• Journal of Periodontal and Implant Science
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• v.26 no.2
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• pp.531-541
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• 1996

Periodontal disease is characterized by destruction of supporting tissues caused by invasion of plaque bacteria and defense mechanism of host. Many dentists are very interested in laser therapy on various intraoral soft tissue lesions including inflammatory periodontal pocket. In order to determine the therapeutic effect of intrapocket irradiation of a pulsed- Nd : YAG laser on the inflammatory periodontal pockets, bilateral 60 teeth with 4-6mm in probing pocket depth and gingival inflammation were selected and evaluated by sulcus bleeding index(SBI), and plaque index(pI) for baseline record. Intrapocket irradiation($300{\mu}m$ fiber optic, I.5W power, for 2 min.) of a pulsed-Nd : YAG laser(EL.EN.EN060, Italy) was applied on half of them. As the control group, the same procedure except power-off was repeated on the contralateral 30 teeth. At 1-, 2-, 3-, and 4-week after intrapocket manipulation, every tooth was reevaluated by the same clinical indices. And the difference between the lased group and control group was statistically analyzed by paired t-test and Chi-square test in Microstat program. Following results were obtained: 1. Until I-week and 2-week after intrapocket manipulation, SBI was lowered in both lased group and control group, compared to baseline SBI, but from 3-week after, the recovering tendency toward baseline was noted, and at only 2-week after, the number of teeth showing lowered SBI was significantly more in lased group than in control group(p<0.05). 2. PI of both lased group and control group was lowered through whole experimental period from I-week to 4-week after, compared to baseline PI(p<0.05), but there was no significant difference between lased group and control group(p>0.1). The results suggest that intrapocket irradiation of a pulsed-Nd:YAG laser may lead somewhat remission of gingival inflammation, but for more favorable therapeutic result the thorough root planing should be necessarily accompanied with gingival curettage.

• Journal of Periodontal and Implant Science
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• v.51 no.1
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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.

• Journal of Periodontal and Implant Science
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• v.33 no.2
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• pp.167-178
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• 2003

Many researches are being done to study the effect of toothpaste containing natural extracts. The aim of this study was to evaluate the plaque control effect and therapeutic effect of toothpaste products containing chitosan extract. 120 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in the experimental group only used toothpaste containing chitosan and subjects in the control group used toothpaste without chitosan. At first, subjects received scaling and tooth brushing instruction. Gingival index, bleeding index, probing pocket depth, probing attachment level were scored at baseline, 2 months, and 3 months, and plaque index were scored at baseline, 1 month, 2 months, 3 months. Gingival index of experimental group and control group at baseline, 2 months, and 3 months use were 0.71${\pm}$0.66, 0.49${\pm}$0.55, 0.36${\pm}$0.49 and 0.62${\pm}$0.58, 0.51${\pm}$0.52, 0.48${\pm}$0.50 (mean${\pm}$SD), respectively (statistically significant different at p <0.05 ). Plaque index of experimental group and control group at baseline, 1 month, 2 months, and 3 months were 0.52${\pm}$0.50, 0.43${\pm}$0.50, 0.39${\pm}$0.49, 0.29${\pm}$0.46 and 0.49${\pm}$0.50, 0.50${\pm}$0.50, 0.51${\pm}$0.50, 0.45${\pm}$0.50, respectively (statistically significant different at p<0.05 ). Bleeding index of experimental group and control group were 0.40${\pm}$0.49, 0.33${\pm}$0.47, 0.24${\pm}$0.43 and 0.40${\pm}$0.49,0,38${\pm}$0.49,0.30${\pm}$0.46, respectively (statistically significant different at p<0.05). Probing depth of experimental group and control group were 2.41${\pm}$0.64, 2.31${\pm}$0.60, 2.28${\pm}$0.55 and 2.51${\pm}$0.67, 2.47${\pm}$0.63,2.42${\pm}$0.62, respectively (statistically significant different at p${\pm}$0.66, 2.32${\pm}$0.62 and 2.54${\pm}$0.70, 2.51${\pm}$0.69,2.46${\pm}$0.66, respectively (statistically significant different at p<0.05 ). From these finding, it can be concluded that toothpaste containing chitosan have better plaque control effect and therapeutic effect on gingivitis and early periodontitis compared to conventional toothpastes.

• Journal of Periodontal and Implant Science
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• v.39 no.2
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• pp.157-166
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• 2009

Purpose: There are numerous reports about the usefulness of antibiotics such as doxycycline or metronidazole in the conventional treatment for the patients with chronic periodontal diseases. However, seldom are the reports about effects of vitamins or nutraceuticals. The purpose of this study was to evaluate the effects of nutrient supplement including multiple vitamins and neutraceuticals with PRF-K2 from plants and seaweed in treatment of the patients with chronic periodontitis which is needed a nonsurgical or a surgical treatment by evaluating the clinical parameters and the gingival crevicular fluid volume. Methods: The systemically healthy and nonsmoking patients diagnosed with chronic periodontitis were divided into a nonsurgical group and a surgical group. They were also divided into the test group with nutrient supplements and the control group without nutrient supplements. In the nonsurgical group, the clinical parameters (probing depth, clinical attachment level, sulcus bleeding index, and plaque index) and the gingival crevicular fluid volume were checked on baseline, at 1 week, at 3 week and at 9 week after a supplement treatment. In the surgical group, the clinical parameters and the gingival crevicular fluid volume were also checked at 15 week after a surgical treatment. Results: In both nonsurgical and surgical groups, reduction of pocket depth and increment of clinical attachment level were revealed in the test group compared with the control group, but there was not statistically significant difference (p>0.05), and sulcus bleeding index was decreased with statistically significant difference (p<0.05). In addition, plaque index was decreased with statistically significant difference (p<0.05) in the nonsurgical group. Gingival crevicular fluid volume was decreased with statistically significant difference (p<0.05) at week 9 in both non-surgical and surgical groups. Conclusions: In conclusion, our results demonstrate that providing nutrient supplement in both nonsurgical or surgical periodontal treatments may improve gingival inflammation and gingival crevicular fluid.

• Journal of dental hygiene science
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• v.11 no.4
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• pp.339-344
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• 2011

Matrix metalloproteinase(MMP)-9 is considered important in tissue destruction in periodontitis. The aim of this study was to investigate the influence of smoking on MMP-9 in the gingival crevicular fluid(GCF). GCF samples in upper incisors area from 332 male subjects were collected after the informed consent. The dental examination included the assessment of oral hygiene, gingival inflammation and probing pocket depth. A quantitative assessment of MMP-9 levels in GCF was performed utilizing and immunological procedure. The mean MMP-9 concentrations found in GCF of smokers(30.86 ng/ml) and quit-smokers(29.82 ng/ml) differed from non-smokers(11.33 ng/ml), adjusted by age, gingival index and Community periodontal index(p<0.001). Smoking seems to influence MMP-9 in GCF regardless of gingival inflammation and age. It means smoking can destruct the periodontal tissue for itself.

• Journal of Periodontal and Implant Science
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• v.29 no.2
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• pp.433-447
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• 1999

The objective of this study was to evaluate the effect a chewable tablet containing sodium flouride and lauroyl sodium sulfate on removing plaque and inhibiting gingival inflammation. A randomized parallel study was designed. 100 voluteers participated in the study. There were two test groups each with 30 subject. Test group A was instructed to brush once in the morning, and to use the tablet once in the afternoon and once in the evening. Test group B was instructed to use the tablet three times a day without brushing. There were two control groups each with 20 subjects. Control group A was instructed to brush once in the morning only. Control group B was instructed not to brush all. Two weeks before the test period, the subjects received through tooth cleaning and polishing. At baseline, GI, PI, BOP, and GCF of the Ramfjord teeth were measured in all groups. Bacteria culture was done with the plaque sampled from tooth with the deepest pocket. After 5 days, clinical indices were measured and the bacterial culture was repeated. Control group B was dropped from the study after this period. All the other groups remained and the indices and the culture was repeated after 2 weeks, and 3weeks. Also whether the oral mucosa showed signs of irritation was monitored throughout the test period. Test group A showed less PI, GI, BOP, probing depth, GCF than test group B or control group A. Especially, PI and the BOP was significantly less than that of the group that was instructed to brush once a day. This implies that the added use of this tablet aids in plaque removal in people who brush just once a day. Test group A showed increase of cocci, decrease of motile rods, and decrease of spirochetes after 14-21 days. And this was significantly different from the control group A. At no time of the test period did any of the subjects show signs of irritation of the oral mucosa or adverse reactions. Following conclusions could be obtained from this study. This chewable tablet for enhanced oral hygiene could be used as an adjunct to oral hygiene in people who do not brush adequately. The use of this tablet decreased the number of subgingival bacteria, and this could be effective in plaque removal and for prevention of gingival inflammation.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.657-668
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• 2008

Purpose: In this study, we compared low-power $CO_2$ laser treatment to ultrasonic scaling, which is generally approved as a power-driven mechanical instrumentation, and evaluated both of these treatments regarding their clinical effectiveness and change in the volume of in GCF. Material and methods: 20 patients who had gingivitis were selected. all of patients has no systemic problems. Randomly selected, one quadrant received ultrasonic scaling only, another quadrant received ultrasonic scaling and $CO_2$ laser irradiation, the other quadrant received $CO_2$ laser irradiation only. Clinical parameters measured at baseline, 1 weeks, 2weeks, 4weeks and 8weeks. Result: Pocket probing depth and clinical attachment level were not changed during study period. Gingival index of all group were improved after treatment. At 1 weeks after treatment, Gingival index of ultrasonic scaling group was only significantly different compared to control group. At 2 weeks after treatment, gingival index of all experimental group were significantly different compared to control group. At 4 and 8 weeks after treatment, gingival index of all group were increased, but experimental group were lower than control group. Sulcus bleeding index was similar to the results of gingival index. At 1 weeks after treatment, all experimental group were significantly different compared to control group and it maintained during study. At 2 weeks after treatment, sulcus bleeding index of all group were lowest during study. Gingival crevicular fluid were measured with $Periotron^{(R)}$ 8000($Oraflow^{(R)}$, Inc. USA). At baseline, all group were showed moderately severe condition. At 1 week after treatment, laser treatment only group was reduced quantity of gingival crevicular fluid mostly, and all group were reduced quantity of gingival crevicular fluid. At 2 weeks after treatment, all group were health state. At 4 and 8 weeks after treatment, all group were showed recurrent of inflammation, and control group was the most significantly increased. Conclusion: This study showed that the effects of $CO_2$ laser treatment were similar to conventional ultrasonic scaling and this result remained longer than plaque control only. These results suggest possibility of $CO_2$ laser treatment for altered periodontal therapy.

• Journal of Periodontal and Implant Science
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• v.44 no.4
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• pp.158-168
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• 2014

Purpose: The present study was conducted to evaluate the impact of scaling and root planing (SRP) on the C-reactive protein (CRP) levels of gingival crevicular fluid (GCF) and serum in chronic periodontitis patients with type 2 diabetes mellitus (T2DM-CP) or without type 2 diabetes mellitus (NDM-CP). Methods: Forty-eight human participants were divided into two groups: an experimental (T2DM-CP) group (group I, n=24) comprising chronic periodontitis patients with random blood sugar ${\geq}200mg/dL$ and type 2 diabetes mellitus, and control (NDM-CP) group (group II, n=24) of those with chronic periodontitis and random blood sugar <200 without T2DM for the study. All subjects underwent nonsurgical periodontal therapy (NSPT) including complete SRP and subgingival debridement. Periodontal health parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), GCF volume (GCF vol), GCF-CRP, random blood glucose (RBS), glycated hemoglobin, and systemic inflammatory markers, serum CRP, total leukocyte count (TLC), neutrophil count (Neutr) and lymphocyte count (Lymph), were evaluated at baseline, 1 month, and 3 months after SRP. Results: NSPT resulted in statistically significant improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum as well as GCF of both groups I and II. The mean improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum and GCF was greater in group I than group II after NSPT. There was nonsignificant increase in GCF-CRP, TLC, Lymph, and RBS, and a significant increase in Neutr and Serum CRP in group II at 1 month. The Serum CRP level of 20 out of 24 group II patients had also increased at 1 month. Conclusions: The CRP levels in both GCF and serum were higher in T2DM-CP patients than in NDM-CP patients. Although there was a significant improvement in both the groups, greater improvement was observed in both GCF and serum samples of T2DM-CP patients.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.3
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• pp.186-195
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• 2018

Purpose: We performed quantitative and qualitative analysis of typical periodontal bacteria using real time PCR method to investigate the microbiological difference according to the severity of peri-implant disease in Koreans. Materials and Methods: Total of 60 implants were divided into three groups (healthy group, peri-implant mucositis group, peri-implantitis group) through periapical radiographs and clinical indices. The evaluated clinical parameters were pocket depth, plaque index, suppuration and bleeding on probing. Using a sterilized curette instrument, microbial samples were collected from the subgingival plaque and real-time PCR was performed on five periodontal bacteria. The relative expression levels of microorganisms were compared by comparative delta-CT method. Results: The relative expression levels of E. corrodens and T. denticola were significantly higher in the peri-implantitis group (P < 0.017). On the other hand, the relative expression level of F. nucleatum and P. gingivalis was relatively high in the healthy implant group regardless of the severity of disease. P. intermedia was significantly lower in the healthy implant group (P < 0.017). Conclusion: Periodontal bacteria were detected in Koreans with peri-implant diseases, but there was no microbiological distribution similar to periodontitis.

• Journal of Periodontal and Implant Science
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• v.37 no.1
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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.