Purpose: In advanced case of periodontitis, surgical treatment without bone contouring may result in residual pockets inaccessible to proper cleaning during post-treatment maintenance. This problem can be avoided or reduced by applying guided tissue regeneration. Materials and Methods: All of 3 patients had deep periodontal pocket depth and bleeding on probing, and radiograph revealed osseous defect, so we planned guided tissue regeneration using resorbable membrane with or without xenograft. Result: 6 months later, periodontal pocket depth and bleeding on probing was improved and gingiva was stable. Conclusion: Guided tissue regeneration using resorbable membrane with or without xenograft in osseous defect is predictable.
The purpose of this study was to assess the recolonization of the subgingival microflora following scaling and root planing on single and multiroot teeth with periodontal pockets which were above 5mm. 7 patients with deep pockets were selected for this study. They had not taken antibiotics for 6 months and no history of dental treatment for 6 months before the study. After initial clinical(plaque index, gingival index, probing pocket depth), microbiological and BANA test were determined, each subject received a single session of scaling and root planing, but they were not received oral hygiene instructions. Clinical indices, microbial parameters and BANA test were reassessed 1, 2, and 4 weeks after treatment. The results were as follows : 1. Plaue index, gingival index and pocket depth were not significantly when compared single root group with multiroot group, both groups were siginficantly reduced at 2weeks in plaque index and 2, 4 weeks in gingival index(P<0.05), probing pocket depth was siginificantly changed at 2, 4weeks in multiroot teeth group and 4 weeks in single root teeth group(P<0.05). 2. Percentage of cocci was significantly increased at 4weeks in single root teeth group(P<0.05), motile rod was significantly changed at 4weeks in both group(P<0.05), spirochetes and nonmotile rods were not significantly changed. 3. BANA test was significantly reduced at 1 and 2 weeks (P<0.05) in single root teeth group, multiroot teeth group was not significantly all weeks. This results were suggested that clinical and microbiological effect following scaling and root planing on periodontal disease.
In this study, 21 patients diagnosed as adult periodontitis were divided into 4 groups. One quadrant with an average of 6mm deep pocket depth was chosen from each individual - Group A inserted tetra-cycline fiber after removing supragingival calculus while group RP had calculus removal and root planning alone. Group RP+A received combination of these treatments while group C received none. Plaque index, bleeding on probing, pocket depth, attachment level, and distribution of subgingival plaque were compared and evaluated among these groups at periods of first visit, 4th week and 8th week. The results were as follows ; 1. Plaque index and bleeding on probing improved after treatment and no significant difference was found between the groups. 2. When comparing the change in pocket depth between the groups, the use of tetracycline fiber showed significant reducton in pocket depth comparable to root planing. Combined therapy of tetracycline fiber and root planing showed synergistic effect in pocket depth reduction. 3. When comparing the change in attachment level between the groups, the use of tetracycline fiber showed significant increase in clinical attachment level comparable to root planing, but no synergistic effect was found in the combined therapy. 4. When comparing the change in the motile bacteria ratio between the groups, group RP and group RP+A showed significant decrease compared with control group. 5. There were no severe adverse effects from using tetracycline fiber, except for a few patient who experienced mild discomfort. In summary, the use of local adminstration of tetracycline fiber in adjunction to mechenical treatment can be effective for adult periodontitis.
Bone graft using growth factors and guided tissue regeneration have been used for the regeneration of infrabony defects which caused by periodontal disease. Calcium sulfate which is one of the resorbable barrier materials used for guided tissue regeneration. Platelet rich plasma which is a easy method to obtain the growth factors had many common points but, platelet rich plasma was still studying. This study was the comparative study between bone graft using platelet rich plasma and guided tissue regeneration using calcium sulfate barrier material in clinical view. For the study, 28 sites(2 or 3 wall infrabony defects) were treated. 14 infrabony defects were received surgical implantation of BBP-calcium sulfate composite with a calcium sulfate barrier and the others received BBP mixed with platelet rich plasma. Clinical outcome was accessed 3 and 6 months of postsurgery. 1. There was no statistical difference between CS group and PRP group in pocket depth, gingival recession, clinical attachment level, and probing bone level at baseline. 2. There was statistically significant reduction in probing depth, clinical attachment level, and probing bone level at 3 and 6 months postsurgery(p<0.05). 3. In the probing depth and clincial attachment level PPR group had less improvement than CS group, but there was no statistically difference at 3 and 6 months postsurgery. 4. In the recession PPR group had less recession than CS group, but there was no statistically difference at 3 and 6 months postsurgery. 5. In the probing bone level PPR group had less improvement than CS group, but there was no statistically difference at 6 months postsurgery. In conclusion bone graft using platelet rich plasma and guided tissue regeneration using calcium sulfate barrier showed similar clinical improvement for the treatment of 2 or 3 wall infrabony defects.
Purpose: The aim of this study was to evaluate clinical and radiographic changes and the survival rate after periodontal surgery using deproteinized bovine bone mineral (DBBM) with 10% collagen or DBBM with a collagen membrane in endo-periodontal lesions. Methods: A total of 52 cases (41 patients) with at least 5 years of follow-up were included in this study. After scaling and root planing with or without endodontic treatment, periodontal regenerative procedures with DBBM with 10% collagen alone or DBBM with a collagen membrane were performed, yielding the DBBM + 10% collagen and DBBM + collagen membrane groups, respectively. Changes in clinical parameters including the plaque index, bleeding on probing, probing pocket depth, gingival recession, relative clinical attachment level, mobility, and radiographic bone gains were evaluated immediately before periodontal surgical procedures and at a 12-month follow-up. Results: At the 12-month follow-up after regenerative procedures, improvements in clinical parameters and radiographic bone gains were observed in both treatment groups. The DBBM + 10% collagen group showed greater probing pocket depth reduction ($4.52{\pm}1.06mm$) than the DBBM + collagen membrane group ($4.04{\pm}0.82mm$). However, there were no significant differences between the groups. Additionally, the radiographic bone gain in the DBBM + 10% collagen group ($5.15{\pm}1.54mm$) was comparable to that of the DBBM + collagen membrane group ($5.35{\pm}1.84mm$). The 5-year survival rate of the teeth with endo-periodontal lesions after periodontal regenerative procedures was 92.31%. Conclusions: This study showed that regenerative procedures using DBBM with 10% collagen alone improved the clinical attachment level and radiographic bone level in endo-periodontal lesions. Successful maintenance of the results after regenerative procedures in endo-periodontal lesions can be obtained by repeated oral hygiene education within strict supportive periodontal treatment.
Seong-Ho Jin;Eun-Mi Lee;Jun-Beom Park;Youngkyung Ko
Journal of Periodontal and Implant Science
/
제54권2호
/
pp.85-95
/
2024
Purpose: Developmental endothelial locus-1 (DEL-1) plays a role in regulating neutrophil migration within the periodontium. The objective of this study was to evaluate the levels of DEL-1 in saliva and gingival crevicular fluid (GCF), as well as the number of neutrophils in patients with periodontitis. Methods: Forty systemically healthy, non-smoking periodontitis patients participated in this study. Clinical periodontal parameters, including the plaque index, probing pocket depth (PPD), clinical attachment level, bleeding on probing, modified sulcular bleeding index, and marginal bone level, were measured. Levels of DEL-1, interleukin (IL)-1β, IL-6, and IL-8 in unstimulated saliva samples, as well as DEL-1 in the GCF of 3 teeth from each participant, were assessed. Neutrophil counts in oral rinse and GCF samples were recorded. Spearman correlation coefficients were used to examine the correlation between protein levels, clinical parameters, and neutrophil quantities. Participants were divided into 2 age groups (those under 50 years and those 50 years or older) in order to investigate potential age-related differences. Results: DEL-1 levels in the GCF showed a negative relationship with PPD (sum). Neutrophils in oral rinse samples were positively correlated with PPD, IL-8, and IL-1β levels. Neutrophils in GCF exhibited a positive correlation with PPD (sum). Salivary DEL-1 levels showed correlations with IL-8 and IL-1β, but not with the clinical parameters of periodontitis. Conclusions: The negative relationship observed between PPD and GCF DEL-1 levels is consistent with the proposed protective role of DEL-1.
Periodontal surgery can be directed to remove the irritants from the tooth surface and reduce the periodontal pocket. The purpose of this study is to compare the clinical effects after between modified Widman flap and modified flap in periodontal patients. Ninety six molar area teeth of 9 patients were used. One of sextants performed a modified Widman flap, while the other side performed a modified flap. After initial periodontal therapy, the following measurements prior to surgery(baseline) were taken : pocket depth, gingival recession, clinical attachment level, tooth mobility, bleeding on probing. Also these measurements were taken at 4 weeks, 8weeks, and 12 weeks after surgery. Significant decrease of pocket depth was shown in both techniques, and the degree of decrease was significant in modified flap than modified Widman flap at 12 weeks. Significant increase of gingival recession was shown in both techniques, and the degree of increase was significant in modified Widman flap than modified flap at 4 weeks, 8 weeks, and 12 weeks. Significant attachment gain was shown in both techniques, and the degree of increase was significant in modified flap than modified Widman flap at 4 weeks, 8 weeks, and 12 weeks. Significant increase of tooth mobility was shown in both techniques at 4 weeks, but the decrease of tooth mobility was shown at 12 weeks. Greater decrease of bleeding on probing was shown in both techniques at 4 weeks. Modified flap was better than modified Widman flap in the decrease of gingival recession and the attachment gain. These results indicate that modified flap operation is better than modified Widman flap operation in the effect of periodontal treatment.
In order to evaluate the effects of the early exposure of e-PTFE membrane on the periodontal regeneration, 21 cases of 21 patients diagnosed as the chronic adult periodontitis were evaluated. All were class II furcation involvement cases. The control group was composed of 7 cases treated only by the flap operation. 14 cases were treated by the e-PTFE membrane as the experimental group, the membranes of 7 cases were exposed more than 1mm during healing period, which were named as the experimental group I, and the others, experimental group II. Clinical parameters such as probing pocket depth, clinical attachment level, bone probing depth, and gingival recession were recorded before the treatment and 6 months after the treatment. The results were as follows. 1. Significant probing depth reductions were observed for all groups(p<0.05), but no group shows significantly greater reductions than another. 2. Significant clinical attachment gains were observed for the experimental group II(p<0.05), no significant gains were observed in the other groups. 3. Significant bone probing depth reductions were observed for the experimental group II(p<0.05), no significant reductions were observed in the other groups. 4. All but the experimental group II exhibited a significant increase in gingival recession(p<0.05). The result suggested that is case of the e-PTFE membrane is exposed, the result is similar to that of flap operation without membrane. Therefore selecting the proper treatment case, intricate surgical procedure and infection control are essential for minimizing the chance of membrane exposure and finally for the good treatment results.
Purpose: Root resection can be a valuable procedure when the tooth in question has a high strategic value. The prognosis of root resection has been well documented in previous studies, but the results focused on the palatal root resection have not been discussed in depth. I represent here the short term effectiveness of palatal root resection of maxillary first molars. Methods: Palatal root resection was performed on maxillary first molars of three patients. All the palatal roots were floating state on the radiographic finding and showed full probing depth and purulent exudation at initial examination. Reduction of palatal cusp and occlusal table was performed concomitantly. Endodontic therapy was completed after root resection. Results: Compromised maxillary first molars were treated successfully by palatal root resection in 3 cases. The mobility of resected tooth was decreased a little bit. The probing pocket depth of remaining buccal roots was not increased compared to initial depth. All the patients satisfied with comfort and cost effective results and the fact they could save their natural teeth. Conclusions: Within the above results, palatal root resection is an effective procedure treating compromised maxillary first molar showing advanced palatal bone loss to root apex with or without pulp involvement when proper case selection is performed.
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.
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