• Journal of Periodontal and Implant Science
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• v.52 no.1
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• pp.77-87
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• 2022

Purpose: This pilot study assessed the immediate in vivo effect of high peak pulse power neodymium-doped yttrium aluminum garnet (Nd:YAG) laser monotherapy on selected red/orange complex periodontal pathogens in deep human periodontal pockets. Methods: Twelve adults with severe periodontitis were treated with the Laser-Assisted New Attachment Procedure (LANAP®) surgical protocol, wherein a free-running, digitally pulsed, Nd:YAG dental laser was used as the initial therapeutic step before mechanical root debridement. Using a flexible optical fiber in a handpiece, Nd:YAG laser energy, at a density of 196 J/cm² and a high peak pulse power of 1,333 W/pulse, was directed parallel to untreated tooth root surfaces in sequential coronal-apical passes to clinical periodontal probing depths, for a total applied energy dose of approximately 8-12 joules per millimeter of periodontal probing depth at each periodontal site. Subgingival biofilm specimens were collected from each patient before and immediately after Nd:YAG laser monotherapy from periodontal pockets exhibiting ≥6 mm probing depths and bleeding on probing. Selected red/orange complex periodontal pathogens (Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia/nigrescens, Fusobacterium nucleatum, Parvimonas micra, and Campylobacter species) were quantified in the subgingival samples using established anaerobic culture techniques. Results: All immediate post-treatment subgingival biofilm specimens continued to yield microbial growth after Nd:YAG laser monotherapy. The mean levels of total cultivable red/orange complex periodontal pathogens per patient significantly decreased from 12.0% pretreatment to 4.9% (a 59.2% decrease) immediately after Nd:YAG laser monotherapy, with 3 (25%) patients rendered culture-negative for all evaluated red/orange complex periodontal pathogens. Conclusions: High peak pulse power Nd:YAG laser monotherapy, used as the initial step in the LANAP® surgical protocol on mature subgingival biofilms, immediately induced significant reductions of nearly 60% in the mean total cultivable red/orange complex periodontal pathogen proportions per patient prior to mechanical root instrumentation and the rest of the LANAP® surgical protocol.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.592-596
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• 2010

The common local causes of active gingival bleeding are the vessel engorgement and erosion by severe inflammation and injury to hypervascularity lesion. Abnormal gingival bleeding is also associated with systemic bleeding disorders (liver disease, leukemia etc.). There are many conventional methods for gingival bleeding control, such as, direct pressure, packing, electrocoagulation, tight suture and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the all local application methods, the medical consultation should be obtained for systemic condition care and the major feeding arterial embolization. This is a case report of severe gingival bleeding and periodontitis control in a patient with liver cirrhosis and oral metastatic lesion of hepatocellular carcinoma. The bleeding lesion was placed in left buccal mucosa and gingiva of the left mandibular molars. The control methods were dental crown removal, primary endodontic drainage, gingival sulcus drainage and maxillary arterial embolization with medical consultation.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.1
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• pp.24-30
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• 2019

The successful results of the treatment using a double crown denture have been reported in several papers for some of the few remaining teeth in patient. In particular, double crown dentures may be an alternative to treatment in cases where the periodontal status is poor and clasp type removable partial dentures are inappropriate (crown/root ratio > 1). In this case, the patient visited clinic with a chief complaint of difficulty in mastication due to loss of posterior teeth and overall teeth mobility. After teeth with severe periodontitis were extracted, treatment plan of mandible is Kennedy class I removable partial denture (RPD) and treatment plan of maxilla is hybrid telescopic double crown RPD with a friction pin. Patient is well adapted after the prosthetic treatment and we report due to achieving satisfactory results in pronunciation, mastication, retention and aesthetics.

• Journal of Periodontal and Implant Science
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• v.45 no.5
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• pp.178-183
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• 2015

Purpose: Elderly people are thought to be more susceptible to periodontal disease due to reduced immune function associated with aging. However, little information is available on the nature of immune responses against putative periodontal pathogens in geriatric patients. The purpose of this study was to evaluate the serum IgG antibody responses to six periodontal pathogens in geriatric subjects. Methods: The study population consisted of 85 geriatric patients and was divided into three groups: 29 mild (MCP), 27 moderate (MoCP), and 29 severe (SCP) chronic periodontitis patients. Serum levels of IgG antibody to Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, and Prevotella intermedia were measured by enzyme-linked immunosorbent assay (ELISA) and compared among the groups. Results: All three groups showed levels of serum IgG in response to P. gingivalis, A. actinomycetemcomitans, and P. intermedia that were three to four times higher than levels of IgG to T. forsythia, T. denticola, and F. nucleatum. There were no significant differences among all three groups in IgG response to P. gingivalis (P=0.065), T. forsythia (P=0.057), T. denticola (P=0.1), and P. intermedia (P=0.167), although the IgG levels tended to be higher in patients with SCP than in those with MCP or MoCP (with the exception of those for P. intermedia). In contrast, there were significant differences among the groups in IgG levels in response to F. nucleatum (P=0.001) and A. actinomycetemcomitans (P=0.003). IgG levels to A. actinomycetemcomitans were higher in patients with MCP than in those with MoCP or SCP. Conclusions: When IgG levels were compared among three periodontal disease groups, only IgG levels to F. nucleatum significantly increased with the severity of disease. On the contrary, IgG levels to A. actinomycetemcomitans decreased significantly in patients with SCP compared to those with MCP. There were no significant differences in the IgG levels for P. gingivalis, T. forsythia, T. denticola, and P. intermedia among geriatric patients with chronic periodontitis.

• The Journal of the Korean dental association
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• v.53 no.7
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• pp.485-499
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• 2015

Purpose: Delayed intentional replantation was introduced as a new alternative to treat the teeth with severe periodontal involvement. The purpose of this study was to elucidate the possibility of delayed intentional replantation and establish theoretical backgrounds. Materials and Methods: Studies were performed into the following two subjects; (1)Clinical evaluation of patients who underwent delayed intentional replantation using clinical and radiographic data. Severe periodontitis involved teeth were carefully extracted and proper time for delayed replantation was evaluated by analyzing inflammation markers (IL-6, TNF-${\alpha}$). (2) Theoretical studies for efficacy of delayed intentional replantation using (-)-Epigallocatechin-3-gallate (EGCG) for preservation of periodontal ligament cells on root surface by minimizing inflammation and treatment of inflammatory extraction sockets. Results: Meaningful success ratio and survival rate were found in delayed intentional replantation showing reduced bone loss and maintained bone level. Additionally, viability of EGCG applied periodontal ligament cells was much higher than control group. Also, EGCG promoted healing of inflammatory extraction sockets by inhibiting inflammatory cell proliferation. Conclusion: Within the limitations of this study, 1-2 weeks after extraction is an appropriate time to do delayed intentional replantation. Also, EGCG provides helpful effects on viability of periodontal ligament cells and periodontium.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.521-528
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• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.382-394
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• 2022

The treatment of patients with severe periodontitis should be proceeded step-bystep through an accurate diagnosis of each patients' individual tooth and with a strategic treatment plan. Implant-supported fixed prosthetic restoration has the advantage of high patient satisfaction and stable vertical dimension compared to the removable partial denture. However, multiple teeth defect areas lacking hard tissue may be disadvantageous in aesthetic failure and longer treatment time. In addition, it takes a certain period of time to manufacture and install a conventional fixed prosthesis, and during this process, the provisional prosthesis must satisfy the mechanical, biological, and aesthetic requirements of teeth. The purpose of this article is to describe the fabrication of implant-supported fixed prosthesis through a step-by-step approach in a partially edentulous patient.

• The Journal of the Korean dental association
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• v.54 no.8
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• pp.592-603
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• 2016

Pathologic tooth migration (PTM) caused by periodontal disease is a relatively common disease with a prevalance rate of 30~55%. It is one of the reasons for periodontal treatment of patients. PTM occurs when various factors related to the position of the tooth are altered and clinical features of PTM include facial flaring, diastema, proximal tilting, rotation, and extrusion of teeth. The purpose of this study was to assess the treatment of teeth of hopeless prognosis through the practice of modified intentional replantation on pathologic migrated tooth. This study presents cases using modified intentional replantation for the treatment of pathologic tooth migration caused by severe periodontitis. Modified intentional replantation is a technique that prepares extraction socket by using an implant drill. Based on 3 cases performed with modified intentional replantation, an improvement of clinical periodontal indicators such as probing pocket depth, bleeding on probing, tooth mobility, and pathologic teeth migration was observed after surgery. Also, the patients were satisfied with the functional and esthetic improvement.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.1-8
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• 2005

Bacterial heat shock protein has been one of the components that are responsible to induce autoimmune disease mechanisms in the pathogenesis of atherosclerosis due to high level of homology in sequence with human counterpart. This mechanism may explain how bacterial infectious disease, such as periodontal disease, might contribute to the acceleration of the disease process of atherosclerosis. Porphyromonas gingivalis which is a major periodontal pathogenic bacterial species, has been implicated as one of the pathogenic bacteria playing the role in this context. The present study has been performed to evaluate the anti-atherosclerotic effect of adoptive transfer of Porphyromonas gingivalis heat shock protein epitope-specific T cell lines into severe combined immunodeficiency (SCID) mice. Peptide no. 15 with amino acid sequence VKEVASKTND-specific T cell line was selected for the transfer. When experimental atherosclerosis was induced in SCID mice adoptively transferred either by the T cell lines (experimental group) or by non-specific mouse T cells (control group), there was no significant difference in the severity and extent of the atherosclerosis induced by hypercholesterol diet.

• Journal of The Korean Dental Society of Anesthesiology
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• v.4 no.1 s.6
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• pp.17-20
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• 2004

Chronic periodontitis is one of the most common disease in clinical dentistry, which needs various surgical interventions to treat the moderate to severe destruction of supporting periodontium. Most patients have fear and anxiety to these surgical procedures and some dentists also have problems to deal with these patients. Applying the conscious sedation technique in outpatient units, periodontists have become to manage their patients successfully without any fear and anxiety and increased the level of patients' satisfaction. Particularly, periodontal treatments require relative long chair-time and patients are usually reluctant to the periodontal instruments used in the oral cavity. This study is focused on the sedation procedure with intravenous midazolam infusioon performed in Department of Periodontology, Ewha Womans University Hospital. The whole procedure of intravenous midazolam sedation is briefly reviewed from patient selection to patient discharge.