• Journal of Periodontal and Implant Science
• /
• 제38권3호
• /
• pp.521-528
• /
• 2008

Purpose: Tunneling is a periodontal surgical procedure that creates access for patient cleansing and maintenance within the furcal area of a molar tooth with severe furcation involvement. Up to date, there are few studies about a long term clinical and radiographic stability of tunneling. The purpose of this retrospective study is to evaluate the long term prognosis after tunnel preparation of molars with through and through furcation. Material and Methods: 25 teeth of 23 patients aged 36 to 70 (mean age 51.7) were treated surgically with tunnel preparation. These cases were followed for 2 to 13 years (mean 6.5years) after surgery. Patients were recalled for an evaluation which was based on a questionnaire, a clinical examination, and radiographic analysis. Clinical assessment included plaque index, caries registration, probing pocket depth, bleeding on probing, tooth mobility. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Result: 3 teeth(12%) had been extracted and 1 tooth(4%) hemisected. Root caries was detected in 3 teeth(12%). Thus 72% of the teeth were still caries tree and in function. Clinical parameters including PI, PD, BOP, mobility showed somewhat favourable results. Radiographic furcal bone loss showed no statistically significant difference compared to interproximal crestal bone loss ($3.59{\pm}1.69%$ vs $3.42{\pm}2.95%$) when root length was used as reference. There was no correlation between root trunk length and furcal bone loss. Conclusion: Over 2 years after tunneling procedure, teeth showed a clinically and radiographically stable condition, despite of slight root caries and alveolar bone loss within clinically acceptable range. The tunnel procedure may be considered as a viable periodontal treatment option for molar teeth with severe furcation involvement in individuals following a regular maintenance program.

• Journal of Periodontal and Implant Science
• /
• 제51권4호
• /
• pp.276-284
• /
• 2021

Purpose: The aim of this randomized clinical trial was to assess whether chemical cleansing using a sulfonic/sulfuric acid gel solution (HBX) as an adjunct to scaling and root planing (SRP) resulted in a decrease in residual plaque and calculus in deep periodontal pockets compared to SRP alone. Methods: Fifty-six patients with 56 hopeless posterior teeth, scheduled for extraction due to severe periodontitis, were enrolled in this study. Each tooth was randomly assigned to 1 of the 2 experimental procedures. The test teeth were subjected to the irrigation of the subgingival area with HBX for 2 minutes, followed by SRP with hand and ultrasonic instruments for 14 minutes, and then extracted. The control teeth received only mechanical instrumentation before extraction. Residual biofilm was evaluated on photographs and measured as total area and percentage of root surface covered by remaining plaque (RP) or calculus (RC) after treatment. Results: The initial pocket depth (PD) and total subgingival root surface area were similar between the 2 treatment groups. After treatment, the total subgingival root area covered by RP and RC was statistically significantly larger (P<0.001) in the control group than in the test group. The test teeth showed a lower percentage of RP, but a higher percentage of RC than the control teeth (both P<0.001). Complete calculus removal was achieved in 42% of the control teeth surfaces and in 25% of the test teeth surfaces for a PD of 4 mm. Conclusions: The additional chemical cleansing with HBX resulted in a statistically significant improvement in bacterial plaque removal during SRP of deep pockets, but it was not effective in reducing calculus deposits.

• Journal of Periodontal and Implant Science
• /
• 제23권3호
• /
• pp.475-492
• /
• 1993

The effect of synthetic bone materials was assessed in the patients with pure periodontal class II and III furcation defects. The buccal aspects of the maxillary and mandilular first and second molars were surgically exposed, and synthetic bone materials were interposed between the gingival flap and the furcation defects in the experimental group. The control group were treated without the use of synthetic bone materials by same operator. Probing pocket depth, gingival recession, and loss of attachment, were measured by Michigan O-probe and tooth mobility was evaluated by an electronic mobility tester(Periotest(R), Siemens co. Germany) at preoperation and 3-, 6-, and 12-month postoperation. Standardized radiogrphs were taken at preoperation and 6-month and 12-month postoperation. The postoperative change of clinical parameters and the difference between experimental group and control group were statistically analyzed by Student, t-test. The results were as follows: 1. The probing pocket depth at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at preoperative examination in both experimental group and control group(P<0.005), but there was no significantly difference between experimental group and control group. 2. The amount of gingival recession at the 3-, 6-, and 12-month postoperative examination was increased, compared to that at the preoperative examination in both experimental and control group(P<0.005). In the case of the class III furcation involvement, the amount of gingival recession at the 3-, 6-, and 12-month postoperative examination was more significantly increased in control group than experimental group(P<0.05). 3. The amount of loss of attachment at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at the preoperative examination in both experimental and control group in the case of class II furcation involvement, and in experimental group only in the case of furcation III involvement(P<0.005). The amount of loss of attachment at, the 3-, 6-, and 12-month postoperative examination was more significantly decreased in experimental group than control group in the case of the class III furcation involvement(P<0.05), but in the case of class II furcation involvement there was no significant difference between experimental group and control group. 4. The tooth mobility at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at the preoperative examination in both experimental and control group(P<0.005), but there was no significant difference between experimental group and control group. 5. Radiopacity of furcation area was greatly increased in the experiment group, but there was no radiographic change in the control group.

• The Journal of Advanced Prosthodontics
• /
• 제15권4호
• /
• pp.202-213
• /
• 2023

PURPOSE. This prospective clinical study was conducted to evaluate the clinical usefulness of the freely detachable zirconia ball- and spring-retained implant prosthesis (BSRP) through a comparative analysis of screw- and cement-retained implant prosthesis (SCRP). MATERIALS AND METHODS. A multi-center, randomized, prospective clinical study evaluating the clinical usefulness of the detachable zirconia ball- and spring-retained implant prostheses was conducted. Sixty-four implant prostheses in 64 patients were examined. Periodic observational studies were conducted at 0, 3, 6, and 12 months after delivery of the implant prosthesis. Factors such as implant success rate, marginal bone resorption, periodontal pocket depth, plaque and bleeding index, and prosthetic complications were evaluated, respectively. RESULTS. During the 1-year observation period, all implants survived without functional problems and clinical mobility, showing a 100% implant success rate. Marginal bone resorption was significantly higher in the SCRP group than in the BSRP group only at the time of implant prosthesis delivery (P = .043). In all observation periods, periodontal pocket depth was slightly higher in the BSRP group than in the SCRP group, but there was no significant difference (P > .05). The modified plaque index (mPI) scores of both groups were moderate. Higher ratio of a score 2 in modified sulcus bleeding index (mBI) was observed in the BSRP group in the 6- and 12-months observation. CONCLUSION. Within the limitations of this study, the newly developed zirconia ball- and spring-retained implant prosthesis could be considered as an applicable and predictable treatment method along with the existing screw- and cement-retained prosthesis.

• 구강회복응용과학지
• /
• 제34권1호
• /
• pp.39-45
• /
• 2018

목적: 치석제거 및 치근면활택술(scaling and root planing, SRP)은 만성 치주염 환자에서 대표적인 비외과적 치주치료법이나 술자가 잔존치석을 시각적으로 확인하지 못하는 한계가 있다. 본 연구는 중등도 만성 치주염 환자에서 비외과적 치주치료 시 SRP에 부가적으로 erythritol 공기분말 연마기구를 사용하는 것의 임상적 효과를 평가해 보고자 한다. 연구 재료 및 방법: 중등도 만성 치주염을 가지는 21명의 환자에서 비외과적 치주치료를 위해 SRP로만 치료받은 21부위(대조군)와 SRP에 부가적으로 erythritol 공기분말 연마기구를 사용하여 치료한 21부위(실험군)에서 4 - 6 mm의 치주낭을 가지는 치아를 선택하여 평가하였다. 치료 전, 치료 완료 1개월, 3개월 후에 치주낭 깊이, 치은퇴축, 임상부착수준, 치태지수, 탐침시 출혈이 임상지표로 측정되었다. 결과: 실험군과 대조군 모두에서 치료 전에 비해 치료 1개월 후, 3개월 후 치주낭 깊이, 치태지수, 탐침시 출혈의 유의한 감소와 치은 퇴축의 증가 및 임상부착수준의 유의한 획득이 관찰되었다. 그러나 실험군과 대조군 간에 임상지표들의 변화에는 유의한 차이가 관찰되지 않았다. 치료 3개월 후 모든 임상지표들은 치료 전에 비해서는 개선되었으나 치료 1개월 후에 비해서는 악화되었다. 결론: 중등도 만성 치주염 환자의 비외과적 치주치료 시 erythritol 공기분말 연마기구는 부가적으로 적용될 수 있으나 SRP 단독과 비교하였을 때 임상적으로 더 효과적이라고 제안할 수는 없다. 또한 최소 3개월 간격의 주기적인 유지관리치료가 필요함을 알 수 있다.

• 치위생과학회지
• /
• 제12권6호
• /
• pp.583-590
• /
• 2012

본 연구는 경제적 스트레스와 상태 특성불안이 치주질환에 미치는 영향을 파악하여 치주질환의 예방과 발생 및 진행 정도를 미연에 방지할 수 있는 방안을 마련하기 위하여 실시되었다. 연구대상은 일부 지역 치과의원에 내원한 40~50대 성인남녀 총 326명을 대상으로 하여 구조화된 설문지와 치주상태를 측정하여 조사 분석하였다. 수집된 자료는 IBM SPSS ver. 19.0 통계프로그램(IBM Co., Armonk, NY, USA)을 이용하여 빈도와 백분율, t-test (검증), One way ANOVA (일원배치 분산분석), Multiple regression Analysis (다중회귀분석)을 실시하여 분석결과는 다음과 같다. 1. 경제적 스트레스는 치은염 지수의 고($1.12{\pm}0.72$), 중($0.85{\pm}0.62$), 저($0.88{\pm}0.62$)에 따라 통계적으로 유의한 차이를 보였다(p<0.01). 2. 상태 특성불안은 치은염 지수(p<0.001)의 고($1.16{\pm}0.71$), 중($0.81{\pm}0.63$), 저($0.86{\pm}0.60$), 치주낭 깊이(p<0.05)의 고($3.86{\pm}1.12$), 중($3.44{\pm}1.07$), 저($3.57{\pm}1.01$), 임상적 부착소실(p<0.05)의 고($3.86{\pm}1.12$), 중($3.44{\pm}1.07$), 저($3.57{\pm}1.01$)에 따라 통계적으로 유의한 차이를 보였다. 3. 치은염 지수에 영향을 미치는 요인으로 경제적 스트레스($\beta$=0.052, p<0.01)가 높을수록, 상태 특성불안($\beta$=0.052, p<0.01)이 높을수록 영향을 미치는 것으로 조사되었다. 이상의 연구결과에서 치과의료기관은 치주질환으로 힘들어 하는 환자에게 경제적 스트레스와 상태 특성불안이 치주질환에 영향을 미친다는 사실을 인식시킬 필요가 있으며 이에 따른 치주질환의 예방과 발생 및 진행 정도를 방지할 수 있는 스트레스 관리능력배양을 위한 교육프로그램 개발이 마련되어야 할 것이다.

• Journal of Periodontal and Implant Science
• /
• 제49권6호
• /
• pp.355-365
• /
• 2019

Purpose: The modified minimally invasive surgical technique (M-MIST) has been successfully employed to achieve periodontal regeneration. Platelet-rich fibrin (PRF) is known to enhance wound healing through the release of growth factors. This study aimed to observe the outcomes of periodontal surgery when M-MIST was used with or without PRF for the treatment of isolated intrabony defects. Methods: This randomized clinical trial was conducted on 36 systemically healthy patients, who had chronic periodontitis associated with a single-site buccal probing pocket depth (PPD) and clinical attachment level of ≥5 mm. Patients were randomly divided into 2 groups: the test group treated with M-MIST and PRF, and the control group treated with M-MIST alone. The primary periodontal parameters analyzed were PPD, relative attachment level (RAL), and relative gingival margin level. The radiographic parameters analyzed were change in alveolar crest position (C-ACP), linear bone growth (LBG), and percentage bone fill (%BF). Patients were followed up to 6 months post-surgery. Results: Intragroup comparisons at 3 and 6 months showed consistently significant improvements in PPD and RAL in both the groups. In intergroup comparisons, the improvement in PPD reduction, gain in RAL, and the level of the gingival margin was similar in both groups at 3 and 6 months of follow-up. Furthermore, an intergroup comparison of radiographic parameters also demonstrated similar improvements in C-ACP, LBG, and %BF at 6 months of follow-up. Conclusions: M-MIST with or without PRF yielded comparable periodontal tissue healing in terms of improvements in periodontal and radiographic parameters. Further investigation is required to confirm the beneficial effects of PRF with M-MIST.

• Journal of Periodontal and Implant Science
• /
• 제33권3호
• /
• pp.485-497
• /
• 2003

Grapefruit seed extract has been reported to have antimicrobial effect. The purpose of this study was to evaluate the antimicrobial and anti-gingivitis effect of chewing gum containing grapefruit seed extract and xylitol. 40 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in the experimental group chewed gum containing grapefruit seed extract and xylitol while subjects in the control group chewed gum containing only xylitol. All subjects received scaling and tooth brushing instruction. 1 week after scaling was set as baseline. Gingival index and plaque index were scored at baseline, 1 week, 2 week, 3 week and 4 week. Bleeding index, probing pocket depth and clinical attachment level were scored at baseline, 2 week and 4 week. The number of total bacteria and Streptococcus mutans in unstimulated saliva of experimental group were counted at 1 week, 2 week, 3 week and 4 week. Gingival indices of experimental group and control group at baseline, 1 week, 2 week, 3 week and 4 week were 0.850${\pm}$0.298, 0.575${\pm}$0.345, 0.533${\pm}$0.332, 0.459${\pm}$0.311, 0.408${\pm}$0.224 and 0.758${\pm}$0.379, 0.592${\pm}$0.276, 0.563${\pm}$0.281, 0.454${\pm}$0.194, 0.413${\pm}$0.199 (mean${\pm}$SD), respectively. Plaque indices of experimental group and control group at baseline, 1 week. 2 week, 3 week and 4 week were 0.497${\pm}$0.500, 0.375${\pm}$0.484, 0.332${\pm}$0.471, 0,286${\pm}$0.452, 0.210${\pm}$0.407 and 0.411${\pm}$0.492, 0.375${\pm}$0.484, 0.354${\pm}$0.479, 0.313${\pm}$0.463, 0.193${\pm}$0.395, respectively. Bleeding indices of experimental group and control group at baseline, 2 week and 4 week were 0.377${\pm}$0.177, 0.298${\pm}$0.152, 0.192${\pm}$0.108 and 0.383${\pm}$0.124, 0.318${\pm}$0.153, 0.225${\pm}$0.126, respectively. Probing pocket depth of experimental group and control group at baseline, 2 week and 4 week were 2.56${\pm}$1.00, 2.40${\pm}$0.65, 2.23${\pm}$0.64 and 2.45${\pm}$0.682.37${\pm}$0.57, 2.19${\pm}$0.57, respectively. Clinical attachment level of experimental group and control group at baseline, 2 week and 4 week were 2.58${\pm}$1.01, 2.43${\pm}$0.67, 2.26${\pm}$0.65 and 2.49${\pm}$0.70, 2.40${\pm}$0.59, 2.22${\pm}$0.62, respectively. The % of reduction of total bacteria in saliva of experimental group at 2 week, 3 week and 4 week were 46 ${\pm}$ 53%, 53 ${\pm}$ 5% and 69 ${\pm}$ 33%. The % of reduction of Streptococcus mutans count in saliva of experimental group at 2 week, 3 week and 4 week were 52${\pm}$69%, 88${\pm}$30% and 89${\pm}$17%. From these findings, it can be concluded that regular use of grapefruit seed extract /xylitol chewing gum may be effective to control and prevent gingivitis and may have caries-preventive effect.

• Journal of Periodontal and Implant Science
• /
• 제44권4호
• /
• pp.158-168
• /
• 2014

Purpose: The present study was conducted to evaluate the impact of scaling and root planing (SRP) on the C-reactive protein (CRP) levels of gingival crevicular fluid (GCF) and serum in chronic periodontitis patients with type 2 diabetes mellitus (T2DM-CP) or without type 2 diabetes mellitus (NDM-CP). Methods: Forty-eight human participants were divided into two groups: an experimental (T2DM-CP) group (group I, n=24) comprising chronic periodontitis patients with random blood sugar ${\geq}200mg/dL$ and type 2 diabetes mellitus, and control (NDM-CP) group (group II, n=24) of those with chronic periodontitis and random blood sugar <200 without T2DM for the study. All subjects underwent nonsurgical periodontal therapy (NSPT) including complete SRP and subgingival debridement. Periodontal health parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), GCF volume (GCF vol), GCF-CRP, random blood glucose (RBS), glycated hemoglobin, and systemic inflammatory markers, serum CRP, total leukocyte count (TLC), neutrophil count (Neutr) and lymphocyte count (Lymph), were evaluated at baseline, 1 month, and 3 months after SRP. Results: NSPT resulted in statistically significant improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum as well as GCF of both groups I and II. The mean improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum and GCF was greater in group I than group II after NSPT. There was nonsignificant increase in GCF-CRP, TLC, Lymph, and RBS, and a significant increase in Neutr and Serum CRP in group II at 1 month. The Serum CRP level of 20 out of 24 group II patients had also increased at 1 month. Conclusions: The CRP levels in both GCF and serum were higher in T2DM-CP patients than in NDM-CP patients. Although there was a significant improvement in both the groups, greater improvement was observed in both GCF and serum samples of T2DM-CP patients.

• Journal of Periodontal and Implant Science
• /
• 제37권1호
• /
• pp.91-102
• /
• 2007

The long term success of periodontal treatment is dependent upon the effectiveness of the main-tenance care program after active treatment. The purpose of this study was to evaluate whether nutraceutical containing PRF-K2 as natural product from plant and seaweed has beneficial effects on clinical parameters, gingival crevicular fluid (GCF) volume and GCF cytokine levels during main- tenance phase after periodontal treatment. Among the generally healthy and non-smoking. moderate to severe chronic periodontitis patients during maintenance phase in Department of Periodontics, Chonnam National University Hospital, twenty eight patients took nutraceutical containing PRF-K2 (Oscotec Inc. Cheonan, Korea) for 3 months as experimental group and sixteen patients received only maintenance care as control group. Clinical examination and GCF collection were performed at baseline, 1, 2 and 3 months of experiment. Total amounts and concentrations of GCF IL-1{\beta}, IL-1ra and $PGE_2$ were evaluated using ELISA kit. In probing pocket depth, experimental group showed the tendency of more reduction than control group after 3 months of experiment. Sulcus bleeding index (SBI) and GCF volume were significantly decreased in experimental group(p<0.05), whereas they were increased in control group. GCF IL-1{\beta} level tended to decrease in both experimental and control group and IL-1ra concentration tended to increase in experimental group and to decrease in control group. IL-1ra/IL-1{\beta} ratio tended to increase in experimental group and to decrease in control group during experimental period. GCF $PGE_2$ amount did not show any change in experimental group and tended to increase in control group. These results suggest that nutraceutical supplement which contain PRF-K2 could improve perio-dontal condition during maintenance phase after periodontal therapy.