• 대한치과의사협회지
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• 제54권5호
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• pp.365-373
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• 2016

Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

• Journal of Periodontal and Implant Science
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• 제23권1호
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• pp.170-182
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• 1993

The purpose of this study was to evaluate the clinical and microbiological effects of minocycline-loaded polycaprolactone strip on periodontal disease. Ten patients with probing depth (deeper than 5mm) were tested. Of the two periodontal pockets selected from each patient, one randomly selected pocket was treated by the insertion of 30% minocycline-loaded polycaprolactone sttip as the experimental group and the other with a minocycline-free polycaprolactone strip as the control group. All groups were examined by clinical and microbiological methods. 1. Plaque index scores, gingival index scores and sulcular bleeding index scores in both group were significantly reduced from the baseline to 2 weeks. Plaque index scores of experimental group and sulcular bleeding index scores of control group tended to be progressively reduced in all experimental periods. 2. Probing depth amounts in both group were significantly reduced from 4 weeks to 8 weeks. 3. Attachment loss amounts in both group shows no singnificant differences in time. Attachment loss amounts in experimental group tended to be less than those in control group. 4. The number of cocci in both groups were significantly increased in all experimental periods, but that of the non-motile rods were significantly reduced from 2 weeks in experimental group, and from 4 weeks in control group, that of the motile rods were reduced from 4 weeks in experimental group and from 1 week in control group. The number of spirochetes were reduced from I week during all experimental period in experimental group, but there was no changes in control group.

• Journal of Periodontal and Implant Science
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• 제24권2호
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• pp.421-432
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• 1994

The local route of antibiotic administration can accomplish higher therapeutic doses in subgingival sites than those possible by systemic therapy. This investigation assessed on the clinical and microbiological effect of 30% Minocycline loaded polycaprolactone film (Mino-strip) on rapidly progressive periodontitis. Mino-strip was applied in the periodontal pockets of 15 patients with clinically diagnosed as a rapidly progressive periodontitis. 8sites for each patient with a 5mm probing pocket depth were selected in split mouth design and were assigned into group. i.e., placebo(group 1), supragingival scaling and R/P(group 2), Mino-strip applied only(group 3), R/P and Mino-strip applied(group 4). Supragingival scaling and oral hygiene instruction were performed 1 wk before experiment. Mino-strip was applied weekly on day 0 and 7. Clinical and microbiological test were performed on day 0, 7, 14, 28, 56. In R/P and Mino-strip applied group, Gingival index, GCF volume, probing depth and loss of attachment level were significantly reduced after the first weeks following treatment. In R/P and Mino-strip applied group, the relative proportions of spirochetes and motile rods were significantly reduced and the proportions of cocci and non motile rod were correspondingly increased for eight weeks following treatment. In R/P and Mino-strip treated group, total anaerobic and aerobic bacterial count were significantly decreased for the first two weeks following treatment and streptococcus count was decreased for eight weeks following treatment. In R/P and Mino-strip applied group, P. gingivalis, P. intermedius, B. forsythus, A. actinomycetemcomitans, F. nucleatum, E. corrodens, C. rectus counts were significantly reduced after the first week following treatment. According to this study, it is appeared that 30% Minocycline-loaded polycaprolacton film was effective in the treatment on rapidly progressive periodontitis.

• Journal of Periodontal and Implant Science
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• 제44권4호
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• pp.194-200
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• 2014

Purpose: The purpose of this study was to assess and compare the clinical and radiographic outcomes of guided tissue regeneration therapy for human periodontal intrabony defects using two different collagen membranes: a porous nonchemical cross-linking collagen membrane (NC) and a bilayer collagen membrane (BC). Methods: Thirty subjects were randomly assigned and divided into the following 3 groups: a test group (NC+BM), in which a NC was used with xenograft bone mineral (BM), a positive control group (BC+BM), in which a BC was used with xenograft BM, and a negative control group (BM), in which only xenograft BM was used. The following clinical measurements were taken at baseline and 3 months after surgery: plaque index, gingival index, probing pocket depth, gingival recession, and clinical attachment level. Radiographic analysis was performed at baseline, 1 week and 3 months after surgery. Results: Membrane exposure was not observed in any cases. Significant probing depth reduction, attachment-level gain and bone fill were observed for both test and control groups compared to baseline at 3 months after surgery (P<0.05). However, there were no statistically significant differences in clinical improvement and radiographic bone fill between treatment protocols (P>0.05). Conclusions: Within the limitations of this study, the results suggest that both NC and BC were comparable in terms of clinical and radiographic outcomes for the treatment of periodontal intrabony defects in human subjects.

• Journal of Periodontal and Implant Science
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• 제31권4호
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• pp.765-775
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• 2001

The aim of the study was to investigate the effect of surgical therapy combined with the usage of metronidazole gel in the treatment of juvenile periodontitis by comparing clinical indices of flap operation along with application of metronidazole gel and flap operation only. Comparing clinical indices of the baseline, 3 months after surgery, 6 months after surgery statistically, the results are as follows; 1. Bleeding on probing (BOP) was decreased significantly both in the experimental group and the control group at 3 months after surgery (p<0.05). BOP increased 0.9% in the control group 6 months after surgery, while in the experimental group, decreased 4.7% (p>0.05). However, there was no statistically significant difference in these groups (p>0.05). 2. Pocket probing depth (PPD) was decreased significantly both in the experimental group and the control group at 3 months after surgery (p<0.05). PPD increased 0.lmm in the control group 6 months after surgery, while in the experimental group, no increase of the depth could be observed (p>0.05). However, there was no statistically significant and difference in these groups (p>0.05). 3. Loss of attachment level(LOA) was decreased significantly both in the experimental group and the control group at 3 months after surgery (p<0.05). LOA increased 0.2mm in the control group 6 months after surgery, while in the experimental group, increased 0.3mm However, there was no statistically significant difference in these groups (p>0.05). In conclusion, flap operation was effective on the treatment of juvenile periodontitis. However, combined therapy of metronidazole gel could not give rise to any significant adjunctive effect on the treatment outcome.

• Journal of Periodontal and Implant Science
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• 제24권1호
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• pp.39-49
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• 1994

It has been believed that antioxidant enzymes such as CuZn- and Mn-superoxide dismutase and catalase protect the tissue from damage resulting from the oxygen derived free radicals($O_2\;^-$, $H_2O_2$ and OH ). The purpose of this study was to investigate the relationship between activity of antioxidant enzymes including CuZn- and Mn- superoxide dismutase and catalase and inflammatory periodontal disease and periodontal parameters. For this study, the patients were classified into normal, gingivitis, adult periodontitis and rapidly progressive periodontitis, and then their papillary bleeding index(PBI) and probing depth were checked. Gingival tissues were surgically obtained from the patients during periodontal surgery, extraction, and clinical crown lengthening procedure. The activity of CuZn- and Mn- superoxide dismutase and catalase in the gingival tissues was measured by using UV-spectrophotometer by the same methods as Crapo et al. And Aebi did, respectively. The results were as follows : 1. CuZn- and Mn- and total-superoxide dismutase activity were significantly low in rapidly progressive periodontitis group in comparison to normal group (P<0.05). 2. In comparison of the antioxidant enzyme activity according to papillary bleeding index group(PBI), Mn-superoxide dismutase activity only was significantly lower in PBI 2, 3, and 4 groups than PBI 0 group(P<0.05). 3. Superoxide dismutase activity failed to show any significant difference according to probing depth. But significant]y high catalase activity was shown in deep pocket group (${\ge}7mm$)(P<0.05). In conclusion, these results suggest that the activity of Mn-superoxide dismutase among the antioxidant enzymes may reflect the inflammatory status of gingival tissue and that the decreased activity of superoxide dismutase may be one of responsibe factors for progression of rapidly progressive periodontitis.

• 한국치위생학회지
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• 제22권3호
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• pp.161-170
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• 2022

Objectives: This study aims to conduct in-depth research on the effect of non-surgical periodontal therapy (NSPT) with the application of a comprehensive dental hygiene care (CDHC) process, and provide basic data for the wide application of CDHC. Methods: From May 8, 2021 to September 24, 2021, mixed-methods research was conducted in 36 patients with periodontal diseases. A paired samples t-test was used to analyze the quantitative research data using IBM SPSS program(ver. 22.0; IBM Corp., Armonk, NY, USA) and qualitative research data were analyzed using the thematic analysis method. Results: With NSPT applying the CDHC process, the perception of periodontal health and self-efficacy of periodontal healthcare were increased (p<0.001). Presence of gingivitis, probing pocket depth, bleeding on probing rate, presence of subgingival calculus, and dental plaque index were reduced (p<0.001). Based on 195 meaningful statements, 26 concepts, 12 sub-themes, and 5 themes , , , and were drawn. Conclusions: The perception of periodontal health and the self-efficacy were improved, and substantial change in the clinical index. The CDHC application allowed the study participants to perceive the importance of dental care and professionalism of dental hygienists.

• Journal of Periodontal and Implant Science
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• 제52권4호
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• pp.298-311
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• 2022

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.

• 치위생과학회지
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• 제23권1호
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• pp.13-19
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• 2023

Background: Periodontitis is a chronic inflammatory condition associated with dysbiosis of the oral microbiota. The aim of the present clinical study was to explore the adjunctive effect of ozonized water irrigation in the circuits of ultrasonic scalers for the full-mouth decontamination of patients with periodontitis Stage I or II. Methods: The study was a randomized, single-blinded, parallel-group clinical trial. The test group (n=25) was treated with ultrasonic scalers irrigated with ozonized water, whereas the control group (n=25) received normal tap water irrigation within the ultrasonic scalers used during the professional mechanical debridement. Full mouth plaque score, bleeding score, probing pocket depth, and the gingival index were evaluated at baseline, two, and 4 weeks after treatment. The pain perceived and dental anxiety were also assessed after treatment by means of the visual analog scale (VAS). Results: All periodontal parameters resulted in significant improvement for both study groups. The effect of the treatment group on the gingival index was significant, in particular, patients in the test group experienced a greater reduction in this score. No significant differences could be observed with regards to the average probing depth, full mouth plaque index and bleeding score. Patients treated with ozonized water running in the circuits of ultrasonic scalers displayed also lower scores for pain and dental anxiety. Conclusion: The present study showed a significant clinical effect on gingival inflammation attributable to adjunctive ozone irrigation during nonsurgical periodontal therapy. Further studies, including patients with severe periodontitis and greater sample sizes, are recommended to test the clinical effect of ozonized water in the circuits of ultrasonic scalers.

• Journal of Periodontal and Implant Science
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• 제38권1호
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• pp.97-102
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• 2008

Purpose: Periodontal intrabony defects have great deal of importance since they contribute to the development of periodontal disease. Current treatment regimens for intrabony defects involve grafting of numerous bony materials, GTR using biocompatible barriers, and biomodification of root surface that will encourage the attachment of connective tissue. Xenograft using deproteinized bovine bone particles seems to be very convenient to adjust because it doesn't require any donor sites or imply the danger of cross infections. These particles are similar to human cancellous bone in structure and turned out to be effective in bone regeneration in vivo. We here represent the effectiveness of grafting deproteinized bovine bone particles in intrabony defect and furcation involvements that have various numbers of bony walls. Materials and methods: Open flap debridement was done to remove all root accretions and granulation tissue from the defects within persisting intrabony lesions demonstrating attachment loss of over 6mm even 3 months after nonsurgical periodontal therapy have been completed. Deproteinized bovine bone particles($BBP^{(R)}$, Oscotec, Seoul) was grafted in intrabony defects to encourage bone regeneration. Patients were instructed of mouthrinses with chlorohexidine-digluconate twice a day and to take antibiotics 2-3 times a day for 2 weeks. They were check-up regularly for oral hygiene performance and further development of disease. Probing depth, level of attachment and mobility were measured at baseline and 6 months after the surgery. The radiographic evidence of bone regenerations were also monitored at least for 6 months. Conclusion: In most cases, radio-opacities increased after 6 months. 2- and 3-wall defects showed greater improvements in pocket depth reduction when compared to 1-wall defects. Class I & II furcation involvements in mandibular molars demonstrated the similar results with acceptable pocket depth both horizontally and vertically comparable to other intrabony defects. Exact amount of bone gain could not be measured as the re-entry procedure has not been available. With in the limited data based on our clinical parameter to measure pocket depth reduction following $BBP^{(R)}$ grafts, it was comparable to the results observed following other regeneration techniques such as GTR.