Tooth mobility is one of the most important clinical parameters in examination, diagnosis, prognosis and treatment planning procedure. In order to determine the differences of tooth mobility according to radiographical bone level, clinical root length, clinical crown/root ratio, and bleeding on probing, 90 male adults with periodontal disease and 10 male adults with periodontal health($25{\sim}45$ years old) were selected through clinical examinations including occlusal relationship, probing depth, attachment level, and bleeding on probing. On the mandibular anterior teeth, standard periapical radiographs were taken, and tooth mobility was measured by Periotest(Siemens Co., Germany). The radiographic bone level of individual tooth was evaluated as coronal 1/3, middle 1/3, and apical 1/3 to anatomical root length, and clinical crown length from incisal edge to bone level and clinical root length from bone level to root apex were measured with Boley gauge, and subsquently clinical crown/root ratio was calculated. The difference of tooth mobility(Periotest value) according to radiographical bone level, clinical root length, clinical crown/root ratio, and bleeding on probing was statistically analyzed by unpaired Student t-test. Tooth mobility was significantly higher in bleeding group than non-bleeding group on probing in the teeth radiographic bone level of middle 1/3, with clinical root length longer than 6mm, and with clinical crown/root ratio over 0.3(p<0.01). But there was no statistical difference in tooth mobility between bleeding group and non-bleeding group on probing in the teeth with radiographic bone level of apical 1/3, with short clinical root length less than 5mm, and with clinical crown/root ratio under 0.2(p>0.05). The results note that the tooth mobility depends on clinical root length, clinical crown/root ratio and gingival inflammation, and in the teeth with relatively good alveolar bone support gingival inflammation is one of the most important factors that affect tooth mobility.
The purpose of this study was to evaluate relationship of probing attachment levels, radiographic measurements and surgical measurements according to gingival inflammatory condition. Patients with incipient to moderate periodontitis were selected. Upper and lower premolar and molar teeth excluding third molars were measured. At first visit, gingival index and bleeding on probing were taken, and subjects were grouped into 4 categories as follows : Experimental group I : gingival index 1 and no bleeding on probing. Experimental group II : gingival index 2 and no bleeding on probing absent. Experimental group III : gingival index 1 and bleeding on probing present. Experimental group IV : gingival index 2 and bleeding on probing present. Probing attachment levels were measured with manual probe on mesial and distal surfaces from cementoenamel junctions to terminal ends of probe. Radiographic measurements were made to assess bone loss by measuring the distance from cementoenamel junction to the alveolar crest. After thorough scating, a flap was raised exposing the alveolar bone and surgical measurements were made from cementoenamel junction to alveolar bone. The results were as follows: 1. Differences between probing attachment level and radiographic measurements showed $1.01{\pm}0.73mm$ for experimental group I, $0.98{\pm}0.48mm$ for experimental group II, $0.59{\pm}0.66mm$ for experimental group III, $0.98{\pm}0.38mm$ for experimental group IV and with no significant difference between groups. 2. Differences between probing attachment level and surgical measurements showed $1.36{\pm}0.80mm$ for experimental group I, $1.47{\pm}0.54mm$ for experimental group II, $1.06{\pm}0.39mm$ for experimental group III, $1.41{\pm}0.40mm$ for experimental group IV and with no significant difference between groups. 3. Differences between surgical and radiographic measurements showed $0.36{\pm}0.48mm$ for experimental group I, $0.51{\pm}0.54mm$ for experimental group II, $0.57{\pm}0.72mm$ for experimental group III, $0.41{\pm}0.49mm$ for experimental group IV and with significant difference between experimental group I and experimental group II, III, IV(P<0.05).
PURPOSE. The study was conducted to evaluate the efficacy of implant supported tooth replacement in diabetic patients. MATERIALS AND METHODS. The study involved placement of implants (UNITI implants, Equinox Medical Technologies, Zeist, Holland, diameter of 3.7 mm and length 13 mm) in five diabetic patients (three females and two males) of age ranging from 35-65 years with acceptable metabolic control of plasma glucose. All patients included in the study were indicated for single tooth maxillary central incisor replacement, with the adjacent teeth intact. The survival of the restored implants was assessed for a period of three months by measurement of crestal bone heights, bleeding on probing and micro flora predominance. Paired t-test was done to find out the difference in the microbial colonization, bleeding on probing and crestal bone loss. P values of less than 0.05 were taken to indicate statistical significance. RESULTS. Results indicated that there was a significant reduction in bleeding on probing and colonization at the end of three months and the bone loss was not statistically significant. CONCLUSION. The study explores the hypothesis that patients with diabetes are appropriate candidates for implants and justifies the continued evaluation of the impact of diabetes on implant success and complications.
Tooth mobility may be the decisive factor that determines whether dental treatment of any kind is undertaken. Although tooth mobility in isolation says little in itself, the finding of increased tooth mobility is of both diagnostic and prognostic importance. Only the detection of an increase or decrease in mobility makes an evaluation possible. Thus prior to treatment, we must understand the pathologic process causing the observed the tooth mobility and decide whether the pattern and degree of observed tooth mobility is reversible or irreversible. And then it must be decided whether retention and treatment or extraction and replacement. The purpose of this study was to compare tooth mobility at different time period during root planing and flap operation and to relate changes in mobility to each treatment method. Twenty-one patients (287 teeth) with chronic adult periodontitis were treated with root planing(control group) and flap operation(experimental group), and each group was divided 3 subgroups based upon initial probing pocket depth (1-3mm, 4-6mm, 7mm and more). Tooth mobility was measured with $Periotest^{(R)}$ at the day of operation, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 8 weeks, 12 weeks after each treatment. Tooth mobility, attachment loss, radiographic bone loss, and bleeding on probing were measured at the day of operation, 4 weeks, 8 weeks and 12 weeks after treatment. 1. In group initial probing depth was 1-3mm, tooth mobility had no significant difference after root planing and flap operation. 2 . In group initial probing depth was 4-6mm, 7mm and more, tooth mobility had decreased in 12 weeks after root planing(p<0.01). And the mobility had increased after flap operation(p<0.01) and was at peak in 1 week, and decreased at initial level in 4 weeks, below the initial level in 12 weeks(p<0.01). 3. In 1 week, significant difference in tooth mobility between control and experimental group was found(p<0.01) but, in 12 weeks no difference between two groups was found. 4. Change of immediate tooth mobility after treatment was more larger in deep pocket than in shallow one. In group with the same probing pocket depth, the change of tooth mobility in molar group was greater than that of premolar group. 5. Tooth mobility before treatment was more strongly correlated with radiographic bone loss (r=0.5325) than probing depth, attachment loss and bleeding on probing, in 12 weeks after treatment, was more strongly correlated with attachment loss($r^2$=0.4761) than probing depth and bleeding on probing. Evaluation of the treatment effect and the prognosis after root planing and flap operation were meaningful on tooth initial probing depth 4mm and more. After flap operation, evaluation of the prognosis should be performed at least in 4 weeks and in 12 weeks after treatment, no difference in tooth mobility between two groups was observed. Radiographic bone loss and attachment loss were good clinical indicators to evaluate tooth mobility.
Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.
Purpose : Preservation of the periodontal health of the treated patient requires supportive periodontal therapy for the elimination of periodontal disease. After Phase I therapy is completed, patients are placed on a schedule of periodic recall visits for maintenance care to prevent recurrence of the disease. The amount of tooth loss would be the most relevant criterion in an evaluation of the effect of periodontal treatment, but this would require studies with extremely long follow-up periods. Thus the most commonly used outcome criteria in clinical research have been clinical attachment level change, reduction of pocket depth and bleeding frequency. The purpose of this case study is to identify the effect of supportive periodontal therapy after periodontal flap surgery. Materials & Methods : Following routine hygienic phase of treatment, patients with chronic periodontitis received surgical periodontal treatment. Bleeding on probing, pocket depth and clinical attachment level were measured at baseline, pre-operation and 1 year follow up. All procedures were performed by one operator. Results : One year a total of 28 patients (58sites) to recheck remained, when conducted maintenance program after periodontal flap surgery was observed reduction of bleeding frequency, pocket depth and improvement of clinical attachment level. Conclusion : The results from this study indicate that supportive periodontal therapy after periodontal flap surgery is effective for reduction of bleeding frequency, pocket depth and gain of clinical attachment level.
Kim, Yoon-Sik;Paik, Jeong-Won;Kim, Chang-Sung;Choi, Seong-Ho;Kim, Chong-Kwan
Journal of Periodontal and Implant Science
/
v.32
no.2
/
pp.415-428
/
2002
Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.
Peri-implant diseases are inflammatory lesions, which include peri-implant mucositis and peri-implantitis. Peri-implant mucositis is described as the presence of inflammation in the mucosa around implants without any bone loss. By contrast, in peri-implantitis, besides the inflammation in the peri-implant mucosa, loss of supporting bone is also seen. Diagnosis of peri-implant diseases require the use of gentle probing(0.2 ~ 0.3N) to identify the presence of bleeding on probing, probing depth and suppuration, both signs of clinical inflammation. Radiographs are required to detect loss of supporting bone. Baseline probing measurements and high quality, long cone periapical radiographs should be obtained once the restoration of the implant is completed to make possible longitudinal monitoring of peri-implant tissue.
The aim of this study is to determine whether full-mouth disinfection therapy(FMT) in our clinical setting would show better improvement of clinical parameters than partial mouth disinfection therapy(PMT) in chronic periodontitis and aggressive periodontitis patients. Among 12 patients, 6 were treated FMT and other 6 were treated PMT. Clinical parameters were calculated 3 months and 6 months after initial therapy. 1. There were no statistically significant differences between FMT and PMT in the reduction rate of bleeding on probing after 3 months, 6 months 2. Initial probing depth was 4-6mm, the mean probing depth after 3 months was 2.2mm vs 2.5mm(FMT vs PMT), after 6 months was 2.4mm vs 2.8mm. This was significantly lower in the FMT groups. 3. Initial probing depth was ${\geqq}$ 7mm, the reduction rate of mean probing depth during first 3 months was 4.8mm vs 4.1mm(FMT vs PMT), and 3 to 6 months was 0.5mm vs 0.3mm. This was significantly larger in the FMT groups. 4. Initial probing depth was 4-6mm, the mean clinical attachment level after 3 months was 2.3mm vs 2.7mm(FMT vs PMT), after 6 months was 2.7mm vs 3.0mm. This was significantly lower in the FMT groups. 5. Initial probing depth was ${\geqq}$ 7mm, the reduction rate of mean probing depth during first 3 months was 4.0mm vs 3.0mm(FMT vs PMT), and 3 to 6 months was 0mm vs -0.1mm. This was significantly larger in the FMT groups. Although the results provided us with succeccful clinical improvement in aggressive periodontitis, further research is needed to prove its additional benefit in the treatment of chronic periodontitis
Many tooth cleansing instruments and agents have been developed for removal of plaque, inhibition of plaque formation and reduction of gingival inflammation. The aim of this study was to evaluate the plaque control effect and the therapeutic effect of newly developed tooth cleansing instrument(Belloblanco(R)). 40 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in control group only used manual tooth brushing and in experimental group used manual tooth brush and additive tooth cleansing instrument(Belloblanco(R)). Additive tooth cleansing instrument was used once a week. At baseline scaling and tooth brushing instruction was performed. Probing depth, bleeding on probing, plaque index, gingival index were scored at baseline, 2weeks, 4weeks. Probing depth of control and experimental group were significantly reduced at 2 weeks, 4weeks, hut there were no differences between two groups(P<(0.05). Bleeding on probing, plaque index and gingival index of control and experimental group were significantly reduced at 2weeks and 4weeks and there was significantly more reduction in the experimental group than the experimental group than the control group(p<(0.05). From these finding. it can be conclude that newly developed tooth cleansing instrument(Belloblanco(R)) are effective on the removal of plaque and the reduction of gingival inflammation
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