• Journal of Korean Dental Hygiene Science
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• v.6 no.1
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• pp.65-76
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• 2023

Background: The aim of this study was to examine the association between physical activity and periodontitis in the Korean population. Methods: This study utilized data from 9,191 participants of the Korea National Health and Nutrition Examination Survey. Periodontitis was defined as a CPI score of 3 or 4. Physical activity was assessed by the trained interviewer using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). IPAQ-SF is composed of vigorous physical activity, moderate physical activity, and walking activity. Multivariable logistic regression analyses and stratified analyses by obesity were performed. All analyses were conducted separately for males and females. Results: Females who engaged in vigorous and moderate physical activity had a 28% (OR = 0.72, 95% CI = 0.54 - 0.95) and 34% (OR = 0.66, 95% CI = 0.44 - 0.98) lower risk of periodontitis, respectively. In obese females, moderate physical activity in obese had a 65% lower risk of periodontitis (OR = 0.35, 95% CI = 0.18 - 0.67). Conclusions: Our findings suggest that moderate-intensity physical activity was inversely associated with a lower risk of periodontitis. In obese females, moderate physical activity had an independent inverse association with periodontitis.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.415-428
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• 2002

Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.

• Journal of Periodontal and Implant Science
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• v.53 no.3
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• pp.173-183
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• 2023

Purpose: Treatment for periodontitis has evolved over the years as new technologies have become available. Currently, lasers seem attractive as a treatment modality, but their effectiveness needs to be verified. The purpose of this project was to evaluate Laser Assisted New Attachment Procedure^® (LANAP^®) surgery as a single treatment modality. Methods: As part of a mandatory training program for periodontists and other dentists, 22 consecutive patients diagnosed with moderate to severe periodontitis (probing depth [PD] up to 11 mm) were treated with the LANAP^® surgical approach using a 1064-nm Nd:YAG laser as part of a multi-step protocol. Following single-session active therapy, they were entered into a maintenance program. Their clinical status was re-evaluated at 12-18 months following surgery. Results: All 22 patients completed the 12- to 18-month follow-up. PD, clinical attachment level, and furcation (FURC) showed substantial improvement. Recession was minimal (mean, 0.1 mm), while 93.5% of PD measurements were 3 mm or less at re-evaluation. Furthermore, 40% of grade 2 FURC closed clinically. Conclusions: Within the limits of this case series, LANAP^® was found to be an effective, minimally invasive, laser surgical therapy for moderate to advanced periodontitis.

• Journal of Periodontal and Implant Science
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• v.48 no.1
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• pp.47-59
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• 2018

Purpose: To evaluate the clinical and microbiological effects of the local use of egg yolk immunoglobulin against Porphyromonas gingivalis (anti-P.g. IgY) as an adjunct to scaling and root planing (SRP) in the treatment of moderate to severe chronic periodontitis. Methods: This was a randomized, placebo-controlled, double-blind trial involving 60 systematically healthy patients with moderate to severe chronic periodontitis. Subjects (n=20/group) were randomly assigned to receive SRP combined with subgingival irrigation of anti-P.g. IgY and anti-P.g. IgY mouthwash, subgingival irrigation of 0.2% chlorhexidine and 0.2% chlorhexidine mouthwash, or subgingival irrigation of placebo and placebo mouthwash for 4 weeks. Probing pocket depth, clinical attachment level, bleeding on probing, and the plaque index were evaluated at baseline and at 4 weeks. Subgingival plaque, gingival crevicular fluid, and saliva were simultaneously collected for microbiological analysis. Results: Our results showed that anti-P.g. IgY mouthwash was as effective as chlorhexidine at improving clinical parameters over a 4-week period. All the groups showed a significant reduction in levels of P.g. at 4 weeks. No significant difference was observed in the test group when compared to placebo regarding the reduction in the levels of P.g. Anti-P.g. IgY significantly suppressed the numbers of red complex bacteria (RCB) in subgingival plaque and saliva in comparison with placebo. No adverse effects were reported in any of the subjects. Conclusions: Within the limitations of the study, the present investigation showed that passive immunization with anti-P.g. IgY may prove to be effective in the treatment of chronic periodontitis due to its ability to improve clinical parameters and to reduce RCB. No significant differences were found between the anti-P.g. IgY and placebo groups in the reduction of P.g.

• Journal of dental hygiene science
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• v.16 no.5
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• pp.339-348
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• 2016

We investigated the gender-specific association between average volume of alcohol consumption, binge drinking, and periodontitis using representative nationwide data. In total, we included 3,549 men and 4,810 women, aged 19 years and older, who participated in the sixth Korea National Health and Nutrition Examination Survey performed in 2013~2014. According to the average volume of alcohol consumption, study participants were grouped as follows: mild drinkers (0.1~2.0 drinks/day in men and 0.1~1.0 drink/day in women), moderate drinkers (2.1~4.0 drinks/day in men and 1.1~2.0 drinks/day in women), and heavy drinkers (>4.0 drinks/day in men and >2.0 drinks/day in women). Additionally, binge drinking was categorized as never (no binge drinking), rarely (<1 time/month), occasionally (1 time/month), frequently (1 time/week), and always (almost every day/week). Periodontitis was defined as a community periodontal index equal to code 3 or greater. In men, after controlling for covariates, the association between average volume of alcohol consumption and periodontitis showed a J-shaped curve; the risk of periodontitis was significantly higher in moderate drinkers (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.01~1.56) and heavy drinkers (OR, 1.39; 95% CI, 1.04~1.87) than in mild drinkers. In contrast, no significant association between average volume of alcohol consumption and periodontitis was observed in women. In a fully adjusted analysis, which used 'never binge drinking' as a reference, a significant dose-response relationship between binge drinking and periodontitis was observed only in men: rarely (OR, 1.64; 95% CI, 1.16~2.34), occasionally (OR, 1.51; 95% CI, 1.05~2.16), frequently (OR, 1.58; 95% CI, 1.07~2.33), and always (OR, 2.56; 95% CI, 1.56~4.22) (p for trend=0.005). In conclusion, unhealthy drinking patterns such as moderate or heavy alcohol consumption and binge drinking were significantly associated with periodontitis in men but not in women.

• BMB Reports
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• v.44 no.7
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• pp.473-477
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• 2011

Periodontitis is a very prevalent disease. Therefore, biomarkers for the early and standard diagnoses of periodontitis are urgently needed. TACE is a membrane-bound metalloprotease. Although a recent study suggested that TACE levels in GCF are elevated during periodontal disease, the levels of TACE in GCF at different stages of chronic periodontitis have not been determined. Here, we analyzed the protein levels of TACE in GCF from periodontal disease subjects and confirmed that the protein levels of TACE were higher in the moderate periodontitis groups. TACE is known to be a NF-${\kappa}B$ ligand that stimulates RANKL secretion in osteoblasts. To understand the effects of TACE on RANKL and OPG in osteoblasts, we treated MG63 cells with TACE. We observed an increase in RANKL protein expression but a decrease in OPG protein expression. Our data suggest that TACE can induce RANKL expression and promote osteoclastogenesis, thus worsening the outcome of periodontitis.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.20-24
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• 2014

Purpose: The aim of this clinical trial was to explore the impact of intentional passive eruption (IPE) using occlusal reduction on the periodontal parameters of teeth with moderate chronic periodontitis and traumatic occlusion. Methods: This study was performed on 40 teeth from 16 subjects. At baseline, 4 weeks after initial periodontal treatment, and 6 months after IPE, clinical and radiographic examinations were performed. The 20 teeth in the test group underwent IPE using occlusal reduction, whereas the 20 control teeth did not undergone occlusal reduction. Results: All the periodontal parameters were improved by the initial periodontal treatment. The teeth in the test group showed a significantly greater decrease in pocket depth, tooth mobility, and marginal bone loss than did the control group (P<0.05), but there were no significant changes in the attachment level. Significantly greater improvements in all the parameters were observed in the test group after 6 months of IPE compared to 4 weeks after the initial periodontal treatment (P<0.05). Conclusions: Within the limits of this study, performing initial periodontal therapy combined with IPE using occlusal reduction was shown to be very simple and effective. Moreover, IPE would be helpful in improving periodontal parameters.

• The Journal of the Korean dental association
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• v.51 no.9
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• pp.501-510
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• 2013

This paper reviews a current view regarding the association between periodontitis and atherosclerotic cardiovascular diseases (ACVD). Many evidences have suggested that there exist biological mechanisms by which periodontitis can lead to ACVD. Periodontal infection can lead to direct bacterial invasion into endothelial tissues through the blood stream, then the bacteria can activate the host inflammatory response followed by atheroma formation, maturation and exacerbation. Also, chronic periodontal infections may indirectly induce endothelial activation or dysfunction through a state of systemic inflammation as evidenced by elevated plasma acute proteins, IL-6 and fibrinogen as well. There is moderate evidence that periodontal treatment can reduce systemic inflammation and improvement of both clinical surrogate markers. But there is no periodontal intervention study available on primary ACVD prevention. There is consistent and strong epidemiologic evidence, including in vitro, animal and clinical studies, that periodontitis imparts increased risk for future ACVD. However, evidences from intervention trials to date are not sufficient to confirm the multi directional causality of periodontitis in ACVD etiology. Well-designed intervention trials on the impact of periodontal treatment on the prevention of ACVD outcomes are needed.

• Journal of Periodontal and Implant Science
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• v.36 no.3
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• pp.693-703
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• 2006

The purpose of this study was to evaluate the efficacy of the Sonicare $Elite^{(R)}$ power toothbrush in plaque removal and reduction of gingivitis from hard-to-reach sites of the moderate periodontitis compared to regular manual toothbrush in 12 week follow-up. 82 subjects with incipient to moderate periodontitis were randomly assigned to use either the manual or sonic brush, instructed in its use, and asked to brush 2 times a day for 2 minutes. Plaque scores were taken at baseline, 1, 4, 12 weeks using Silness & $L\ddot{o}e$ plaque index and gingival inflammation was assessed by the $L\ddot{o}e$ & Silness gingival index. The results were as follows. 1. The Sonicare $Elite^{(R)}$ power toothbrush showed a significant reduction(p<0.0001) of the plaque(Silness & $L\ddot{o}e$) and gingival inflammation(Loe & Silness). 2. The Sonicare $Elite^{(R)}$ power toothbrush showed a significant better reduction of plaque and gingivitis(p<0.05) than the manual toothbrush after 1, 4, and 12 weeks. 3. The Sonicare $Elite^{(R)}$ power toothbrush demonstrated a significant reduction(p<0.0001) of the plaque in interproximal sites(p<0.0001), buccal sites(p<0.0001) and the lingual sites(p=0.00l8) of the teeth. 4. The Sonicare $Elite^{(R)}$ power toothbrush demonstrated a significant reduction(p<0.0001) of the gingival inflammation in the interproximal sites(p<0.0001), the buccal sites(p<0.0001) and the lingual sites(p<0.0001) of the teeth. The results of this study support the findings that Sonicare $Elite^{(R)}$ power toothbrush has a great potential to remove the plaque and resolve the gingival inflammation during the period of 12 week.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.25-32
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• 2014

Purpose: Periodontitis is an infectious disease caused predominantly by gram-negative anerobes. The host inflammatory response to these bacteria causes alveolar bone loss that is characterized as periodontitis. Omega-3 fatty acids (${\omega}$-3 FAs) have anti-inflammatory properties, thus have been used to treat some chronic inflammatory diseases such as cardiovascular disease and rheumatoid arthritis. We aimed to evaluate the effect of dietary supplementation with ${\omega}$-3 FAs as a host modulating agent in patients with chronic periodontitis. Methods: Sixty otherwise healthy subjects with moderate and severe chronic periodontitis were enrolled in our randomised, double-blind, placebo-controlled trial. The control group (CG, n=30) was treated with scaling and root planing (SRP) and given a placebo; the treatment group (TG, n=30) was treated with SRP and dietary supplementation of ${\omega}$-3 FAs (one 300 mg tablet daily for 12 weeks). Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated in all patients at baseline, a 6-week and 12-week period after treatment. Results: A significant reduction in the gingival index, sulcus bleeding index, pocket depth, and clinical attachment level was found in the TG compared to the CG at a 12-week period. However, no statistically significant changes in serum CRP levels were found. Conclusions: Our findings suggest that ${\omega}$-3 FAs can successfully reduce gingival inflammation, pocket depth, and attachment level gain. Dietary supplementation with ${\omega}$-3 FAs may have potential benefits as a host modulatory agent in the prevention and/or C management of chronic periodontitis.