Removal of subgingival calculus is essential for the success in periodontal treatment. Subgingival instrumentation is used for the removal of all bacterial plaque and calculus. In this study, Gracey curet and Ultrasonic curet were used on single rooted teeth to conduct subgingival scaling and root planning. The remaining amount of calculus was evaluated according to type of instrument, depth of pocket, and tooth surface. 24 teeth were extracted from 14 patients being treated at department Periodontology Seoul Advantist dental hospital were used. Total 96 area(4 surface per teeth) were evaluated. 12 teeth treated with Gracey curet were used as the control group and the other 12 teeth treated with Ultrasonic curet were examined for experimental group. The 4 surfaces of the teeth(buccal, mesial, lingual or palatal, distal) were observed through the stereomicroscope and the images of the surface were captured and saved in CCD. The images were displayed on the monitor and the amount of calculus remained was evaluated by overlapping 10x10 grid pixel screen produced by Microsoft power point. The results evaluated were as follows 1. There was no statistically significant difference in residual calculus and tooth position following scaling and root planning of all group, but statistically significant correlation with residual calculus, probing depth, instruments and tooth surface. 2. There was statistically significant correlation between residual calculus and probing depth, but no statistically significant difference in residual calculus, tooth surface and tooth position on experimental(Ultrasonic curet) group. 3. There was no statistically significant difference in residual calculus according to the pre-treatment pocket depth and tooth position, but statistically significant correlation with tooth surface. The amount of residual calculus increase with mesial, distal, buccal and lingual(or palatal) surface on control(Gracey curet) group. 4. The Gracey curet showed better results than ultrasonic curet in mesial and distal surface, and there is significant difference. The results demonstrate that ultrasonic curet alone is inadequate for thorough subgingival debridement and suggest that Ultrasonic curet with Gracey curet should be more effective.
Calculi ; Debridement ; Dental Scaling* ; Humans ; Seoul ; Tooth ; Ultrasonics*

A mucogingival grafting procedure has been developed to cover denuded root surface. The subepithelial connective tissue graft technique is very predictable and allows for a good esthetic results and minimum patient discomfort on the palate. However, in areas where there is a lack of vestibular depth and keratinized attached tissue, the presence of frena or heavy muscle attachment, covering the connective tissue graft with a mucosal flap is very difficult. The purpose of this study is to evaluate an alternative technique of root coverage using the free connective tissue graft. The results were as follows: 1. Probing depths didn't seem to vary significantly from the preoperative to postoperative period. 2. The amount of keratinized tissue showed an increase of 5.9+/-0.97mm from the preoperative level. 3. Total clinical exposed root coverage increase 72.2% compare with preoperative level. 4. The shrinkage from gingival margin is 4.2+/-1.15mm and the mean shrinkage rate is 40.1%. 5. The depth of the vestibule increased with the average distance from cementoenamel junction to mucogingival junction being 7.4+/-1.65mm.
Connective Tissue* ; Humans ; Palate ; Postoperative Period ; Tooth Cervix ; Transplants*

The purpose of this study was to evaluate clinical changes in graft size after treatment with connective tissue autograft in human. 40 premolar teeth in 23 patients having the following mucogingival problemswere selected. The width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth were measured at the initial examination, 2, 12 and 24 weeks following the connective tissue autograft and free gingival autograft. The change of width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth according to healing process in both graft procedures was statistically analyzed by ANOVA test and independent t-test using SPSS program. The results were as follows: 1. The change of keratinized gingiva in both grafting procedures was increased significantly at 24 weeks post-op. 2. The clinical sulcus depth exhibited no marked changes throughoutthe entire investigation in both grafting procedures. 3. After 12 weeks, no dimensional variation was seen in graft size in both grafting procedures. 4. Shrinkage differs significantly in both grafting procedures. From the day of graft to 24 weeks after surgery the percentages of shrinkage were connective tissue autograft 55% and free gingival autograft 29%.
Autografts* ; Bicuspid ; Connective Tissue* ; Gingiva ; Humans ; Tooth ; Transplants*

In periodontal regeneration treatment, access to the frucation area is very difficult. Thus complete removal of plaque, calculus and endotoxin is somewhat impossible. In this study, teeth that were extracted due to periodontal disease were used. The furcation area was treated with periodontal curette, ultrasonic scaler, roto bur and they observed using SEM. The result was follows 1. The group treatment with curette showed remaining plaque, the cementum existed in most of the surface and partial dentinal tubule orifice could be seen. 2. The group treatment with ultrasonic scaler showed less removalof plaque compared to curette and irregular surface could be seen. 3. The group treatment with roto bur showed cleaner surface and many dentinal tubule orifice could be seen compared to the curette and ultrasonic scaler groups. Thus when suing treatments such as bone grafting or guided tissue regeneration, it is considered that the furcation area should be treatment with Roto bur.
Bone Transplantation ; Calculi ; Dental Cementum ; Dentin ; Guided Tissue Regeneration ; Periodontal Diseases ; Regeneration ; Tooth ; Ultrasonics

Recently, alteration on chemical treatment on the root and removal of pathologic bacteria, which is the main reason for periodontal disease, by complete removal of infected cementum layer was been emphasied In this study, teeth extracted due to periodontal disease were root planed using periodontal curette and roto bur. Then they were treated with different concentration of Tetracycline HCl at different time. The state of root surface and change in the pre and post treatment was observed. The results were as follows. 1. The group treatment with periodontal curette and saline showed remaining plaque, debris and irregular surface and no dentianl tubule orifice could be seen. 2. The group treatment with periodontal curette and tetracycline HCl showed process compoed with decacified material and there was concanity seemed to be a lacunae of cementocyte. 3. The group treatment with roto bur and saline, there was no remaning plaque and partial dentinal tubule orifice could be seen but smear layer covering them. 4. The group treatment with roto bur and tetracycline HCl showed various shape and size dentinal tubule orifice could be seen. From the results, roto bur showed cleaner surfaces than treatment with periodontal curette. But still smear layer existed. Thus for regeneration of periodontal tissue, chemical treatment using tetracycline HCl should follow roto bur treatment. And it is considered that the treatment time is more important than the concentration of tetracycline HCl.
Bacteria ; Dental Cementum ; Dentin ; Periodontal Diseases ; Regeneration ; Root Planing* ; Smear Layer ; Tetracycline* ; Tooth

Teeth mobility is an important part of a periodontal examination, because it represents a function of the persisting height of the alveolar bone and the width of the periodontal ligament. The purpose of this study was to evaluate clinical difference in teeth mobility after treatment with the modified Widman flap and the undisplaced flap in humans. Twenty males with moderate periodontal disease were selected. The severity of periodontal disease was evaluated with sulcular bleeding index, pocket depth and attachment level and tooth mobility was measured with Periotest(Siemens Co., Germany) at the initial examination, 1, 2, 4, 6, 8 and 12 weeks following the modified Widman flap and the undisplaced flap operation using the split-mouth technique. The relation of mobility to clinical parameters was statistically analyzed by multiple regression and the change of teeth mobility according to healing process by independent t-test using SPSS program. The results were as follows: 1. There was a strong relationship between the Periotest value(PTV) and attachment level. 2. The change of teeth mobility in both flap procedures was increased significantly at 1 week post-op. and was decreased to preoperative level at 4 weeks post-op. in modified Widman flap and at 6 weeks post-op. in undisplaced flap. 3. The change of teeth mobility in premolar teeth group in undisplaced flap compared to modified Widman flap was generally increased but these changes were not statistically significant. The changes of teeth mobility in molar teeth group in undisplaced flap was increased significantly at 2 weeks post-op.. 4. The change of teeth mobility following undisplaced flap was increased significantly compared to that of modified Widman flap at 2 weeks post-op.
Bicuspid ; Hemorrhage ; Humans ; Male ; Molar ; Periodontal Diseases ; Periodontal Ligament ; Tooth Mobility ; Tooth*

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polylactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.
Humans

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polylactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.
Humans

The present study evaluated the effects of guided tissue regeneration using xenograft material(deproteinated bovine bone powder), with and without biodegradable membrane in beagle dogs. Contralateral fenestration defects (6 x 4 mm) were created 4 mm apical to the buccal alveolar crest of maxillary premolar teeth in 5 beagle dogs. Deproteinated bovine bone powders were implanted into fenestration defect and one randomly covered biodegradable membrane (experimental group). Biodegradable membrane was used to provide GTR. Tissue blocks including defects with soft tissues which were harvested following four & eight weeks healing interval, prepared for histo-phathologic analysis. The results of this study were as follows. 1. In control group, at 4 weeks after surgery, new bony trabecular contacted with interstitial tissue and osteocytes like cell were arranged in new bony trabecule. Bony lamellation was not observed. 2. In control gruop, at 8 weeks after surgery, scar-like interstitial tissue was filled defect and bony trabecule form lamellation. New bony trabecular was contacted with interstitial tissue but defect was not filled yet. 3. In experimental group, at 4 weeks after surgery, new bony trabecular partially recovered around damaged bone. But new bony trabecule was observed as irregularity and lower density. 4. In experimental group, at 8 weeks after surgery, lamella bone trabecular developed around bone cavity and damaged tissue was replaced with dense interstitial tissue. In conclusion, new bone formation regenerated more in experimental than control groups and there was seen observe more regular bony trabecular in experimental than control groups at 4 weeks after surgery. In control group, at 8 weeks after surgery, the defects was filled with scar-like interstitial tissue but, in experimental group, the defects was connected with new bone. Therefore xenograft material had osteoconduction but could not fill the defects. We thought that the effective regeneration of periodontal tissue, could be achieved using GTR with biodegradable membrane.
Animals ; Bicuspid ; Bone Regeneration ; Dogs* ; Furcation Defects* ; Guided Tissue Regeneration ; Heterografts ; Membranes* ; Osteocytes ; Osteogenesis ; Powders ; Regeneration* ; Tooth

Tooth mobility is an important part of a periodontal examination and represents a function of the persisting height of the alveolar bone and the width of the periodontal ligament. The purpose of this study was to evaluate the changes of the tooth mobility over 4 week-period following surgical therapy on the periodontal disease. Thirty five patients presenting with moderate periodontal pockets were selected and tooth mobility was measured at weekly intervals using Periotest (Siemens Co., Germany) beginning at the pre-operation examination and ending four weeks following the modified Widman Flap. All data were statistically analyzed using the one-way ANOVA test. The results were obtained as follows; 1. All teeth exhibited the greatest change in mobility at 1 week post-op, mobility generally decreasing with time. 2. Comparison of the weekly tooth mobility data regarding the 1st premolars showed significant differences only between weeks 1 (9.94) and 4 (6.14) (p<0.05). 3. Comparison of the weekly tooth mobility data regarding the 1st molar showed significant changes in the intervals between pre-op (6.49) and week 1 (11.22), pre-op and week 2 (9.37), weeks 1 and 3 (7.65), weeks 1 and 4 (5.62), and weeks 2 and 4 (p<0.05). 4. Comparison of the weekly tooth mobility data regarding the 2nd premolar and 2nd molar showed significant differences between pre-op (6.91, 8.60) and week 1 (11.02, 12.62), weeks 1 and 3 (8.00, 8.05), weeks 3 ad 4 (6.22, 6.71), and weeks 2 (9.34, 11.01) and 4 (p<0.05).
Bicuspid ; Humans ; Molar ; Periodontal Diseases ; Periodontal Ligament ; Periodontal Pocket ; Tooth Mobility* ; Tooth*