• Journal of Periodontal and Implant Science
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• v.29 no.2
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• pp.371-387
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• 1999

The present study was performed to assess and compare the clinical and microbiological effects following local application of 2% minocycline gel or 0.1% chlorhexidine subgingival irrigation to augment scaling and root planing in patients with moderate to advanced chronic adult periodontitis. 32 healthy patients with moderate to advanced chronic adult periodontitis were enrolled in the study. In each patient, the quadrants that had 2 or more teeth with $5{\sim}8mm$ probing pocket depth and radiographic evidence of alveolar bone loss were selected and divided into test side and control side according to the split-mouth design. All patients received standardized oral hygiene instructions at the beginning of the study and all remaining teeth received scaling and root planing until 0 week. The 2% minocycline gel was applied to periodontal pocket at 0, 1, 2, 3 week in the test side. The 0.1% chlorhexidine solution and the normal saline were irrigated subgingivally for about 30 seconds in the positive control side and negative control side respectively. The clinical and microbiological analysis carried out at 0, 4, 8, and 12 weeks . The results of this study were as follows; 1. In saline irrigation group, there was no adjunctive effects in probing pocket depth reduction, sulcular bleeding index and no significant changes in relative proportions of subgingival bacteria. 2. The chlorhexidine irrigation as an adjunct to scaling and root planing results in reduction in the plaque index and sulcular bleeding index, but there was not statistically significant. The relative proportion of spirochetes was significantly reduced, but the proportion of motile rods was no significant reduction. 3. The minocycline gel delivered subgingivally as an adjunct to scaling and root planing provide significant benefit in reducing probing depths and sulcular bleeding index compared to saline and chlorhexidine irrigation groups. 4. The relative proportions of spirochetes and motile rods were significantly reduced and the proportions of cocci and non-motile bacteria were correspondingly increased in the minocycline gel group. In conclusion, minocycline gel delivered subgingivally as an adjunct to scaling and root planing induces clinical and microbial responses more favorable for periodontal health than saline and chlorhexidine subgingival irrigation.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.81-93
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• 1999

Non-surgical therapy is still an important technique in periodontal treatment. In this study, scaling and root planing(SRP) with or without concomitant subgingival curettage were compared clinically and microbiologically. 14 moderate adult periodontitis patients were included in this study. After 2 weeks from screening visit, with split mouth design, one quadrant was treated by SRP, and the opposite side was treated by SRP with subgingival curettage. Clinical measurement and microbiological analysis was taken at baseline, 1 month, 3 month post-treatment. Clinical parameters used in this study was probing depth, gingival recession, gingival index, bleeding on probing, plaque index, tooth mobility(Periotest Value). Microbiological analysis consisted of determination of the percentages of 4 bacterial groups according to morphologic type with phase-contrast microscope and measuring Black-pigmented Bacteroides after anaerobic culture. 1. There were significant changes in probing depth and gingival recession at 1 month(P<0.05), and these changes remained through 3 month. However, no significant differences were observed between two groups(P<0.05). 2. There were also significant reductions in gingival index and bleeding on probing at 1 month(P<0.05),and these reduced levels were maintained through 3 month with no significant differences between two groups(P<0.05). 3. In both groups, motile bacteria decreased significantly at 1 months(P<0.05), but increased nearly to baseline level at 3 month. 4. The percentages of Black-pigmented Bacteroides, in both groups, decreased significantly at 1 month(P<0.05), and in the subgingival curettage group, significant more reductions were observed than in the root planing group(P<0.05). At 3 month, significant reduction was found in subgingival curettage group only(P<0.05). According to these results, we surmised that concomitant subgingival curettage and root planing give some advantageous effect on bacterial recolonization.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.13-23
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• 2002

The ultimate goal of periodontal therapy is directed to arresting the progression of the disease, and regenerating the fibrous attachment. In order to achieve such treatment aim, the plaque and calculus must be eliminated and the physiological conditions of the root surface must be changed to facilitate the attachment and migration of the new fibroblasts, The method of changing the proper root surface conditions to promote the healing of periodontal tissue involves mechanical procedures, such as scaling and root planing, and chemical procedures such as tetracycline-HCl. However, the formation of a long junctional epithelium was most frequently observed type of healing. Thus, the aim of this study was to examine in vitro the influence of surface conditioning of dentin by TC-HCl on human gingival epithelial cell attachment. Human gingival epithelial cells were obtained from healthy retromolar pad area(under the age 23 years). Seventy two teeth extracted from severe periodontitis were used as study material. To evaluate the epithelial cell attachment to dentin, the prepared specimen was divided to four groups. For the control group, only scaling and root planing were carried out, and for the test group, 1 to 3, the concentration of the TC-HCl was 50, 125 and 250mg/ml respectively. After cell cultivation time of 1-, 3-. 24 hour, for the indirect quantitative assessment of gingival epithelial cell attached to dentin sample, the absorbance of epithelial cell unattached to dentin was measured. The results were as follows; 1. There was no statistically significant difference between scaling and root planing group and TC-HCl 50mg/ml 125mg/ml and 250mg/ml group about absorbance of unattached epithelial cell to dentin sample(p>0.5). 2. As time passes, the absorbance of unattached gingival epithelial cell to dentin sample was decreased statistically significant(p<0.05). 3. There was no statistically significant difference among the TC-HCl group(p>0.05) We concluded that there was similar effect on gingival epithelial cell attachment between TC-HCl conditioning on root surface and only scaling and root planing treatment

• Journal of Periodontal and Implant Science
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• v.24 no.3
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• pp.503-512
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• 1994

The purpose of this study was to assess the clinical and microbiological effect of chlorhexidine rinse following scaling and root planing on periodontits. 10 patients with periodontal disease were selected for the study. They had not taken antibiotics for months and no history of dental treatment for 6 months before the study. They were good in general health. Patients received a scaling and root planing under local infiltration anesthesia, chlorhexidine rise group were subjected to twice a day 0.1% chlorhexidine rinse for a period 2 week. After initial clinical(plaque index, gingival index, probing pocket depth), microbiological and BANA tests were determined, each subject received a single session of scaling and root planing but no oral hygiene instructions. Clinical indices were measured, microbial parameters and BANA test were reassessed 1, 2 and 4 weeks after treatment. The results were as follows : 1. Plaque index, gingival index and pocket depth in chlorhexidine rinse group and control group were not significantly reduce during all weeks when compared chlorhexidine rinse group with control groups. Plaque index in chlorhexidine rinse group and control group were siginificantly reduced at 1, 2, 4weeks(P<0.05), gingival index and pocket depth wee ignificantly reduced at 2, 4weeks in both groups(P<0.05). 2. Perecntage of cocci and motile rods was significantly changed at 1, 2, 4weeks in chlorhexidine rinse group(P<0.05), control group was significantly changed at 4weeks in control group(P<0.05), intergroup difference was significantly at 2weeks in cocci and 4weeks in motile rods(P<0.05). 3. Percentage of non-motile rods in all group were not significantly changed when compared with those of baseline. 4. Percentage of spirochetes was significantly reduced at 4 week(P<0.05), control group was not significantly reduced during all weeks. 5. BANA test scores was significantly reduced during all weeks in chlorhexidine rinse group(P<0.05), control group was not significantly reduced during all weeks. The result showed that clinical and microbiological effect following scaling, root palning and chlorhexidine on periodontal disease.

• The Journal of the Korean dental association
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• v.27 no.2 s.237
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• pp.116-121
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• 1989

• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.531-545
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• 1998

The objective of the present study was to evaluate the clinical and microbiological effects of scaling and root planing combined with local application of 2% minocycline gel to patients with moderate to advanced chronic adult periodontitis. 27 healthy patients with moderate to advanced chronic adult periodontitis were enrolled in the study. The quadrants that had 2 or more teeth with $5{\sim}8mm$ probing pocket depth and radiographic evidence of alveolar bone loss were selected and divided into test side and control side according to the splitmouth design. All patients received standardized oral hygiene instructions at the beginning of the study. Subsequently scaling and root plaining was performed on all remaining teeth until 0 week. The 2% minocycline gel was applied to periodontal pocket at 0, 1, 2, 3week in the test side. The normal saline was irrigated subgingivally for about 30 seconds in the control side. The clinical and microbiological analysis was carried out at 0, 4, 8, and 12weeks. The results of this st udy were as follows; 1.2% minocycline gel delivered subgingivally as an adjunct to scaling and root planing provided benefit in reducing sulcular bleeding index and pocket depth than the use of normal saline. 2. The relative proportion of cocci and non-motile bacteria was increased in the test and control groups with time, and there was no statistically significantdifference between two groups. 3. The proportion of spirochetes was slowly reduced in the control group, but, inthe test group, they were remarkably reduced from the 4th week, and there was a statistically significant difference between two groups. 4. In both groups, the relative proportion of motile rods was notably decreasedat the beginning of the study, and remained until 12th week in the test group,but, in the control group, they were slowly increased from the 4th weekand finally similar to that of the initial examination. In conclusion, local application of 2% minocycline gel may be effective in the clinical and microbiological aspects as an adjunct to scaling and root planing in periodontal disease sites.

• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.809-822
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• 1998

Adequate root preparation in the treatment of periodontal disease often involves mechanical instrumentation to remove plaque, calculus perhaps contaminated cementum. Although meticulous scaling and root planing may remove some cementum, the use of aggressive root planing to remove cementum does not appear warranted. So ultrasonic device and rotary instrument appear to be replacing hand instrument. But it is not clear those instruments make smooth root surface as hand instrument. The roghness of the root surface were evaluate with SEM following instrumentation with Gracey curette, Perio Clean and piezo ultrasonic device(Setlec) with various tip. 20 extracted teeth were used in vitro experiment, and 9 teeth of a patient destined for extraction for periodontal reasons were utilized in vivo experiment. It was demonstrated that hand curette created the smoothest surface, while diamond tip tended to roughen the root surface. But the hand curette, Perio Clean, and piezo ultasonic device with scaler tip tend to remove cementum completely. Piezo ultrasonic device with curette-like tip made the desirable smooth surface with partial removal of cementum.

• Journal of Periodontal and Implant Science
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• v.50 no.2
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• pp.83-96
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• 2020

Purpose: The present study aimed to evaluate the clinical benefit of additional toothbrushing accompanying non-surgical periodontal treatment on oral and general health in patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a doubled-blind randomized controlled trial in 60 T2DM patients between June 2013 and June 2014. The patients were randomly assigned to the scaling and root planing (SRP) group; the scaling and root planing with additional toothbrushing (SRPAT) group, in which additional toothbrushing was performed by toothpick methods; or the control group. Microbiological and oral examinations were performed for up to 12 weeks following treatment. Non-surgical treatment was conducted in the experimental groups. The SRP group received scaling and root planing and the SRPAT group received additional toothbrushing with the Watanabe method once a week from the first visit through the fifth visit. The primary outcomes were changes in haemoglobin A1c (or glycated haemoglobin; HbA1c) levels, serum endotoxin levels, and interleukin-1 beta levels. Periodontal health status was measured by periodontal pocket depth, the calculus index, and bleeding on probing (BOP). Results: Both the SRP and SRPAT groups showed improvements in periodontal health and HbA1c, but the SRPAT group showed significantly less BOP than the SRP group. Furthermore, only the SRPAT group showed a statistically significant decrease in serum endotoxin levels. Conclusions: Non-surgical periodontal treatment was effective in improving HbA1c and serum endotoxin levels in T2DM patients. Furthermore, non-surgical treatment with additional tooth brushing had a more favourable effect on gingival bleeding management. Trial RegistrationClinical Research Information Service Identifier: KCT000416.

• Journal of Periodontal and Implant Science
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• v.43 no.6
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• pp.283-290
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• 2013

Purpose: The concept of gingival biotype has been used as a predictor of periodontal therapy outcomes since the 1980s. In the present study, prospective and controlled experiments were performed to compare periodontal pocket depth (PPD) reduction and gingival shrinkage (GSH) after scaling and root planing (SRP) according to gingival biotype. Methods: Twenty-five patients diagnosed with chronic periodontitis participated in the present study. The PPD and GSH of the labial side of the maxillary anterior teeth (from the right canine to the left canine) were evaluated at baseline and 3 months after SRP. Changes in the PPD following SRP were classified into 4 groups according to the gingival thickness and initial PPD. Two more groups representing normal gingival crevices were added in evaluation of the GSH. The results were statistically analyzed using the independent t-test. Results: In the end, 16 patients participated in the present study. With regard to PPD reduction, there were no significant differences according to gingival biotype (P>0.05). Likewise, sites with a PPD of over 3 mm failed to show any significant differences in the GSH (P>0.05). However, among the sites with a PPD of under 3 mm, those with the thin gingival biotype showed more GSH (P<0.05). Conclusions: PPD changes after SRP were not affected by gingival biotype with either shallow or deep periodontal pockets. GSH also showed equal outcomes in all the groups without normal gingival crevices. The results of SRP seem not to differ according to gingival biotype.

• Journal of Periodontal and Implant Science
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• v.28 no.1
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• pp.37-56
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• 1998

The purpose of this study was to evaluate the clinical and microbiological outcomes following the use of 30% minocycline-loaded polycaprolacton film and 2% minocycline-loaded gel that was applied locally into pockets combined with scaling and root planing. 25 human subjects who were non-pregnant, non-lactating, aged 20-50 and diagnosed as moderate to advanced adult periodontitis were enrolled. Subjects were excluded if they had a history of severe acute or chronic systemic disease, if they required antibiotic prophylaxis for dental treatment for any reason, or if they reported a history suggestive of hypersensitivity reactions to minocycline or tetracycline. 4quadrants that had several teeth with a 5-8mm probing pocket depth and radiographic evidence of alveolar bone loss for each patient were selected and divided into test sites and control sites according to the split-mouth design. Scaling and root planing was done for each site at baseline(0week). Test sites received the minocycline gel and strip and control sites had saline irrigation. The patients received both treatments simyltaneously. Subgingival irrigation of sterile saline was applied to the control sites for approximately 30 seconds. Minocycline strip and gel was applied into the periodontal pocket at 1, 2, 3, 4 weeks each after scaling and root planing in the test sites. The clinical and microbiological measurements were made at baseline and at the follow-up visits 6, 10, 14, 20 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth and Periocheck test was significantly reduced and the relative proportions of spirochetes and motile rods were significantly reduced and the proportion of cocci was correspondingly increased, in locally delivered minocycline strip group compared to saline irrigation group. 2. In locally delivered minocycline gel group, The effect was the same with minocycline strip group as compared with saline irrigation therapy. 3. There was no significant differences between minocycline strip group and minocycline gelgroup. In conclusion, minocycline HCl local drug delivery combined with scaling and root planing may provide added improvement of clinical and microbiological responses by inhibiting bacterial recolonization of treated sites. It is suggested that the local administration of minocycline-HCl in the periodontal pocket is effective when combined with subgingival mechanical debridement.