• Journal of Periodontal and Implant Science
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• v.30 no.1
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• pp.203-212
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• 2000

Putrefactive activity within the oral cavity is the principal cause of halitosis. The most common intraoral sites of oral malodor production are tongue, interdental and subgingival areas. The other foci may include faulty restorations, sites of food impaction and abscesses. Periodontal disease frequently involves pathological oral malodor, which is caused mainly by volatile sulfur compounds(VSC), such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. The purpose of this study is to evaluate the association between oral malodor and periodontal status. Volatile sulfur compounds in mouth air were estimated by portable sulfide monitor($Halimeter^{TM}$). The results were as follows : 1. The levels of volatile sulfur compounds were significantly greater in a periodontitis group than in a control group(P<0.01). The amounts of VSC in mouth air from patients with periodontal involvement were four times greater than those of the control group. 2. The significant positive correlation was found between VSC concentrations and the number of pocket depth above 4mm(P<0.01), but correlation between VSC concentrations and plaque score was not statistically significant(P>0.05). 3. In the periodontitis group, VSC concentrations of pre-treatment significantly decreased after scaling and root planing(P<0.01). 4. No statistically significant correlation was found between VSC concentrations and sex / age in the periodontitis group. The above results indicate that periodontal disease may play a role as an important factor of oral malodor and deep periodontal pockets are a source of volatile sulfur compounds.

• The Journal of the Korean dental association
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• v.54 no.8
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• pp.592-603
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• 2016

Pathologic tooth migration (PTM) caused by periodontal disease is a relatively common disease with a prevalance rate of 30~55%. It is one of the reasons for periodontal treatment of patients. PTM occurs when various factors related to the position of the tooth are altered and clinical features of PTM include facial flaring, diastema, proximal tilting, rotation, and extrusion of teeth. The purpose of this study was to assess the treatment of teeth of hopeless prognosis through the practice of modified intentional replantation on pathologic migrated tooth. This study presents cases using modified intentional replantation for the treatment of pathologic tooth migration caused by severe periodontitis. Modified intentional replantation is a technique that prepares extraction socket by using an implant drill. Based on 3 cases performed with modified intentional replantation, an improvement of clinical periodontal indicators such as probing pocket depth, bleeding on probing, tooth mobility, and pathologic teeth migration was observed after surgery. Also, the patients were satisfied with the functional and esthetic improvement.

• The Journal of the Korean dental association
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• v.40 no.7 s.398
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• pp.542-547
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• 2002

This study was aimed to help diagnose the vertical root fractures in endodontically and in nonendodontically treated teeth. This was a study about mine teeth with a vertical root fractures. Four cases were nonendodontically treated teeth and five cases were endodontically treated teeth. A collection of information including past dental history, periodontal probing, and X-ray was gathered on each case. One of the endodontic cases had no periodontal pocket depth and was in acute pain. It was confusing to find whether causes were because of endodontic failure or vertical root fractures. Most of the vertical root fractures were found in patients aged between 50 and 60. Vertical root fractures were found in the molar and premolar of maxillary and mandibular teeth. The second molars repecially, which had C shaped roots had vertical root fractures with apical propagation type. The apical propagation type means that vertical root fracture initiates in root apex and propagate to coronal root. The teeth with vertical root fractures of the apical propagation type, which was in acute pain, were very difficult in differential diagnosis of periodontal lesion and endodontic failure. Therefore, the dental history was very important to make a differential diagnosis. Past pain history repeated uncomfortable symptoms in bite was a key of differential diagnosis.

• The korean journal of orthodontics
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• v.15 no.2
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• pp.291-301
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• 1985

Fifty subjects who were to be treated with fixed orhodontic appliances by light wire edgewise technique were selected. Bands with different marginal depth were made in first molar and direct bonding brackets were bonded in second premolar. For determining the effects of fixed orthodontic appliance on the gingival tissue, the changes of clinical crown length, periodontal pocket depth, gingival sulcus fluid were checked. The results were as follows: 1. Gingival condition was deteriorated after wearing the fixed orthodontic appliance, and the deteriorative rate was decreased gradually. 2. The greatest gingival change was occurred in the maxillary first molar among the experimental teeth. 3. The gingival change of maxillary teeth was greater than that of mandibular teeth. $(p\leq0.01)$ 4. The greater gingival change was occurred around subgingivally located band than around supragingivally located band. 5. Comparing the gingival changes of banded teeth with them of bonded teeth, the gingival tissue was more effected by oral hygiene than by type of appliances. 6. In the quantitive changes of gingival crevicular fluid, there was no exact relationship with gingival inflammation.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.893-914
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• 1999

Tooth mobility may be the decisive factor that determines whether dental treatment of any kind is undertaken. Although tooth mobility in isolation says little in itself, the finding of increased tooth mobility is of both diagnostic and prognostic importance. Only the detection of an increase or decrease in mobility makes an evaluation possible. Thus prior to treatment, we must understand the pathologic process causing the observed the tooth mobility and decide whether the pattern and degree of observed tooth mobility is reversible or irreversible. And then it must be decided whether retention and treatment or extraction and replacement. The purpose of this study was to compare tooth mobility at different time period during root planing and flap operation and to relate changes in mobility to each treatment method. Twenty-one patients (287 teeth) with chronic adult periodontitis were treated with root planing(control group) and flap operation(experimental group), and each group was divided 3 subgroups based upon initial probing pocket depth (1-3mm, 4-6mm, 7mm and more). Tooth mobility was measured with $Periotest^{(R)}$ at the day of operation, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 8 weeks, 12 weeks after each treatment. Tooth mobility, attachment loss, radiographic bone loss, and bleeding on probing were measured at the day of operation, 4 weeks, 8 weeks and 12 weeks after treatment. 1. In group initial probing depth was 1-3mm, tooth mobility had no significant difference after root planing and flap operation. 2 . In group initial probing depth was 4-6mm, 7mm and more, tooth mobility had decreased in 12 weeks after root planing(p<0.01). And the mobility had increased after flap operation(p<0.01) and was at peak in 1 week, and decreased at initial level in 4 weeks, below the initial level in 12 weeks(p<0.01). 3. In 1 week, significant difference in tooth mobility between control and experimental group was found(p<0.01) but, in 12 weeks no difference between two groups was found. 4. Change of immediate tooth mobility after treatment was more larger in deep pocket than in shallow one. In group with the same probing pocket depth, the change of tooth mobility in molar group was greater than that of premolar group. 5. Tooth mobility before treatment was more strongly correlated with radiographic bone loss (r=0.5325) than probing depth, attachment loss and bleeding on probing, in 12 weeks after treatment, was more strongly correlated with attachment loss($r^2$=0.4761) than probing depth and bleeding on probing. Evaluation of the treatment effect and the prognosis after root planing and flap operation were meaningful on tooth initial probing depth 4mm and more. After flap operation, evaluation of the prognosis should be performed at least in 4 weeks and in 12 weeks after treatment, no difference in tooth mobility between two groups was observed. Radiographic bone loss and attachment loss were good clinical indicators to evaluate tooth mobility.

• Journal of Periodontal and Implant Science
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• v.51 no.1
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• pp.53-62
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• 2021

Purpose: This study aimed to evaluate the clinical and microbiological efficacy of adjunctive local delivery of minocycline (Periocline^®) in patients receiving supportive periodontal therapy (SPT) after initial treatment. Methods: The participants were 16 men and 8 women (age, 20-65 years) who had at least 15 natural teeth, underwent SPT for more than 1 year due to chronic periodontitis, had 4 or more periodontal pocket sites deeper than 5 mm, and showed >25% gingival bleeding on probing (BoP). They were randomly assigned to the test and control groups. In the test group, mechanical debridement and local antibiotic delivery were performed for all periodontal sulci/pockets; in the control group, mechanical debridement and saline irrigation were performed. In patients who underwent SPT for more than 1 year, clinical and microbiological examinations were performed at baseline and 1 and 3 months after SPT. The clinical examination included an assessment of the periodontal pocket depth, clinical attachment level, plaque index, and BoP. Microbial tests were performed using real-time polymerase chain reaction; the relative ratios of Porphyromonas gingivalis and Fusobacterium nucleatum were determined. Results: Both groups showed significant improvements in clinical parameters at 1 and 3 months from baseline; there were no significant changes between months 1 and 3. Intergroup differences were insignificant. The microbiological analysis revealed no significant differences in P. gingivalis and F. nucleatum ratios across time points. While intergroup differences were insignificant, there was a tendency for the P. gingivalis and F. nucleatum ratios to decrease in the test group. Conclusions: Mechanical debridement in patients receiving maintenance therapy resulted in clinically significant improvement; the effectiveness of additional local delivery of antibiotics was not significant. The ratios of P. gingivalis and F. nucleatum showed a tendency to decrease in the test group, although it was not significant.

• Journal of Periodontal and Implant Science
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• v.50 no.2
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• pp.83-96
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• 2020

Purpose: The present study aimed to evaluate the clinical benefit of additional toothbrushing accompanying non-surgical periodontal treatment on oral and general health in patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a doubled-blind randomized controlled trial in 60 T2DM patients between June 2013 and June 2014. The patients were randomly assigned to the scaling and root planing (SRP) group; the scaling and root planing with additional toothbrushing (SRPAT) group, in which additional toothbrushing was performed by toothpick methods; or the control group. Microbiological and oral examinations were performed for up to 12 weeks following treatment. Non-surgical treatment was conducted in the experimental groups. The SRP group received scaling and root planing and the SRPAT group received additional toothbrushing with the Watanabe method once a week from the first visit through the fifth visit. The primary outcomes were changes in haemoglobin A1c (or glycated haemoglobin; HbA1c) levels, serum endotoxin levels, and interleukin-1 beta levels. Periodontal health status was measured by periodontal pocket depth, the calculus index, and bleeding on probing (BOP). Results: Both the SRP and SRPAT groups showed improvements in periodontal health and HbA1c, but the SRPAT group showed significantly less BOP than the SRP group. Furthermore, only the SRPAT group showed a statistically significant decrease in serum endotoxin levels. Conclusions: Non-surgical periodontal treatment was effective in improving HbA1c and serum endotoxin levels in T2DM patients. Furthermore, non-surgical treatment with additional tooth brushing had a more favourable effect on gingival bleeding management. Trial RegistrationClinical Research Information Service Identifier: KCT000416.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.647-657
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• 2004

A non-carious cervical lesion(NCCL) is the loss of tooth structure at the cementoenamel junction level that is unrelated to dental caries. This study was to evaluate the occlusal and periodontal status of teeth with non-carious cervical lesions. We evaluated 105 teeth with non-carious cervical lesions in 35 subjects aged 38-75 years and characterized them based on the shape and dimension, plaque retention, bleeding on probing(BOP), probing pocket depth(PPD), occlusal status, brushing type, hypersensitivity and wear facet. The results of this study were as follows 1. No significant association was observed between cervical lesions and occlusal contact in lateral excursions. 2. No significant difference occurred in plaque retention, PPD, BOP between teeth with and without cervical lesions. 3. Test teeth had a significantly higher percentage of hypersensitivity and occlusal wear facet than teeth without cervical lesions. 4. Wedge shaped lesions had a significantly higher percentage of plaque than saucer shaped lesions. 5. Teeth with plaque were found to have significantly deeper PPD than teeth without plaque retention in cervical regions. 6. Teeth with occlusal contacts were found to have significantly deeper PPD than teeth without occlusal contacts. 7. No significant association was observed between cervical lesions and PPD independent of plaque retention and occlusal contacts Although more knowledge is necessary, our results suggest that occlusal contact and bacterial plaque may influence on periodontal tissue, but NCCL is not directly associated with periodontal health

• Journal of Periodontal and Implant Science
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• v.43 no.4
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• pp.177-182
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• 2013

Purpose: Diabetes and periodontal disease are two common diseases with high prevalence rates. Recent evidence has shown a bidirectional relationship between diabetes and periodontitis. The aim of this study was to investigate the effects of nonsurgical periodontal therapy on glycemic control in type 2 diabetes mellitus patients. Methods: Sixty subjects aged 35-45 years with blood sugar controlled by oral hypoglycaemic agents were randomly divided equally among 3 groups: group A (scaling, mouthwash, and brushing), group B (mouthwash and brushing), and group C (brushing only). Glycated haemoglobin (HbA1c), fasting blood sugar (FBS), probing pocket depth (PPD), gingival index (GI), plaque index (PI), and the relevant drug history were recorded at baseline and after 3 months of intervention. Comparison of the mean difference among the variables was performed by parametric and nonparametric tests, which were further evaluated using multiple regression analysis. Results: The mean differences between the PPD, FBS, HbA1c, GI, and PI in groups A and B were found to be statistically significant (P<0.001). Multiple regression analysis in group A showed that out of all the independent variables, GI and frequency of drug administration independently (b=0.3761 and b=0.598) showed a significantly greater impact on HbA1c ($R^2$=0.832, P<0.05). Conclusions: Nonsurgical periodontal therapy can effectively decrease HbA1c levels in type 2 diabetes mellitus patients on medication.

• Journal of Periodontal and Implant Science
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• v.51 no.3
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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.