The purpose of this study was designed to evaluate the existence of the junctional epithelia on the tooth surface in periodontal pocket, and what were the morphologic differences between the junctional epithelia on the healthy and advanced periodontitis tooth. Fifteen premolar teeth from patients of Yon Sei University, Dental Infirmary were selected for this study. After extration, the teeth were prepared and examined in Scanning electro microscope. The results were as follows. 1. The junctional epithelia from healthy tooth surface were irreguraly round, oval, polygonal and slightly elongated while those from periodontal pocket were so elongated that difficult to distinguished the individual cell boundary. 2. There were a lot of round space so called 'HOLE or WHORL' which seemed tunnel in periodontal pocket with advanced periodontitis. 3. Microvilli were going to destructed and disappeared on surfaces of junctional epithelia in periodontal pocket with advanced periodontitis. 4. There were a lot of Filopodia on Junctional epithelia from healthy surfaces. %. Junctional epithelia from periodontal pocket with advanced periodontitis contained more inflammatory cells than healthy junctional epithelia did.
54 clinical isolates of Actinobacillus actinomycetemcomitans showed distinct hybrdization patern(DAN fingerprinting patterns) when the bacterial DNA were hybridized with randomly cloned 4.7 - kb DNA probe. The frequency of the genotypic distribution demonstrated that type C was the most prevalent genotype, the next being D, NT, A, B, and E in the descending order. The most prevalent serotype was serotype c, the next being a, nd, and b in the descending order. It was noted that the one serotype can represent more than two different genotypes and that multiple genotypic variants can also exist in the periodontal pockets within the sam subject.
Journal of Korean Academy of Dental Administration
/
v.6
no.1
/
pp.1-10
/
2018
Prior to the end of the 20th century, microorganism research was limited to culture and has since been revolutionized by genetic analysis. Microorganisms, including bacteria, can cause disease, but most of them are commensal microorganisms in our bodies. This knowledge changes the pathological approach to infectious diseases and lends to a new perspective on the effects of gut and oral microorganisms on disease and health. The oral cavity, particularly the periodontal pocket, is considered to be a reservoir of microbes that cause disease, and oral microbial control is becoming more important. In this review, I will examine the changes in the microbiological revolution and the meaning of oral healthcare management based on those changes.
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.
Purpose: The aim of this study was to evaluate the clinical outcomes of periodontal granulation tissue preservation (PGTP) in access flap periodontal surgery. Methods: Twenty patients (stage III-IV periodontitis) with 42 deep periodontal pockets that did not resolve after non-surgical treatment were consecutively recruited. Access flap periodontal surgery was modified using PGTP. The clinical periodontal parameters were evaluated at 9 months. The differences in the amount of granulation tissue width (GTw) preserved were evaluated and the influence of smoking was analyzed. Results: GTw >1 mm was observed in 97.6% of interproximal defects, and the granulation tissue extended above the bone peak in 71.4% of defects. At 9 months, probing pocket depth reduction (4.33±1.43 mm) and clinical attachment gain (CAG; 4.10±1.75 mm) were statistically significant (P<0.001). The residual probing depth was 3.2±0.89 mm. When GTw extended above the interproximal bone peak (i.e., the interproximal supra-alveolar granulation tissue thickness [iSUPRA-GT] was greater than 0 mm), a significant CAG was recorded in the supra-alveolar component (1.67±1.32 mm, P<0.001). Interproximal gingival recession (iGR) was significant (P<0.05) only in smokers, with a reduction in the interdental papillary tissue height of 0.93±0.76 mm. In non-smokers, there was no increase in the iGR when the iSUPRA-GT was >0 mm. The clinical results in smokers were significantly worse. Conclusions: PGTP was used to modify access flap periodontal surgery by preserving affected tissues with the potential for recovery. The results show that preserving periodontal granulation tissue is an effective and conservative procedure in the surgical treatment of periodontal disease.
Prevotella intermedia has been implicated as a potent pathogen in many kinds of periodontal, pulpal and periapical diseases. However, it has been isolated from periodontally healthy adults and from edentulous children as well. The intraspecies heterogeneity of Prevotella intermedia has been demonstrated in early studies and finally Shah & Gharbia confirmed the existence of 2 DNA homology groups and proposed dividing Prevotella intermedia into 2 species, Prevotella intermedia and Prevotella nigrescens. This study was designed to examine the frequency of Prevotella intermedia and Prevotella nigrescens in diseased periodontal pockets and healthy gingival sulcus of Korean people by PCR based on 16s ribosomal DNA sequence. One hundred adults who had adult periodontitis but not taken any periodontal treatment or antibiotics during previous 6 months and 50 adults who had healthy periodontal tissue were selected for this study. The sulcular fluid was collected into VMGA by sterilized paper point and diluted to 1,000 times in anaerobic chamber. $100{\mu}{\ell}$ of sample was cultured in $37^{\circ}C$ for 10 days. Among the bacterial colonies, BPB were selected and cultured in BHI broth and then Prevotella intermedia was identified through Gram staining and biochemical test. Identified Prevotella intermedia was cultured again and centrifuged. DNA was extracted from the pellet using several reagents. PCR was performed by previously designed primer. The results were followed. 1. BPB were isolated from 39 of 100 samples of diseased periodontal pockets(39%). 2. Prevotella intermedia was identified from 24 of 39 BPB samples. 3. Among 24 Prevotella intermedia, 21 were confirmed as Prevotella inter - media(87.5) and 2 were confirmed as Prevotella nigrescens(8.33%). 4. BPB were isolated from 9 of 50 samples of periodontally healthy patients. Among them only two were identified as Prevotella intermedia, that is, one was confirmed as Prevotella intermedia and the other was Prevotella nigrescens.
Purpose: The purpose of this study was to investigate the incidence of curet fracture and its contributing factors. Material and Methods: Fifty-eight periodontal curets which were broken during periodontal treatment in Kangnung National University Dental Hospital for 1 year were used as study materials. The blade thickness of new curets and broken ones was measured using a digital micrometer. Types of treatment procedures, clinical experience of operators, point of breakage, and method of removal of broken fragments were recorded for each broken curet. Results: The incidence of curet fracture in root planing (16.4 curets per 1,000 procedures) was higher than those in flap surgery (7.5) or supragingival scaling (2.7). No curet was broken during supportive periodontal treatment. The incidence of fracture did not seem to be related with clinical experience of operators. The most frequent breakage point of the curets were upper 1/3 of blades. Fifty-six of 58 broken fragments were removed by non-surgical methods. Two broken tips which could not removed non-surgically were left in the pockets, and proved to be removed spontaneously 1 week later. Conclusion: Root planing showed higher incidence of curet fracture than any other type of periodontal treatment. Most of the fractured fragments were removed by non-surgical method. Further study is needed to develop methods of removal of the fragments which can not be removed non-surgically.
Purpose: Aggressive periodontitis, especially in its severe form, was traditionally considered to have an unfavourable prognosis. It required a complex treatment and its stabilization was often achieved by surgical therapy. The aim of this study was to investigate the results of nonsurgical periodontal treatment in severe generalized forms of aggressive periodontitis. Methods: Patients with advanced generalized aggressive periodontitis were included in the study. Probing depth (PD) of pockets ${\geq}7mm$ and clinical attachment level (CAL) of sites with attachment loss ${\geq}5mm$ were measured at baseline before nonsurgical periodontal treatment, at re-evaluation, and after treatment. The following other parameters were recorded: resolution of inflammation and bone fill. We compared the baseline values with re-evaluation and posttreatment values using the Friedman test. The Wilcoxon test with the Bonferroni correction was used for both re-evaluation and posttreatment values. Results: Seven patients with 266 periodontal sites were examined. A significant difference was found between values, reported as medians with interquartile ranges, for PD at baseline (7.94 [7.33-8.19] mm) and both re-evaluation (4.33 [3.63-5.08] mm) and posttreatment (3.54 [3.33-4.11] mm) values (P=0.002). A significant difference was also found between values for CAL at baseline (9.02 [7.5-9.2] mm) and both re-evaluation (6.55 [6.30-6.87] mm) and posttreatment (6.45 [5.70-6.61] mm) (P=0.002). Inflammation was resolved and angular bone defects were repaired in all cases. Conclusions: These therapeutic results suggest that this form of periodontitis could have positive outcomes after nonsurgical periodontal treatment. The reparative potential of tissue affected by severe aggressive periodontitis should encourage clinicians to save apparently hopeless teeth in cases of this form of periodontitis.
Putrefactive activity within the oral cavity is the principal cause of halitosis. The most common intraoral sites of oral malodor production are tongue, interdental and subgingival areas. The other foci may include faulty restorations, sites of food impaction and abscesses. Periodontal disease frequently involves pathological oral malodor, which is caused mainly by volatile sulfur compounds(VSC), such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. The purpose of this study is to evaluate the association between oral malodor and periodontal status. Volatile sulfur compounds in mouth air were estimated by portable sulfide monitor($Halimeter^{TM}$). The results were as follows : 1. The levels of volatile sulfur compounds were significantly greater in a periodontitis group than in a control group(P<0.01). The amounts of VSC in mouth air from patients with periodontal involvement were four times greater than those of the control group. 2. The significant positive correlation was found between VSC concentrations and the number of pocket depth above 4mm(P<0.01), but correlation between VSC concentrations and plaque score was not statistically significant(P>0.05). 3. In the periodontitis group, VSC concentrations of pre-treatment significantly decreased after scaling and root planing(P<0.01). 4. No statistically significant correlation was found between VSC concentrations and sex / age in the periodontitis group. The above results indicate that periodontal disease may play a role as an important factor of oral malodor and deep periodontal pockets are a source of volatile sulfur compounds.
Objectives: The purpose of this study was to compare the oral health statuses pre- and post-insurance using the $5^{th}$ and $6^{th}$ National Health and Nutrition Examination Survey data to confirm the effect of scaling insurance after a year. Methods: Data were analyzed using IBM SPSS ver. 21.0 (IBM Co., Armonk, NY, USA). The four years were integrated, and a composite sample analysis was performed. A total of 26,990 people were included in the study before applying for scaling insurance (14,343 persons) or after receiving scaling insurance (12,647 persons). A chi-squared test was performed to compare the demographic characteristics and oral health status of the subjects. The significance level of the statistical test was 0.05. Results: The proportion of patients without implants was high before the provision of scaling insurance once a year, however, the proportion of patients with one or more implants was high (p<0.05) after the provision of scaling insurance once a year. Hemorrhagic periodontal tissues and tartar formation in periodontal tissues were highly prevalent before the provision of scaling insurance once a year, however, healthy periodontal tissues and formation of periodontal pockets were highly prevalent (p<0.05) after the provision of scaling insurance once a year. The decay, missing, and filled teeth index scores were higher before the provision of scaling insurance once a year (p<0.05). Conclusions: The aforementioned results showed that scaling once a year helps prevent or treat periodontal disease. In addition, we confirmed the effect of prevention on periodontal disease and dental caries, therefore, we expect it to develop into a stable policy.
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