• 치위생과학회지
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• 제23권1호
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• pp.13-19
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• 2023

Background: Periodontitis is a chronic inflammatory condition associated with dysbiosis of the oral microbiota. The aim of the present clinical study was to explore the adjunctive effect of ozonized water irrigation in the circuits of ultrasonic scalers for the full-mouth decontamination of patients with periodontitis Stage I or II. Methods: The study was a randomized, single-blinded, parallel-group clinical trial. The test group (n=25) was treated with ultrasonic scalers irrigated with ozonized water, whereas the control group (n=25) received normal tap water irrigation within the ultrasonic scalers used during the professional mechanical debridement. Full mouth plaque score, bleeding score, probing pocket depth, and the gingival index were evaluated at baseline, two, and 4 weeks after treatment. The pain perceived and dental anxiety were also assessed after treatment by means of the visual analog scale (VAS). Results: All periodontal parameters resulted in significant improvement for both study groups. The effect of the treatment group on the gingival index was significant, in particular, patients in the test group experienced a greater reduction in this score. No significant differences could be observed with regards to the average probing depth, full mouth plaque index and bleeding score. Patients treated with ozonized water running in the circuits of ultrasonic scalers displayed also lower scores for pain and dental anxiety. Conclusion: The present study showed a significant clinical effect on gingival inflammation attributable to adjunctive ozone irrigation during nonsurgical periodontal therapy. Further studies, including patients with severe periodontitis and greater sample sizes, are recommended to test the clinical effect of ozonized water in the circuits of ultrasonic scalers.

• Journal of Periodontal and Implant Science
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• 제37권3호
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• pp.613-624
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• 2007

Full-mouth disinfection (Fdis) completes the entire scaling and root planing (SRP) in one stage within 24 hours for the prevention of microbial recolonization from untreated sites and ecological niches. The aim of this study is to compare the clinical short-term effects of modified Fdis with those of the conventional SRP in the therapy of moderate and severe chronic periodontitis. Modified Fdis group (5 patients) received the entire SRP within 24 hours using chlorhexidine solution (0.1%) and conventional SRP group (5 patients) received SRP per quadrant at one-week intervals. Clinical parameters were measured at baseline, one month and three months after both therapies. The results of this case report were as follows: 1. There were considerable decreases in sulcus bleeding index and plaque index one month after Fdis. 2. The mean probing depth of single-rooted teeth decreased more in Fdis group than conventional SRP group after therapy and, that of multi-rooted teeth decreased similarly in both groups. 3. The mean probing depth decreased 1.77mm in case of initial probing depth of 4-6mm and it decreased 4.13mm in case of initial probing depth of ${\geq}$ 7mm three months after Felis. 4. There were the smaller increases in gingival recession together with the larger gains in attachment in Fdis group than conventional SRP group after three months. Within the limitations of this study, one could conclude that Fdis has beneficial clinical effects in the treatment of moderate and severe chronic periodontitis and further research would be helpful including more subjects during a longer period to confirm the beneficial long-term effects of Fdis.

• Journal of Periodontal and Implant Science
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• 제47권2호
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• pp.96-105
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• 2017

Purpose: The National Health Insurance Service-National Sample Cohort and medical checkup data from 2002 to 2013 were used to evaluate the association between periodontal surgery for the treatment of periodontitis (PSTP) and vasculogenic erectile dysfunction (VED). Methods: Bivariate and multivariate logistic regression analyses were applied to a longitudinal retrospective database to assess the association between PSTP and VED while adjusting for the potential confounding effects of sociodemographic factors (age, household income, insurance status, health status, residence area, and smoking status) and comorbidities (diabetes mellitus, angina pectoris, cerebral infarction, and myocardial infarction). Results: Among the 7,148 PSTP within the 268,296 recruited subjects, the overall prevalence of VED in PSTP was 1.43% (n=102). The bivariate analysis showed that VED was significantly related to PSTP (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.38-2.06; P<0.001), and this was confirmed in the multivariate analysis after adjusting for sociodemographic factors and comorbidities (OR, 1.29; 95% CI, 1.06-1.58; P=0.002). Conclusions: Subjects with a history of periodontal flap surgery had a significantly higher risk of VED, after adjusting for potential confounding factors. Further studies are required to identify the key mechanisms underlying the association between severe periodontal disease and VED.

• Journal of Periodontal and Implant Science
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• 제44권2호
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• pp.71-78
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• 2014

Purpose: Host modulatory therapy has been proposed as a treatment for periodontal diseases. A class of herbal medicines, known to be immunomodulators, alters the activity of immune function through the regulation of informational molecules such as cytokines. In the current study, we tested the hypothesis that herbal immunomodulator drugs act as an adjuvant to scaling and root planing (SRP) in alleviating periodontal inflammation by improving clinical and biochemical parameters. Methods: Sixty healthy subjects (30 in each group) with moderate and severe chronic periodontitis were enrolled in a double-blind, placebo-controlled, double-masked randomised controlled trial. The control group was treated with SRP and a placebo, whereas the test group was treated with SRP followed by dietary supplementation of Septilin for 3 weeks. Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated for all patients at the baseline, 3 weeks, and 6 weeks. Results: Improved gingival index scores found in the test group as compared to the control group were found to be statistically significant only after 3 weeks (P<0.001). In contrast, the decrease in the sulcus bleeding index and pocket depth scores was statistically highly significant in the test group as compared to the control group after 3 weeks and 6 weeks (P<0.001). However, reduced clinical attachment level and CRP scores, as reflected in the test group as compared to the control group, were not found to be statistically significant after both 3 weeks (P>0.05) and 6 weeks (P>0.05). Conclusions: The results of this clinical-biochemical study suggest that dietary supplementation with herbal immunomodulatory agents may be a promising adjunct to SRP and may aid in improving periodontal treatment outcomes.

• Journal of Periodontal and Implant Science
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• 제24권3호
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• pp.541-560
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• 1994

The present study was performed to evaluate the relationship between the serotype or the genotype of Actnobacillus actinomycetemcomitans (A. a.) and the severity of periodontal disease. Total 64 A. a. clinical isolates were sampled from 46 sites of 20 subjects classified into the group I (1 periodontally healthy subject, 2 gingivitis patients, 5 ealry adult periodontitis patients), group II (3 moderatelly adult periodontitis patients) and group III (1 advanced adult periodontitis patient, 8 RPP patients). Southern bolt hybridization (fingerprinting) patterns of the five reference strains, A. a. strain ATCC 29523 (serotype a), ATCC 29522 (Serotype b), ATCC 43719 (serotype c), IDH 781 (serotype d) and IDH 1705 (serotype e), were used as the five basic genotypic patterns (A, B, C, D, E). NT type was designated as one which did dnot represent any of those five basic types. The serotypes were determined by ELISA technique with the serum samples from pre-immunized rabbit. Based on subject-based analysis, it was noted that genotypes A and C, NT, and B, D, E were significantly related to the disease groups I, II, and III, respectively. It was also noted that both the serotypes a and c were significantly related to the disease group I and II, while serotypes were significantly related bm), and serotypes b and nd were frequently found in sites with severe attachment loss (LA>6mm). The results indicated that the significant relationship can be delineated beteen the genotypes and the serotypes of Acinobacillus actinomycetemcomitans and the periodontal disease severity. The results also indicated that genotyping can provide more detailed information on its relationship with the disease severity based on both the patient-based and the site-based analyses.

• Journal of Periodontal and Implant Science
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• 제43권2호
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• pp.96-100
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• 2013

Purpose: Chronic periodontitis (CP) seems to be associated with stress and depression, but little information on this possible association is available in the literature. Thus, the objective of this study was to evaluate the association among stress, the salivary cortisol level (SCL), and CP. Methods: Seventy systemically healthy subjects were included in the study from January to September 2011. Full medical and dental histories were obtained, and the following measurements were recorded: 1) probing depth; 2) clinical attachment level; 3) bleeding on probing; and 4) tooth mobility. Saliva samples were collected for the evaluation of SCL (via a highly sensitive electrochemiluminescence immunoassay), and all subjects also answered a questionnaire (i.e., the Zung Self-rating Depression Scale). The odds ratio (OR) with a 95% confidence interval (CI) was calculated, and one way analysis of variance and the Tukey-Kramer method were performed. Results: A total of 36 subjects with CP (51.4%) and 34 without CP were evaluated. Of them, all of the subjects with CP and one periodontally healthy subject were diagnosed with depression. Subjects with moderate CP had statistically significantly higher levels of SCL than subjects with a diagnosis of slight CP (P=0.006). Also, subjects with severe CP showed the same outcome when compared to those with slight CP (P=0.012). In addition, 46 subjects presented high SCL whereas 24 had a normal level. CP was found to be correlated with the SCL, with an OR of 4.14 (95% CI, 1.43 to 12.01). Conclusions: Subjects with a high SCL and depression may show an increased risk for CP.

• Journal of Periodontal and Implant Science
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• 제36권1호
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• pp.69-84
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• 2006

Reports on the comparison of clinical effect between non-surgical and surgical therapy, and the change of the clinical parameters during maintenance phase have been rarely presented in Korea. This study was to observe the clinical changes during maintenance phase of 6 months in patients with chronic periodontitis treated by non-surgical or surgical therapy in Department of Periodontics, Chonnam National University Hospital. Among the systemically healthy and non-smoking patients with moderate to severe chronic periodontitis, twenty eight patients (mean age: 47.5 years) treated by non-surgical therapy (scaling and root planning) and nineteen patients (mean age: 47.3 years) treated by surgical therapy (flap surgery) were included in this study. The periodontal supportive therapy including recall check and oral hygiene reinforcement was started as maintenance phase since 1 month of healing after treatment. Probing depth, gingival recession. clinical attachment level and tooth mobility were recorded at initial, baseline and 1, 2, 3 and 6 month of maintenance phase. The clinical parameters were compared between the non-surgical and surgical therapies using Student t-test and repeated measure ANOVA by initial probing depth and surfaces. Surgical therapy resulted in greater change in clinical parameters than non-surgical therapy. During the maintenance phase of 6 months, the clinical effects after treatment had been changed in different pattern according to initial probing depth and tooth surface. During maintenance phase, probing depth increased more and gingival recession increased less after surgical therapy, compared to non-surgical therapy. The sites of initial probing depth less than 3 mm lost more clinical attachment level, and the sites of initial probing depth more than 7 mm gained clinical attachment level during maintenance phase after non-surgical therapy, compared to surgical therapy. Non-surgical therapy resulted in greater reduction of tooth mobility than surgical therapy during maintenance phase. These results indicate that the clinical effects of non-surgical or surgical therapy may be different and may change during the maintenance phase.

• Journal of Periodontal and Implant Science
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• 제35권2호
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• pp.311-319
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• 2005

In order to examine the effects of advanced periodontitis on the dental pulps, 38 extracted human teeth were examined histologically. The 38 teeth had a positive or negative state in the electric pulp test(EPT). In addition, almost of the 38 teeth had a deep pocket and severe mobility, and floating state. A medical and dental history was elicited. The extracted teeth fixed in 10% neutral formalin solution. The general tissue processing method was followed. The tissue block including the teeth was prepared for optical microscopy using hematoxillin-eosin staining. Among the 38 periodontally involved teeth, the dental pulps were respectively intact in 12(31%), and a pulp stone(or linear calcifications) was found in 18 teeeth(47%). In addition, 17 teeth(44%) had pulps exhibiting inflammatory reactions with varying intensities, such as hyperemia, pulp abscess, pulp necrosis. Among the 38 periodontally involved teeth, 37 teeth tested a positive to the EPT, and 7 teeth tested negative. The EPT positive 37 teeth had various histological features such as 7 normal pulp(18%), 17 pulp stone(44%), 1 hyperemia (2%), 9 pulpitis(23%), 5 root resorption(13%), 3 pulp abscess(7%), and 3 pulp necrosis(7%), In conclusion, it is suggested that in the EPT positive teeth, advanced periodontally involved teeth can cause inflammation of the dental pulp.

• 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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• 제52권1호
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• pp.65-76
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• 2022

Purpose: The present study measured changes in arteriolar and venular capillary flow and structure in the gingival tissues during the development of plaque-induced gingival inflammation by combining dynamic optical coherence tomography (OCT), laser perfusion, and capillaroscopic video imaging. Methods: Gingival inflammation was induced in 21 healthy volunteers over a 3-week period. Gingival blood flow and capillary morphology were measured by dynamic OCT, laser perfusion imaging, and capillaroscopy, including a baseline assessment of capillary glycocalyx thickness. Venular capillary flow was estimated by analysis of the perfusion images and mean blood velocity/acceleration in the capillaroscopic images. Readings were recorded at baseline and weekly over the 3 weeks of plaque accumulation and 2 weeks after brushing was resumed. Results: Perfusion imaging demonstrated a significant reduction of gingival blood flow after 1 and 2 weeks of plaque accumulation (P<0.05), but by 3 weeks of plaque accumulation there was a more mixed picture, with reduced flow in some participants and increased flow in others. Participants with reduced flux at 3 weeks also demonstrated venular-type flow as determined by perfusion images and evidence of the development of venular capillaries as assessed by the velocity/acceleration ratio in capillaroscopic images. After brushing resumed, these venular capillaries were broken down and replaced by arteriolar capillaries. Conclusions: After 3 weeks of plaque accumulation, there was wide variation in microvascular reactions between the participants. Reduced capillary flow was associated with the development of venular capillaries in some individuals. This is noteworthy, as an early increase in venous capillaries is a key vascular feature of cardiovascular disease, psoriasis, Sjögren syndrome, and rheumatoid arthritis-diseases with a significant association with the development of severe gingival inflammation, which leads to periodontitis. Future investigations of microvascular changes in gingival inflammation might benefit from accurate capillary flow velocity measurements to assess the development of venular capillaries.