• Journal of Periodontal and Implant Science
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• 제33권2호
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• pp.247-257
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• 2003

The purpose of this study was to evaluate the difference of subgingival bacterial compositions between periodontally healthy and diseased sites. Subgingival plaque samples were obtained from 100 sites in 20 untreated adult periodontitis patients(experimental group), and 100 sites in healthy individuals(contro1 group). Before sampling, probing pocket depth(PPD) and clinical level of attachment(CAL), Plaque Index(PI), and Sulcus Bleeding Index(SBI) were recorded for each sampled sites. Microbial samples were collected from the bases of gingival sulci or periodontal pockets with sterile curettes. The samples were examined under darkfield microscope(${\times}$400). At least 150 bacteria were evaluated and categorized on the basis of bacterial morphology and motility, i.e. cocci, non-motile rods, motile rods, and spirochetes. In control group, subgingival microbial flora consisted of 73.7% of cocci, 20.0% of non-motile rods, 4.3% of motile rods, and 2.0% of spirochetes. The microbial samples from experimental group consisted of 51.5% of cocci, 19.4% of non-motile rods, 17.6% of motile rods, and 11.6% of spirochetes. The proportion of cocci was higher in control group than in experimental group. Proportions of motile rods and spirochetes were higher in experimental group than in control group. The proportion of nonmotile rods in experimental group and control group was not significantly different. Sulcus Bleeding Index and Plaque Index showed high correlation with the bacterial composition. These findings suggests that examination of subgingival bacterial proportion may serve as more sensitive mirror of the local periodontal status than clinical parameters.

• Journal of Periodontal and Implant Science
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• 제25권3호
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• pp.648-658
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• 1995

The present study has been performed to evaluate the clinical, microbiological, biochemical and immunological parameters associated with the periodontal disease activity in adolescent periodontitis. 21 young adolescents with evidences of periodontal attachment loss participated in the study for upto 3 years of examination. Probing pocket depths and attachment levels of whole dentitions were annually recorded and 4 deepest pockets, with initial probing depth ${\geq}$ 4mm, were selected as the representative experimental sites of a patient. Sites experiencing attachment loss ${\geq}$ 1mm during the 3-year experimental period were designated as the active sites and these sites were examined for the microbiological and biochemical profiles at the time when attachment loss occurred. Microbiological assay included cultural studies and PerioScan for monitoring BANA(+) organisms(e.g. Porphyromonas gingivalis, Treponema denticola, Bacteriodes forsythus). Biochemical assay has been performed for monitoring GCF levels of neutral protease. Serum IgG and IgG2 titers against Porphyromonas gingivalis 381 were determined of a patients at the beginning and the end of the study, respectively for patient-based analysis. The results indicated that the parameters consisting of microbiological cultures and GCF neutral protease exhibited low association with the periodontal disease activity in adolescents. However, the specificity for microbiological culture of the selected periodontopathic organisms(Aa,Pg,Pi) were considerably high. Moreover, the clinical pameters such as bleeding on probing and presence of plaque as well as IgG levels against Pg at the baseline exminations were closely associated with the subsequent evidences of attachment loss during the whole experimental period(3-year).

• Journal of Periodontal and Implant Science
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• 제51권2호
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• pp.124-134
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• 2021

Purpose: The aim of this study was to assess the association between the clinical status of rheumatoid arthritis (RA) and periodontitis (PD) in patients diagnosed with PD and to evaluate the impact of RA treatment on the severity of PD. Methods: The study included 148 participants with PD, of whom 64 were also diagnosed with RA (PD+RA group), while 84 age-matched participants were rheumatologically healthy (PD-only group). PD severity was assessed by the following periodontal parameters: clinical attachment loss, probing pocket depth (PPD), bleeding on probing (BOP), alveolar bone loss, and number of missing teeth. RA disease characteristics and impact of disease were evaluated by the Disease Activity Score 28 using C-reactive protein, disease duration, RA treatment, the RA Impact of Disease tool, and the Health Assessment Questionnaire. Outcome variables were compared using parametric and non-parametric tests and associations were evaluated using regression analysis with the calculation of odds ratios (ORs). Results: Participants in the PD+RA group had higher mean PPD values (2.81 ± 0.59 mm vs. 2.58 ± 0.49 mm, P=0.009) and number of missing teeth (6.27±4.79 vs. 3.93±4.08, P=0.001) than those in the PD-only group. A significant association was found between mean PPD and RA (OR, 2.22; 95% CI, 1.16-4.31; P=0.016). Within the PD+RA group, moderate to severe periodontal disease was significantly more prevalent among participants with higher RA disease activity (P=0.042). The use of biologic disease-modifying antirheumatic drugs (bDMARDs) was associated with a lower BOP percentage (P=0.016). Conclusions: In patients with PD, RA was associated with a higher mean PPD and number of missing teeth. The severity of PD was affected by the RA disease clinical activity and by treatment with bDMARDs, which were associated with a significantly lower mean BOP percentage.

• Journal of Periodontal and Implant Science
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• 제52권2호
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• pp.116-126
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• 2022

Purpose: This study evaluated the efficacy of treating periodontitis using subgingival nano-hydroxyapatite powder with an air abrasion device (NHAPA) combined with scaling and root planing (SRP). Methods: A total of 28 patients with stage III periodontitis (grade B) were included in this study, although 1 was lost during follow-up and 3 used antibiotics. The patients were divided into a test group and a control group. All patients first received whole-mouth SRP using hand instruments, and a split-mouth approach was used for the second treatment. In the test group, the teeth were treated with NHAPA for 15 seconds at 70% power per pocket. Subgingival plaque samples were obtained from the 2 deepest pockets at the test and control sites before treatment (baseline) and 3 months after treatment. The full-mouth plaque index (PI), gingival index (GI), papillary bleeding index (PBI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and at 1- and 3-month post-treatment. Real-time polymerase chain reaction was used to determine the colonisation of Treponema denticola (Td), Porphyromonas gingivalis (Pg), and Aggregatibacter actinomycetemcomitans in the subgingival plaque. Results: From baseline to the first month, the test group showed significantly larger changes in BOP and CAL (43.705%±27.495% and 1.160±0.747 mm, respectively) than the control group (36.311%±27.599% and 0.947±0.635 mm, respectively). Periodontal parameters had improved in both groups at 3 months. The reductions of PI, GI, BOP, PD, and CAL in the test group at 3 months were greater and statistically significant. The total bacterial count and Td and Pg species had decreased significantly by the third month in both groups (P<0.05). Conclusions: Applying NHAPA in addition to SRP improves clinical periodontal parameters more than SRP alone. Subgingival NHAPA may encourage clot adhesion to tooth surfaces by increasing surface wettability.

• Journal of Periodontal and Implant Science
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• 제53권6호
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• pp.406-416
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• 2023

Purpose: No evidence exists regarding the advantages of periodontal regeneration treatment for furcation defects using soft block bone substitutes. Therefore, this randomized controlled trial aimed to assess the clinical and radiographic outcomes of regenerative therapy using porcine-derived soft block bone substitutes (DPBM-C, test group) compared with porcine-derived particulate bone substitutes (DPBM, control group) for the treatment of severe class II furcation defects in the mandibular molar regions. Methods: Thirty-five enrolled patients (test group, n=17; control group, n=18) were available for a 12-month follow-up assessment. Clinical (probing pocket depth [PPD] and clinical attachment level [CAL]) and radiographic (vertical furcation defect; VFD) parameters were evaluated at baseline and 6 and 12 months after regenerative treatment. Early postoperative discomfort (severity and duration of pain and swelling) and wound healing outcomes (dehiscence, suppuration, abscess formation, and swelling) were also assessed 2 weeks after surgery. Results: For both treatment modalities, significant improvements in PPD, CAL, and VFD were found in the test group (PPD reduction of 4.1±3.0 mm, CAL gain of 4.4±2.9 mm, and VFD reduction of 4.1±2.5 mm) and control group (PPD reduction of 2.7±2.0 mm, CAL gain of 2.0±2.8 mm, and VFD reduction of 2.4±2.5 mm) 12 months after the regenerative treatment of furcation defects (P<0.05). However, no statistically significant differences were found in any of the measured clinical and radiographic parameters, and no significant differences were observed in any early postoperative discomfort and wound healing outcomes between the 2 groups. Conclusions: Similar to DPBM, DPBM-C showed favorable clinical and radiographic outcomes for periodontal regeneration of severe class II furcation defects in a 12-month follow-up period.

• 한방안이비인후피부과학회지
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• 제37권2호
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• pp.14-26
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• 2024

Objectives : The purpose of this study is to assess the feasibility of conducting a study on traditional Korean medicine treatments for periodontal diseases, specifically gingivitis and mild periodontitis. Methods : This study will employ a randomized, controlled, parallel-group design. Subjects with gingivitis and mild periodontitis will be recruited in one university hospital. In total, 45 subjects will be randomized into three arms (Acupuncture therapy group, herbal mouthwash group and usual care group), and will be followed up for 4 weeks. We will assess clinical variables such as, pocket depth, bleeding on probing, gingival index, plaque index, visual analog scale, uroqol-5 dimensions-5 levels to analyze changes in microbial flora before and after the intervention. Results : The protocol for this study was approved by the Institutional Review Board (IRB) of Dongguk University Ilsan Oriental Medicine Hospital, and registered with the Korean Clinical Trial Registry on March 29, 2024. Conclusions : This study is the first clinical research on periodontal diseases conducted in a Korean traditional medicine institution. The research aims to broaden the scope of traditional Korean medicine and is expected to serve as crucial data for future large-scale studies.

• Journal of Periodontal and Implant Science
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• 제26권2호
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• pp.531-541
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• 1996

Periodontal disease is characterized by destruction of supporting tissues caused by invasion of plaque bacteria and defense mechanism of host. Many dentists are very interested in laser therapy on various intraoral soft tissue lesions including inflammatory periodontal pocket. In order to determine the therapeutic effect of intrapocket irradiation of a pulsed- Nd : YAG laser on the inflammatory periodontal pockets, bilateral 60 teeth with 4-6mm in probing pocket depth and gingival inflammation were selected and evaluated by sulcus bleeding index(SBI), and plaque index(pI) for baseline record. Intrapocket irradiation($300{\mu}m$ fiber optic, I.5W power, for 2 min.) of a pulsed-Nd : YAG laser(EL.EN.EN060, Italy) was applied on half of them. As the control group, the same procedure except power-off was repeated on the contralateral 30 teeth. At 1-, 2-, 3-, and 4-week after intrapocket manipulation, every tooth was reevaluated by the same clinical indices. And the difference between the lased group and control group was statistically analyzed by paired t-test and Chi-square test in Microstat program. Following results were obtained: 1. Until I-week and 2-week after intrapocket manipulation, SBI was lowered in both lased group and control group, compared to baseline SBI, but from 3-week after, the recovering tendency toward baseline was noted, and at only 2-week after, the number of teeth showing lowered SBI was significantly more in lased group than in control group(p<0.05). 2. PI of both lased group and control group was lowered through whole experimental period from I-week to 4-week after, compared to baseline PI(p<0.05), but there was no significant difference between lased group and control group(p>0.1). The results suggest that intrapocket irradiation of a pulsed-Nd:YAG laser may lead somewhat remission of gingival inflammation, but for more favorable therapeutic result the thorough root planing should be necessarily accompanied with gingival curettage.

• Journal of Periodontal and Implant Science
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• 제35권3호
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• pp.563-575
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• 2005

The aim of present study is to evaluate the influence of adjacent tooth to the microbiology of clinically healthy implant. Control group included patients who had clinically healthy implant and tooth with healthy $periodontium(PD{\leq}3mm)$, test group was composed of patients who had clinically healthy implant and tooth with periodontal pocket(PD>3mm). The criteria of clinically health implant are no pain or discomfort, the restorative suprastructure provide satisfactory fit and function, and the tissue around the fixtures were firm and probing with standard periodontal probe with a rounded tip 0.5mm in diameter resulted in penetration of no more than 5mm when using a force of 0.5N at any location. 38 patients, partially edentulous subjects with endosseous root-form implants were selected. All subjects were medically healthy and had not taken systemic antibiotics and professional plaque control 3 months before sampling. Number of control group is 25(mean age $52{\pm}13$, 26 teeth, 34 implants) and test group is 13(mean age $60{\pm}13$, 13 teeth, 17 implants). All teeth and implants of each patient were examined probing depth(PD), bleeding on probing(BOP), and plaque index(PI), and samples of subgingival plaque were obtained at each site with sterile curet or fine paper points, then the plaque transferred to PBS. Obtained samples were examined for the presence of P. gingivalis, T. forsythensis, and T. denticola by the polymerase chain reaction(PCR). The relationship among clinical parameters and the colonizations by the 3 bacterial species from natural teeth and implants region were analyzed by student t-test. The results of this study were as follows: 1. PD was different in teeth between 2 groups(p<0.05), but the other parameters were not. 2. Statistically significant difference was not found in clinical parameters of implants between 2 groups. 3. All bacterial prevalences of teeth were higher in test group than in control group, and prevalence of T. forsythensis had statistically significant difference between 2 groups(p<0.05). 4. Prevalences of P. gingivalis and T. forsythensis are higher in test group than control group, and that of T. denticola is higher in control group than in test group. But there were no statistically significant differences between 2 groups. In conclusion, there is no statistically significant difference in prevalence of implant microbiology between 2 groups. But if the number of samples increased, it will be possible to find out statistical significance in prevalence of P. gingivalis. It seems that pocket of adjacent tooth influences prevalence of P. gingivalis. These results mean that improvement of the periodontal condition before implantation is very important.

• Journal of Periodontal and Implant Science
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• 제34권2호
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• pp.255-268
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• 2004

The purpose of the research is to compare the distribution of Black-pigmented Bacteroides between Chronic Periodontitis and Aggressive Periodontitis. P. gingivalis, P. intermedia and P. nigrescens were examined in order to evaluate their distribution in patients with Chronic Periodontitis(CP) and Aggressive Periodontitis(AP). PCR and dot-blots hybridization of 16s rRNA gene were used to compare bacterial distribution of two groups - CP group and AP group, which were divided into two subgroups. Subgingival plaque taken from the diseased sites(pocket $depth{\geq}6$ mm) and healthy sites(pocket $depth{\leq}3$ mm) were grouped into the experimental group and the control group. The result are as follows ; 1. The distribution of P. gingivalis was 98.33% for chronic Periodotitis(CP), 94.17% for Aggressive Periodontitis(AP), the distribution of P. intermedia was 77.50% for CP, 64.17% for AP, and the distribution of P. nigrescens was 35.00%, 29.17%. In all 3 types of bacteria, CP group showed higher distribution compared to AP group, but only P. intermedia showed statistically significant difference. 2. In the case of CP, every type of bacteria showed higher distribution in the experimental group with statistically significant difference. 3. In the case of AP, every type of bacteria also showed higher distribution in the experimental group, but P. gingivalis and p..intermedia showed the result with statistically significant difference, and the other did not 4. In 3 all bacteria type, N-AP showed higher distribution than N-CP without statistically significant difference These results suggest that the comparison of the distribution of Bacteroides between Chronic Periodontitis and Aggressive Periodontitis has no statistically significant difference, except P. intermedia.

• Journal of Periodontal and Implant Science
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• 제39권1호
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• pp.53-58
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• 2009

Purpose: The resective treatment in mandibular Degree III furcation areas includes root resection and tunnel preparation. The purpose of this retrospective study is to evaluate which treatment procedure(root resection vs tunnel preparation) has more favorable prognosis in mandibular Degree III furcation involvement. Materials and methods: The subjects of this study were patients who were treated their mandibular posteriors with either root resection(22 teeth on 22 patients) or tunnel preparation(24 teeth on 22 patients) and have participated in periodic recall check program for at least 2 years. Failure rate, plaque index, bleeding on probing and probing pocket depth were measured and the results were compared and statistically analysed. Results: Failure rates of root resection and tunnel praparation were 13.6% and 16.7%, respectively, and showed no significant difference between two procedures. No significant differences were observed between two procedures with respect to plaque index, bleeding on probing and probing pocket depth. Conclusion: root resection and tunnel preparation are both effective procedures to treat mandibular posterior furcation involvement, if adequate treatment of choice is made and patient's cooperation is accompanied. However, tunnel preparation is more preservative procedure in mandibular posterior furcation involvement since root canal treatment and prosthetic restoration are needed additionally, in case of root resection.