• 한국치위생학회지
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• 제19권3호
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• pp.375-385
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• 2019

Objectives: The purpose of this study was to provide basic data for gingivitis management programs by dental hygienists by evaluating the effect of oral health education, oil pulling, and professional toothbrushing on gingivitis. Methods: A total of 38 subjects were divided into three groups: control group (12 subjects), experimental group 1 (13 subjects), and experimental group 2 (13 subjects). The control and experimental groups were instructed to brush using the rotating method. Distilled water was provided to the control group after training. Coconut oil was provided every morning for about 10 minutes. In the experimental group 2, a professional brushing method was used at each visit. Results: There were no significant differences in oral health among the three groups, and there was homology between patient hygiene performance (PHP) index (p=0.144) and bleeding rate (p=0.213). The PHP index showed a significant interaction between the group and measurement time. The control and experimental groups showed changes in the PHP index with time (F=3.711; p=0.013). The bleeding rate showed a significant interaction between the group and measurement period. The control and experimental groups showed changes in the bleeding rate with time (F=6.707; p<0.001). Conclusions: Oral health education, professional toothbrushing, and oil pulling specialists in oral care of gingivitis were effective in managing gingivitis. It is necessary to educate people on self-management methods for oral health promotion using gingivitis management programs by dental hygienists.

• Journal of Periodontal and Implant Science
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• 제49권2호
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• pp.105-113
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• 2019

Purpose: An unresolved inflammatory state contributes to the pathogenesis of periodontal disease and metabolic syndrome (MetS). Therefore, the purpose of this study was to evaluate the role of lipoxin A4 (LXA4), a proresolving lipid mediator, in the association between periodontal disease and MetS. Methods: Sixty-seven patients with MetS and 65 patients without MetS were included in the study. Sociodemographic information was obtained via a questionnaire, and detailed medical diagnoses were made. Periodontal parameters (plaque index [PI], gingival index [GI], probing pocket depth [PD], and clinical attachment level [CAL]) and metabolic parameters were measured, and serum LXA4 levels were determined. The associations among MetS, periodontal parameters, and serum LX levels were evaluated by adjusted multivariate linear regression analyses. Results: Patients with MetS were older and had a higher body mass index than patients without MetS. Periodontal parameters (PI, GI, PD, and CAL) were higher in patients with MetS than in those without MetS. Serum LXA4 levels were higher in patients without MetS. Multivariate linear regression analysis indicated a positive association between MetS and periodontal parameters (PD and CAL). Negative associations were established between MetS and LXA4 levels, and between LXA4 and periodontal parameters (PI, PD, and CAL). Conclusions: The presence of higher values of periodontal parameters in patients with MetS and the negative relationship of LXA4 with MetS and periodontal disease may support the protective role of proresolving lipid mediators in the association between periodontal disease and MetS.

• Journal of Periodontal and Implant Science
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• 제51권3호
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• pp.163-178
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• 2021

Purpose: The aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients. Methods: In total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs). Results: Twelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22-23.91; P=0.026) than patients with stage I (grade A or B) periodontitis. Conclusions: Although fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.

• Journal of Periodontal and Implant Science
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• 제52권2호
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• pp.116-126
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• 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
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• 제29권1호
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• pp.265-276
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• 1999

This study was performed to evaluate the effect of hydrogen peroxide-producing Lactobacillus acidophilus V-20onthe replication of periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. When A. actinomycetemcomitans and P. gingivalis were incubated alone and in the combination with L. acidophilus V-20, the viable cell numbers of A. actinomycetemcomitans and P. gingivalis were compared between those cultures. The effect of S. mutans, E. durans, and L. lactis on the replication of A. actinomycetemcomitans and P. gingivalis was also evaluated. The change of periodontal indexes(probine depth, gingival index, GCF volume) and the viable cell numbers of A. actinomycetemcomitans and black pigmented bacteroides in subgingival plaque sample were evaluated following gargling of fermented milk made from L. acidophilus V-20 for 1 month on patients with periodontal disease in maintenance phase. In the mixed culture of L. acidophilus V-20 and A. actinomycetemcomitans or P. gingivalis, the replication of A. actinomycetemcomitans or P. gingivalis wascompletely inhibited. But in the mixed culture of P. gingivalis and hydrogen peroxide-nonproducing Lactobacillus casei, the viable ceil numbers of P. gingivaliswas not decreased when compared with the numbers in the mixed culture of P. gingivalis and L. acidophilus V-20. In the mixed culture of A. actinomycetemcomitans and S. mutans, E. durans, or L. lactis, the viable cell number of A. actinomycetemcomitans was not almost changed when compared with the numbers in the culture of A. actinomycetemcomitans alone. And in the mixed culture of P. gingivalis and E. durans or L. lactis, the viable cell numbers of P. gingivaliswas not almost changed compared with the counts in the culture of P. gingivalis alone. But the replication of P. gingivalis was completely inhibited in the mixed culture of P. gingivalis and S. mutans. When the change of periodontal indexes following gargling of fermented milk was compared with baseline, probing depth and gingival index were not changed, but GCF volume was significantly decreased(p<0.05). And when the viable ceil numbers of microorganisms in subgingival plaque sample were compared with baseline, total viable ceil number was almost unchanged and the viable cell numbers of A. actinomycetemcomitans and black pigmented bacteroides were significantly decreased(p<0.05). These results suggest that L. acidophilus V-20 inhibit the replication of A. actinomycetemcomitans and black pigmented bacteroides by the formation of hydrogen peroxide.

• Journal of Periodontal and Implant Science
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• 제30권3호
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• pp.619-632
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• 2000

This clinical study was designed to determine the clinical and microbiological outcomes and safety of using minocycline loaded polycaprolactone strip for pericoronitis patients. 64 patients showing symptoms and signs of pericoronitis were enrolled according to the inclusion criteria in this double blind study. They were randomly assigned to two groups. 32 patients comprised control group and they received only polycaprolactone films in pericoronal spaces, and another 32 patients comprised experimental group and they received polycaprolactone films loaded with 30% minocycline. Informed consent was obtained from all the participants before beginning the study. At the initial visit, gingival index(GI), papillary bleeding index(PBI), amount of gingival crevicular fluid(GCF) were recorded, and microbiological sampling was done. Then, loaded or unloaded polycaprolactone film was inserted into the pericoronal spaces. No drug was prescribed excepting this film. After one week, clinical and microbiological exam was repeated. Presence of any side effects or inconveniences were checked. Chi-square test and t-test was performed to compare outcomes. At baseline, there were no significant differences in all the criteria between experimental group and control group. Experimental group showed significant improvement compared with control group both in GI(p<0.01) and PBI(p<0.01). The amount of GCF of the experimental group was significantly decreased compared with the control group(p<0.01) and baseline(p<0.01). In microbiological study, percentage of motile rod was prominently decreased in the experimental group. Also, aerobic(p<0.001), anaerobic(p<0.001) and black pigmented(p<0.01) bacteria were significantly decreased from the baseline. Furthermore, no side effects or inconveniences was reported in the experimental group. From this study, it was concluded that insertion of polycaprolactone film with 30% minocycline into the pericoronal spaces would be effective and safe treatment for pericoronitis.

• Journal of Periodontal and Implant Science
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• 제34권3호
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• pp.607-622
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• 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.

• 치위생과학회지
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• 제12권5호
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• pp.469-476
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• 2012

본 연구는 스트레스 대처방법이 치주질환에 미치는 영향을 파악하여 적절한 스트레스 대처방법을 통한 치주질환의 예방과 발생 및 진행 정도에 긍정적인 성과를 위한 기초 자료를 제공하기 위하여 실시되었다. 연구대상은 창원시 소재 MY치과의원에 내원한 40~50대 성인 남녀와 같은 지역 소재 M대학 치위생과에 예방적 치석제거에 동의한 40~50대 성인 남녀로 총 326명을 대상으로 하여 설문지와 치주건강상태를 측정하여 조사 분석하였다. 자료의 분석방법은 SPSS ver. 19.0 (IBM Co.)을 이용하여 빈도와 백분율, t-검증, MANOVA, 다중회귀분석의 통계방법을 사용하였으며 분석결과는 다음과 같다. 1. 여자보다 남자에서 치은염 지수(p<0.001), 치주낭 깊이(p<0.001), 임상적 부착소실(p<0.01)에 대한 평균이 높게 나타났다. 2. 치은염 지수에 영향을 미치는 요인으로 정서 중심적 스트레스 대처방법($\beta$=0.341, p<0.001)이 영향을 미치는 것으로 조사되었다. 3. 치주낭 깊이에 영향을 미치는 요인으로 정서 중심적 스트레스 대처방법($\beta$=0.239, p<0.002)이 영향을 미치는 것으로 조사되었다. 4. 임상적 부착소실에 영향을 미치는 요인으로 정서 중심적 스트레스 대처방법($\beta$=0.158, p<0.042)이 영향을 미치는 것으로 조사되었다.

• 대한치과교정학회지
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• 제34권4호
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• pp.363-370
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• 2004

고정식 교정장치를 부착한 경우 장치주위의 치태 축적 가능성이 증가되고 이로 인해 치은염, 법랑질 탈회 등의 부작용이 초래 될 수 있는 바 치태 제거를 위한 효과적인 칫솔질이 필요하다. 본 연구는 교정환자에서 일반적으로 사용되고 있는 치솔에 비하여 전동치솔이 구강위생에 도움이 되는지 알아보기 위하여 시행되었다. 고정식 장치에 의한 교정치료 예정인 환자 34명을 본 연구의 대상으로 하여 고정식 교정장치 부착 전에 치태지수, 치은염지수, 치은출혈지수를 측정하였다. 장치 부착 4주 후에 각 지수를 측정한 다음, 연구대상을 치솔의 종류에 따라 전동치솔군과 수동치솔군으로 임의 구분하여 수동치솔 또는 전동치솔을 사용하도록 구강위생교육을 각각 시행하였다. 이때 전동치솔의 경우 본체는 Braun Oral-B D9511을 브러쉬 헤드는 Braun Oral-B Ortho OD 15-1을 사용하게 하였으며, 수동치솔의 경우는 Butler G.U.M 124를 사용하게 하였을. 구강위생교육 4주 및 8주 후에 각 지수를 측정한 다음 시간 경과에 따른 전동치솔군과 수동치솔군의 구강위생 상태를 비교 분석하여 다음과 같은 결과를 얻었다. 1. 고정식 교정장치 부착 4주 후 치태지수, 치은염지수, 치은출혈지수 모두 증가 양상을 나타내었다. 2. 구강위생교육 후 치태지수, 치은염지수, 치은출혈지수 모두 감소 양상을 나타내었다. 3. 치은염지수, 치은출혈지수의 경우 감소양상이 수동치솔과 전동치솔군 간의 유의한 차이를 보이지 않았다. 4. 치태지수의 경우 수동치솔에 비해 전동치솔군에서 감소효과가 유의하게 크게 나타났다. 이상의 연구 결과는 고정식 교정장치로 치료받는 환자에서 전동치솔이 구강위생에 도움이 됨을 시사하였다.

• Journal of Periodontal and Implant Science
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• 제33권2호
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• pp.167-178
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• 2003

Many researches are being done to study the effect of toothpaste containing natural extracts. The aim of this study was to evaluate the plaque control effect and therapeutic effect of toothpaste products containing chitosan extract. 120 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in the experimental group only used toothpaste containing chitosan and subjects in the control group used toothpaste without chitosan. At first, subjects received scaling and tooth brushing instruction. Gingival index, bleeding index, probing pocket depth, probing attachment level were scored at baseline, 2 months, and 3 months, and plaque index were scored at baseline, 1 month, 2 months, 3 months. Gingival index of experimental group and control group at baseline, 2 months, and 3 months use were 0.71${\pm}$0.66, 0.49${\pm}$0.55, 0.36${\pm}$0.49 and 0.62${\pm}$0.58, 0.51${\pm}$0.52, 0.48${\pm}$0.50 (mean${\pm}$SD), respectively (statistically significant different at p <0.05 ). Plaque index of experimental group and control group at baseline, 1 month, 2 months, and 3 months were 0.52${\pm}$0.50, 0.43${\pm}$0.50, 0.39${\pm}$0.49, 0.29${\pm}$0.46 and 0.49${\pm}$0.50, 0.50${\pm}$0.50, 0.51${\pm}$0.50, 0.45${\pm}$0.50, respectively (statistically significant different at p<0.05 ). Bleeding index of experimental group and control group were 0.40${\pm}$0.49, 0.33${\pm}$0.47, 0.24${\pm}$0.43 and 0.40${\pm}$0.49,0,38${\pm}$0.49,0.30${\pm}$0.46, respectively (statistically significant different at p<0.05). Probing depth of experimental group and control group were 2.41${\pm}$0.64, 2.31${\pm}$0.60, 2.28${\pm}$0.55 and 2.51${\pm}$0.67, 2.47${\pm}$0.63,2.42${\pm}$0.62, respectively (statistically significant different at p${\pm}$0.66, 2.32${\pm}$0.62 and 2.54${\pm}$0.70, 2.51${\pm}$0.69,2.46${\pm}$0.66, respectively (statistically significant different at p<0.05 ). From these finding, it can be concluded that toothpaste containing chitosan have better plaque control effect and therapeutic effect on gingivitis and early periodontitis compared to conventional toothpastes.