• The Journal of Advanced Prosthodontics
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• v.8 no.2
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• pp.150-157
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• 2016

PURPOSE. The modified lateral-screw-retained implant prosthesis (LSP) is designed to combine the advantages of screw- and cement-retained implant prostheses. This retrospective study evaluated the mechanical and biological complication rates of implant-supported single crowns (ISSCs) inserted with the modified LSP in the posterior region, and determined how these complication rates are affected by clinical factors. MATERIALS AND METHODS. Mechanical complications (i.e., lateral screw loosening [LSL], abutment screw loosening, lateral screw fracture, and ceramic fracture) and biological complications (i.e., peri-implant mucositis [PM] and peri-implantitis) were identified from the patients' treatment records, clinical photographs, periapical radiographs, panoramic radiographs, and clinical indices. The correlations between complication rates and the following clinical factors were determined: gender, age, position in the jaw, placement location, functional duration, clinical crown-to-implant length ratio, crown height space, and the use of a submerged or nonsubmerged placement procedure. RESULTS. Mechanical and biological complications were present in 25 of 73 ISSCs with the modified LSP. LSL (n=11) and PM (n=11) were the most common complications. The incidence of mechanical complications was significantly related to gender (P=.018). The other clinical factors were not significantly associated with mechanical and biological complication rates. CONCLUSION. Within the limitations of this study, the incidence of mechanical and biological complications in the posterior region was similar for both modified LSP and conventional implant prosthetic systems. In addition, the modified LSP is amenable to maintenance care, which facilitates the prevention and treatment of mechanical and biological complications.

• Journal of dental hygiene science
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• v.17 no.5
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• pp.447-453
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• 2017

The purpose of this study was to analyze the relationship between objective oral health status determined by dentists, self-perceived subjective oral health status, and oral health related quality of life (OHRQoL) in the elderly. The related factors affecting OHRQoL in the elderly were also surveyed. Four hundred and thirty elderly individuals who visited the three public health centers and four dental clinics in Busan were selected by convenience sampling. Twelve dental hygienists investigated the subjective oral health status and OHRQoL using the 14-item Oral Health Impact Profile (OHIP-14) and twentyone dentists examined the objective oral health status, including healthy remaining teeth, treated remaining teeth, functional remaining teeth, missing teeth, and non-treated missing teeth. Data were analyzed using SPSS ver. 12.0. OHRQoL was higher when oral and periodontal status was perceived as healthy, when there was no toothache, no interference in mastication, and when study subjects had the ability of food softening. It was also higher when study subjects had ${\geq}20$ remaining teeth and <9 missing teeth, and were wearing denture. The related factors affecting OHRQoL of the elderly were the type of medical insurance, toothache, ability of food softening, perception of periodontal status, and the number of healthy remaining teeth. There was a significant relationship between the subjective-objective oral health status and OHRQoL in the elderly. A continuous oral health care system aimed at retaining ${\geq}20$ healthy remaining teeth is needed to improve oral health and OHRQoL for the elderly, especially for the elderly receiving medical aid.

• Journal of dental hygiene science
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• v.18 no.1
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• pp.60-68
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• 2018

This study investigates the relationship between smoking and periodontal disease through quantitative analysis of intra-buccal oral pathogenic bacteria detected in smokers and aims to yield objective baseline data for applications in anti-smoking and dental health education programs. From April to May 2016, participants in an oral health management program within an intensive dental hygiene training course at Choonhae College of Health Sciences received an explanation of the study purposes and methods, after which male smokers aged 18~30 years agreed to participate voluntarily. Real-time polymerase chain reaction (PCR) analysis of oral pathogenic bacteria was performed after collecting gingival sulcus fluid samples from 67 smokers. The intra-buccal oral pathogenic bacteria distributions were analyzed based on the subjects' general characteristics, smoking behaviors, and oral care behaviors. The distribution results show that pathogens in the anterior teeth are affected (in this order) by age, toothbrush size, and smoking status; older people had fewer pathogens, those who used larger toothbrushes had more pathogens, and smokers had more pathogens, compared to non-smokers ($_{adj}R^2=19.1$). In the posterior teeth, pathogens were influenced (in this order) by smoking status, smoking duration, and the number of tooth brushings per day; smokers had more pathogens than non-smokers, and those who brushed their teeth more often had fewer pathogens ($_{adj}R^2=25.1$). The overall pathogen distribution was affected only by smoking status: smokers generally had more pathogens, compared to non-smokers. Therefore, it is necessary to provide information about the risk of periodontal disease due to smoking during anti-smoking or dental health education sessions; particularly, the use of smaller toothbrushes for anterior teeth and the need for smokers in their early twenties to quit smoking for dental health should be highly emphasized.

• Journal of Periodontal and Implant Science
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• v.46 no.4
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• pp.266-276
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• 2016

Purpose: The aim of the present study was to retrospectively investigate the influence of potential risk indicators on the development of peri-implant disease. Methods: Overall, 103 patients referred for implant treatment from 2000 to 2012 were randomly enrolled. The study sample consisted of 421 conventional-length (>6 mm) non-turned titanium implants that were evaluated clinically and radiographically according to preestablished clinical and patient-related parameters by a single investigator. A non-parametric Mann-Whitney U test or Kruskal-Wallis rank test and a logistic regression model were used for the statistical analysis of the recorded data at the implant level. Results: The diagnosis of peri-implant mucositis and peri-implantitis was made for 173 (41.1%) and 19 (4.5%) implants, respectively. Age (${\geq}65$ years), patient adherence (professional hygiene recalls <2/year) and the presence of plaque were associated with higher peri-implant probing-depth values and bleeding-on-probing scores. The logistic regression analysis indicated that age (P=0.001), patient adherence (P=0.03), the absence of keratinized tissue (P=0.03), implants placed in pristine bone (P=0.04), and the presence of peri-implant soft-tissue recession (P=0.000) were strongly associated with the event of peri-implantitis. Conclusions: Within the limitations of this study, patients aged ${\geq}65$ years and non-adherent subjects were more prone to develop peri-implant disease. Therefore, early diagnosis and a systematic maintenance-care program are essential for maintaining peri-implant tissue health, especially in older patients.

• The Journal of the Korean dental association
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• v.54 no.6
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• pp.429-437
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• 2016

Objectives: Photodynamic therapy has been proven to promote additional clinical and microbiological benefits in the treatment of chronic periodontitis and aggressive periodontitis. The purpose of this study is to assess the effectiveness of the photodynamic therapy for patient with periodontitis. Methods: We searched the eight Korean databases and Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library. Total 300 studies were searched and 13 studies were included in the final assessment. Each of the stages from literature search and extraction of data were carried out independently by 2 researchers. We used tools of Scottish Intercollegiate Guidelines Networks for assessment of the quality of studies. Results: The safety of the photodynamic therapy was assessed by bleeding. The effectiveness of the photodynamic therapy was assessed by the reduction of Probing pocket depth (PPD) and the gain of Clinical attachment level (CAL). The mean difference of PPD was 0.46(95% CI 0.09~0.82), (p=.01).). The mean difference of CAL was ?0.49(95% CI ?1.12~0.14), (p=.13). Conclusion: The additional use of $^{\circ}{\infty}$Antimicrobial Photodynamic Therapy for Periodontitis$^{\circ}{\pm}$ caused hemorrhage to similar extents to conventional treatment modalities, where scaling and root planing are solely performed, in patients with periodontitis who are expected to have a lower degree of treatment response to non-surgical or surgical periodontal therapies (implant or refractory periodontitis) and those where there is a concern for the possible occurrence of antimicrobial side effects or resistance. This indicates that there are no problems with its safety. But there were no consistent reports about the effects of the additional use of photodynamic therapy. This led to a decision that the safety and efficacy of the current technology deserve further studies (Recommendation rating of A, Classification of technology II-a).

• The Journal of the Korean dental association
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• v.45 no.12 s.463
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• pp.753-760
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• 2007

Recently orthodontics in elderly people is continually increasing due to aging of the society arising from decrease of birth rate as well as death rate. As the elderly population grows, needs for oral health care increases, and elderly patients with poor teeth alignment need more attention with orthodontic treatment. Our study analyzes various treatment protocols for different cases of aged orthodontic patients, and following are considerations in orthodontic treatment of elderly patients. 1. Periodontal treatment should be preceded before orthodontic treatment. 2. Periodontal condition should be considered when selecting teeth for extraction 3. In dealing with the residual prosthesis, condition of prosthesis, anchorage availability, and need for size reduction, patient seconomic status should be taken into consideration. 4. Fixed retainers are recommended for retention.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.287-295
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• 2007

As a general treatment modality of subgingival tooth defect in aethetic area, implant or crown and bridge therapy after extraction of affected tooth can be used. But as more conservative treatment, crown lengthening can be considered and not to lose periodontal attachment and impair aethetic appearance, surgical extrusion can be considered as a treatment of choice. In this case report, 3 cases of surgical extrusion was represented and appropriate time for initiation of endodontic treatment according to the post-surgical tooth mobility was investigated. In 8 patient who has subgingival tooth defect in aethetic area, intracrevicular incision is performed and flap was reflected with care not to injure interproximal papillae. With forcep or periotome, tooth was luxated and sutured in properely extruded position according to biologic width with or without $180^{\circ}$ rotation. 8 cases show favorable short and long term results. In some cases, surgical extrusion with $180^{\circ}$ rotation can minimized extent of extrusion and semi-rigid fixation without apical bone graft seems to secure good prognosis. In 8 cases, endodontic treatment started about 3 weeks after surgery. This time corresponds with the moment when mobility of extruded tooth became 1 degree and this results concide with other previous reports. If it is done on adequate case selection and surgical technique, surgical extrusion seems to be a good treatment modalilty to replace the implant restoration in aethetic area.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.6
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• pp.367-373
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• 2018

Background: Fear of local anesthesia (LA) is a significant impediment to dental care as many patients delay or avoid treatment to avert pain. Computer-controlled local anesthetic delivery system (CCLAD), with constant and controlled rate of flow, present a painless alternative. The present study aimed to compare anxiety and pain perceived with conventional and computerized systems, for different stages of anesthesia delivery when administering various nerve blocks. Methods: One hundred patients requiring bilateral LA participated in the study. One side was anesthetized using one system and the contralateral side was anesthetized using the other, in two separate appointments. Patients assigned anxiety scores on a 5-point scale and used the visual analogue scale (VAS) for pain determination at needle insertion, during delivery of anesthetic solution, immediately after injection, and at the end of the periodontal procedure. Each patient's preference for the delivery system of future injections was also recorded. Results: Patients reported significantly lower anxiety levels with CCLAD compared to the syringe. Significantly lower mean VAS scores for anesthesia deposition, pain immediately after, and at the end of the periodontal procedure were also noted. However, pain at needle insertion was comparable between the two systems, with no statistical significance. Overall, 64.4% patients preferred CCLAD for future anesthesia. Conclusion: Lower pain perceived with CCLAD and higher preference for the system suggest that CCLAD should replace conventional syringes to allow pain-free dental treatment.

• Journal of Periodontal and Implant Science
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• v.49 no.4
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• pp.248-257
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• 2019

Purpose: The purpose of this retrospective study was to investigate the relationships of types of dental insurance coverage in Korea with sociodemographic characteristics and the prevalence of systemic and oral diseases, as well as to evaluate the socioeconomic impact of Korean dental insurance policies. Methods: Sample cohort data from 2006 to 2015 were obtained from the National Health Insurance Service. Patients were divided into 2 groups. The exposed group comprised patients who received insurance benefits for complete dentures, removable partial dentures, and implant care, while the control group comprised patients who did not receive these benefits. The type of insurance coverage and the prevalence of systemic and oral diseases were compared between the 2 groups. Results: Patients who received benefits in the form of complete dentures, removable partial dentures, and implants had similar sociodemographic characteristics in terms of sex, age, income quintile, and type of insurance coverage to the control group. The prevalence of hypertension, anemia, renal disease, rheumatoid arthritis, osteoporosis, asthma, and cerebral infarction was higher in the exposed group than in the control group (P<0.05). The prevalence of periodontal diseases and dental caries was also higher in the exposed group. Conclusions: Korean dental health insurance policy has been beneficial for the medical expenses of low-income and elderly people suffering from a cost burden due to systemic diseases. However, since there is a tendency to avoid invasive interventions in older patients due to the high risk of systemic diseases, insurance coverage of dentures may be more helpful from a socioeconomic perspective than coverage of dental implant treatments.

• Journal of Periodontal and Implant Science
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• v.52 no.3
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• pp.194-205
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• 2022

Purpose: This study aimed to determine the long-term outcomes after peri-implantitis treatment and the factors affecting these outcomes. Methods: This study included 92 implants in 45 patients who had been treated for peri-implantitis. Clinical data on the characteristics of patients and their implants were collected retrospectively. The change in the marginal bone level was calculated by comparing the baseline and the most recently obtained (≥3 years after treatment) radiographs. The primary outcome variable was progression of the disease after the treatment at the implant level, which was defined as further bone loss of >1.0 mm or implant removal. A 2-level binary logistic regression analysis was used to identify the effects of possible factors on the primary outcome. Results: The mean age of the patients was 58.7 years (range, 22-79 years). Progression of peri-implantitis was observed in 64.4% of patients and 63.0% of implants during an observation period of 6.4±2.7 years (mean±standard deviation). Multivariable regression analysis revealed that full compliance to recall visits (P=0.019), smoking (P=0.023), placement of 4 or more implants (P=0.022), and marginal bone loss ≥4 mm at baseline (P=0.027) significantly influenced the treatment outcome. Conclusions: The long-term results of peri-implantitis treatment can be improved by full compliance on the part of patients, whereas it is impaired by smoking, placement of multiple implants, and severe bone loss at baseline. Encouraging patients to stop smoking and to receive supportive care is recommended before treatment.