• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.193-204
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• 2015

Purpose: With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. Methods: A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. Results: The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (P<0.01). The overall bone level also improved (P=0.045). However, the bone level changes in the FA and CAT groups were not significantly different. Significant differences were found between the FA and CAT groups in probing depth, change in probing depth, and duration of treatment (P<0.05). However, no significant differences were found between the FA and CAT groups regarding the plaque index, changes in the plaque index, the gingival index, changes in the gingival index, or changes in the alveolar bone level. The percentage of females in the CAT group (88%) was significantly greater than in the FA group (37%) (P<0.01). Conclusions: After orthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients' periodontal health irrespective of orthodontic techniques.

• The korean journal of orthodontics
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• v.24 no.1 s.44
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• pp.221-231
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• 1994

The short-term effects of plaque control instruction were studied in 42 adolescent orthodontic patients under active fixed treatment. At first visit, all the patients were received plaque control instruction using materials such as oral hygiene education slides, dentiform, disclosing agents, tooth brush and interdental brush. After that, Pateints were asked to perform the tooth brushing according to instructions. Such a procedure was repeated every week lot 3 weeks. Plaque index and bleeding index were scored once a week for 4 weeks and were compared according to ages, sex and duration with fixed appliance. The results were as follows: 1. Plaque control instruction was effective in reducing plaque accumulation and gingival inflammation of the orthodontic patients. 2. The effect of plaque control instruction was continued during 3 weeks among all groups of subjects, and it was prominent at the first week. 3. There was no statistically significant difference in the effects of the plaque control of instruction according to sex, ages, or duration with fixed appliances.

• The korean journal of orthodontics
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• v.24 no.3 s.46
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• pp.673-693
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• 1994

Most adults, unlike growing children, have some periodontal problems which can influence the outcome of the orthodontic treatment. In cases where periodontal disease progression resulted in marked reduction of periodontium, orthodontic treatment could result in the worsening of the periodontal conditions, and therefore orthodontic treatment planning in such adult patients requires special considerations for the periodontal problems. This study investigates the effects of horizontal orthodontic tooth movement on the changes in the mesial, distal and furcation areas of the disease affected periodontium of adult dogs with advanced bone loss. Six adult dogs with healthy periodontium were selected, and mandibular 2nd premolars were extracted. In the mandibular 3rd premolars, angular bony defects in the mesial and distal sides, and horizontal bony defects in the furcation areas were created. Those that received the flap operation and plaque control were designated as the control, those that had horizontal tooth movement without plaque control after the flap operation as Experimental group I, those that had horizontal tooth movement under plaque control without the flap operation as Experimental group II, and those that had horizontal tooth movement under plaque control after the flap operation as Experimental group III. The control group was sacrificed 2 months postoperatively, and the experimental groups were sacrificed 5 months after the initiation of tooth movement. Specimens were histologically analyzed under light microscope. The results were as follows; 1. After the horizontal tooth movements, Experimental group I and II showed angular bony defects in the mesial sides of the roots and the distal side of the furcation areas, which correspond to the pressure sides. 2. After the horizontal tooth movements, Experimental group I and II showed decreased level of alveolar bone crest in the distal sides of the roots, which correspond to the tension sides. 3. Long junctional epithelium in the control group has not been replaced by periodontal connective tissue after the horizontal tooth movements. 4. Limited formation of new bone was observed in the angular bony defects in the mesial and distal aspects of the roots in the control group. 5. Inflammatory cell infiltration in the connective tissue was most severe in the Experimental group I, followed by Experimental group II, III, and the control group in that order. These results seem to indicate that plaque control was the most influencing factor in the alteration of the periodontal tissue after the horizontal tooth movements in the periodontal tissue with alveolar bone defects.

• The korean journal of orthodontics
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• v.30 no.3 s.80
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• pp.335-342
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• 2000

The authors observed the long term effects of chlorhexidine varnish treatment on microbial change of dental plaque in orthodontic patients with fixed appliances. The initial sample was 100 patients who were arranged to be treated with fixed orthodontic appliances. The final sample consisted of 21 patients who could be traced for 32 weeks after application of fixed orthodontic appliances. They were classified into the experimental group (12 patients) and the control group (9 patients). The experimental group was treated with chlorhexidine varnish once a week for 4 weeks before application of fixed orthodontic appliance. The control group was not treated with chlorhexidine varnish before application of fixed orthodontic appliance. The experimental group was treated once more after 20 weeks. The microbial changes of dental plaque were analysed by indirect immunofluorescence technique at pre-treatment, post-treatment 4, 8, 20, and 32 weeks. The results were as follows. 1. In the experimental group, streptococus mutans was significantly suppressed during experimental period. (p<0.01) But, in the control group, streptococcus mutans was significantly increased after placement of fixed orthodontic appliances during experiment period. (p<0.05) 2. Streptococcus sanguis, Streptococcus mitis, Actinomyces viscosus, md Actinomyces naeslundii did not show significant change between the experimental and the control group during experiment period. So, if we treat the orthodontic patients with chlorhexidine varnish before application of fixed appliances, we may suppress the major cariogenic bacteria, Streptococcus mutans, selectively for long period.

• International Journal of Clinical Preventive Dentistry
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• v.14 no.4
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• pp.209-215
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• 2018

In recent years, the numbers of the orthodontic dental patients have been rapidly increased in adolescent or young adult aged generation. It has been well known that it would be very hard to control the oral hygiene cares for orthodontic applied dental patient because of the complexity of the appliance. So the caries prevalence of the orthodontic dental patients would be higher than non-appliance persons, and it might be easy to cause the dental caries especially on the labial or buccal surface of the tooth through equipping the fixed type appliance with a long period, even though the alignment of the teeth would be arranged well. So, the massive preventive program for preventive dentistry should be needed for the dental patients for orthodontic treatment, in order to protect the dental caries and the periodontal disease for them. But, lots of the dentists or dental hygienists sometimes neglect of this point for preventive dental cares orthodontic dental patients, or do not know the importance and how to manage the skill for the preventive dental works in clinical. In this article, it will be introduced the basic theories and skills for preventive cares as tooth-brushing instruction, fluoride topical application and pit and fissure sealant, scaling and professional mechanical tooth cleansing and the diet control, for the dental patients with the fixed type of the orthodontic appliance, in case by case.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.4
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• pp.743-750
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• 1997

Gingivitis is the most prevalent type of periodontal disease and the dental plaque is considered as a major contributory factor. As the poor oral hygiene is firmly related to the occurrence of periodontal disease, pediatric dentist should make every effort to promote the oral health and control the plaque effectively for the high risk patients, especially for those who are under orthodontic treatment. P.M.T.C.(Professional Mechanical Tooth Cleaning), introduced by Dr. P. Axelsson in 1969, is a very effective method of plaque removal and can be performed by specially trained personnel. Two pediatric orthodontic patients were treated by P.M.T.C. for the elimination of gingivitis and gingival swelling. Signi ficant improvements of gingival condition were achieved in both cases but additional preventive programs and home care along with professional office care seem to be necessary for the best result.

• The korean journal of orthodontics
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• v.27 no.2
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• pp.173-180
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• 1997

The purpose of this study was to evaluate the effectiveness of chlorhexidine varnish treatment in the prevention of dental caries in orthodontic patients by observing microbial change in dental plaque after varnish treatment. The sample consisted of 26 patients who were classified into an experimental group and a control group, 13 patients each. The experimental group was treated with chlorhexidine varnish once a week for 4 weeks. The control group was treated with placebo varnish using the same procedure, The microbial change was analysed by indirect immunofluorescene technique before treatment and 4 weeks, 8 weeks after treatment. The results were as follows. 1. Streptococcus mutans were strongly suppressed until 8 weeks after chlorhexidine varnish treatment(p<0.01). 2 The proportion of Streptococcus sanguis increased temporarily 4 weeks after chlorhexidine varnish treatment(p<0.05), decreased to original level after 8 weeks. 3. Streptococcus mitts, Actinomyces viscosus, Actinomyces naeslundii did not show significant change after chlorhexidine varnish treatment.

• The korean journal of orthodontics
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• v.25 no.3 s.50
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• pp.235-245
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• 1995

The purpose of this paper is to review two recently reported, long-term studies of several chemical methods to control gingivitis and decalcification in adolescent orthodontic patients. The first study(gingivitis study) was designed to determine whether conventional toothbrushing and twice daily use of a brush-on 0.4 per cent $SnF_2$ gel containing more than 90 per cent available $Sn^{2+}$ would be more effective for controlling plaque accumulation and gingivitis in the presence of orthodontic appliances than conventional toothbrushing alone. The second study(decalcification study) was designed to compare the effectiveness of controlling decalcification in orthodontic patients with either a II00 ppm F tooth paste used alone, this same toothpaste and a 0.05 percent NaF rinse or this toothpaste and a 0.4 percent $SnF_2$ gel. In the gingivitis study, sixty-five consecutively treated adolescents who were to receive full-mouth fixed orthodontic appliances were assigned to two groups according to age and sex criteria. In the decalcification study an additional 30 subjects(95 total) were similarly assigned to a third group. The first group(control, n=35) used only toothbrushing with a standard fluoride(1100 ppm F) toothpaste. The second group used toothbrushing with a similar dentifrice supplemented with a 0.4 percent $SnF_2$ gel($SnF_2$ gel group, n=30) used twice daily for the entire 18-month study period. The third group(in the decalcification study only) used a similar toothpaste and 0.05 percent NaF rinse(NgF rinse group, n=30). Clinical assessments of plaque accumulation using the Plaque Index, gingival inflammation using the Gingival Index, and coronal staining were completed single-blinded before appliances were placed and 1, 3, 6, 9, 12 and 18 months after appliances were placed. Decalcification was assessed single blind on all labial surfaces of all erupted teeth before appliances were placed and 3 months after appliances were removed. The results of the gingivitis study indicated that the $SnF_2$ gel gorup had significantly lower scores for the Plaque Index(p<0.01) and Gingival Index(p<0.001) at all examinations during orthodontic treatment than did the control group. In the $SnF_2$ gel group, one subject developed mild coronal staining and two subjects developed moderate staining. In the decalcification study, when pre-treatment levels of decalcification were subtracted from post-treatment values, significantly lower decalcification scores(p<0.05) were found for both whole mouth and first molars in the NaF rinse and gel groups as compared with the control gorup(toothpaste alone). Although the gel group consistently had less decalcification than the rinse group, this difference only approached statistical significance.

• The korean journal of orthodontics
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• v.34 no.2 s.103
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• pp.189-195
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• 2004

The purpose of this research is to evaluate and compare the plaque removal ability of sonic brushing and manual brushing in order to present a method for continuous and effective oral hygiene control during orthodontic treatment. Nonextracted adolescent patients (male: 23 persons, female: 37 persons) and adult patients (male: 15 persons, female: 45 persons) outfitted with a fixed orthodontic appliance from their incisors to second molar, in both the maxilla and mandible, were divided into manual brushing and sonic brushing groups. A Philips oral healthcare HX-4401 sonic toothbrush was used, and the application of brushing for the two groups was standardized at two minutes. After brushing, the plaque score was measured with a modified Wilkin's PHP. The following results were achieved after comparing each group's plaque score. 1. In patients with a fixed orthodontic appliance when age was not accounted for, the application of sonic brushing exerted a beneficially decreased effect on the plaque score. (adolescents : p<0.01, adults: p<0.05) 2. When comparing the adolescent and adult groups in regard to plaque score, the adolescent group showed a more decreased effect. 3. When using the same toothbrush type, there was no difference between the adolescent and adult groups.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.4
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• pp.686-692
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• 2006

The impacted teeth were surgically exposed by the closed-eruption technique and orthodontically retracted. The subject of this study are 24 patients(Mx. insiors; 10 Mx. canines; 14) who finished their treatment. The periodontal condition of the impacted teeth and the normally erupted proximal and opposed teeth were compared and analysed. The results are the followings ; 1. When the gingival index, plaque index, pocket depth and attached gingiva in periodontal evaluation were compared, there was no significant difference between the study group and the control group (P>0.05). 2. When the alveolar bone support of the mesial and the distal surface of the maxillary central incisors and proximal teeth was compared, there was no significant difference between the study group and the control group (P<0.05). 3. When the alveolar bone support of the maxillary canines was compared, there was no significant difference between the retracted teeth and the normally erupted teeth(P>0.05). The results above showed that the surgical exposure by closed-eruption technique followed by the orthodontic retraction of the impacted teeth has a positive influence on the regeneration of gingival tissue in clinical practice and is esthetically more stable. And it is considered that the clinicians should give attention to the direction of retraction power and the maintenance of normal shape of the alveolar bone in treatment of maxillary central incisors.