Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지

Clinical Evaluation of Passive Eruption Using Occlusal Reduction on Periodontium

교합면 삭제(occlusal reduction)를 이용한 수동적 정출 (passive eruption)이 치주조직에 미치는 영향

  • Kim, Yoo-Jin (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Kim, Sung-Jo (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Choi, Jeom-Il (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Lee, Ju-Youn (Department of Periodontology, School of Dentistry, Pusan National University)
  • 김유진 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 최점일 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 김성조 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 이주연 (부산대학교 치의학전문대학원 치주과학교실)
  • Received : 2012.01.23
  • Accepted : 2012.03.25
  • Published : 2012.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

The relationship between occlusion and periodontal health has been extensively studied. However, reports on the effects of passive eruption using occlusal reduction has not been sufficient. The purpose of the present randomized clinical trial was to assess the influence of passive eruption using occlusal reduction on the clinical periodontal parameters consisting of attachment level, pocket depth, tooth mobility, width of keratinized gingiva and osseous defect. The study was performed on 40 teeth of 16 subjects who have been treated for the moderate periodontitis at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, after hygienic-phase and after 6 month from passive eruption using occlusal reduction, clinical parameters were monitored and radiographs were taken. The 20 teeth in the test group received passive eruption using occlusal reduction while the 20 control teeth did not receive any occlusal reduction. The results were as follows; 1) Degree of inflammation of periodontium was improved by initial therapy 2) Teeth received passive eruption using occlusal reduction demonstrated significantly greater reduction in pocket depth, tooth mobility and amount of bone loss, and increase in the width of keratinized gingiva, but no significant changes in the attachment level compared to the control teeth 3) There was significantly greater reduction in pocket depth, mobility, amount of bone loss and attachment level in the test teeth after initial hygienic phase when compared with baseline data. Taken together, these results suggest that the passive eruption using occlusal reduction would be helpful to improve periodontal health.

치주치료에 있어 교합치료의 타당성은 오래전부터 연구되어오고 있으나 아직도 논란이 많은 부분이다. 그 중에서도, 교합삭제를 이용한 수동적 정출(passive eruption)의 치료 효과에 대한 연구는 아직 보고된 바가 많지 않다. 본 연구의 목표는 교합삭제를 이용한 수동적 정출이 치주부착수준, 치주낭깊이 등의 치주임상지표들에 미치는 효과를 평가하는 것이다. 본 연구는 부산대학교 치과병원 치주과에서 중등도 치주염으로 치료받은 환자 중, 연구대상조건을 만족하는 16명의 환자, 40개의 치아를 대상으로 하였다. 연구 시작 단계에서 임의로 분류한 실험군과 대조군 치아 모두 임상적, 방사선적 검사를 시행하였다. 치석제거술과 치근활택술, 구강 위생 교육을 포함한 초기치료를 시행하고 4주 후 임상적, 방사선적 검사를 재실시하였다. 이 때 실험군은 교합면 삭제를 이용한 수동적 정출을 시행하고 대조군은 아무런 처치를 하지 않았다. 그 후 6개월 이후 임상적, 방사선적 검사를 재실시하였다. 그 결과 1)연구시작 단계와 비교 시, 초기치료에 의해 임상지표를 통한 치주조직의 염증상태가 개선되었으며, 2)실험군에서 치주낭깊이, 치아동요도, 치조골 소실 감소와 각화치은 폭경 증가가 더 큰 것으로 나타났다 (p<0.05). 이 결과로 볼 때, 초기치료와 함께 교합조정을 이용한 수동적 정출술이 치주치료에 도움을 줄 수 있을 것으로 사료된다.

Keywords

References

  1. Serio FG, Hawley CE. Periodontal trauma and mobility. diagnosis and treatment planning. Dent Clin North Am 1999;43(1):37-44.
  2. Svanberg G. Influence of trauma from occlusion on the periodontium of dogs with normal or inflamed gingivae. Odontol Revy 1974;25(2):165-178.
  3. Lindhe J, Svanberg G. Influence of trauma from occlusion on progression of experimental periodontitis in the beagle dog. J Clin Periodontol 1974;1(1):3-14. https://doi.org/10.1111/j.1600-051X.1974.tb01234.x
  4. Lindhe J, Ericsson I. The influence of trauma from occlusion on reduced but healthy periodontal tissues in dogs. J Clin Periodontol 1976;3(2):110-122. https://doi.org/10.1111/j.1600-051X.1976.tb01857.x
  5. Ericsson I, Lindhe J. Lack of significance of increased tooth mobility in experimental periodontitis. J Periodontol 1984;55(8):447-452. https://doi.org/10.1902/jop.1984.55.8.447
  6. Meitner S. Co-destructive factors of marginal periodontitis and repetitive mechanical injury. J Dent Res 1975;54 Spec no C:C78-85. https://doi.org/10.1177/002203457505400309011
  7. Polson AM, Meitner SW, Zander HA. Trauma and progression of marginal periodontitis in squirrel monkeys. IV reversibility of bone loss due to trauma alone and trauma superimposed upon periodontitis. J Periodontal Res 1976;11(5):290-298. https://doi.org/10.1111/j.1600-0765.1976.tb00083.x
  8. Harrel SK, Nunn ME. The effect of occlusal discrepancies on periodontitis. II. relationship of occlusal treatment to the progression of periodontal disease. J Periodontol 2001;72(4):495-505. https://doi.org/10.1902/jop.2001.72.4.495
  9. Harrel SK, Nunn ME. Longitudinal comparison of the periodontal status of patients with moderate to severe periodontal disease receiving no treatment, nonsurgical treatment, and surgical treatment utilizing individual sites for analysis. J Periodontol 2001;72(11):1509-1519. https://doi.org/10.1902/jop.2001.72.11.1509
  10. Orban B, Weinmann J. Signs of traumatic occlusion in average human jaws. J Dent Res 1993;13:216 (Abstract).
  11. Ferris RT. Quantitative evaluation of tooth mobility following initial periodontal therapy. J Periodontol 1966;37(3):190-197. https://doi.org/10.1902/jop.1966.37.3.190
  12. Laster L, Laudenbach KW, Stoller NH. An evaluation of clinical tooth mobility measurements. J Periodontol 1975;46(10):603-607. https://doi.org/10.1902/jop.1975.46.10.603
  13. Perlitsh MJ. A systematic approach to the interpretation of tooth mobility and its clinical implications. Dent Clin North Am 1980;24(2):177-193.
  14. Polson AM, Adams RA, Zander HA. Osseous repair in the presence of active tooth hypermobility. J Clin Periodontol 1983;10(4):370-379. https://doi.org/10.1111/j.1600-051X.1983.tb01286.x
  15. Ingber JS. Forced eruption: Part I. A method of treating isolated one and two wall infrabony osseous defects. Rationale and case report. J Periodontol 1974;45:199-206. https://doi.org/10.1902/jop.1974.45.4.199
  16. Steedle JR, Proffit WR. The pattern and control of eruptive tooth movements. Am J Orthod 1985;87(1):56-66. https://doi.org/10.1016/0002-9416(85)90174-5
  17. Frank CA, Pearson BS, Booker BW. Orthodontic eruption of furca-involved molars. Compend Contin Educ Dent 1995;16(7):664,666, 668 passim; quiz 682.
  18. Silness J, Loe H. Periodontal disease in pregnancy. ii. correlation between oral hygiene and periodontal condtion. Acta Odontol Scand 1964;22:121-135. https://doi.org/10.3109/00016356408993968
  19. Loe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38(6):Suppl:610-6. https://doi.org/10.1902/jop.1967.38.6_part2.610
  20. Hill RW, Ramfjord SP, Morrison EC, et al. Four types of periodontal treatment compared over two years. J Periodontol 1981;52(11):655-662. https://doi.org/10.1902/jop.1981.52.11.655
  21. Kaldahl WB, Kalkwarf KL, Patil KD, et al. Evaluation of four modalities of periodontal therapy. Mean probing depth, probing attachment level and recession changes. J Periodontol 1988;59(12):783-793. https://doi.org/10.1902/jop.1988.59.12.783
  22. Pihlstrom BL, Ortiz-Campos C, McHugh RB. A randomized four-years study of periodontal therapy. J Periodontol 1981;52(5):227-242. https://doi.org/10.1902/jop.1981.52.5.227
  23. Kantor M, Polson AM, Zander HA. Alveolar bone regeneration after removal of inflammatory and traumatic factors. J Periodontol 1976;47(12):687-695. https://doi.org/10.1902/jop.1976.47.12.687
  24. Schulte W. The periotest-periodontal status. Zahnarztl Mitt 1986;76(12):1409-10, 1412-4.
  25. Schulte W, Lukas D. The periotest method. Int Dent J 1992;42(6):433-440.
  26. Egloff ET, Hochman M. The assessment of periodontal disease activity. Compend Suppl. 1988;12:S424-7.
  27. Schulte W, Lukas D, Ernst E. Periotest values and mobility of periodontally diseased teeth-comparative study. Quintessenz 1991;42(8):1255-1263.
  28. Nunn ME, Harrel SK. The effect of occlusal discrepancies on periodontitis. I. relationship of initial occlusal discrepancies to initial clinical parameters. J Periodontol. 2001;72(4):485-494. https://doi.org/10.1902/jop.2001.72.4.485
  29. Neiderud AM, Ericsson I, Lindhe J. Probing pocket depth at mobile/nonmobile teeth. J Clin Periodontol 1992;19(10):754-759. https://doi.org/10.1111/j.1600-051X.1992.tb02166.x
  30. Burgett FG, Ramfjord SP, Nissle RR, et al. A randomized trial of occlusal adjustment in the treatment of periodontitis patients. J Clin Periodontol 1992;19(6):381-387. https://doi.org/10.1111/j.1600-051X.1992.tb00666.x
  31. Kajiyama K, Murakami T, Yokota S. Gingival reactions after experimentally induced extrusion of the upper incisors in monkeys. Am J Orthod Dentofacial Orthop 1993;104(1):36-47. https://doi.org/10.1016/0889-5406(93)70025-J