• Journal of Periodontal and Implant Science
• /
• v.25 no.3
• /
• pp.648-658
• /
• 1995

The present study has been performed to evaluate the clinical, microbiological, biochemical and immunological parameters associated with the periodontal disease activity in adolescent periodontitis. 21 young adolescents with evidences of periodontal attachment loss participated in the study for upto 3 years of examination. Probing pocket depths and attachment levels of whole dentitions were annually recorded and 4 deepest pockets, with initial probing depth ${\geq}$ 4mm, were selected as the representative experimental sites of a patient. Sites experiencing attachment loss ${\geq}$ 1mm during the 3-year experimental period were designated as the active sites and these sites were examined for the microbiological and biochemical profiles at the time when attachment loss occurred. Microbiological assay included cultural studies and PerioScan for monitoring BANA(+) organisms(e.g. Porphyromonas gingivalis, Treponema denticola, Bacteriodes forsythus). Biochemical assay has been performed for monitoring GCF levels of neutral protease. Serum IgG and IgG2 titers against Porphyromonas gingivalis 381 were determined of a patients at the beginning and the end of the study, respectively for patient-based analysis. The results indicated that the parameters consisting of microbiological cultures and GCF neutral protease exhibited low association with the periodontal disease activity in adolescents. However, the specificity for microbiological culture of the selected periodontopathic organisms(Aa,Pg,Pi) were considerably high. Moreover, the clinical pameters such as bleeding on probing and presence of plaque as well as IgG levels against Pg at the baseline exminations were closely associated with the subsequent evidences of attachment loss during the whole experimental period(3-year).

• Journal of Periodontal and Implant Science
• /
• v.37 no.4
• /
• pp.849-857
• /
• 2007

Purpose: The purposes of this study were to compare and quantify the expressions of RANK and RANKL in the gingival tissues of non-periodontitis patient and patients with chronic periodontitis, in order to understand the contribution of these proteins to periodontal destruction. Material and methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was divided into two groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from non-periodontitis patients. Group 2 (n=8) is inflammed gingiva from patients with chronic periodontitis. Tissue samples were prepared and analyzed by Western blotting. The quantification of RANK and RANKL were performed using a densitometer and statistically analyzed by Student's t-Test. Results: The expression of RANK were similar in group 1 and 2. The difference between group 1 and 2 was not statistically significant. And the mean amount of RANKL was more increased in group 2 than group 1. The difference between group 1 and group 2 was statistically significant. Conclusion: The expression level RANK didn't show any significant difference between healthy tissue from non-periodontitis patients and inflamed tissue from chronic periodontitis, but the expression level of RANKL in inflammed tissue from chronic periodontitis showed significantly increased tendency compared to healthy gingiva from non-periodontitis patients. Therefore, characteristics of RANK and RANKL in progress of chronic periodontitis would be basis of further studies in diagnostic method and treatment index of the disease.

• Journal of Periodontal and Implant Science
• /
• v.52 no.2
• /
• pp.116-126
• /
• 2022

Purpose: This study evaluated the efficacy of treating periodontitis using subgingival nano-hydroxyapatite powder with an air abrasion device (NHAPA) combined with scaling and root planing (SRP). Methods: A total of 28 patients with stage III periodontitis (grade B) were included in this study, although 1 was lost during follow-up and 3 used antibiotics. The patients were divided into a test group and a control group. All patients first received whole-mouth SRP using hand instruments, and a split-mouth approach was used for the second treatment. In the test group, the teeth were treated with NHAPA for 15 seconds at 70% power per pocket. Subgingival plaque samples were obtained from the 2 deepest pockets at the test and control sites before treatment (baseline) and 3 months after treatment. The full-mouth plaque index (PI), gingival index (GI), papillary bleeding index (PBI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and at 1- and 3-month post-treatment. Real-time polymerase chain reaction was used to determine the colonisation of Treponema denticola (Td), Porphyromonas gingivalis (Pg), and Aggregatibacter actinomycetemcomitans in the subgingival plaque. Results: From baseline to the first month, the test group showed significantly larger changes in BOP and CAL (43.705%±27.495% and 1.160±0.747 mm, respectively) than the control group (36.311%±27.599% and 0.947±0.635 mm, respectively). Periodontal parameters had improved in both groups at 3 months. The reductions of PI, GI, BOP, PD, and CAL in the test group at 3 months were greater and statistically significant. The total bacterial count and Td and Pg species had decreased significantly by the third month in both groups (P<0.05). Conclusions: Applying NHAPA in addition to SRP improves clinical periodontal parameters more than SRP alone. Subgingival NHAPA may encourage clot adhesion to tooth surfaces by increasing surface wettability.

• Journal of Periodontal and Implant Science
• /
• v.31 no.2
• /
• pp.489-499
• /
• 2001

Bone graft and guided tissue regeneration have been used for the regeneration of periodontal tissue which is the ultimate goal of periodontal treatment. Recently, it was reported that some kind of growth factors were used for regeneration. Platelet rich plasma was researched that it could increase the density of bone and the rate of bone regeneration. For that, 25 patients which have pocket depth more than 5mm at any of 6 surfaces, of healthy patient without any systemic disease were treated. $Biogran^{?}$ Were grafted into 14 infrabony pockets as controls, and $Biogran^{(R)}$ with PRP were inserted into 31 infrabony pockets. And then, follwing evaluations were made at the end of 1, 3 and 6 months. 1. There was no statistical difference between control and experimental group in pocket depth, gingival recession, minimum probing attachment level and maximum probing attachment level at preoperation(p>0.05). 2. Decrease in probing pocket depth were reduced to 3.32mm for experimental group and 2.71mm for control group. The decrease was evident at the end of 1 month, they were 2.97mm and 2.29mm,and it was statistically difference(p<0.05). 3. Gingival recession was increased by 0.55mm in experimental group and 0.50mm in control group, it was evident at the end of 1 month. And it was statistically difference(p<0.05). 4. Minimum probing attachment level was increased by 0.35mm in experimental group and 0.36mm in control group, it was statistically difference(p<0.05). 5. Maximum probing attachment level was decreased by 3.19mm in experimental group and 2.93mm in control group, it was statistically difference(p<0.05). 6. There was no statistical difference between control and experimental group in pocket depth, gingival recession, minimum probing attachment level and maximum probing attachment level(p>0.05). There was statistical difference in decrease of pocket depth between pre-operation and 1 month after post-operation(p<0.05). In conclusion, bone graft using $Biogran^{?}$ and bone graft using $Biogran^{?}$ With platelet rich plasma were both effective in treatment of infrabony pocket, bone graft using $Biogran^{?}$ With platelet rich plasma was more effective in early soft tissue healing.

• Journal of Periodontal and Implant Science
• /
• v.27 no.4
• /
• pp.739-749
• /
• 1997

The purpose of this study was to assess the antimicrobial and clinical effects of acid water mouthrinse prepared by an electrolysis apparatus on chronic periodontitis and to evaluate the lasting period of these effects. The change' in the pattern of colonization of bacteria within the subgingival pockets was monitored by phase contrast microscopy, in 40 patients, over a period of 8 weeks. In addition, changes in the clinical parameters of the diseased sites were also monitored. Site of pocket ${\geq}$ 5mm was selected in each patient randomly divided into two groups. As a test group, acid water mouthrinse was used twice a day in 20 patients. As control, no mouthrinse was used in 20 patients The results were as follows : 1. The suppression of motile bacteria was maintained for up to 3-4 weeks at test group. 2. Two groups did not differ significantly in proportion of bacteria in subgingival plaque over a period of 8 weeks. 3. Loss of attachment showed a significant difference in test group and in test group compared with control group (P<0.05), but there was no significant difference in control group. 4. No statistical difference was shown in two groups concerning the gingival index, plaque index, bleeding index. The results suggest that acid water mouthrinse is effective for reducing subgingival bacteria. It can be concluded that acid water may be useful as an mouthrinsing agent.

• Journal of Periodontal and Implant Science
• /
• v.23 no.3
• /
• pp.359-373
• /
• 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
• /
• v.34 no.3
• /
• pp.607-622
• /
• 2004

Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of $PGE_2$ was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood $PGE_2$. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15% vs. 3.3%, OR 5.118,p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.

• The Journal of the Korean dental association
• /
• v.55 no.4
• /
• pp.276-283
• /
• 2017

Maxillary sinus squamous cell carcinoma is a relatively rare disease, comprising only 3% of malignant diseases of head and neck. As the growth rate is high and its prognosis is poor compared to others, the 5-year survival rate of maxillary sinus squamous cell carcinoma(MSSCC) is 23.4-49%. We introduce two rare clinical cases of squamous cell carcinoma originated from maxillary sinus of which symptoms include toothache and gingival swelling. On clinical examinations of both patients, deep periodontal pockets on upper right posterior teeth were detected. On panoramic images, the bony destruction of the maxillary sinus and its surrounding structures were not obvious and only alveolar bone loss was noted. It is difficult to diagnose MSSCC at an early stage due to symptoms of tooth pain and gingival swelling that are similar to that of periodontal diseases. However, if the symptoms do not improve after routine treatment of upper teeth, dentists should bear in mind of underlying malignant mass as differential diagnosis, thus early detection of the lethal disease. The aim of this study is to caution dental practitioners that malignancies have a potential to mimic periodontal diseases by introducing two cases of maxillary sinus squamous cell carcinoma presented as periodontitis.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.3
• /
• pp.448-452
• /
• 2004

Trauma from occlusion(TFO) is injury to the periodontal tissue as a result of occlusal forces. Mobility is a common clinical sign of occlusal trauma. In acute occlusal trauma, this may be accomanied by pain, tenderness to percussion, thermal sensitivity, and pathologic tooth migration. Chronic occlusal trauma may be marked by excessive wear and gingival recession. Radiographic finding include a widened periodontal ligament space, radiolucence and condensation of the alveolar bone and root resorption. TFO is related to the pathogenesis of periodontal disease. It can cause increased tooth mobility TFO itself does not initate or aggravate marginal gingivitis or initiate periodontal pockets. Active trauma can accelerate bone loss, pocket formation and gingival recession depending on the presence of local irritants and inflammation. Gingival recession associated with occlusal forces includes traumatic crescent, McCall's festoon and Stillman's cleft. TFO plays a minor role in the pathogenesis of early to moderate periodontitis. A 5-year-old male visited Yonsei University Pedodontics clinic with a chief complaint about gingival recession. Mobility, excessive wear, gingival recession were detected by clinical exam on the both mandibular deciduous ca nine. On the radiographic view, vertical alveolar bone loss was observed on both mandibular deciduous canine.

• Journal of Periodontal and Implant Science
• /
• v.51 no.1
• /
• pp.53-62
• /
• 2021

Purpose: This study aimed to evaluate the clinical and microbiological efficacy of adjunctive local delivery of minocycline (Periocline^®) in patients receiving supportive periodontal therapy (SPT) after initial treatment. Methods: The participants were 16 men and 8 women (age, 20-65 years) who had at least 15 natural teeth, underwent SPT for more than 1 year due to chronic periodontitis, had 4 or more periodontal pocket sites deeper than 5 mm, and showed >25% gingival bleeding on probing (BoP). They were randomly assigned to the test and control groups. In the test group, mechanical debridement and local antibiotic delivery were performed for all periodontal sulci/pockets; in the control group, mechanical debridement and saline irrigation were performed. In patients who underwent SPT for more than 1 year, clinical and microbiological examinations were performed at baseline and 1 and 3 months after SPT. The clinical examination included an assessment of the periodontal pocket depth, clinical attachment level, plaque index, and BoP. Microbial tests were performed using real-time polymerase chain reaction; the relative ratios of Porphyromonas gingivalis and Fusobacterium nucleatum were determined. Results: Both groups showed significant improvements in clinical parameters at 1 and 3 months from baseline; there were no significant changes between months 1 and 3. Intergroup differences were insignificant. The microbiological analysis revealed no significant differences in P. gingivalis and F. nucleatum ratios across time points. While intergroup differences were insignificant, there was a tendency for the P. gingivalis and F. nucleatum ratios to decrease in the test group. Conclusions: Mechanical debridement in patients receiving maintenance therapy resulted in clinically significant improvement; the effectiveness of additional local delivery of antibiotics was not significant. The ratios of P. gingivalis and F. nucleatum showed a tendency to decrease in the test group, although it was not significant.