Purpose: This study investigated the adjunctive effect of light-emitting diodes (LEDs) in the treatment of experimental periodontitis. Methods: Experimental periodontitis was induced by placing ligatures around the mandibular second, third, and fourth premolars of 6 beagles for 3 months. After ligature removal, periodontitis progressed spontaneously for 2 months. The animals' hemimandibles were allocated among the following 3 groups: 1) no treatment (control), 2) scaling and root planing (SRP), and 3) SRP with LED irradiation at 470-nm and 630-nm wavelengths (SRP/LED). The probing pocket depth (PPD) and gingival recession (GR) were measured at baseline, 6 weeks, and 12 weeks. The clinical attachment level (CAL) was calculated. After 12 weeks, histological and histomorphometric assessments were performed. The distances from the gingival margin to the apical extent of the junctional epithelium (E) and to the connective tissue (CT) attachment were measured, as was the total length of soft tissue (ST). Results: PPD and CAL increased at 12 weeks compared with baseline in the control group (6.31±0.43 mm to 6.93±0.50 mm, and 6.46±0.60 mm to 7.61±0.78 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP group (6.01±0.59 to 4.81±0.65 mm, and 6.51±0.98 to 5.39±0.93 mm, respectively). PPD and CAL decreased at 12 weeks compared with baseline in the SRP/LED group (6.03±0.39 to 4.46±0.47 mm, and 6.11±0.47 to 4.78±0.57 mm, respectively). The E/ST and CT/ST ratios significantly differed among the 3 groups (P<0.05). The clinical parameters and histologic findings demonstrated that 470-nm and 630-nm wavelength LED irradiation accompanying SRP could improve treatment results. Conclusions: Within the study limitations, 470 nm and 630 nm wavelength LED irradiation might provide additional benefits for periodontitis treatment.
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.
The purpose of this study was to observe the control effect of hypersensitivity after periodontal treatment in the 19% microcrystalline hydroxyapatite containing toothpaste for the subject of 85 persons of both sexes, who complained hypersensitivity. At 2 weeks and 4 weeks after periodontal treatment, comparison of control effect was performed between the 19% microcrystalline hydroxyapatite containing toothpaste group and control group. The result were as follows, 1. The main causes of dentin hypersensitivity are the root exposure with gingival recession and cervical abrasion. 2. The occurance rate of hypersensitive tooth in the upper jaw was higher than that of the lower jaw, and more or less, the molar area showed more occlurance of hypersensitivity than the premolar and incisor area in both jaw. 3. Patients showed very sensitive response to the thermal stimulus, especially cold stimulus. 4. Exellent control effect of hypersensitivity in 19% microcrystalline hydroxyapatite containing toothpaste group showed 83.02% at 2weeks, 92.45% at 4weeks and these values were higher than the control group. In conclusion, we find that 19% microcrystalline hydroxyapatite containing toothpaste have the control effect of hypersensitivity and the proper toothbrushing method is the key in attaining more effectiveness of the toothpaste.
PURPOSE. The purpose of this study was to assess the prevalence and extent of clinical attachment loss of periodontal tissue and to find out variables related to clinical attachment loss (CAL) in Korean adults older than 40 years of age. MATERIALS AND METHODS. Data were collected from 2,519 subjects who were part of a cohort study conducted in Ansan city by Korea University Medical School for Korean Genome project. Age, sex, smoking, drinking, fast glucose, blood pressure, obesity and total cholesterol levels were examined. The oral examination included probing pocket depth, gingival recession and CAL of Ramford's teeth. The severity of periodontitis was classified based on the mean value of CAL. The relationship between each risk factor and the severity of CAL was independently estimated using the chi-square test, the test or one-way ANOVA. Multiple regression analysis was used to determine the significance of each factor in the periodontal disease. RESULTS. The prevalences of clinical attachment between 1 and 3 mm, between 3 and < 5 mm, and ${\geq}$ 5 mm were 80.27%, 16.75% and < 1%, respectively. Although the univariate analysis showed age, gender, smoking, fasting glucose, blood pressure and total cholesterol levels were significantly related to the severity of CAL, multiple regression analysis indicated that age (P < .0001), gender (P < .0001) and smoking (P < .05) were only significantly related. CONCLUSION. Older age, male gender and smoking were significant risk factor for the increase of CAL, and these may be useful indicators of periodontitis high-risk groups.
This article presents a modified palatal pedicled incision design in anterior segmental maxillary osteotomy. This method included the circumcrevicular incisions and two vertical relaxing incisions. Then, it is different from the Couper's method with vestibular horizontal incision and other anterior segmental osteotomy techniques. The main advantages of this method are an improved visibility of surgical field and favorable preservation of palatal pedicle. A patient who had been operated by anterior segmental maxillary and mandibular osteotomy without pre operative orthodontic treatment was analyzed for advantages and complications during the intraoperative and early post operative period. There are no specific major complications such as infection, gingival recession and dehiscence. And the patient had a pleasing esthetic facial appearance.
The purpose of this study was to evaluate the changes of interproximal bone density by means of videodensitometer and to examine the clinical applicability of videodentitometer to assess the periodontal disease activity.Twelve interproximal sites, with periodontal pockets deeper than 5mm and vertical loss of bone on standard dental radiograph, were treated by subgingival curettage. The papilla bleeding index, the plaque index, the degree of mobility, the depth of pockets, and the level of attachment were measured. Standardized reproducible radiographs were taken by using the occlusal stent with parallelling film holder. The density of the interdental bone was measured on the radiographs by a videodensitometer at three levels: the most 'superficial' level; the 'deep' level, arbitrarily 1.5mm below: and the 'apical' level, where no bony changes were to be expected. The clinical parameter and the radiographical change were measured at initial, and 1 month, 3 months, and 6 months after treatment.The results were as follows :1. The papilla bleeding index and the degree of mobility decreased significantly until 3 months after subgingival curettage and showed the Same level in the remaining experimental periods. 2. The pocket depth mainly decreased due to the gingival recession until 1 month after treatment, but to the attachment gain after 1 month. 3. The density of the interdental bone did not show a significance increase until 1 month after treatment, but showed a steady increase throughout the 6 months of observation. 4. The close relationships were shown between the decrease in pocket depth and the gain of attachment and the improvement of bone density at 6 months after treatment.
Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggests that the application of electrical currents to periodontal defects could promote bone and cementum formation. The purpose of this study was to determine the effect of direct microcurrent to the periodontal regeneration of class III furcation defects in dogs. Class III furcation defects were surgically created on the third and the fourth premolars bilaterally in the mandibles of nine mongrel dogs. Experimental periodontitis were induced by placing small cotton pellets into the created defects for 3 weeks. The experimental sites were divided into three groups according to the treatment modalities: Group I-surgical debridement only; Group II-allogenic demineralized freeze dried bone grafting; Group III-allogenic demineralized freeze dried bone grafting and electrical stimulation. For fluorescence microscopic evaluation, calcein, oxytetracycline HCI and alizarin red were injected 2, 4 and 8 weeksfS days prior to sacrifice) after surgery. The animals were sacrificed in the 1st, 2nd, 4th and 8th week after periodontal surgery and the decalcified and undecalcified specimens were prepared for histological and histometrical examination. After the first and the second weeks, gingival recession was more severe in group I than groups II and III. After the fourth and the eighth weeks, there was no difference in the width of junctional epithelium and connective tissue attachment among the three groups, but the width of connective tissue attachment increased in group II at the eighth week, compared to the fourth week. The amount of bone repair in new attachment was significantly greater in group III, compared to groups I and II. New attachment formation was significantly greater in group III, compared to groups I and group II. These results suggest that electrical stimulation using microcurrent generator could be a useful tool for periodontal regenerative therapy in class III furcation defect.
The purpose of the present investigation was to compare the effectiveness of porous hydroxyapatite (PHA) and coralline based porous calcium carbonate(PCC) as implant materials in human periodontal osseous defects. 10 adult patients having periodontitis and 2 similar angular osseous defects ${\ge}$5mm as verified by radiographic analysis and clinical probing depth ${\ge}$4mm were selected. The measurements were recorded just before surgery and after 6 month. Clinical parameters used in this study included gingival recession, pocket depth, probing attachment level, Sulcus Bleeding Index, Plaque Index, tooth mobility and bone defect depth measurements. After initial therapy, patients were treated with mucoperiosteal flap surgery. The contralateral bony defects in each patient randomly assigned to either bone graft material, one with PHA(Interpore 200) and the other with coralline based calcium carbonate(Biocoral). After 6 month both groups showed statistically significant reduction of pocket depth, Sulcus Bleeding Index, Plaque Index and significant improvement in probing attachment level. No statistically significant differences were found between the groups. There were 3.0mm or 68% of bone repair with PHA and 3.1mm, 61% with PCC. These values were likewise not significantly different. The data and clinical impression strongly suggest that both PHA and PCC are alloplastic implants with clinically apparent acceptance by the soft and hard tissue and that they can be used as bone graft materials successfully.
Kim, Sang-Jun;Um, Heung-Sik;Chang, Beom-Seok;Lee, Jae-Kwan
Journal of Periodontal and Implant Science
/
v.39
no.1
/
pp.37-44
/
2009
Purpose: Tetracycline and its chemically modified non-antibacterial analogues can inhibit certain host-derived tissue destructive collagenases such as matrix metalloproteinases. The purpose of this study was to evaluate clinical and microbiologic effects of the subantimicrobial dose of doxycycline(SDD) in conjunction with scaling and root planing. Materials and methods: A total of 30 patients with chronic periodontitis who were going to receive scaling and root planing were randomly allocated to receive either a doxycycline hyclate for 3 months or nothing. Clinical probing depth, clinical attachment level, gingival recession, and bleeding on probing were measured by one periodontist. After a periodontal examination, microbial samples were collected using sterile paper points. The effect of SDD in conjunction with scaling and root planing on alterations of the periodontal pathogens (Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis) were also assessed using l6S rRNA polymerase chain reaction. Results: During the treatment period, clinical parameters for both treatment group and control group were improved. After 3 months, reductions in probing depth and gains in clinical attachment level were significantly greater for the SDD group than control group. Microbial analysis showed that there was no alteration of the periodontal pathogens and no difference between the groups. Conclusion: This study suggested that the subantimicrobial dose of doxycycline as an adjunct therapy with scaling and root planing might be effective and safe in the management of chronic periodontitis.
Journal of Dental Rehabilitation and Applied Science
/
v.28
no.4
/
pp.407-421
/
2012
Orthodontic problems of the oral maxillofacial area could be classified into skeletal and dental problems. Dental problems might cause various occlusal disharmony and among them congenital missing or eruption failure might cause not only functional problems but also esthetic problems. Additional psychological problems are also one of the reasons for patients seeking treatment. In cases showing eruption failure of many teeth in the maxilla, not only occlusal and esthetic problems but also difficulty in alveolar bone maintainment could occur. Therefore, successive approach is necessary when multiple teeth show eruption problems. In this case, a patient with eruption problems of #13, 12, 11, 23, 43 was successfully treated by surgical exposure and successive orthodontic extrusion resulting perfect occlusion. By additional periodontal treatment, gingival recession that occurred along with teeth eruption was solved. The impacted right mandibular canine was erupted successfully only by natural arch expansion and leeway space without any special surgical treatment.
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