• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.61-68
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• 2006

The factors influencing long-term prognosis of teeth must be carefully considered. Among these, attachment level is strongly associated with tooth loss. The purpose of the present study was to estimate pattern of attachment loss based on attachment area in extracted teeth. 197 satisfied the criteria for assessment after staining. The protocol described by Waerhaug(l975) was performed. An indir ect method, based on digital image abstracted from digital camera and digital imaging software program, was used to calculate the root surface area and the attachment loss area. The data were analysed using SPSS. Except maxillary central incisior and mandibular canine, no statistical significant differences between each root surfaces were observed in anterior teeth. In posterior teeth, statistical significant differences in palatal surface of maxillary molar and mandibular molar compared with others were observed. Statistical significant difference in buccal surface compared with others was lowly observed in single and multi rooted. This study did not reveal progressive loss pattern of attachment area in each root surface but clarified root surface that has relative high loss rate of attachment area at extraction. Thus understanding this pattern of attachment loss is helpful for dentist to treat the periodontitis.

• Journal of Periodontal and Implant Science
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• v.42 no.1
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• pp.3-12
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• 2012

Purpose: Anti-rheumatic agents target common molecular pathways of inflammation in rheumatoid arthritis (RA) and periodontitis. The purpose of this study was to determine the relative effect of anti-rheumatic agents on the levels of inflammatory biomarkers and periodontal inflammation in RA patients with periodontitis. Methods: A systematic review and meta-analysis were conducted of studies comparing periodontal parameters of inflammation, such as bleeding on probing, and biomarkers of inflammation in RA patients with periodontitis and healthy adults with and without periodontitis. The search included the electronic databases MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar, inclusive through October 2011, with no language restrictions. Hand searches were conducted of the bibliographies of related journals and systematic reviews. Observational and interventional studies assessing the effects of antirheumatic therapy qualified for inclusion. Two reviewers performed independent data extraction and risk-of-bias assessment. Of the 187 identified publications, 13 studies fulfilled the inclusion criteria. Results: When compared to healthy adults without periodontitis, RA subjects were found to have significantly higher levels of bleeding on probing and limited evidence of higher levels of interleukin-$1{\beta}$ and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in gingival crevicular fluid and saliva. No consistent differences were found in periodontal parameters and inflammatory biomarkers between RA subjects and adults with periodontitis. Studies evaluating the effect of anti-TNF-${\alpha}$ therapy in RA subjects with periodontitis have yielded inconsistent results. Conclusions: There are limited data, however, to suggest that anti-TNF-${\alpha}$ agents can reduce local production of inflammatory cytokines and periodontal inflammation in RA patients with periodontitis.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.51-59
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• 2002

The aim of the present study was to investigate the distribution of periodontally hopeless teeth in patients who had not been treated. Five hundred nineteen teeth of 163 patients who had visited at the Department of Periodontology, Chonbuk National University Hospital during the period from January 1999 to July 2001 were selected as a periodontally hopeless tooth. Selection criteria were as follows: 1) probing pocket depth more than 8mm, 2) tooth mobility of degree III, 3) radiographic bone loss more than 75%. The contralateral tooth to a hopeless tooth (experimental tooth) was designated as a control tooth. Between the experimental and control tooth, differences in probing pocket depth, tooth mobility and amount of radiographic bone loss were examined as well as correlation. The results showed that hopeless teeth were most frequently found in the maxillary first molar position and least frequently in the maxillary canine position. Differences between experimental and control teeth were 2mm in probing depth, 1 degree in tooth mobility, and 20% in amount of bone loss (p<0.01). The periodontal conditions between the experimental and control teeth showed correlation in general, however, statistical significances were found in posterior teeth positions. Within limitations of this study, it can be concluded that local factors may play a role in deterioration of periodontal disease along with symmetrical character of periodontal disease.

• Journal of Periodontal and Implant Science
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• v.36 no.4
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• pp.809-816
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• 2006

Periodontal disease accompany the inflammation around periodontal tissue and generally periodontal destruction is followed, This destruction often makes the molar teeth have furcation defect. And to treat molar furcation involvement, resective surgery such as root resection and ostectomy and regenerative procedure such as guided tissue regeneration were introduced. Also implant can be considered as one of the good treatment methods, Among these treatment alternatives, root resection can be considered as a good procedure in the point of saving one's natural teeth or amount of cost. Therefore the purpose of this article is to evaluate root-resected teeth which were done at least 2 years ago. 70 root-resected teeth in 58 patient who visited Kyungpook National University Hospital were included in this study. They were evaluated by two clinical method. One is subjective evaluation and another is objective evaluation. To evaluate subjective outcome, 58 patients answered to the questionnaire if they experienced tooth extraction, bleeding, swelling, pain, mobility and chewing problem. To evaluate objective outcome, 28 teeth was evaluated according to Langer's criteria. The subjective result showed 82% of success rate and 18% of failure rate. 13 of 70 teeth showed discomfort and were considered as failure, which include chewing problem (39%) and pain (23%). The objective outcome showed that 4 failure (14% failure rate) which were 2 cases of bone loss by periodontal problem, one endodontic problem and one untreatable caries. By these limited results, some of clinical consideration in root resective procedure can be suggested. Periodontal support and less occlusal loading on resected tooth should be evaluated before the procedure, moreover, good oral hygiene is essential. When these factors are considered carefully, the root resection may produce predictive outcomes in the treatment of furcational involvement.

• The korean journal of orthodontics
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• v.29 no.6 s.77
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• pp.637-648
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• 1999

Finishing is usually accomplished about four to seven months before the removal of orthodontic appliance in order to achieve ideal occlusion and excellent aesthetics. This process, called finishing, is the key to obtain excellent final results. Some of orthodontists believe it can be accomplished at the final stage of orthodontic treatment, and they complete it without their special rationale and criteria for finishing. However, it should be considered as a part of the total treatment plan from the beginning to end, and a guideline for finishing, which is based on rationale and criteria for the removal of orthodontic appliance, is needed to obtain the desired results. The guideline should include a checklist for finishing. This checklist is divided into four categories: occlusal, aesthetic, periodontal, and habitual factors. Occlusal fators include alignment, marginal ridge discrepancy, interproximal contact, anterior inclination, posterior inclination, over-jet over-bite, arch fen and functional occlusion. Aesthetic factors include gingival form, crown fen crown width, and crown length. Periodontal factors include root angulation, bone level, and black hole in periodontal factors. Habitual factors consist of mouth breathing, tongue position at rest, tongue thrust, lip biting, nail biting, and finger sucking

• Journal of the Korean Academy of Esthetic Dentistry
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• v.25 no.1
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• pp.50-63
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• 2016

Successful treatment in the anterior esthetic prosthetic can be a balance between aesthetics in the facial, tooth, and periodontal tissue in the oral. In the case of facial symmetry of patients with normal occlusal plane, If you establish criteria of finding balance of aesthetics such as a several books and articles and manufacture a prostheses by the established-criteria, you can manufacture a harmonious and aesthetic prostheses without any trouble. However, in the case of patients with facial asymmetry, if you manufacture a tooth as patient's facial aesthetic symmetry by force even facial asymmetry case, you can't get a result not only aesthetic but also functional prostheses. Also, to produce the prosthetic of harmonious and aesthetic with periodontal tissue, and excellent self-cleansing function, you must apply to the form of the prosthetic changed dental environment.

• Journal of Periodontal and Implant Science
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• v.48 no.2
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• pp.103-113
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• 2018

Purpose: The purpose of this retrospective study with 4-12 years of follow-up was to compare the marginal bone loss (MBL) between external-connection (EC) and internal-connection (IC) dental implants in posterior areas without periodontal or peri-implant disease on the adjacent teeth or implants. Additional factors influencing MBL were also evaluated. Methods: This retrospective study was performed using dental records and radiographic data obtained from patients who had undergone dental implant treatment in the posterior area from March 2006 to March 2007. All the implants that were included had follow-up periods of more than 4 years after loading and satisfied the implant success criteria, without any peri-implant or periodontal disease on the adjacent implants or teeth. They were divided into 2 groups: EC and IC. Subgroup comparisons were conducted according to splinting and the use of cement in the restorations. A statistical analysis was performed using the Mann-Whitney U test for comparisons between 2 groups and the Kruskal-Wallis test for comparisons among more than 2 groups. Results: A total of 355 implants in 170 patients (206 EC and 149 IC) fulfilled the inclusion criteria and were analyzed in this study. The mean MBL was 0.47 mm and 0.15 mm in the EC and IC implants, respectively, which was a statistically significant difference (P<0.001). Comparisons according to splinting (MBL of single implants: 0.34 mm, MBL of splinted implants: 0.31 mm, P=0.676) and cement use (MBL of cemented implants: 0.27 mm, MBL of non-cemented implants: 0.35 mm, P=0.178) showed no statistically significant differences in MBL, regardless of the implant connection type. Conclusions: IC implants showed a more favorable bone response regarding MBL in posterior areas without peri-implantitis or periodontal disease.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.87-95
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• 2013

Purpose: The purpose of this study was to analyze the expression of inducible nitric oxide synthases (iNOS), tissue inhibitors of metalloproteinase $(TIMP)_{-3}$, and $TIMP_{-4}$ in the gingival tissues of periodontal patients with or without type 2 diabetes mellitus (DM). Methods: Depending on the patient's systemic condition and clinical criteria of the gingiva, each gingival sample was classified into one of three groups. Sixteen clinically, systemically healthy patients (group 1), 16 periodontal patients (group 2), and 16 periodontal patients with DM (group 3) were included. Tissue samples in each group were collected, prepared, and analyzed by western blotting. Quantification of the relative amount of $TIMP_{-3}$, $TIMP_{-4}$, and iNOS was performed. Results: The expression levels of iNOS and $TIMP_{-3}$ both increased in group 1, group 2, and group 3 in increasing order, and were significantly higher in both group 2 and group 3 as compared to group 1 (P<0.05). The expression levels of $TIMP_{-4}$ increased in the same order, but significantly increased in group 2 as compared to group 1, in group 3 as compared to group 1, and group 3 as compared to group 2 (P<0.05). Conclusions: This study demonstrated that iNOS, $TIMP_{-3}$, and $TIMP_{-4}$ might be involved in the progression of periodontal inflammation associated with type 2 DM. It is thought that further study of these factors can be applied practically for the diagnosis and control of periodontitis in diabetics.

• Journal of Periodontal and Implant Science
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• v.51 no.3
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• pp.179-188
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• 2021

Purpose: Due to the difficulty of the hygienic care and sanitary management of abutment teeth and subpontic areas associated with fixed dental prostheses (FDPs), intrabony defects occur and accelerate due to the accumulation of plaque and calculus. This study aimed to evaluate the efficacy of regenerative periodontal surgery for intrabony defects associated with FDPs. Methods: The study inclusion criteria were met by 60 patients who underwent regenerative treatment between 2016 and 2018, involving a total of 82 intrabony defects associated with FDPs. Periodontal osseous lesions were classified as 1-, 2-, and 3-wall intrabony defects and were treated with an enamel matrix derivative in combination with bone graft material. The changes in clinical (pocket probing depth [PPD] and clinical attachment level [CAL]) and radiographic (defect depth and width) outcomes were measured at baseline and at 6, 12, and 24 months. Results: Six months after regenerative treatment, a significant reduction was observed in the PPD of 1-wall (P<0.001), 2-wall (P<0.001), and 3-wall (P<0.001) defects, as well as a significant reduction in the CAL of 2-wall (P<0.001) and 3-wall (P<0.001) intrabony defects. However, there was a significant increase in the CAL of 1-wall intrabony defects (P=0.003). Radiographically, a significant reduction in the depth of the 3-wall (P<0.001) defects and a significant reduction in the width of 2-wall (P=0.008) and 3-wall (P<0.001) defects were observed. The depth decreased in 1-wall defects; however, this change was not statistically significant (P=0.066). Conclusions: Within the limitations of the current study, regenerative treatment of 2- and 3-wall intrabony defects associated with FDPs improved clinical and radiological outcomes. Additional prospective studies are necessary to confirm our findings and to assess long-term outcomes.

• Journal of Periodontal and Implant Science
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• v.40 no.1
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• pp.33-38
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• 2010

Purpose: The purpose of this study was to observe and quantify the expression of interleukin-4 (IL-4), interferon-$\gamma$ (IFN-$\gamma$), and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) in the gingival tissue of patients with type 2 diabetes mellitus (DM) and healthy adults with chronic periodontitis. Methods: Twelve patients with type 2 DM and chronic periodontitis (Group 3), twelve patients with chronic periodontitis (Group 2), and twelve healthy individuals (Group 1) were included in the study. Clinical criteria of gingival (sulcus bleeding index value, probing depths) and radiographic evidences of bone resorption were divided into three groups. The concentrations of cytokines were determined by a western blot analysis and compared using one-way ANOVA followed by Tukey's test. Results: The expression levels of IFN-$\gamma$ and TIMP-2 showed an increasing tendency in Groups 2 and 3 when compared to Group 1. On the other hand, the expression of IL-4 was highest in Group 1. Conclusions: The findings suggest that IFN-$\gamma$ and TIMP-2 may be involved in the periodontal inflammation associated with type 2 DM. IL-4 may be involved in the retrogression of the periodontal inflammation associated with type 2 DM.