• Journal of Periodontal and Implant Science
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• v.41 no.1
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• pp.44-50
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• 2011

Purpose: Pathologic tooth migration (PTM) is a tooth displacement which is derived from imbalance of tooth retention force and is dominantly found out in maxillary anterior area. PTM in maxillary anterior area was tried to corrected with periodontal treatment and a clear aligner in this study and the result was evaluated clinically and radiographically. Methods: For the treatment of a patient with chronic periodontal disease accompanied by maxillary anterior pathologic tooth migration, clear aligner was applied to move teeth after a series of case-related periodontal therapy. Clinically, probing depth, gingival recession, clinical attachment level and mobility were measured pre- and post-treatment, and radiographic examination was performed as well. Results: Clinically, we found the decrease of the probing depth, gingival recession, clinical attachment level and mobility. And we could also acknowledge the reduction of vertical and horizontal dimension on infrabony defect radiographically. However, it is still controversial if there was an actual bone filling. Conclusions: Clear aligner is an effective appliance to move teeth since it costs little in terms of expense and time. In addition, it wraps whole crowns, providing advantages to deal with crowding, spacing, and size of arch. In short, clear aligner could be a useful treatment option for PTM patient, since it provides decreased probing depth, gingival recession, clinical attachment level, mobility and esthetical restoration.

• Journal of Periodontal and Implant Science
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• v.42 no.6
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• pp.237-242
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• 2012

Purpose: The aim of this study was to clinically and radiographically evaluate and compare treatment of intrabony defects with the use of decalcified freeze-dried bone allograft in combination with a calcium sulphate barrier to collagen membrane. Methods: Twelve patients having chronic periodontal disease aged 20 to 50 years and with a probing depth >6 mm were selected. Classification of patient defects into experimental and control groups was made randomly. In the test group, a calcium sulphate barrier membrane, and in control group, a collagen membrane, was used in conjunction with decalcified freeze-dried bone graft in both sides. Ancillary parameters as well as soft tissue parameters along with radiographs were taken at baseline and after 6 months of surgery. Parameters assessed were plaque index, modified gingival index, probing depth, relative attachment level, and location of the gingival margin. A Student's t-test was done for intragroup and a paired t-test for intergroup analysis. Results: Intragroup analysis revealed statistically significant improvement in all the ancillary parameters and soft tissue parameters with no statistically significant difference in intergroup analysis. Conclusions: The study concluded that a calcium sulphate barrier was comparable to collagen membrane in achieving clinical benefits and hence it can be used as an economical alternative to collagen membrane.

• Journal of Periodontal and Implant Science
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• v.30 no.3
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• pp.569-584
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• 2000

In order to evaluate the effects of the early exposure of e-PTFE membrane on the periodontal regeneration, 21 cases of 21 patients diagnosed as the chronic adult periodontitis were evaluated. All were class II furcation involvement cases. The control group was composed of 7 cases treated only by the flap operation. 14 cases were treated by the e-PTFE membrane as the experimental group, the membranes of 7 cases were exposed more than 1mm during healing period, which were named as the experimental group I, and the others, experimental group II. Clinical parameters such as probing pocket depth, clinical attachment level, bone probing depth, and gingival recession were recorded before the treatment and 6 months after the treatment. The results were as follows. 1. Significant probing depth reductions were observed for all groups(p<0.05), but no group shows significantly greater reductions than another. 2. Significant clinical attachment gains were observed for the experimental group II(p<0.05), no significant gains were observed in the other groups. 3. Significant bone probing depth reductions were observed for the experimental group II(p<0.05), no significant reductions were observed in the other groups. 4. All but the experimental group II exhibited a significant increase in gingival recession(p<0.05). The result suggested that is case of the e-PTFE membrane is exposed, the result is similar to that of flap operation without membrane. Therefore selecting the proper treatment case, intricate surgical procedure and infection control are essential for minimizing the chance of membrane exposure and finally for the good treatment results.

• Journal of Periodontal and Implant Science
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• v.48 no.5
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• pp.326-333
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• 2018

Purpose: The present study investigated the outcomes of a newly-developed, simple, and practical nonsurgical treatment modality suitable for most forms of intrabony defects around failing dental implants using intrasulcular delivery of chlorhexidine solution and minocycline hydrochloride (HCl). Methods: Forty-five dental implants in 20 patients diagnosed with peri-implantitis were included. At baseline and the study endpoint, the probing pocket depth (PPD), clinical attachment level (CAL), and the presence of bleeding on probing (BOP) at 6 sites around each implant were recorded. The radiographic osseous defect morphology at the mesial or distal proximal aspect of each implant was classified as 1) narrow or wide and 2) shallow or deep. For a comparative analysis of bone changes according to the defect morphology, the distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) at the mesial and distal aspects of each implant was measured at baseline and the endpoint. Patients were scheduled to visit the clinic every 2-4 weeks for intrasulcular irrigation of chlorhexidine and delivery of minocycline HCl. Results: We observed statistically significant decreases in PPD, CAL, and BOP after treatment. At the endpoint, bone levels increased in all defects, regardless of the osseous morphology of the intrabony defect. The mean DIB change in deep defects was significantly greater than that in shallow defects. Although the mean bone gain in narrow defects was greater than in wide defects, the difference was not statistically significant. Conclusions: We propose that significant and sustainable improvements in both clinical and radiographic parameters can be expected when intrabony defects around dental implants are managed through a simple nonsurgical approach involving combined intrasulcular chlorhexidine irrigation and local delivery of minocycline HCl.

• Journal of Periodontal and Implant Science
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• v.44 no.4
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• pp.194-200
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• 2014

Purpose: The purpose of this study was to assess and compare the clinical and radiographic outcomes of guided tissue regeneration therapy for human periodontal intrabony defects using two different collagen membranes: a porous nonchemical cross-linking collagen membrane (NC) and a bilayer collagen membrane (BC). Methods: Thirty subjects were randomly assigned and divided into the following 3 groups: a test group (NC+BM), in which a NC was used with xenograft bone mineral (BM), a positive control group (BC+BM), in which a BC was used with xenograft BM, and a negative control group (BM), in which only xenograft BM was used. The following clinical measurements were taken at baseline and 3 months after surgery: plaque index, gingival index, probing pocket depth, gingival recession, and clinical attachment level. Radiographic analysis was performed at baseline, 1 week and 3 months after surgery. Results: Membrane exposure was not observed in any cases. Significant probing depth reduction, attachment-level gain and bone fill were observed for both test and control groups compared to baseline at 3 months after surgery (P<0.05). However, there were no statistically significant differences in clinical improvement and radiographic bone fill between treatment protocols (P>0.05). Conclusions: Within the limitations of this study, the results suggest that both NC and BC were comparable in terms of clinical and radiographic outcomes for the treatment of periodontal intrabony defects in human subjects.

• Journal of Periodontal and Implant Science
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• v.43 no.3
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• pp.136-140
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• 2013

Purpose: The aim of this study was to identify a role for endodontic intervention in enhancing the regenerative potential of the periodontal ligament when combined with periodontal treatment in seriously involved teeth with a secondary endodontic component. Methods: Patients who exhibited radiolucency extending to the periapical region, abnormal electric pulp testing values, and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Intentional root canal treatment was applied to those teeth in which the apical lesions were presumed to communicate with those of the periodontal lesion of the teeth that remained vital. In all three selected cases, regenerative periodontal therapy incorporating either bone graft or guided tissue regeneration was instituted 3 months after the endodontic intervention. Results: Remarkable enhancement in radiographic density was noticeable around the affected teeth as evidenced by changes in radiopacity. There was a significant reduction in the probing pocket depth and gain in the clinical attachment level. Chewing discomfort gradually disappeared from the commencement of the combined treatment. Conclusions: An intentional endodontic intervention may be a worthwhile approach for the sophisticated management of teeth suffering from serious attachment loss and alveolar bone destruction with concomitant secondary endodontic involvement.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.325-332
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• 2014

PURPOSE. The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS. A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS. Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION. For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.415-428
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• 2002

Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.

• The Journal of Advanced Prosthodontics
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• v.13 no.1
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• pp.46-54
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• 2021

Purpose. The design of the implant-abutment complex is thought to be responsible for marginal bone loss (MBL) and might affect the condition of the peri-implant tissues. This the present study aimed to evaluate the influence of the implant-abutment complex on MBL and the peri-implant tissues in partially edentulous patients treated with dental implants and determine the most advantageous design. Materials and Methods. A total of ninety-one endosseous implants with different designs of implant-abutment complex [tissue level-TL (n = 30), platform switch-PS (n = 18), and platform match-PM (n = 43)] were reviewed for MBL, Probing Pocket Depth (PPD) and Bleeding on Probing (BoP). MBL was calculated for first year of the insertion and the following years. Results. The median MBL for the PM implants (2.66 ± 1.67 mm; n = 43) in the first year was significantly higher than those for the other types (P=.033). The lowest rate of MBL (0.61 ± 0.44 mm; n = 18) was observed with PS implants (P=.000). The position of the crown-abutment border showed a statistically significant influence (P=.019) and a negative correlation (r=-0.395) on MBL. BoP was found significantly higher in PM implants (P=.006). The lowest BoP scores were detected in PS implants, but the difference was not significant (P=.523). The relation between PPD and connection type revealed no statistically significant influence (P>.05). Conclusion. Within the limitations of the present study, it may be concluded that PS implants seem to show better peri-implant soft tissue conditions and cause less MBL.

• Journal of Periodontal and Implant Science
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• v.28 no.2
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• pp.263-273
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• 1998

For histologic observation of the regenerated bone following guided tissue regeneration (GTR) using ePTFE membranes with calcium carbonate implant and autogenous bone graft, biopsies were collected from 2 patients during 5-year-postoperative surgical reentry. In both combined cases with guided tissue regeneration in conjunction with calcium carbonate implant and autogenous bone graft, significant bone fill and gain in probing attachment level was observed. In histologic examination, specimen in GTR case with calcium carbonate grafting was composed of a dense bone containing vascular channel with lamellar structure and viable bone cells in lacunae, however considerable calcium carbonate particles remained unresorbed and isolated from regenerated bone by the dense cellular and fibrous connective tissue. No formative cells could be seen in contact with remained calcium carbonate particles. In GTR case with autogenous bone grafting, specimen show was composed of a dense lamellar bone containing vascular channel, which showed normal alveolar bone architectures. The present observation indicate that guided tissue regeneration in conjunction with grafting, especially autogenous bone graft, has highly osteogenic potential, however resorbable calcium carbonate granules were not completely resorbed at 5 year postimplantation.