• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.230-243
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• 1996

Root surface exposure due to gingival recession after periodontal surgery, dentin exposure after root planing elicit pain response when exposed to mechanical, heat, chemical or osmotic stimulation. Especially, patients treated with periodontal surgery, show high frequency and there have been reports showing the 1 out of 7 patients have dentin hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentin hypersensitivity. but, none could provide absolute clinical efficacy. In this study, 45 teeth from 30 patients, who had had periodontal surgery and showed dentin hypersensitivity after surgery were chosen for the experimental group and they were illuminated with laser, 15teeth were chosen for the control group and they were not exposed to laser. After this dentin hypersensitivity was elicited by tactile, compressed air, cold water and then, the degree was evaluated using NRS(Numerical Rating Scale). And during LLLT(Low Level Laser Therapy) semiconductor laser using Gallium - Arsenide as a diode was illuminated for 180 seconds at a frequency of 7(500Hz). This therapy was done 10 times, and each time the changes in dentin hypersensitivity was evaluated using NRS. The results were as follows : 1. After treat with LLLT on dentin hypersensitivity due to periodontal surgery, 22.2% showed total loss of dentin hypersensitivity, 60.0% showed loss of tactile dentin hypersensitivity, 48.8% showed loss of compressed air dentin hypersensitivity, 22.2% showed loss of cold water dentin hypersensitivity. 2. As a result of clinical evaluation of dentin hypersensitivity using NRS, there was significant increase in improvement of dentin hypersensitivity in the experimental group compare to the control group(P<0.05). And there was almost no natural loss of dentin hypersensitivity in the control group. 3. In comparison of the stages of evaluation, there was significant difference in between experimental and control group. after the second visit(P<0.05), and the difference increased with each visit.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.69-84
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• 2006

Reports on the comparison of clinical effect between non-surgical and surgical therapy, and the change of the clinical parameters during maintenance phase have been rarely presented in Korea. This study was to observe the clinical changes during maintenance phase of 6 months in patients with chronic periodontitis treated by non-surgical or surgical therapy in Department of Periodontics, Chonnam National University Hospital. Among the systemically healthy and non-smoking patients with moderate to severe chronic periodontitis, twenty eight patients (mean age: 47.5 years) treated by non-surgical therapy (scaling and root planning) and nineteen patients (mean age: 47.3 years) treated by surgical therapy (flap surgery) were included in this study. The periodontal supportive therapy including recall check and oral hygiene reinforcement was started as maintenance phase since 1 month of healing after treatment. Probing depth, gingival recession. clinical attachment level and tooth mobility were recorded at initial, baseline and 1, 2, 3 and 6 month of maintenance phase. The clinical parameters were compared between the non-surgical and surgical therapies using Student t-test and repeated measure ANOVA by initial probing depth and surfaces. Surgical therapy resulted in greater change in clinical parameters than non-surgical therapy. During the maintenance phase of 6 months, the clinical effects after treatment had been changed in different pattern according to initial probing depth and tooth surface. During maintenance phase, probing depth increased more and gingival recession increased less after surgical therapy, compared to non-surgical therapy. The sites of initial probing depth less than 3 mm lost more clinical attachment level, and the sites of initial probing depth more than 7 mm gained clinical attachment level during maintenance phase after non-surgical therapy, compared to surgical therapy. Non-surgical therapy resulted in greater reduction of tooth mobility than surgical therapy during maintenance phase. These results indicate that the clinical effects of non-surgical or surgical therapy may be different and may change during the maintenance phase.

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.877-889
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• 2005

This study was designed to compare the effects of treatment using chitosan membrane $(Nanogide-C^{(R)})$ resorbable barrier with control treated by polylactic acid/polylacticglycolic acid membrane(PLA/PLGA membrane, $Biomesh^{(R)}$). 44 furcation defecs from 44 patients with class 2 furcation degree were used for this study, 22 sites of them were treated by chitosan membrane as experimental group and 22 site were treated by PLA/PLGA membrane as control group. Clinical parameters including probing depth, gingival recession, attachment level and radiographic examination were evlauated at base line, 1 month, 2 month and 3 month. after surgery. Statistical test used to analyze these data included paired t-test, one way ANOVA. The results are as follows : 1. Probing depth was significanlly decreased in the two group and there were significant differences between groups(p<0.05). 2. Gingival recession was not significanlly increased in the two group and there were no significant differences between groups(p<0.05). 3. Loss of attachment was statistically decreased in the two group and there were no significant differences between groups(p<0.05). 4. Horizontal bone level was significanlly increased in the two group and there were significant differences between groups(p<0.05). On the basis of these results, chitoans resorbable membrane has similar potential to PLA/PLGA membrane in GTR for furcation defect.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.17-26
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• 2009

Purpose: The non-carious cervical lesion(NCCL) is a loss of tooth structure at the neck of affected teeth that is unrelated to tooth caries. The reported prevalence of NCCL varies from 5% to 85%. Prevalence and severity of lesions have been found to increase with age. They are becoming more significant as people live longer and become more aware of the importance of oral health. The purposes of this study were first, to examine the periodontal conditions associated with NCCL, and second, to investigate the clinical effects of class V restorations of NCCL on periodontal tissues. Materials and methods: The sample size was 982 teeth of 50 subjects(25 male, mean age $52{\pm}7$) who were seen at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, clinical periodontal parameters were measured. After the initial examination, 24 patients who were absent from hypersensitivity were selected. The teeth with NCCL were randomly divided into the test and control groups. The teeth in the test group were restored with flowable resin; the control teeth were not restored. Six months later, the clinical examinations were repeated. The data were analyzed using the SPSS program. Results: The results were as follows: 1) NCCL occurred on 45.8% of examined teeth. The percentage of affected teeth was higher in maxillary and premolar teeth. 2) The shallow saucer type was the most common. 3) Teeth with NCCL had more gingival recession, lower attachment level, and higher incidences of bleeding on probing(BOP) and plaque than NCCL-free teeth. 4) Six months later, gingival recession, attachment level, the percentages of BOP and plaque in the test group were lower than in the control group(p<0.05). Conclusion: NCCLs were more found in maxillary teeth, especially in premolar teeth. The results suggest that the restoration of NCCL could affect some periodontal parameters favorably.

• Journal of Periodontal and Implant Science
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• v.50 no.1
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• pp.2-13
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• 2020

Purpose: Subepithelial connective tissue grafts (SCTGs) are commonly performed for the treatment of gingival recession due to their high predictability. This study evaluated and histologically compared connective tissue grafts in terms of the presence of epithelial remnants and composition of the tissue types that were present (epithelium, lamina propria, and submucosa). Methods: Ten patients underwent epithelium removal using 2 different techniques: the use of a blade (group B) and through abrasion (group A). Twenty samples were collected and each tissue type was analyzed histologically in terms of its area, thickness, and proportion of the total area of the graft. Results: In 4 samples (40%) from group B (n=10) and 2 samples (20%) from group A (n=10), the presence of an epithelial remnant was observed, but the difference between the groups was not statistically significant (P>0.05). Likewise, no statistically significant differences were observed between the groups regarding the area, mean thickness, or proportion of the total area for any of the tissue types (P>0.05). Conclusions: Histologically, SCTGs did not show statistically significant differences in terms of their tissue composition depending on whether they were separated from the epithelial tissue by abrasion or by using a blade.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.2
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• pp.169-175
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• 2020

Traditionally, gingival retraction has been performed to obtain customized abutment impressions with subgingival margins of the implant supported prosthesis. However, gingival retraction may have side effects such as gingival recession and bleed, leading to an inaccurate impression. In order to prevent these problems, in this case, the new technique has been introduced; a customized abutment which is designed for superimposition is used. Before the connection of the abutment to the implant fixture, pre-scanned shape data are stored, and then the optical impression without gingival retraction is obtained after connecting to the fixture. The suprastructure is fabricated by superimposing the two data. This technique showed the clinical efficacy of fabricating the implant supported prosthesis with subgingival margin, which satisfied the aesthetics, convenience, and clinically acceptable marginal and internal fit.

• Journal of Periodontal and Implant Science
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• v.46 no.1
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• pp.46-56
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• 2016

Purpose: We evaluated the efficacy of a mouthwash containing potassium nitrate ($KNO_3$) as its main component, along with sodium fluoride (NaF) and cetylpyridinium chloride (CPC). The primary endpoint was the relief of dentin hypersensitivity (DH) against the cold stimuli. The effects on other DH tests and periodontal inflammation were also evaluated. Methods: We used a single-center, double-blind, placebo-controlled, randomized design. A total of 82 patients with DH (40 in the test group, 42 placebo controls) were analyzed using visual analog scales (VASs) for a cold test, a tactile test, a compressive air test, and self-reported pain during daily activities, as well as clinical parameters including plaque index, gingival index, modified sulcular bleeding index (mSBI), gingival recession, and probing depth, which were collected at baseline and after four and six weeks of mouthwash use. Results: VAS scores for cold sensations, tactile sensations, the compressive air test, and self-reported pain significantly decreased from baseline during the six weeks in both groups (P<0.01), and no significant differences between the groups were found. In male patients (10 in the test group and 7 in the control group), both groups showed significant reductions in VAS scores for the cold test over the six weeks, and greater reductions were found in the test group than in the control group between four and six weeks (P=0.01) and between baseline and six weeks (P<0.01). In addition, the mSBI in the test group significantly decreased from baseline during the six weeks (P<0.01), and the changes at four and six weeks from baseline were significantly greater in the test group compared to the control group (P=0.03 and P=0.02, respectively). Conclusions: A mouthwash containing a mixture of $KNO_3$, NaF, and CPC reduced DH and gingival inflammation, however, the efficacy was comparable to the control group.

• Journal of Periodontal and Implant Science
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• v.31 no.1
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• pp.233-242
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• 2001

In the treatment of chronic adult periodontitis, scaling and root planing have been generally performed prior to periodontal flap surgery. The purpose of this study was to evaluate the clinical significance of nonsurgical periodontal therapy prior to periodontal flap surgery in patients with chronic adult periodontitis. Fifty six molars showing bilateral bony defects and 4-6mm periodontal pocket in twelve patients with chronic adult periodontitis were selected. By randomized split-mouth design, in one side, flap operation was performed 4 weeks after scaling and root planing, in the other group, flap operation was only performed without scaling and root planing. Probing pocket depth, gingival recession, clinical attachment level, gingival index, plaque index, and tooth mobility were measured at baseline, before flap operation and post-operation

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.359-373
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• 1993

The ultimate objective of periodontal therapy is not only stopping the progression of periodontal disease, but also promoting the regeneration of lost periodontal tissue. Guided Tissue Regeneration, which is based on the principle that the goal of periodontal regeneration can be achieved by preventing apical migration of gingival epithelium and blocking cells originating from connective tissue, has been developed and used as a clinical procedure, and although it has shown excellent results in connective tissue healing, there have not been many studies showing its effect on the regeneration of alveolar bone loss due to periodontal disease. The objectives of this study are to investigate the result of 12 months-long treatment following guided tissue regeneration using expanded polytetrafluoroehylene membrane, and to observe the presence of regenerated alveolar bone. Forty-one teeth from 28 patients with clinical diagnosis of periodontitis has been selected. In fifteen of those interproximal intrabony defects, only flap operation had been carried out, and designated as the control group. Twenty-six intrabony defects received e-PTFE membrane following flap operation, and designated as the experimental group. Eleven teeth whose membrane had been exposed were excluded from the experiment. Various measurements including probing depth, loss of attachment, probing bone level and gingival recession have been recorded at 6th month and 12th month, and the significance of the changes has been analyzed. The results are as follows: 1. Probing depth at 6th and 12th month has shown a significant decrease in both groups (p<0.01), but significantly higher decrease was found in the experimental group compared to the control at the month(p<0.05). 2. Loss of attachment at 6th and 12th month has shown a significant decrease in both groups, but significantly higher decrease was found in the experimental group compared to the control (p<0.05). 3. Probing bone level at 6th and 12th month has shown a insignificant decrease in the control group and significant decrease in the experimental group (p<0.01). Significantly higher decrease in probing bone level was found in the experimental group (p<0.05). 4. Gingival recession at 6th and 12th month has shown a statistically significant increase (p<0.05), and the control group showed higher increase compared to the experimental group although no statistical significance was found. As these results have shown, the use of e-PTFE membrane in intrabony pockets results in marked decrease in the loss of attachment and probing bone level. This seems to indicate that e-PTFE membrane may play a role in alveolar bone regeneration in intrabony defects.

• Journal of Periodontal and Implant Science
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• v.51 no.6
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• pp.398-408
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• 2021

Purpose: In this study, we aimed to evaluate the clinical validity of the modified tunneling technique using minimal soft tissue harvesting and volume-stable collagen matrix in the anterior mandible. Methods: In total, 27 anterior mandibular teeth and palatal donor sites in 17 patients with ≥1 mm of gingival recession (GR) were analyzed before and after root coverage. For the recipient sites, vertical vestibular incisions were made in the interdental area and a subperiosteal tunnel was created with an elevator. After both sides of the marginal gingiva were tied to one another, a prepared connective tissue graft and volume-stable collagen matrix were inserted through the vestibular vertical incision and were fixed with resorbable suture material. The root coverage results of the recipient site were measured at baseline (T₀), 3 weeks (T₃), 12 weeks (T₁₂), and the latest visit (T_l). For palatal donor sites, a free gingival graft from a pre-decided area avoiding the main trunk of the greater palatine artery was harvested using a prefabricated surgical template at a depth of 2 mm after de-epithelization using a rotating bur. In each patient, the clinical and volumetric changes at the donor sites between T₀ and T₃ were measured. Results: During an average follow-up of 14.5 months, teeth with denuded root lengths of 1-3 mm (n=12), 3-6 mm (n=11), and >6 mm (n=2) achieved root coverage of 97.01%±7.65%, 86.70%±5.66%, and 82.53%±1.39%, respectively. Miller classification I (n=12), II (n=10), and III (n=3) teeth showed mean coverage rates of 97.01%±7.65%, 86.91%±5.90%, and 83.19%±1.62%, respectively. At the donor sites, an average defect depth of 1.41 mm (70.5%) recovered in 3 weeks, and the wounds were epithelized completely in all cases. Conclusions: The modified tunneling technique in this study is a promising treatment modality for overcoming GR in the anterior mandible.