforcement of periodontal scaling covered by national health insurance, the number of patients diagnosed with periodontal disease and received treatment, has increased from 35,234 to 99,576 people in the last 4 years. Further, the number of patients who received the treatment of periodontal disease more than once, have also increased to around 69% in 2013 when compared to 2012. Moreover, the number of patients receiving periodontal scaling has been steadily increasing every year. Among the patients who visited hospital for periodontal disease, there has been an increase of 280%. As a result, continuous public relations and long-term research on the effect of periodontal scaling as a prophylactic treatment is necessary.
The purpose of this study was to observe the effects of periodontal therapy, including nonsurgical periodontal therapy with azithromycin, surgical therapy, and maintenace therapy on the drug-induced gingival enlargement, by means of measuring gingival thickness. The test group of 18 patients with drug-induced gingival enlargement received scaling, root planing with azithromycin for 5 days, with or without surgical periodontal treatment. The control group of 18 patients who had not taken any medication, received scaling and root planing, with or without surgical periodontal treatment. Both groups received supportive periodontal therapy every 3 months for 2 years. The mean period of total treatment is 32 months in the test group and 31 months in the control group. The thickness of the buccal gingiva was measured using an ultrasonic device of $SDM^{(R)}$(Krupp Corp., Essen, Germany). The results revealed that the test $group(1.21{\pm}0.51mm)$ showed statistically thicker buccal gingiva than the control $group(1.01{\pm}0.3mm)$. In the test group, the buccal gingiva was thickest on 2nd molars and was thinnest on canines of both dental arches. In the control group, the buccal gingiva was thickest on central incisors in the maxilla and 2nd molars in the mandible, while the thinnest areas were on canines in the maxilla and 1st premolars in the mandible. It would be concluded that the periodontal treatment with azithromycin aids in decreasing the degree of the gingival enlargement but cannot prevent the recurrence completely.
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