• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.531-545
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• 1998

The objective of the present study was to evaluate the clinical and microbiological effects of scaling and root planing combined with local application of 2% minocycline gel to patients with moderate to advanced chronic adult periodontitis. 27 healthy patients with moderate to advanced chronic adult periodontitis were enrolled in the study. The quadrants that had 2 or more teeth with $5{\sim}8mm$ probing pocket depth and radiographic evidence of alveolar bone loss were selected and divided into test side and control side according to the splitmouth design. All patients received standardized oral hygiene instructions at the beginning of the study. Subsequently scaling and root plaining was performed on all remaining teeth until 0 week. The 2% minocycline gel was applied to periodontal pocket at 0, 1, 2, 3week in the test side. The normal saline was irrigated subgingivally for about 30 seconds in the control side. The clinical and microbiological analysis was carried out at 0, 4, 8, and 12weeks. The results of this st udy were as follows; 1.2% minocycline gel delivered subgingivally as an adjunct to scaling and root planing provided benefit in reducing sulcular bleeding index and pocket depth than the use of normal saline. 2. The relative proportion of cocci and non-motile bacteria was increased in the test and control groups with time, and there was no statistically significantdifference between two groups. 3. The proportion of spirochetes was slowly reduced in the control group, but, inthe test group, they were remarkably reduced from the 4th week, and there was a statistically significant difference between two groups. 4. In both groups, the relative proportion of motile rods was notably decreasedat the beginning of the study, and remained until 12th week in the test group,but, in the control group, they were slowly increased from the 4th weekand finally similar to that of the initial examination. In conclusion, local application of 2% minocycline gel may be effective in the clinical and microbiological aspects as an adjunct to scaling and root planing in periodontal disease sites.

• Journal of Korean society of Dental Hygiene
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• v.11 no.2
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• pp.293-301
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• 2011

Objectives : The aim of the trial was to study the effect of plaque control(tooth brushing instruction) for oral health improvement on periodontitis patients. Methods : 30 patients(35~65 years) with advanced periodontal disease were subjected to a baseline examination including assessment of oral hygiene status(O'leary index), gingival condition(bleeding). the assessment were repeated after 2, 4, 6 weeks. cognitive, behavioral and clinical outcomes were assessed in the primary care setting by questionnaire and clinical oral examination. Results : The oral hygiene status expressed as the individual mean percentage of tooth surfaces with plaque 59.3% at baseline and 21.2% after 6 weeks(p<0.001). The gingival bleeding status expressed as the individual mean point of interdental papilla 3.8 at baseline and 1.9 after 6 weeks(p<0.001). Also, the patients self-assessment about correct tooth brushing behavior was 3.9(5-point likert scales), satisfaction of plan practices 4.1(5-point likert scales), efficacy of tooth brushing instruction 8.7(10-point likert scales). Patients wanted to continuous participation. Conclusions : A verification of effect after individualized oral health instruction and repeated dental plaque control represented to significance on plaque control score, oral care practice and oral health recognition. The important oral care step against periodontal disease is to establish good oral health habits. Also, oral health behavior recognition is more important for the practice of oral health. Therefore professional plaque control and tooth brushing instruction absolutely need in improving oral health.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.117-132
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• 1996

The purpose of this study was to evaluate the bacterial adherence on e-PTFE membrane immersed in whole saliva from subjects with different periodontal status. Experiment involved 3 subject groups: 5 persons with healthy periodontium(probing depth below 3mm and no signs of gingival inflammation including bleeding on probing), 10 patients with gingivitis(probing depth below 3mm and apparent signs of gingival inflammation), and 10 patients with advanced periodontitis(probing depth over 7mm and apparent signs of gingival inflammation). Each disease group was included before and after scaling and root planing treatment. After obtaining whole saliva from each subject, e-PTFE membrane(Gore-Tex periodontal membrane : $GTPM^{(R)}$, W.L. Gore & Associates, Flagstaff, USA) specimens were immersed at room temperature in the saliva aliqouts for 1, 3, 7 days. The weight between pre - and post - immersion in saliva was measured with the analytical balance and the difference was recorded. The specimens were processed for SEM observation. The bacterial adherence on the membrane specimens was evaluated using the scanning electron microscope images. The obtained results were as follows : 1. There was no difference in the weight of bacteria adherent to e-PTFE membrane specimens according to the periodontal status and the immersion periods. 2. As the exposure time to saliva increased, the bacterial adherence to the membrane specimen significantly increased in all groups(P<0.005). 3. As the severity of periodontal disease increased, the bacterial adherence to the membrane specimens significantly increased(p<0.001). 4. After scaling and root planing, the bacterial adherence to the membrane specimens significantly decreased in gingivitis and periodontitis patient group(P<0.001). These results suggest that bacterial contamination on exposed barrier membrane surface be reduced through improvement of periodontal status and oral health environment before and after GTR procedure for the successful outcome.

• Journal of Periodontal and Implant Science
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• v.28 no.1
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• pp.57-70
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• 1998

The purpose of this study was to evaluate the clinical and microbiological effects of metronidazole 25% dental gel that was applied to periodontal pockets who have moderate to advanced chronic adult periodontitis were selected for this study. The quadrants that had 2 or 3teeth with 5-8mm probing pocket depth were selected and divided into test side and control side according to the split-mouth design. The metronidazole 25% dental gel applied on test side and 0.12% chlorhexidine solution applicated on positive control side, normal saline irrigation into periodontal pocket was applicated to negative control side respectively. Above procedures followed scaling and root planing at baseline(0week). The subgingival sterile saline irrigation and chlorhexidine irrigation were done for about 30 seconds respectively. The metronidazole 25% dental gel was applied to periodontal pocket at 0,1 week in the test side. The clinical and microbiological analysis carried out at baseline(0week) and 4,8 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth were significantly reduced in the test group. The relative proportions of spirochetes and motile rods were significantly reduced to negative control group and the proportion of cocci was correspondingly increased in the test group. 2. The sulcular bleeding index, probing pocket depth were significantly reduced in metronidazole group. and, there was a significant differences between 2 groups. Also, the relative proportions of spirochetes and motile rods were reduced in both group. And, there was a significant differences between 2 groups. In conclusion, application of metronidazole 25% dental gel as an adjunct to mechanical debridement of root surfaces may improved the clinical and microbiological status of periodontal disease sites.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.3
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• pp.221-227
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• 2010

The most common local cause of active gingival bleeding is the vessel engorgement and erosion by severe inflammation. Abnormal gingival bleeding is also associated with the systemic disturbances. Hemorrhagic disorders in which abnormal gingival bleeding is encountered include the following: vascular abnormalities (vitamin C deficiency or allergy), platelet disorders, hypoprothrombinemia (vitamin K deficiency resulting from liver disease), and other coagulation defects (hemophilia, leukemia). There are many conventional methods for gingival bleeding control, such as, direct pressure, electrocoagulation, direct suture, drainage, application of hemostatic agents and crushing and packing. If the active continuous gingival bleeding is not stopped in spite of the application of all conventional bleeding control methods, the life of patient is threatened owing to upper airway obstruction, syncope, vomiting and hypovolemic shock. Therefore, the rapid and correct hemostatic method is very important in the emergency dental care. This is a case report of active gingival bleeding care via dental crown removal and emergency primary endodontic drainage as a last method in liver cirrhosis patient with advanced periodontitis.

• Journal of Periodontal and Implant Science
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• v.27 no.3
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• pp.621-631
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• 1997

To verify the effect of subgingival calculus on the periodontal tissues in periodontitis and the effectiveness of supragingival scaling to remove the calculus, 30 teeth from healthy group (Probing pocket depth:$PPD{\leq}mm$: HP group), 15 teeth from moderate group ($4{\leq}PD<7mm$:MP group), 30 teeth from advanced group (PPD>7mm: AP group) were selected and supragingival scaling was performed before extraction of all experimental teeth. After careful extraction, the teeth were cleaned with saline and disclosed with toluidine blue and carefully examined the relationship and distance between the calculus attached on the root surface and periodontal tissues. As a result, it was; 1. The calculus was not discovered on the root surface of teeth in HP group, but was in MP and AP group, mostly on interproximal surface and furca area. The shape of the attached calculus was ovoid, trepazoid and polygonal and the calculus was distributed randomly over the root surface. 2. PPD was more than the distance between the gingival margin to the level of attached connective tissue in AP group rather than in HP and MP group. 3. The length of calculus was $2.7mm{\pm}.44mm$ in HP group and $4.1{\pm}.89in$ AP group. 4. The distance between the apical margin of calculus and the level of attached connective tissue was $2.4{\pm}.33mm$ in MP group and $3.4{\pm}.89mm$ in AP group. 5. The length of subgingival calculus was tended to increase in relation to the probing pocket depth. Therefore, it can be concluded, the calculus in periodontal pocket can not be removed completely with supragingival scaling. As the terminal part of calculus was far away with limited distance from the periodontal tissue, it can be said that the calculus was not a direct factor in destroying the periodontal tissue. In this study, the extent of the plaque was not verified but the location of calculus can be used in clinical practice for complete removal of calculus when the distance relation bewteen calculus and plaque will be known.

• Journal of Periodontal and Implant Science
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• v.38 no.sup2
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• pp.405-412
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• 2008

Purpose: Pathologic tooth migration (PTM) commonly occurs in the anterior region and is associated with periodontal disease. The treatment of PTM of anterior teeth can be complex and time consuming, and a multidisciplinary approach is often required. Materials and Methods: The patient was a 38-year-old woman with a chief complaint of saving and realigning her elongated maxillary left central incisor. This paper describes the successful combined periodontal regenerative (guided tissue regeneration) and prosthetic treatment and a 2-year follow-up of maxillary central incisor with pathologic tooth migration, deep intrabony defect, and poor prognosis. Results: The right maxillary central incisor was restored by laminate veneer and the left by all-ceramic crown. The patient had no pain and discomfort and was satisfied with the outcomes of her treatment for 2 years. She has maintained her recall program at the Department of Periodontology at 3 months interval. Conclusion: The key step in the successful treatment of PTM in anterior region is to obtain a high level of cooperation from the patient. Maintenance of the treatment result of PTM is dependent on the continuous preservation of periodontal health.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.5
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• pp.461-470
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• 2001

A unhealthy 58-year-old male patient required extraction of left upper second molar due to advanced periodontitis. Lidocaine contained 1 : 100000 epinephrine for left posterior superior alveolar nerve block was administered in the mucobuccal fold above the second molar to be treated at the local private dental clinic. After four hours of posterior superior alveolar block anesthesia, patient feeled double vision and discomfort of eyeball movement. At next day, he complained difficulty of left eyeball movement, vertigo and diplopia. He was referred to our department via local clinic and department of ophthalomology of our hospital. He was treated by medication and eyeball exercise, and then follow up check. The double vision and medial rectus muscle palsy disappeared patially after 2 months of block anesthesia. We described herein an ocular complication of diplopia and inferior rectus muscle palsy after posterior superior alveolar nerve block for extraction of left upper second molar, and review the cause or origin of this case. The autonomic nervous system is presented as the logical basis for the untoward systems of ophthalmologic sign likely to diplopia and inferior rectus muscle palsy, rather then simple circulation of anesthetic solution in the vascular network.

• Journal of Periodontal and Implant Science
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• v.38 no.4
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• pp.737-744
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• 2008

Purpose: In advanced case of periodontitis, surgical treatment without bone contouring may result in residual pockets inaccessible to proper cleaning during post-treatment maintenance. This problem can be avoided or reduced by applying guided tissue regeneration. Materials and Methods: All of 3 patients had deep periodontal pocket depth and bleeding on probing, and radiograph revealed osseous defect, so we planned guided tissue regeneration using resorbable membrane with or without xenograft. Result: 6 months later, periodontal pocket depth and bleeding on probing was improved and gingiva was stable. Conclusion: Guided tissue regeneration using resorbable membrane with or without xenograft in osseous defect is predictable.

• Journal of The Korean Dental Society of Anesthesiology
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• v.5 no.1 s.8
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• pp.6-14
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• 2005

Chronic periodontitis is one of the most common diseases in clinical dentistry, which requires various surgical interventions to treat the moderately to severely destructed supporting periodontium. Most patients have anxiety and fear to these surgical procedures and dentists often have problems dealing with these patients. By applying the conscious sedation technique in outpatient units, periodontists have become able to manage their patients successfully with less anxiety or fear. Also, we have experienced the increased level of patients' satisfaction. Generally, periodontal treatments are time consuming procedures and patients are usually reluctant to the periodontal instruments. This study is focused on the sedation procedure with intravenous midazolam infusion performed in Department of Periodontology of Ewha Womans University Hospital. Using questionnaires, we evaluated 80 randomly selected patients for the anxiolytic effect of intravenous midazolam. Anxiety control using IV sedation was very helpful in performing various periodontal reconstructive and advanced surgical procedures in implant dentistry.