• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.613-624
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• 2007

Full-mouth disinfection (Fdis) completes the entire scaling and root planing (SRP) in one stage within 24 hours for the prevention of microbial recolonization from untreated sites and ecological niches. The aim of this study is to compare the clinical short-term effects of modified Fdis with those of the conventional SRP in the therapy of moderate and severe chronic periodontitis. Modified Fdis group (5 patients) received the entire SRP within 24 hours using chlorhexidine solution (0.1%) and conventional SRP group (5 patients) received SRP per quadrant at one-week intervals. Clinical parameters were measured at baseline, one month and three months after both therapies. The results of this case report were as follows: 1. There were considerable decreases in sulcus bleeding index and plaque index one month after Fdis. 2. The mean probing depth of single-rooted teeth decreased more in Fdis group than conventional SRP group after therapy and, that of multi-rooted teeth decreased similarly in both groups. 3. The mean probing depth decreased 1.77mm in case of initial probing depth of 4-6mm and it decreased 4.13mm in case of initial probing depth of ${\geq}$ 7mm three months after Felis. 4. There were the smaller increases in gingival recession together with the larger gains in attachment in Fdis group than conventional SRP group after three months. Within the limitations of this study, one could conclude that Fdis has beneficial clinical effects in the treatment of moderate and severe chronic periodontitis and further research would be helpful including more subjects during a longer period to confirm the beneficial long-term effects of Fdis.

• Journal of Periodontal and Implant Science
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• v.39 no.sup2
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• pp.239-251
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• 2009

Purpose: Full-mouth disinfection enables to reduce the probability of cross contamination from untreated pockets to treated ones, for completing the entire SRP under local anesthesia with chlorhexidine as a mouth wash in two visits within 24 hours. This study aimed to compare the clinical effects of modified full-mouth disinfection (Fdis) after 6 months with those of conventional SRP (cSRP). Methods: Thirty non-smoking chronic periodontitis subjects were randomly allocated two groups. The Fdis group underwent the entire SRP under local anesthesia in two visits within 24 hours, a week after receiving supragingival scaling. A chlorhexidine (0.1%) solution was used for rinsing and subgingival irrigation for Fdis. The cSRP group received SRP per quadrant under local anesthesia at one-week intervals, one week after they had received scaling. Clinical parameters were recorded at baseline, after 1, 3 and 6 months. Results: There are significant (P<0.05) decreases in the sulcus bleeding index, and plaque index, and the increases in gingival recession were significantly smaller with Fdis after six months compared with cSRP. There was significant improvement in the probing depth and clinical attachment level for initially medium-deep pockets (4-6mm) after Fdis compared with cSRP. Multi-rooted teeth showed significantly larger attachment gain up to six months after Fdis. Single-rooted teeth showed significantly more attachment gain, 1 and 6 months after Fdis. Conclusions: Fdis has more beneficial effects on reducing gingival inflammation, plaque level, probing depth, gingival recession and improving clinical attachment level over cSRP.

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.71-78
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• 2014

Purpose: Host modulatory therapy has been proposed as a treatment for periodontal diseases. A class of herbal medicines, known to be immunomodulators, alters the activity of immune function through the regulation of informational molecules such as cytokines. In the current study, we tested the hypothesis that herbal immunomodulator drugs act as an adjuvant to scaling and root planing (SRP) in alleviating periodontal inflammation by improving clinical and biochemical parameters. Methods: Sixty healthy subjects (30 in each group) with moderate and severe chronic periodontitis were enrolled in a double-blind, placebo-controlled, double-masked randomised controlled trial. The control group was treated with SRP and a placebo, whereas the test group was treated with SRP followed by dietary supplementation of Septilin for 3 weeks. Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated for all patients at the baseline, 3 weeks, and 6 weeks. Results: Improved gingival index scores found in the test group as compared to the control group were found to be statistically significant only after 3 weeks (P<0.001). In contrast, the decrease in the sulcus bleeding index and pocket depth scores was statistically highly significant in the test group as compared to the control group after 3 weeks and 6 weeks (P<0.001). However, reduced clinical attachment level and CRP scores, as reflected in the test group as compared to the control group, were not found to be statistically significant after both 3 weeks (P>0.05) and 6 weeks (P>0.05). Conclusions: The results of this clinical-biochemical study suggest that dietary supplementation with herbal immunomodulatory agents may be a promising adjunct to SRP and may aid in improving periodontal treatment outcomes.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.25-32
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• 2014

Purpose: Periodontitis is an infectious disease caused predominantly by gram-negative anerobes. The host inflammatory response to these bacteria causes alveolar bone loss that is characterized as periodontitis. Omega-3 fatty acids (${\omega}$-3 FAs) have anti-inflammatory properties, thus have been used to treat some chronic inflammatory diseases such as cardiovascular disease and rheumatoid arthritis. We aimed to evaluate the effect of dietary supplementation with ${\omega}$-3 FAs as a host modulating agent in patients with chronic periodontitis. Methods: Sixty otherwise healthy subjects with moderate and severe chronic periodontitis were enrolled in our randomised, double-blind, placebo-controlled trial. The control group (CG, n=30) was treated with scaling and root planing (SRP) and given a placebo; the treatment group (TG, n=30) was treated with SRP and dietary supplementation of ${\omega}$-3 FAs (one 300 mg tablet daily for 12 weeks). Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated in all patients at baseline, a 6-week and 12-week period after treatment. Results: A significant reduction in the gingival index, sulcus bleeding index, pocket depth, and clinical attachment level was found in the TG compared to the CG at a 12-week period. However, no statistically significant changes in serum CRP levels were found. Conclusions: Our findings suggest that ${\omega}$-3 FAs can successfully reduce gingival inflammation, pocket depth, and attachment level gain. Dietary supplementation with ${\omega}$-3 FAs may have potential benefits as a host modulatory agent in the prevention and/or C management of chronic periodontitis.

• The Journal of the Korean dental association
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• v.53 no.9
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• pp.618-627
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• 2015

Purpose : The purpose of this clinical study was to evaluate the effect of chelating and deproteinizing agent containing dental conditioning gel on alleviation of peri-implant mucosa inflammation. Methods: 36 patients with functionally loaded implants for at least 1 year and have clinical signs of peri-implant mucositis were recruited. At baseline, all implants received subgingival prophylaxis with ultrasonic scaler. In the test group, patients were provided a chelating and deproteinizing agent dental conditioning gel (Clinplant$^{(R)}$) and were given instructions to applicate it around the implants using an interdental brush for 2 weeks. Chlorhexidine and saline were provided to the positive control group and negative control group, respectively. The modified sulcus bleeding index (mSBI), modified plaque index (mPI), and probing pocket depth (PPD) were evaluated at baseline, 1 week, and 2 weeks. Results: In the Clinplant$^{(R)}$ and chlorhexidine group, mSBI (-0.81, -0.85 respectively; p<0.01), mPI (-0.46, -0.5 respectively; p<0.01), and PPD (-0.58, -0.48 respectively; p<0.01) at 2 weeks were significantly reduced from baseline. In the saline group, all the clinical parameters were reduced but there was no statistical significance. The saline may be attributed to the influence of prophylaxis at baseline. Conclusions: The present study demonstrated the beneficial clinical effects of chelating and deproteinizing agent containing dental conditioning gel to decrease peri-implant mucosa inflammation equivalent to chlorhexidine. This dental conditioning gel might be useful for alleviation of peri-implant mucosa inflammation.

• Journal of Periodontal and Implant Science
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• v.23 no.2
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• pp.345-351
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• 1993

Various alloplastic materials have been used on the periodontally diseased ossous defects. Hydroxyapatite, which is used the most common alloplastic material is a non-resorbable form of calcium phosphate and natural coral which is a biodegradable by carbonic anhydrase in osteoclast was introduced recently. The purpose of the present study was to evaluate the clinical effects of porous hydoxyapatite and natural coral on the human periodontal defects. Four males and three females who had adult periodontitis were selected for this study. The teeth that had similar bone loss radiographically and periodontal pocket deeper than 5mm were selected. Gingival recession, pocket depth, plaque index(Silness & Loe), sulcus bleeding index and tooth mobility (measured by Periotest$^{(r)}$) were examined before graft. Before insertion of alloplastic materials, the depth from CEJ to bone crest and from CEJ to base of the osseous defect was recorded. Porous particulate hydroxyapatite(Interpore 200$^{(r)}$, A group) was place on the defect and natural coral(Biocoral$^{(r)}$, B group) was placed on the defect of the opposing tooth. Six months post-surgically the same parameters were recorded by reentry procedures. A and B group showed 0.6mm of mean recession. Mean reduction of pocket depth were 5mm for A group and 4.9mm of B group. Reduced SBI and tooth mobility were recorded. Osseous defect fills of the original defects were 2.9mm for A and 3mm for B group. Percentage defect fills were 71% for A and 59% for B group. The difference of defect fill between pre- and post-insertion was statstically significant(p<0.05). But the difference between the two groups was not significant statistically(p<0.05). The clinical impression at 6 month re-entry and the numerical date indicate that natural coral as well as porous particulate hydoxyapatite has a definite potential as an alloplastic implant in the treatment of periodontal osseous defects.

• Journal of Periodontal and Implant Science
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• v.45 no.2
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• pp.56-61
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• 2015

Purpose: The aim of this study was to evaluate the effectiveness of powered toothbrushes for plaque control in patients with peri-implant mucositis, in comparison with manual toothbrushes. Methods: This randomized, prospective, controlled, clinical parallel study compared the efficacy of manual and powered toothbrushes for plaque control in implant restorations. Patients with bleeding on probing, no residual pocket depth (as indicated by a pocket probing depth ${\geq}5mm$), and no radiological peri-implant bone loss were eligible for this study. Patients were requested to complete a questionnaire describing their oral hygiene habits. The duration and frequency of tooth brushing were recorded by subjects in order to assess their compliance. Clinical parameters, including the modified plaque index (mPI), the modified sulcus bleeding index (mSBI), and clinical photographs (buccal and lingual views) were recorded at baseline and at one-month and two-month follow-up visits. Results: Statistically significant differences between patients who used manual toothbrushes and those who used powered toothbrushes were found regarding the frequency of tooth brushing per day and the duration of brushing at one-month and two-month follow-up visits, while no statistically significant differences were found relating to other oral hygiene habits. A statistically significant difference in patient compliance for tooth brushing was found at one month, while no difference was found at two months. Statistically significant decreases in the mPI and the mSBI were observed in both groups from baseline to the one- and two-month follow-ups. The overall reduction of these parameters was not significantly different between the two groups, except for mPI reduction between baseline and one month of follow-up. Conclusions: Sonic-powered toothbrushes may be a useful device for plaque control in patients with peri-implant mucositis.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.563-575
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• 2005

The aim of present study is to evaluate the influence of adjacent tooth to the microbiology of clinically healthy implant. Control group included patients who had clinically healthy implant and tooth with healthy $periodontium(PD{\leq}3mm)$, test group was composed of patients who had clinically healthy implant and tooth with periodontal pocket(PD>3mm). The criteria of clinically health implant are no pain or discomfort, the restorative suprastructure provide satisfactory fit and function, and the tissue around the fixtures were firm and probing with standard periodontal probe with a rounded tip 0.5mm in diameter resulted in penetration of no more than 5mm when using a force of 0.5N at any location. 38 patients, partially edentulous subjects with endosseous root-form implants were selected. All subjects were medically healthy and had not taken systemic antibiotics and professional plaque control 3 months before sampling. Number of control group is 25(mean age $52{\pm}13$, 26 teeth, 34 implants) and test group is 13(mean age $60{\pm}13$, 13 teeth, 17 implants). All teeth and implants of each patient were examined probing depth(PD), bleeding on probing(BOP), and plaque index(PI), and samples of subgingival plaque were obtained at each site with sterile curet or fine paper points, then the plaque transferred to PBS. Obtained samples were examined for the presence of P. gingivalis, T. forsythensis, and T. denticola by the polymerase chain reaction(PCR). The relationship among clinical parameters and the colonizations by the 3 bacterial species from natural teeth and implants region were analyzed by student t-test. The results of this study were as follows: 1. PD was different in teeth between 2 groups(p<0.05), but the other parameters were not. 2. Statistically significant difference was not found in clinical parameters of implants between 2 groups. 3. All bacterial prevalences of teeth were higher in test group than in control group, and prevalence of T. forsythensis had statistically significant difference between 2 groups(p<0.05). 4. Prevalences of P. gingivalis and T. forsythensis are higher in test group than control group, and that of T. denticola is higher in control group than in test group. But there were no statistically significant differences between 2 groups. In conclusion, there is no statistically significant difference in prevalence of implant microbiology between 2 groups. But if the number of samples increased, it will be possible to find out statistical significance in prevalence of P. gingivalis. It seems that pocket of adjacent tooth influences prevalence of P. gingivalis. These results mean that improvement of the periodontal condition before implantation is very important.

• Journal of Periodontal and Implant Science
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• v.31 no.4
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• pp.689-711
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• 2001

The purpose of this study was to compare clinical results of guided tissue regeneration(GTR) using either a nonresorbable ePTFE membrane or a resorbable membrane made from a synthetic copolymer of glycolide and lactide(PLGA) in the treatment of human class Ⅱ furcation defects. The ePTEE membranes were applied to 16 patients with maxillary molar buccal class Ⅱ furcation defects as Group I, PLGA membranes were applied to 15 patients with maxillary molar buccal class Ⅱ furcation defects as Group Ⅱ, ePTFE membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅲ and PLGA membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅳ and bone graft materials(DFDBA) were applied in all groups. Probing depth, gingival recession, clinical attachment level, tooth mobility and sulcus bleeding index(SBI) were measured at baseline, 3, 6 and 12months postoperatively. In addition, membrane exposure levels were measured at surgery, 1, 2 and 6weeks postoperatively and postoperative complications were evaluated. The results were as follows: In all groups, there were statistically significant differences in probing depth reduction, gain of clinical attachment and mobility reduction at values of 3, 6 and 12months postoperatively compared to values of baseline, whereas no significant differences in SBI except Group I and gingival recession(p<0.05). Membrane exposure levels were increased at 1, 2 and 6weeks postopratively compared to value of baseline in Group I(p<0.05). There were no statistically significant differences between ePTFE and PLGA membrane in probing depth, clinical attachment level and SBI. There were minimal gingival recession and membrane exposure in Group Ⅳ and pain and swelling were the most common postoperative complications in Group Ⅱ, Ⅲ(p<0.05). In conclusion, this study showed that both nonresorbable membrane and resorbable membrane were effective similarly in the treatment of class Ⅱ furcation defects, without statistical differences in clinical measurements.

• 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.