• Journal of Periodontal and Implant Science
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• v.40 no.4
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• pp.164-171
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• 2010

Purpose: This study compared the total antioxidant status (TAS) and superoxide dismutase (SOD) activity in the saliva of periodontally compromised patients before and after scaling and root planing (SRP) to assess their diagnostic utility. Methods: Severe chronic periodontitis patient (test group) and subjects with no attachment loss, sites showing a 3 mm or more probing depth and a sulcus bleeding index < 10% (control group) were enrolled in this study. Saliva sampling and clinical examination were performed at one week, one month and 3 months after SRP. The TAS and SOD activity in each patient's saliva was measured for the comparative analysis between the groups. Results: In the test group, the TAS decreased directly after SRP. With time, it increased slightly and was relatively unchanged compared to the baseline. In the control group, the TAS also decreased immediately after SRP but increased gradually with time until 3 months. The SOD activity in the test and control subjects decreased immediately after SRP until 1 month. At 3 months, the SOD activity had increased. Both groups had a similar profile of SOD activity. However, the SOD activity of the control group was significantly higher than that of the test group at each point in time (P < 0.05). Conclusions: There was a significant difference in the total salivary antioxidant level between the periodontitis and healthy or gingivitis (control) group during the experiment period. The total antioxidant level in the saliva was higher in the patients with severe chronic periodontitis than the healthy or gingivitis control before SRP. The SOD activity of the periodontitis patients was lower than the control at each time point. These findings conclusively reveal the possible use of saliva as a diagnostic tool for periodontal health.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.725-737
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• 1999

The present study was performed to evaluate the clinical effects following local application of 30% minocycline strip(polycaprolactone), 2% minocycline gel(hydrocarbon gel) and 12% minocycline strip(polylactide, Minodent) to augment scaling and root planing in patients with chronic adult periodontitis. Forty teeth with periodontitis were enrolled in the study anddistributed into 4 groups including control group. All patients performed standardized oral hygiene instructions and mechanical debridement at the beginning of the study and then each local delivery drugs were inserted into periodontal pocket in each groups. Examinations regarding plaque index(PI), papillary bleeding index (PBI), probing pocket depth (PPD) were carried out at 0, 2, 4 weeks. All experimental groups showed statistically significant differences between baseline and 2 and 4 weeks in every clinical indices. Especially, 30%minocycline strip and Minodent group showed a significant improvement in PBI at 2 weeks and in PPD at 2 and 4 weeks. In conclusion, highly bio-resorbable Minodent delivered subgingivally as an adjunct to scaling and root planing induces better clinical effects for periodontal health than 2% minocycline gel and control group.

• Journal of Periodontal and Implant Science
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• v.27 no.3
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• pp.585-595
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• 1997

Removal of subgingival calculus is essential for the success in periodontal treatment. Subgingival instrumentation is used for the removal of all bacterial plaque and calculus. In this study, two types of anterior curet were used on ant. teeth to conduct subgingival scaling and root planing. The remaining amount of calculus was evaluated according to type of instrument, depth of pocket, and tooth surface. 24 teeth extracted from patients being treated at Dan Kook University dept. Perio. were used. 4 surfaces per tooth a total of 96 areas were evaluated. 12 teeth treated with Gracey No. 1-2 was used as the control group and 12 teeth treated with Mini-five curet No. 1-2 was the experimental group. The 4 surfaces of the teeth {buccal, mesial, lingual or palatal, distal) were observed under a stereomicroscope and the images were captured 3 times per surfaced with a CCD. The image were observed on the monitor using a $10{\times]10$ grid produced with the Microsoft power point. The amount of calculus remaining was evaluated 3 times per surface. The results were as follows. 1. There was no significant difference in remaining calculus according to the pre-treatment pocket depth, and tooth position{Mx. or Mn). 2. The Mini-five curet showed better results than the Gracey curet but there was no statistically significant difference. 3. In both Gracey curet group and Mini-five curet group the lingual(or palatal) surface showed significant difference compared to the other surfaces(p<0.05). From the results above, it is thought that when treating ant. teeth consideration of the tooth surface is more important than the choice of instrument.

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.1109-1116
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• 2005

The purpose of this study was to observe the effects of periodontal therapy, including nonsurgical periodontal therapy with azithromycin, surgical therapy, and maintenace therapy on the drug-induced gingival enlargement, by means of measuring gingival thickness. The test group of 18 patients with drug-induced gingival enlargement received scaling, root planing with azithromycin for 5 days, with or without surgical periodontal treatment. The control group of 18 patients who had not taken any medication, received scaling and root planing, with or without surgical periodontal treatment. Both groups received supportive periodontal therapy every 3 months for 2 years. The mean period of total treatment is 32 months in the test group and 31 months in the control group. The thickness of the buccal gingiva was measured using an ultrasonic device of $SDM^{(R)}$(Krupp Corp., Essen, Germany). The results revealed that the test $group(1.21{\pm}0.51mm)$ showed statistically thicker buccal gingiva than the control $group(1.01{\pm}0.3mm)$. In the test group, the buccal gingiva was thickest on 2nd molars and was thinnest on canines of both dental arches. In the control group, the buccal gingiva was thickest on central incisors in the maxilla and 2nd molars in the mandible, while the thinnest areas were on canines in the maxilla and 1st premolars in the mandible. It would be concluded that the periodontal treatment with azithromycin aids in decreasing the degree of the gingival enlargement but cannot prevent the recurrence completely.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.2
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• pp.195-202
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• 2013

The relationship between occlusion and periodontal health has been studied extensively. Despite this, there are few reports on the effects of intentional passive eruption (IPE) using an occlusal reduction. The aim of this clinical report was to present the favorable long-term results of IPE using an occlusal reduction combined with scaling and root planing. After periodontal examination, teeth were diagnosed as moderate chronic periodontitis with intrabony defects and mobility. IPE was performed using periodic occlusal reduction combined with initial periodontal therapy. All teeth examined healed uneventfully and the patients did not complain of discomfort. It has been clinically well maintained during 8 years after completion of IPE. Overall, these results suggest that the IPE would be helpful in improving periodontal health.

• Journal of Periodontal and Implant Science
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• v.51 no.4
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• pp.276-284
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• 2021

Purpose: The aim of this randomized clinical trial was to assess whether chemical cleansing using a sulfonic/sulfuric acid gel solution (HBX) as an adjunct to scaling and root planing (SRP) resulted in a decrease in residual plaque and calculus in deep periodontal pockets compared to SRP alone. Methods: Fifty-six patients with 56 hopeless posterior teeth, scheduled for extraction due to severe periodontitis, were enrolled in this study. Each tooth was randomly assigned to 1 of the 2 experimental procedures. The test teeth were subjected to the irrigation of the subgingival area with HBX for 2 minutes, followed by SRP with hand and ultrasonic instruments for 14 minutes, and then extracted. The control teeth received only mechanical instrumentation before extraction. Residual biofilm was evaluated on photographs and measured as total area and percentage of root surface covered by remaining plaque (RP) or calculus (RC) after treatment. Results: The initial pocket depth (PD) and total subgingival root surface area were similar between the 2 treatment groups. After treatment, the total subgingival root area covered by RP and RC was statistically significantly larger (P<0.001) in the control group than in the test group. The test teeth showed a lower percentage of RP, but a higher percentage of RC than the control teeth (both P<0.001). Complete calculus removal was achieved in 42% of the control teeth surfaces and in 25% of the test teeth surfaces for a PD of 4 mm. Conclusions: The additional chemical cleansing with HBX resulted in a statistically significant improvement in bacterial plaque removal during SRP of deep pockets, but it was not effective in reducing calculus deposits.

• Journal of Periodontal and Implant Science
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• v.46 no.6
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• pp.382-395
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• 2016

Purpose: Alendronate has been proposed as a local and systemic drug treatment used as an adjunct to scaling and root planing (SRP) for the treatment of periodontitis. However, its effectiveness has yet to be conclusively established. The purpose of the present meta-analysis was to assess the effectiveness of SRP with alendronate on periodontitis compared to SRP alone. Methods: Five electronic databases were used by 2 independent reviewers to identify relevant articles from the earliest records up to September 2016. Randomized controlled trials (RCTs) comparing SRP with alendronate to SRP with placebo in the treatment of periodontitis were included. The outcome measures were changes in bone defect fill, probing depth (PD), and clinical attachment level (CAL) from baseline to 6 months. A fixed-effect or random-effect model was used to pool the extracted data, as appropriate. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Cochrane ${\chi}^2$ and $I^2$ tests. Results: After the selection process, 8 articles were included in the meta-analysis. Compared with SRP alone, the adjunctive mean benefits of locally delivered alendronate were 38.25% for bone defect fill increase (95% CI=33.05%-43.45%; P<0.001; $I^2=94.0%$), 2.29 mm for PD reduction (95% CI=2.07-2.52 mm; P<0.001; $I^2=0.0%$) and 1.92 mm for CAL gain (95% CI=1.55-2.30 mm; P<0.001; $I^2=66.0%$). In addition, systemically administered alendronate with SRP significantly reduced PD by 0.36 mm (95% CI=0.18-0.55 mm; P<0.001; $I^2=0.0%$) and increased CAL by 0.39 mm (95% CI=0.11-0.68 mm; P=0.006; $I^2=6.0%$). Conclusions: The collective evidence regarding the adjunctive use of alendronate locally and systemically with SRP indicates that the combined treatment can improve the efficacy of non-surgical periodontal therapy on increasing CAL and bone defect fill and reducing PD. However, precautions must be exercised in interpreting these results, and multicenter studies evaluating this specific application should be carried out.

• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.631-646
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• 1998

The purpose of this study was to access the clinical effects of C31G, Listerine and CPC on the earlyx periodontitis when they were used as a adjunctives to the mechanical plaque control. Each groups were composed of 12 patients and in three test groups, C31G(Exp 1 group), Listerine(Exp 2 group) and CPC mouthrinse(Exp 3 group) were used three times a day. and as a control, placebo solution was used. Plaque index, gingival index, bleeding index, pocket depth and loss of attachment were measured as clinical parameters. After scaling and oral hygiene instruction, root planing is done two weeks later. During the eight weeks of experimental period, mouth gargling is done by all groups. The changes in the clinical parameters of the all sites were monitored every two weeks. The results were as follows : 1. The plaque index showed a siginificant difference in Exp 1 group compared with test 2 group after 2 weeks use of mouth rinse(P<0.05). 2. The gingival index showed a significant difference in Exp 1 group compared with baseline value(P<0.05) but there was no significant difference between the groups after 2 weeks use of mouthrinse (P<0.05). 3. The plaque index, gingival index and bleeding index showed a significant difference in all groups compared with baseline value after 4 weeks of root planing and mouthrinse use(P<0.05). but there was no significant difference between the groups(P<0.05). 4. Periodontal pocket depth showed a significant difference in all groups compared with baseline value after 4 weeks of root planing and mouthrinse use(P<0.05). and there was significant difference between the Exp 1 group and control group(P<0.05). 5. Loss of attachment showed a significant difference in all Exp groups compared with baseline value after 4 weeks of root planing and mouthrinse use(P<0.05). and there was significant difference between the Exp 1 group and control group(P<0.05). The results suggest that C31G, Listerine and CPC were effective for early periodontitis as a adjunctive to mechanical plaqe control.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.315-324
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• 2002

The purpose of this in vitro study was to evaluate the efficiency of Er:YAG laser on calculus removal and the morphologic changes and hardness of the irradiated surface at different power settings. This experiment used human teeth which were extracted due to periodontal disease and had a band of calculus. Forty root slabs ($5{\times}5mm$) were made and divided into control group and irradiated groups. Experimental groups were as follows; Control group (root planing), Group1 (irradiated with laser at 30mJ), Group2 (irradiated with laser at 60mJ), Group3 (irradiated with laser at 100mJ). Twelve root slab embedded in resin block were used in each group. Er:YAG laser was applied under water irrigation with the tip held perpendicular to the root surface in contact mode. The treatment time was measured until the calculus was removed completely under naked eyes. The efficiency of calculus removal was evaluated by the time for removal. Morphological changes of laser irradiated site were observed under SEM and the surface hardness was measured using a VH tester. The results were as follows; 1. The efficiency of laser scaling was increased with increasing the energy level of irradiation(p<0.05). 2. The morphological changes such as carbonization, crater and scale-like defects in the irradiated root surface were frequently observed with increasing the energy level. 3. The surface hardness tended to increase at 60mJ and 100mJ irradiated groups than that of control group. From the results evaluting on the efficiency, morphological change and surface hardness, lower energy level was suggested for the clinical application of the Er:YAG laser in scaling.

• Journal of Periodontal and Implant Science
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• v.24 no.1
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• pp.109-119
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• 1994

An essential fact in the regeneration of new periodontal tissue after periodontal therapy is the reattachment of collagen fibers to the tooth. Two phenomena play a fundamental role in preventing new connective tissue attachment to the exposed root surface ; 1) The apical migration of the junctional epithelium 2) The contamination of cementum by toxic substances, especially endotoxins. Authors have used rat submucosal implantation of root sections to study the connective tissue healing to periodontally diseaed root, previously planed and demineralized with citric acid and tetracycline- HCl. The results were obtained as follows. 1. The connective tissue attachment was increased in tetracycline, citric acid, non disease, scaling and root planing order and inflammatory reaction was seen in the rat teeth, no treatment group. 2. Collagen fiber attachment at the dentin surface was more increased than cementum surface 3. In 2 week of citric acid and tetracycline-HCl specimens, osteoid was seen near the fibrotic band. 4. In the MT view, collagen fiber formation was increased with time and the numerous collagen fiber and connective tissue was more densly attached to the tooth surfaces in the tetracycline-HCl group than the citric acid group.