• Journal of Periodontal and Implant Science
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• v.38 no.1
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• pp.15-22
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• 2008

Purpose: The attachment level is strongly associated with tooth loss and provides useful information on patterns of destruction of the periodontium. The presence of horizontal attachment loss would not be detected in clinical measurement. Therefore, the purpose of the present study was to estimate the patterns of periodontal destruction based on the attachment area and horizontal attachment loss in extracted teeth due to severe periodontitis. Materials and Methods: 307 teeth satisfied the criteria for assessment. An indirect method, based on digital images obtained from a digital camera and an image analysis program, was used to calculate the area of root surface and attachment loss and the extent of horizontal attachment loss. The data were analysed using SPSS. Results: No statistically significant differences among root surfaces were observed in anterior teeth on the loss of attachment area. However, in posterior teeth statistically significant differences in palatal surfaces of maxillary and mandibular premolar and molar surfaces compared with buccal surfaces were observed. Horizontal attachment loss was observed in 21.5% of the teeth examined. Frequency of horizontal attachment loss was highest in the maxillary first premolar (34.8%), followed by the maxillary second premolar (27.3%) and maxillary canine (25%). The mean length of horizontal attachment loss was 1.5mm. Conclusion: More meticulous examination will be needed of the palatal surfaces of maxillary and mandibular premolar and molar teeth. The percentage of teeth with horizontal attachment loss greater than 2.1 mm was 5.2%. Considering the length of curette blades, about 5.2% of teeth were not properly debrided. Therefore, Additional supportive therapy such as local drug delivery has to be considered in treatment of the first maxillary, second premolar and canine due to the high prevalence of horizontal attachment loss.

• Journal of Periodontal and Implant Science
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• v.41 no.2
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• pp.92-97
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• 2011

Purpose: The present study was performed to compare the treatment outcomes of non-surgical periodontal treatment according to the distribution of attachment loss of a given patient. Methods: Forty-five patients with moderate to severe periodontitis were divided in two subgroups; Group I patients with teeth manifesting attachment loss of ${\geq}$ 6 mm at one or more sites on the buccal/labial aspect while maintaining an attachment level ${\leq}$ 5 mm at the lingual/palatal aspect, Group II patients with teeth manifesting an attachment level ${\geq}$ 6 mm at more than one site on the lingual/palatal aspect while maintaining an attachment level ${\leq}$ 5 mm at the buccal/labial aspect. The probing pocket depth, probing attachment level, tooth mobility, and chewing discomfort were recorded at baseline and 6 months examinations following non-surgical periodontal therapy. Results: The buccal/ abial surfaces of teeth with moderate to severe periodontitis in Group I patients demonstrated a greater amount of pocket reduction, gain of attachment level, and tooth mobility reduction than the lingual/palatal aspects of teeth examined in Group II patients. Conclusions: Within the limits of the present study, the patients demonstrating attachment loss ${\geq}$ 6 mm at buccal/labial surfaces responded better to the nonsurgical periodontal therapy than those demonstrating comparable attachment loss at lingual/ palatal surfaces.

• The Journal of the Korean dental association
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• v.57 no.12
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• pp.736-746
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• 2019

Supportive periodontal therapy(SPT) is essential for the long-term success of periodontal treatment. A patient's compliance with SPT is one of the most important factors affecting periodontal status. There are few studies quantifying compliance with SPT. The aim of this study is to quantify patient's compliance using new method and evaluate tooth loss depending on patient's supportive periodontal treatment compliance index(SPTCI) with SPT. This study included subjects diagnosed with generalized moderate to severe chronic periodontitis, who had completed active periodontal treatment and had SPT over 5 years in Wonkwang university dental hospital. Chart review and radiography analysis were performed. To quantify compliance, SPTCI representing average of gap between recommended schedules and actual visits has been used and evaluated with tooth loss. Mean period of SPT was 8.9 years and mean SPTCI was about 120. In statical analysis, patients who have higher SPTCI with SPT are more likely to have higher rate of tooth loss. Under SPTCI of 120, there were no significant co-relation between SPTCI and tooth loss. Patients diagnosed with moderate chronic periodontitis have significant co-relation between SPTCI and tooth loss, whereas patients diagnosed with severe chronic periodontitis have no co-relation. SPTCI, new method of quantifying compliance in this study, affected to tooth loss. This study suggests that using SPTCI could be helpful for prediction of tooth loss and be used to determine the interval of visit.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.586-590
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• 2009

Leukocyte adhesion deficiency is rare inherited defect on phagocytic function resulting lack of leukocyte cell surface expression of $\beta2$ integrin molecule that are essential for leukocyte adhesion to endothelial cells and chemotaxis. Clinical features of patients with leukocyte adhesion deficiency type I include recurrent necrotic infection of the skin mucous membranes, and intestinal tract with septicemia, and omphalitis arising from delayed umbilical cord separation. Oral manifestations are severe progressive periodontitis with alveolar bone loss, periodontal pockets, and partial and total premature loss of the deciduous and permanent dentitions. We report a case of leukocyte adhesion deficiency type I in a 5-year-old child with severe periodontitis. In order to prevent local and systemic infection, we controlled periodontal disease with periodic oral prophylaxis. Oral swabs and blood cultures were perfomed for suspected infection, so that optimal measures were taken through the use of appropriate antibiotics.

• The korean journal of orthodontics
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• v.39 no.1
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• pp.54-65
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• 2009

This paper describes the case of a 50-year-old female with a Class II malocclusion who presented with severe bimaxillary protrusion and generalized alveolar bone loss due to adult periodontitis. The treatment plan consisted of extracting both upper and lower first premolars and periodontal treatment. Anterior segmental osteotomy(ASO) of the mandible and upper anterior segment retraction using compression osteogenesis after peri-segmental corticotomy(Speedy orthodontics) was performed. Correct overbite and overjet, facial balance, and improvement of lip protrusion were obtained. However, a slight root resorption tendency was observed on the lower anterior dentition. The active treatment period was 9 months and the results were stable for 27 months after debonding. This new type of treatment mechanics can be an effective alternative to orthognathic surgery.

• Journal of Periodontal and Implant Science
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• v.52 no.6
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• pp.509-521
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• 2022

Purpose: Systemic health has a profound effect on dental treatment. The aim of this study was to evaluate peri-implant bone loss and health screening data to discover factors that may influence peri-implant diseases. Methods: This study analyzed the panoramic X-rays of patients undergoing health screenings at the Health Promotion Center at Seoul St. Mary's Hospital in 2018, to investigate the relationship between laboratory test results and dental data. The patients' physical data, such as height, weight, blood pressure, hematological and urine analysis data, smoking habits, number of remaining teeth, alveolar bone level, number of implants, and degree of bone loss around the implant, were analyzed for correlations. Their associations with glycated hemoglobin, glucose, blood urea nitrogen (BUN), creatinine, and severity of periodontitis were evaluated using univariate and multivariate regression analysis. Results: In total, 2,264 patients opted in for dental health examinations, of whom 752 (33.2%) had undergone dental implant treatment. These 752 patients had a total of 2,658 implants, and 129 (17.1%) had 1 or more implants with peri-implant bone loss of 2 mm or more. The number of these implants was 204 (7%). Body mass index and smoking were not correlated with peri-implant bone loss. Stepwise multivariate regression analysis revealed that the severity of periodontal bone loss (moderate bone loss: odds ratio [OR], 3.154; 95% confidence interval [CI], 1.175-8.475 and severe bone loss: OR, 7.751; 95% CI, 3.003-20) and BUN (OR, 1.082; 95% CI, 1.027-1.141) showed statistically significant predictive value. The severity of periodontitis showed greater predictive value than the biochemical parameters of blood glucose, renal function, and liver function. Conclusions: The results of this study showed that periodontal bone loss was a predictor of peri-implant bone loss, suggesting that periodontal disease should be controlled before dental treatment. Diligent maintenance care is recommended for patients with moderate to severe periodontal bone loss.

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.216-222
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• 2015

Purpose: After extraction, the alveolar bone tends to undergo atrophy in three-dimensions. The amount of alveolar bone loss in the horizontal dimension has been reported to be greater than the amount of bone loss in the vertical dimension, and is most pronounced in the buccal aspect. The aim of this study was to monitor the predictive alveolar bone level following the extraction of anterior teeth seriously involved with advanced chronic periodontitis. Methods: This study included 25 patients with advanced chronic periodontitis, whose maxillary anterior teeth had been extracted due to extensive attachment loss more than one year before the study. Periapical radiographs were analyzed to assess the vertical level of alveolar bone surrounding the edentulous area. An imaginary line connecting the mesial and the distal ends of the alveolar crest facing the adjacent tooth was arbitrarily created. Several representative coordinates were established in the horizontal direction, and the vertical distance from the imaginary line to the alveolar crest was measured at each coordinate for each patient using image analysis software. Regression functions predicting the vertical level of the alveolar bone in the maxillary anterior edentulous area were identified for each patient. Results: The regression functions demonstrated a tendency to converge to parabolic shapes. The predicted maximum distance between the imaginary line and the alveolar bone calculated using the regression function was $1.43{\pm}0.65mm$. No significant differences were found between the expected and actual maximum distances. Likewise, the predicted and actual maximum horizontal distances did not show any significant differences. The distance from the alveolar bone crest to the imaginary lines was not influenced by the mesio-distal spans of the edentulous area. Conclusions: After extraction, the vertical level of the alveolar ridge increased to become closer to the reference line connecting the mesial and distal alveolar crests.

• Journal of Periodontal and Implant Science
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• v.41 no.3
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• pp.117-122
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• 2011

Purpose: The purpose of the present randomized controlled clinical study was to evaluate the short-term outcomes of micro-current electrical neuromuscular stimulation (MENS) as an adjunct method to nonsurgical periodontal therapy. Methods: Twenty patients with moderate to severe chronic periodontitis were recruited into the study and randomly treated with either nonsurgical periodontal therapy followed by 5 MENS treatments with a micro current device or by nonsurgical periodontal therapy alone. Periodontal parameters were measured at baseline and 6 weeks following therapy, and included the plaque index, bleeding on probing, probing depth, and clinical attachment level (CAL). Results: All measured values were reduced at the time of re-evaluation. The amount of inflammation was significantly reduced in both the test (P=0.002) and control group (P=0.015). The test group demonstrated a significant CAL gain at 6 weeks following therapy, including non-molar (P=0.009) and molar teeth (P=0.028). In comparison with the control group, the test group showed statistically significant differences in the CAL on both molar (P=0.027) and non-molar teeth (P=0.031). Conclusions: In conclusion, the short-term results of the study indicate that MENS could be a suitable adjunctive method in the treatment of chronic periodontitis.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.4
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• pp.329-338
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• 2014

Patients who lost molars from dental caries or periodontitis have difficulty in maintaining their vertical dimension because their incisors and premolars also show vertical tooth movement. Missing posterior molars leads to occlusal interference and collapse of occlusal plane due to extrusion of opposite teeth and tipping of adjacent teeth. When this condition persists over long time, mandible moves forward, so it causes mobility and labioversion of upper incisors. This progress cannot be stopped spontaneously and the situation gets worse and worse. Therefore, for a patient with pathologic teeth migration caused by chronic periodontitis, interdisciplinary approach which is including periodontal treatment, orthodontic teeth alignment and prosthetic restoration of missing molars is required. This case report shows successful multidisciplinary approach to a patient who lost vertical dimension due to severe dental caries and periodontitis.

• International Journal of Oral Biology
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• v.43 no.4
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• pp.223-230
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• 2018

Exosomes are Nano-sized lipid vesicles secreted from mammalian cells containing diverse cellular materials such as proteins, lipids, and nucleotides. Multiple lines of evidence indicate that in saliva, exosomes and their contents such as microRNAs (miRNAs) mediate numerous cellular responses upon delivery to recipient cells. The objective of this study was to characterize the different expression profile of exosomal miRNAs in saliva samples, periodically isolated from a single periodontitis patient. Unstimulated saliva was collected from a single patient over time periods for managing periodontitis. MicroRNAs extracted from each phase were investigated for the expression of exosomal miRNAs. Salivary exosomal miRNAs were analyzed using Affymetrix miRNA arrays and prediction of target genes and pathways for its different expression performed using DIANA-mirPath, a web-based, computational tool. Following the delivery of miRNA mimics (hsa-miR-4487, -4532, and -7108-5p) into human gingival fibroblasts, the expression of pro-inflammatory cytokines and activation of the MAPK pathway were evaluated through RT-PCR and western blotting. In each phase, 13 and 43 miRNAs were found to be differently expressed $({\mid}FC{\mid}{\geq}2)$. Among these, hsa-miR-4487 $({\mid}FC{\mid}=9.292005)$ and has-miR-4532 $({\mid}FC{\mid}=18.322697)$ were highly up-regulated in the clinically severe phase, whereas hsa-miR-7108-5p $({\mid}FC{\mid}=12.20601)$ was strongly up-regulated in the clinically mild phase. In addition, the overexpression of miRNA mimics in human gingival fibroblasts resulted in a significant induction of IL-6 mRNA expression and p38 phosphorylation. The findings of this study established alterations in salivary exosomal miRNAs which are dependent on the severity of periodontitis and may act as potential candidates for the treatment of oral inflammatory diseases.