• Journal of Periodontal and Implant Science
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• 제32권1호
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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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• 제29권3호
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• pp.635-645
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• 1999

The present study examines the effects of orthodontic treatment of surgically exposed impacted upper canines or ectopically erupted upper canines to periodontal condition and whether various opening procedures have significant difference in postoperative periodontal status. The subjects included 23 orthodontic patients(7 men, 16 women) with unilateral upper canine impaction treated either with closed eruption technique(group I), with apically positioned flap procedure (group II), and those with canines ectopically erupted through keratinized gingiva (group III). In each subject, the ectopic canine was orthodontically aligned, and changes in periodontal tissue were assessed by measuring keratinized gingival width, attached gingival width, probing depth and bone probing depth. In all three groups, the width of keratinized gingiva was preserved while showed no signs of detrimental periodontal condition such as gingival recession. In all three groups, no significant difference in periodontal pocket depth from control was observed. The width of attached gingiva was significantly greater in patients treated with apically positioned flap procedure(group II) than in patients on other groups.

• 대한치과교정학회지
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• 제36권4호
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• pp.263-274
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• 2006

본 연구는 밴드 제거 직후 및 4주 경과 후 치주조직의 임상적인 환경변화와 미생물 분포 변화를 알기 위해 시행하였다. 최후방 구치에 밴드를 포함하는 고정식 교정 장치를 장착하고 교정 치료를 1년 이상 시행한 17명의 환자를 대상으로 하였다 (평균 나이 22세, 남자 6명, 여자 11명). 최후방 구치의 밴드를 제거한 직후와 제거 후 4주가 경과한 다음에 치주조직의 탐침 깊이와 출혈 빈도를 측정하였으며, 치은 연하의 치태를 채취하여 미생물의 분포를 조사하였다. 치주질환에 관련성이 깊은 미생물 중 Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola를 직접 Polymerase Chain Reaction 방법으로 존재 여부를 확인하였다. 밴드 제거 직후와 제거 후 4주가 경과한 시점의 치주조직의 탐침 깊이와 출혈 빈도, 병원성 미생물의 존재 여부를 통계적으로 비교하였다. 탐침 깊이와 출혈 빈도는 모두 하악 좌측 구치 협면에서 감소율이 가장 크게 나타났고, 상악 우측 구치 설면에서 감소율이 가장 작게 나타났다. 병원성 미생물 중 T. denticola가 밴드 제거 4주 후에 가장 높은 감소율을 보였으며, 하악보다 상악에서 감소율이 더 크게 나타났다. 이는 비록 밴드를 장착하여 치주 환경이 불량해졌다 하더라도 올바른 구강 위생 관리가 시행된다면 밴드를 제거한 후 정상적인 치주 상태로 회복될 수 있음을 예시한 것으로 생각되었다.

• 대한치과의사협회지
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• 제47권9호
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• pp.596-606
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• 2009

Aim : The ultimate goal of periodontal treatment is regeneration of periodontium that have been lost due to inflammatory periodontal disease. Recently, Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate bone substitute have been introduced to achieve periodontal regeneration. The purpose of this study is to evaluate the effect of the Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate(BoneMedik-$DM^{(R)}$, Meta Biomed Co., Ltd. Oksan, Korea) on periodontal intrabony defects. Methods and materials : Clinical effects of Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate implantation in intrabony defects were evaluated 6 months after surgery in Sixty-one intrabony defects from Fourty-six patients with chronic periodontitis. Twenty-nine experimental defects in twenty-five patients received the Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate(test group), while Thirty-Three defects in twenty-one patients were treated with flap procedure only( control group). Comparative observation were done for preoperative and postoperative differences between control and experimental clinical parameters,-clinical attachment 10ss(CAL), probing depth(PD), bone probing depth(BPD), gingi val recession. Results : Postoperative improvements in CAL, PD, BPD were observed in both test and control groups(P<0.0l). However, the improvements in CAL, PD, BPD of the test group were significantly greater than control group. Conclusion : Healing of the both groups were uneventful during experimental periods. Use of Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate in a flap operation resulted in significantly greater improvements in CAL, PD, and BPD over flap operation alone. Silicon contained Coralline Hydroxyapatite and Beta Tricalcium Phosphate will be good bone substitute materials for treatment of intrabony defects.

• Journal of Periodontal and Implant Science
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• 제30권1호
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• pp.111-120
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• 2000

Purpose We designed this study for the purpose of determining the relationship between periodontal disease activity and PLBW, using the evaluation of probing pocket depth, loss of attachment, gingival index, gingival crevicular fluid amount and subgingival microflora. Methods A total of 100 volunteer mothers(mean age 30.44) at the Department of Obstetrics and Gynecology Seoul National University Hospital were selected for this study.Pregnancy outcomes were categorized into cases and controls in two ways. our definition was based on the following; Group 1 : Any PLBW cases Vs. All NBW controls Group 2 : PLBW cases Vs. NBW controls A periodontal exam was performed on the Ramfjord( #16, 21, 24, 36, 41, 44) teeth and Clinical evaluation consisted of probing pocket depth, loss of attachment, gingival index and gingival crevicular fluid amount. Subgingival plaque samples were collected by three sterile #35 paper points. The total number of anaerobic colonies and aerobic bacteria were enumerated after incubation. Antisera to P. gingivalis, P. intermedia, A. actinomycetemcomitans were produced in white rabbits with live whole cells suspensions. The specific fluorescent bacteria obtained by immunofluorescence and total cell counts obtained by dark-field microscopy were counted on four fields. The percent of each specific microorganism in the total cell count was determined. Results Any PLBW and PLBW cases showed significantly greater probing depth and attachment loss than all NBW and NBW controls. Cases group had significantly increased anaerobic bacterial counts compared with control group and no differences in the other microbes. This study confirmed that periodontal disease is a statistically significant risk factor for PLBW by investigating clinical parameters and subgingival plaque analysis.

• Journal of Periodontal and Implant Science
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• 제23권3호
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• pp.359-373
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• 1993

The ultimate objective of periodontal therapy is not only stopping the progression of periodontal disease, but also promoting the regeneration of lost periodontal tissue. Guided Tissue Regeneration, which is based on the principle that the goal of periodontal regeneration can be achieved by preventing apical migration of gingival epithelium and blocking cells originating from connective tissue, has been developed and used as a clinical procedure, and although it has shown excellent results in connective tissue healing, there have not been many studies showing its effect on the regeneration of alveolar bone loss due to periodontal disease. The objectives of this study are to investigate the result of 12 months-long treatment following guided tissue regeneration using expanded polytetrafluoroehylene membrane, and to observe the presence of regenerated alveolar bone. Forty-one teeth from 28 patients with clinical diagnosis of periodontitis has been selected. In fifteen of those interproximal intrabony defects, only flap operation had been carried out, and designated as the control group. Twenty-six intrabony defects received e-PTFE membrane following flap operation, and designated as the experimental group. Eleven teeth whose membrane had been exposed were excluded from the experiment. Various measurements including probing depth, loss of attachment, probing bone level and gingival recession have been recorded at 6th month and 12th month, and the significance of the changes has been analyzed. The results are as follows: 1. Probing depth at 6th and 12th month has shown a significant decrease in both groups (p<0.01), but significantly higher decrease was found in the experimental group compared to the control at the month(p<0.05). 2. Loss of attachment at 6th and 12th month has shown a significant decrease in both groups, but significantly higher decrease was found in the experimental group compared to the control (p<0.05). 3. Probing bone level at 6th and 12th month has shown a insignificant decrease in the control group and significant decrease in the experimental group (p<0.01). Significantly higher decrease in probing bone level was found in the experimental group (p<0.05). 4. Gingival recession at 6th and 12th month has shown a statistically significant increase (p<0.05), and the control group showed higher increase compared to the experimental group although no statistical significance was found. As these results have shown, the use of e-PTFE membrane in intrabony pockets results in marked decrease in the loss of attachment and probing bone level. This seems to indicate that e-PTFE membrane may play a role in alveolar bone regeneration in intrabony defects.

• Journal of Periodontal and Implant Science
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• 제47권1호
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• pp.13-19
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• 2017

Purpose: The purpose of this study was to examine whether periodontal pocket could be satisfactorily visualized by optical coherence tomography (OCT) and to suggest quantitative methods for measuring periodontal pocket depth. Methods: We acquired OCT images of periodontal pockets in a porcine model and determined the actual axial resolution for measuring the exact periodontal pocket depth using a calibration method. Quantitative measurements of periodontal pockets were performed by real axial resolution and compared with the results from manual periodontal probing. Results: The average periodontal pocket depth measured by OCT was $3.10{\pm}0.15mm$, $4.11{\pm}0.17mm$, $5.09{\pm}0.17mm$, and $6.05{\pm}0.21mm$ for each periodontal pocket model, respectively. These values were similar to those obtained by manual periodontal probing. Conclusions: OCT was able to visualize periodontal pockets and show attachment loss. By calculating the calibration factor to determine the accurate axial resolution, quantitative standards for measuring periodontal pocket depth can be established regardless of the position of periodontal pocket in the OCT image.

• Journal of Periodontal and Implant Science
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• 제29권1호
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• pp.41-49
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• 1999

The purpose of this study was to evaluate the relationship between osteoporosis and periodontal condition in postmenopausal women. Twenty-eight patients who have been treated at Chonnam national university hospital with osteoporosis(osteoporotic group, mean $age62.2{\pm}6.6$) and 21 normal postmenopausal women with periodontitis(control group, mean $age60.4{\pm}3.7$) were examined. Bone mineral density(BMD) of lumbar spine(L2-L4) was measured by dual energy X-ray absorptiomemtry(DEXA). Percentage to peaked bone mass in osteoporotic group was 70.9% which had lower BMD than in control group(p<0.05). The number of present teeth were 23.6 in osteoporotic group and 23.1 in control group. Percentage of bleeding on probing was 41% in osteoporotic group and 37% in control group. probing depth and attachment level were shown 3.18 mm, 3.63 mm in osteoporotic group and 2.85mm, 3.11mm in control group, respectively. Probing depth and attachment level were significantly greater in osteoporotic group than in control group(p<0.05). The significant negative correlation was found between BMD level and periodontal attachment level(p<0.001, ${\gamma}=-0.56$). These results suggest that osteoporosis may be associated with periodontal breakdown.

• Journal of Periodontal and Implant Science
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• 제27권4호
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• pp.701-722
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• 1997

It was reported that low dose doxycycline(LDD) regimen could inhibit pathologically elevated collagenase activity in the gingival crevicular fluid of petients with adult periodontitis without producing typical antibiotic side effects. The purpose of this study was to evaluate the effects of LDD regimen(20mg) administered during non-surgical therapy on clinical index and gingival crevicular fluid enzyme activity in diabetics who are at high risk for periodontal disease. Forty-nine subjects having at least two sites with probing pocket depths greater than 4mm were selected. In this double-blind, placebo-controlled study, the patients were administered 20 mg doxycycline capsule or placebo capsule b.i.d. for 2 weeks. Clinical parameters of dental plaque, gingival inflammation, probing pocket depth and probing attachment level were assessed at week 0, 2, 4, and 8. Gingival crevicular fluid samples were collected at the same time to evaluate the activities of collagenase and elastase. Clinical parameters and elastase activity were significantly reduced in all groups compared to the baseline value after treatment. Significantly greater reduction in pocket depth and gain in attachment level was shown in the LDD-administered group compared to placebo group in both adult periodontitis and diabetic patients. Total collagenase activity was also reduced significantly in all groups after treatment, but the greater reduction was seen in the LDD-administered diabetics group compared to relevant placebo group(at 4, 8week). Significantly greater reduction in active collagenase activity was also seen in the LDD-administered group compared to placebo group in diabetic patients(at 2, 4, 8week). These results indicated that use of low dose doxycycline could be aueseful adjunct to instrumentation therapy in the management of diabetic patient with periodontitis as well as adult periodontitis patient.

• Journal of Periodontal and Implant Science
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• 제39권1호
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• pp.37-44
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• 2009

Purpose: Tetracycline and its chemically modified non-antibacterial analogues can inhibit certain host-derived tissue destructive collagenases such as matrix metalloproteinases. The purpose of this study was to evaluate clinical and microbiologic effects of the subantimicrobial dose of doxycycline(SDD) in conjunction with scaling and root planing. Materials and methods: A total of 30 patients with chronic periodontitis who were going to receive scaling and root planing were randomly allocated to receive either a doxycycline hyclate for 3 months or nothing. Clinical probing depth, clinical attachment level, gingival recession, and bleeding on probing were measured by one periodontist. After a periodontal examination, microbial samples were collected using sterile paper points. The effect of SDD in conjunction with scaling and root planing on alterations of the periodontal pathogens (Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis) were also assessed using l6S rRNA polymerase chain reaction. Results: During the treatment period, clinical parameters for both treatment group and control group were improved. After 3 months, reductions in probing depth and gains in clinical attachment level were significantly greater for the SDD group than control group. Microbial analysis showed that there was no alteration of the periodontal pathogens and no difference between the groups. Conclusion: This study suggested that the subantimicrobial dose of doxycycline as an adjunct therapy with scaling and root planing might be effective and safe in the management of chronic periodontitis.