• 한국치위생학회지
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• 제14권6호
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• pp.805-812
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• 2014

Objectives: The purpose of the study was to examine the association between diabetes mellitus and community periodontal index in Korean adults. Methods: The study populations were recruited by the Fifth Korea National Health and Nutrition Examination Survey. Study subjects were 10,411 who were examined oral examination, blood test, and aged over 19 years. Using multiple logistic regression analyses, the variables were adjusted for gender, age, household income, family history of diabetes, body mess index, smoking habit, and frequency of tooth brushing. Periodontal tissue examination of the subjects was performed and scored by Community periodontal index(CPI). Using probe, six teeth were examined for hemorrhage, plaque, and pocket depth and classified into $CPI_0$, $CPI_1$, $CPI_2$, $CPI_3$ and $CPI_4$. Healthy periodontal groups($CPI_{0-2}$) and periodontal disease groups($CPI_{3-4}$) were divided by the periodontal disease status. The definition of diabetes mellitus(DM) was decided by the diagnosis by the doctors and fasting blood sugar level. Those who were diagnosed as DM were included in DM group. The DM variables included normal blood sugar level, increased fasting blood sugar level, and DM blood sugar level. The DM variables were compared to periodontal disease blood sugar level and analyzed. Results: The periodontitis prevalence rate was 23.2%. Those who had diabetes mellitus accounted for 5.5% of the subjects. Those who had impaired fasting glucose accounted for 17.7% and 7.9% of subjects were diabetes mellitus by blood test. In the confirmed diabetes group by doctor, the periodontitis prevalence rate was significantly higher than the non-diabetic group. Diabetic group by blood test had the highest prevalence rate of periodontitis than those who had impaired fasting glucose group or normal group. After adjusting for gender, age, household income, family history of diabetes, body mass index, smoking habit, and frequency of tooth brushing, the risk of periodontitis in diagnosed diabetes mellitus was 1.57 times(95% CI; 1.27-1.94) higher than the normal group. In impaired fasting glucose group and diabetes mellitus group by blood test, the risk of periodontitis was 1.11 times(95% CI; 0.95-1.30) and 1.45 times(95% CI; 1.45-2.12) higher, respectively. Conclusions: There was a significant relationship between diabetes mellitus and periodontitis in Korean adults. These results suggest that diabetes mellitus is a risk factor for periodontitis.

• Journal of Periodontal and Implant Science
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• 제46권3호
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• pp.166-175
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• 2016

Purpose: Decision-making by dental and medical experts can be influenced by their biases, interests, and experiences, and academic arguments about controversial issues may additionally be considered indirect experiences capable of affecting decision-making. This study reports on the use of interactive communication devices to evaluate preferences and flexibility in decision-making among dental care providers who attended two distinct academic conferences. Methods: Two debates were presented by a team of two lecturers at two academic conferences (focusing on periodontology and implant dentistry, respectively) and the audience members of each session were surveyed. Before each lecture, two case modules about the diagnosis and treatment of multirooted molar lesions were provided, and interactive communication devices were used to collect responses about decision-making preferences in treatment planning immediately before and after a debate about treatment strategies. Results: In total, 81 and 84 completed answers from both conferences were obtained for the first and second case modules, respectively. The preferred treatment plan differed significantly according to the focus of the conference, and a tendency emerged for the clinicians participating in each conference to express uniform preferences. However, attending the debates resulted in significant changes in decision-making preferences regardless of the conference focus or the characteristics of the participants. Conclusions: Our findings suggest that providing continuing education via debates on controversial issues may be effective in widening conceptual knowledge and reducing biases among experts in the dental and medical fields.

• Journal of Periodontal and Implant Science
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• 제44권6호
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• pp.274-279
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• 2014

Purpose: To evaluate whether the levels of immunoglobulin G (IgG) antibody to Tanerella forsythia are associated with periodontal status. Methods: Patients with a diagnosis of chronic periodontitis were considered candidates for the study; thus 80 chronic periodontitis patients and 28 healthy persons (control group) were invited to participate in this investigation. The presence of T. forsythia was detected by polymerase chain reaction (PCR) analysis using primers designed to target the respective 16S rRNA gene sequences. Peripheral blood was collected from each subject to identify the IgG1 and IgG2 serum antibodies against T. forsythia. All microbiological and immunological laboratory processes were completed blindly, without awareness of the clinical status of the study patients or of the periodontal sites tested. Results: The bivariate analysis showed that lower mean levels of clinical attachment level (CAL) and probing depth were found in the presence of the IgG1 antibody titers against whole-cell T. forsythia; however, only the difference in CAL was statistically significant. In the presence of the IgG2 antibody titers against whole-cell T. forsythia, the periodontal parameters evaluated were higher but they did not show statistical differences, except for plaque. The unadjusted linear regression model showed that the IgG1 antibody against whole-cell T. forsythia in periodontitis patients was associated with a lower mean CAL (${\beta}=-0.654$; 95% confidence interval [CI], -1.27 to -0.28; P<0.05). This statistically significant association remained after adjusting for possible confounders (${\beta}=-0.655$; 95% CI, -1.28 to -0.29; P<0.05). On the other hand, smoking was a statistically significant risk factor in the model (${\beta}=0.704$; 95% CI, 0.24 to 1.38; P<0.05). Conclusions: Significantly lower mean levels of CAL were shown in the presence of the IgG1 antibody titers against whole-cell T. forsythia in periodontitis patients. Thus, the results of this study suggest that IgG1 antibody to T. forsythia may have been a protective factor from periodontitis in this sample.

• Journal of Periodontal and Implant Science
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• 제43권2호
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• pp.87-95
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• 2013

Purpose: The purpose of this study was to analyze the expression of inducible nitric oxide synthases (iNOS), tissue inhibitors of metalloproteinase $(TIMP)_{-3}$, and $TIMP_{-4}$ in the gingival tissues of periodontal patients with or without type 2 diabetes mellitus (DM). Methods: Depending on the patient's systemic condition and clinical criteria of the gingiva, each gingival sample was classified into one of three groups. Sixteen clinically, systemically healthy patients (group 1), 16 periodontal patients (group 2), and 16 periodontal patients with DM (group 3) were included. Tissue samples in each group were collected, prepared, and analyzed by western blotting. Quantification of the relative amount of $TIMP_{-3}$, $TIMP_{-4}$, and iNOS was performed. Results: The expression levels of iNOS and $TIMP_{-3}$ both increased in group 1, group 2, and group 3 in increasing order, and were significantly higher in both group 2 and group 3 as compared to group 1 (P<0.05). The expression levels of $TIMP_{-4}$ increased in the same order, but significantly increased in group 2 as compared to group 1, in group 3 as compared to group 1, and group 3 as compared to group 2 (P<0.05). Conclusions: This study demonstrated that iNOS, $TIMP_{-3}$, and $TIMP_{-4}$ might be involved in the progression of periodontal inflammation associated with type 2 DM. It is thought that further study of these factors can be applied practically for the diagnosis and control of periodontitis in diabetics.

• Journal of Periodontal and Implant Science
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• 제45권6호
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• pp.247-251
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• 2015

Purpose: This report describes a case of granulomatosis with polyangiitis (GPA) in which the gingival manifestation was crucial in both making an early diagnosis and possibly in deciding the approach to treatment. Methods: A 57-year-old sailor presented to the Department of Dentistry at Ulsan University Hospital complaining of gingival swelling since approximately 2 months. He had orofacial granulomatous lesions and the specific gingival manifestation of strawberry gingivitis. Results: The diagnosis of GPA was made on the basis of clinical symptoms and signs, and confirmed by the presence of the anti-neutrophil cytoplasmic antibody and a positive biopsy. The patient was admitted to the hospital and subsequently placed on a disease-modifying therapy regimen that included methotrexate and prednisone. Conclusions: Identification of the gingival manifestation of the disease permitted an early diagnosis and prompt therapy in a disease in which time is a crucial factor. Because of its rapid progression and potentially fatal outcome, an early diagnosis of GPA is important. Therefore, dentists should be aware of the oral signs and symptoms of such systemic diseases.

• Journal of Periodontal and Implant Science
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• 제34권4호
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• pp.723-731
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• 2004

Helicobacter pylori(H. pylori) has been associated with the cause of chronic gastritis, peptic ulcers and gastric cancer. Although it may be transmitted through the oral cavity, it is unknown whether the oral cavity acts as a reservoir of H. pylori. The purpose of this study was to investigate the mode of detection of H. pylori in oral cavity of adult periodontitis patients with plaque and periodontal pocket which atmosphere is grown well H. pylori. We analysed detection rate of H. pylori in saliva and subgingival plaques of 17 adult periodontitis patients without symptoms of gastroduodenal disease by nested PCR. Samples tested comprised saliva and subgingival plaques from central incisor, 1st premolar and 1st molar. H. pylori DNA was not identified in saliva from all patients. The detection rate in subgingival plaque from incisors, premolars and molars was 5.9%, 5.9% and 17.7%, respectively. In conclusion, the dental plaque and periodontal pocket (especially, of molars) in adult periodontitis can be favorable reservoir of H. pylori and may be the source of infection and transmission of H. pylori.

• Journal of Periodontal and Implant Science
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• 제30권4호
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• pp.725-736
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• 2000

It is becoming increasingly apparent that periodontitis consists of mixture of diseases, most of which respond favorably to traditional mechanical therapy. Among these variants of the disease, some appear to be associated with unusual microbial infections and defective host defenses. Many of these fail to respond to conventional treatment. The recognition that some forms of periodontitis are refractory to standard periodontal therapy has given rise to a new classification of peridontitis. A series of 1692 subgingival microbial samples sent to a diagnostic microbiology laboratory included 738 samples that could be identified as compatible with a clinical diagnosis of refractory or recurrent periodontitis. In descending order of prevalence the associated microbiota included Bacteroides forsythus(85%) ,Fusobacterium species(78%), Spirochetes(67%), Campylobacter rectus(64%), Porphyromonas gingivalis(59%), Peptostreptococcus micros(58%), motile rods(46%), Prevotella intermedia(33%), Eikenella corrodens(13%), Capnocytophaga species(12%) ,and Actinobacillus actinomycetemcomitans(6%). Antibiotic resistance to tetracycline, penicillin G, or metronidazole was particularly noticeable for Fusobacterium species, Capnocytophaga species, and Actinobacillus actinomycetemcomitans. It was largely absent for Campylobacter rectus. No antibiotic data were obtained for Porphyromonas gingivalis or Bacteroides forsythus, as these species were detected by immunofluorescence. The results indicate that a substantial number of microorganisms associated with refractory periodontitis are variably resistant to commonly-used antibiotics. Diagnostic microbiology must be considered an essential adjunct to the therapist faced with periodontal lesions refractory to conventional treatment.

• 한국치위생학회지
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• 제11권2호
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• pp.149-158
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• 2011

Objectives : The objective of this study was to analyze cognition and status of oral health education of dental hygienists who manage the patients visiting dental clinics and to utilize the findings as continuous study data required for development of systematic oral health education program for management of peridontal disease of adults. Methods : Survey was carried out for 261 dental hygienists working in dental clinics who are performing oral health education of patients with peridontal disease living. Results : 1. In the socio-dynamic diagnosis, it was analyzed that, the younger the age is and the lower the career is, the more the work is centered around assisting medical treatment job and, the older the age is and the higher the career is, the work is centered around oral health education job. 2. In the behavioral diagnosis, it was analyzed that, as to source of knowledge acquisition, guide of dentists and senior dental hygienists was the highest and, as to education media, visual education and demonstration education were mainly used. 3. In educational diagnosis, as to the degree of knowledge about oral health education and the degree of practice, it showed that the degree of knowledge was lower than the degree of practice in peridontal disease process and oral prophylaxis as well as scaling part. 4. In both the cases of independent practice and group practice, it showed that the most frequent obstacle was insufficient educational materials and tools and it was analyzed that acquisition of new knowledge and technology is required as a matter to be improved. Conclusions : It seems to be required for the dental hygienists to develop detailed knowledge and professional technology in order to induce actions and motive of patients during oral health education of peridontal patients and to develop and produce data for efficient education of peridontal patients.

• Journal of Oral Medicine and Pain
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• 제1권1호
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• pp.8-13
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• 1973

The authors had studied the oral environmental changes by salivary salivary pH, amount, periodontal Index in patient with active pulmonary tuberculosis patients. Among the subjects, The experimental group was consisted of 100 patients (50 males and 50 females) of 20-29 years and 100 persons of control group (50 males and 50 females) of 20-29 years. The measurement of salivary amount was performed with wide mouthed plastic (2 Inches) bottle for avoidance of Ionization of SiO2 by using of glass bottle and salivary pH was checked by pH meter 27 radiometer Copenhagen. The results are as follows : 1. The slivary pH does not appear to be characteristic of tuberculous paticents. 2. The obtained salivary amount indicated no significant to the tuberculous patients as compared to the obtained supposedely wealthg individuals. 3. The Russel Index wasfound higher and there had found more periodontal involvement(3 times than normal) in the experimental group.

• International journal of advanced smart convergence
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• 제7권4호
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• pp.185-196
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• 2018

Based on World Health Organization (WHO) children and adults have a problem with their oral health, such as Dental cavities and periodontal disease. It is not easy to obtain the high convince level of result of the dental and periodontal diseases. Because each of them have different degrees of uncertainty and there have several discounting factors (error rates) in different of survey. To solve this problem we propose the Dezert-Smarandache Theory (DSmT) for efficient combination of uncertain, imprecise and highly conflicting sources of information. Moreover, we apply the SEFP as a context reasoning. Finally, we make the simulation by using 12 surveys and compare Propotional Conflict Redistribution 5 (PCR5) and Dempster-Shafer Theory (DST) to show the belief or probability for the low, a heavy, high and ultra-high risk situation.