• Journal of Periodontal and Implant Science
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• 제29권1호
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• pp.103-115
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• 1999

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. Various periodontal procedures have been used throughout the years in an attempt to reestablish attachment of periodontal tissues to root surfaces affected by periodontitis. Flap debridement surgery has been demonstrated to be a successful procedure in gaining the probing attachment level and reducing probing depth. A tendency towards impaired wound healing following periodontal procedures in smokers has been clinically documented. But, previous clinical studies on healing response in smokers are based on a retrospective design. The purpose of this study was to evaluate the treatment outcome following flap debridement surgery in smokers compared to nonsmokers. 25 patients with moderate to advanced periodontitis were included for study. Among these patients, 13 patients were smokers, and 12 patients were nonsmokers. Mucoperiosteal flap was raised with the sulcular incision. No antibiotic treatment was administered postsurgery. The patients was recalled at monthly intervals during a period of 6 months following the surgery. The patients were received supragingival scaling and oral hygiene reinforcement. All the recordings, including modified O' Leary plaque control record, bleeding on probing, probing pocket depth, probing attachment level,were recorded, presurgery and 6 months postsurgery. The changes of all the recordings at 6 months after flap debridement surgery revealed the following results: 1. PI on all the dentitions and surgical sites showed no statistical significance between smokers and nonsmokers at presurgery. But, smokers demonstrated a significantly lower % of PI than nonsmokers at 6 months postsurgery. 2. Smokers demonstrated a greater % of BOP sites than nonsmokers on the surgical sites and all the dentitions, presurgery and 6 months postsurgery. But, there was no statistical significance between two groups. 3. Smokers exhibited significantly less reduction of probing depth in the 3 mm or less probing pocket depth(PPD) group, 6mm or more PPD group and total PPD group when compared to nonsmokers at 6 months postsurgery. 4. Smokers exhibited significantly less gain of probing attachment level(PAL) in the 3mm or less PPD group, 6 mm or more PPD group and total PPD group when compared to nonsmokers at 6 months postsurgery.

• Journal of Periodontal and Implant Science
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• 제28권1호
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• pp.57-70
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• 1998

The purpose of this study was to evaluate the clinical and microbiological effects of metronidazole 25% dental gel that was applied to periodontal pockets who have moderate to advanced chronic adult periodontitis were selected for this study. The quadrants that had 2 or 3teeth with 5-8mm probing pocket depth were selected and divided into test side and control side according to the split-mouth design. The metronidazole 25% dental gel applied on test side and 0.12% chlorhexidine solution applicated on positive control side, normal saline irrigation into periodontal pocket was applicated to negative control side respectively. Above procedures followed scaling and root planing at baseline(0week). The subgingival sterile saline irrigation and chlorhexidine irrigation were done for about 30 seconds respectively. The metronidazole 25% dental gel was applied to periodontal pocket at 0,1 week in the test side. The clinical and microbiological analysis carried out at baseline(0week) and 4,8 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth were significantly reduced in the test group. The relative proportions of spirochetes and motile rods were significantly reduced to negative control group and the proportion of cocci was correspondingly increased in the test group. 2. The sulcular bleeding index, probing pocket depth were significantly reduced in metronidazole group. and, there was a significant differences between 2 groups. Also, the relative proportions of spirochetes and motile rods were reduced in both group. And, there was a significant differences between 2 groups. In conclusion, application of metronidazole 25% dental gel as an adjunct to mechanical debridement of root surfaces may improved the clinical and microbiological status of periodontal disease sites.

• Journal of Periodontal and Implant Science
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• 제34권3호
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• pp.499-508
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• 2004

Regeneration of Periodontium with PRP does not only improve regeneration rate and density of bone but have a possibility to estimate faster healing process for soft tissue. And also, autogenous bone and xenogenic bone graft are effective on regeneration of periodontium. The purpose of this study is to evaluate the effectiveness of autogenous bone and xenogenic bone $(BBP^{(R)})$ grafts with the PRP technique on regeneration of periodontium. 52 Generally healthy Pt. who had pocket depth 5mm at any of 6 surfaces of the teeth were in the study at Dept. of Perio. in Dankook Dental Hospital. Open Flap was treated for 18 infra-bony pockets as control group, autogenous bone with PRP was inserted for 25 infrabony pockets as first test group, and $(BBP^{(R)})$ with PRP was inserted for 22 infrabony pockets as 2nd test group. Then evaluation was made after 3 and 6 months 1. There were significant differences between average probing pocket depth and clinical attachment level of 3, 6 months and minimal and maximal attachment level after 6 months each other. 2. There were significant differences in average probing pocket depth of control group and 2nd experimental group between 1 and 6 months. For clinical attachment level and minimal and maximal proving attachment level, there was a significant difference after 6 month of surgery. 3. There was no significant difference between two test groups for average probing depth, clinical attachment level, and minimal and maximal probing attachment level. As the result, PRP with bone graft could be very effective for regeneration of periodontium and there was no difference between xenogenic bone and autogenous bone.

• Journal of Periodontal and Implant Science
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• 제38권1호
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• pp.103-108
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• 2008

Purpose: Studies reported controversial results about prognosis of root resection with 0%-38% failure rate. The purpose of this study is to consider clinical efficacy of root resection. Materials and Methods: This study reported three cases of root resection which were performed on different sites. In first case, lower right first molar showed pus discharge and 7 mm of probing pocket depth. It was diagnosed as fracture of mesial root. Hemisection of mesial root was performed. In second case, upper right first molar showed severe bone loss on disto-buccal root and 7 mm of probing pocket. Resection of disto-buccal root was performed In third case, lower left second molar showed severe bone loss on distal root including apex and 15mm of probing pocket depth. Hemisection of distal root was performed. Result: In these three cases of root resection, compromised molars were treated successfully and conserved. Conclusion: Root resection is a successful procedure treating compromised multi-rooted teeth and conserving teeth when proper case selection is performed.

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.427-434
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• 2006

The form of furcation influence both the pathogenesis of periodontal destruction and therapeutic results. The present study was performed to evaluate the effect of root trunk length on clinical outcomes of guided tissue regeneration. Total 30 mandibular first molars were evaluated in this study. Probing pocket depth, clinical attachment level, vertical defect depth and horizontal defect depth were measured at baseline and 6 month after GTR. Correlation coefficients between root trunk length and other clinical measurement were analyzed. The results of this study were as follows 1. The mean root trunk length in lower 1st molar was 2.15 mm. 2. Probing pocket depth, clinical attachment level, vertical defect depth and horizontal defect depth were significantly reduced at 6 month postoperatively compared to values of baseline 3. Correlation coefficient between root trunk length and vertical defect depth at baseline was 0.406 showing the positive correlation 4. Correlation coefficient between root trunk length and horizontal defect depth at baseline was -0.463 showing the negative correlation. 5. Correlation coefficient between root trunk length and decrease of horizontal defect depth after GTR was 0.654 showing the positive correlation. In conclusion, the root trunk length maybe effector for clinical outcome after guided tissue regeneration.

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.51-59
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• 2002

The aim of the present study was to investigate the distribution of periodontally hopeless teeth in patients who had not been treated. Five hundred nineteen teeth of 163 patients who had visited at the Department of Periodontology, Chonbuk National University Hospital during the period from January 1999 to July 2001 were selected as a periodontally hopeless tooth. Selection criteria were as follows: 1) probing pocket depth more than 8mm, 2) tooth mobility of degree III, 3) radiographic bone loss more than 75%. The contralateral tooth to a hopeless tooth (experimental tooth) was designated as a control tooth. Between the experimental and control tooth, differences in probing pocket depth, tooth mobility and amount of radiographic bone loss were examined as well as correlation. The results showed that hopeless teeth were most frequently found in the maxillary first molar position and least frequently in the maxillary canine position. Differences between experimental and control teeth were 2mm in probing depth, 1 degree in tooth mobility, and 20% in amount of bone loss (p<0.01). The periodontal conditions between the experimental and control teeth showed correlation in general, however, statistical significances were found in posterior teeth positions. Within limitations of this study, it can be concluded that local factors may play a role in deterioration of periodontal disease along with symmetrical character of periodontal disease.

• Journal of Periodontal and Implant Science
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• 제35권3호
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• pp.703-718
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• 2005

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polvlactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.

• Journal of Periodontal and Implant Science
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• 제28권4호
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• pp.645-660
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• 1998

The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.244-254
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• 1996

The periodontal probe is a commonly used instrument to assess periodontal conditions. And so, there has been many studies to develop the accuracy and reproducibility of the periodontal probe. The purpose of this study was to compare two different periodontal probes for measurement reliability and time required to use in subjects with moderate periodontitis. It was done after evaluating reproducibility of probing depth by stent guiding for a Manual probe and a Florida probe in subjects with healthy periodontal condition. The results were as follows 1. In experiment to evaluate the reproducibility of probing depth by stent guiding for a Manual probe and Florida probe in subjects with healthy periodontal condition, there was no major significant difference between intraprobe and interprobe relationships. 2. There were reduced probing measuremint error by using the Florida probe for posterior teeth and by using the Manual probe for anterior teeth of subjects with moderate periodontitis. 3. At proximal area, there was higher measurement error by using the Manual probe than the Florida probe. 4. The mean of pocket depth measurement using Manual probe was signifi cantly higher than that using Florida probe(p<0.05). With increasing pocket depth, interprobe difference increased and reproducibility reduced. 5. There was no significant difference in time required to use between Manual probe and Florida probe(p<0.05). 6. There was slight probing measurement difference between Manual probe and Florida probe at different site, but both probes have similar degrees of reproducibility and similar time required to probe.

• Journal of Periodontal and Implant Science
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• 제32권2호
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• pp.415-428
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• 2002

Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.