OBJECTIVE: To evaluate the effectiveness of periodontal endoscope as an adjuvant therapy for the non-surgical periodontal treatment of patients with severe and generalized periodontitis. METHODS: Patients (n=13) were divided into three groups: patients treated with conventional subgingival scaling and root planing (SRP) (n=7, 408 sites) (group A), SRP using periodontal endoscope (n=4, 188 sites) (group B) or SRP with periodontal endoscope 3 months after initial SRP (n=2, 142 sites) (group C). Two subgroups were divided into 2 subgroups according to PD at the baseline: 46 mm as subgroup 2. Probing depth (PD), attachment loss (AL), gingival recession (GR) and bleeding on probing (BOP) were recorded. RESULTS: The results of 3 months after treatment showed all PD, AL, and GR values in group A1 were less than those in group B1 (P<0.05), but no significant difference in BOP was found between the two groups. The decrease in PD, BOP in group B2 was more obvious than those in group A2 (P<0.000 1), and the GR values in group B2 were more than those in group A2 (P<0.000 1). But the improvement of AL showed no statistical difference between the two groups (P=0.296 8). In group C1, no significant difference in PD, AL, and GR was observed after endoscopy-assisted therapy, but it was more effective for BOP (P<0.000 1). In group C2, the improvement in PD and AL was significantly different from the improvement in SRP alone (P=0.000 5, P=0.000 2) and was accompanied by more GR (P=0.000 5). CONCLUSIONS In non-surgical treatment of severe and generalized periodontitis, SRP can achieve good therapeutic effect on sites with 4<
PD≤6 mm. For sites with PD>6 mm, the application of periodontal endoscopy can increase the effect, reducing PD and GR, which may be an effective supplement to the current non-surgical periodontal treatment.
Dental Scaling ; Endoscopes ; Follow-Up Studies ; Gingival Hemorrhage ; Humans ; Periodontal Attachment Loss ; Periodontal Index ; Periodontal Pocket ; Periodontitis ; Root Planing ; Treatment Outcome

BACKGROUND: The mandibular third molar (M3) is typically the last permanent tooth to erupt because of insufficient space and thick soft tissues covering its surface. Problems such as alveolar bone loss, development of a periodontal pocket, exposure of cementum, gingival recession, and dental caries can be found in the adjacent second molars (M2) following M3 extraction. The specific aims of the study were to assess the amount and rate of bone regeneration on the distal surface of M2 and to evaluate the aspects of bone regeneration in terms of varying degree of impaction. METHODS: Four series of panoramic radiographic images were obtained from the selected cases, including images from the first visit, immediately after extraction, 6 weeks, and 6 months after extraction. ImageJ software® (NIH, USA) was used to measure linear distance from the region of interest to the distal root of the adjacent M2. Radiographic infrabony defect (RID) values were calculated from the measured radiographic bone height and cementoenamel junction with distortion compensation. Repeated measures of analysis of variance and one-way analysis of variance were conducted to analyze the statistical significant difference between RID and time, and a Spearman correlation test was conducted to assess the relationship between Pederson’s difficulty index (DI) and RID. RESULTS: A large RID (> 6 mm) can be reduced gradually and consistently over time. More than half of the samples recovered nearly to their normal healthy condition (RID ≤ 3 mm) by the 6-month follow-up. DI affected the first 6 weeks of post-extraction period and only showed a significant positive correlation with respect to the difference between baseline and final RID. CONCLUSIONS: Additional treatments on M2 for a minimum of 6 months after an M3 extraction could be recommended. Although DI may affect bone regeneration during the early healing period, further study is required to elucidate any possible factors associated with the healing process. The DI does not cause any long-term adverse effects on bone regeneration after surgical extraction.
Alveolar Bone Loss ; Bone Regeneration ; Compensation and Redress ; Dental Caries ; Dental Cementum ; Follow-Up Studies ; Gingival Recession ; Molar ; Molar, Third ; Periodontal Pocket ; Retrospective Studies ; Tooth ; Tooth Cervix

PURPOSE: The purpose of this study was to evaluate the clinical effects of erythritol powder air polishing device (EPAP) in addition to scaling and root planing (SRP) in non-surgical periodontal treatment in moderate chronic periodontitis patients. MATERIALS AND METHODS: Clinical evaluation was performed at 21 sites treated with SRP (control) and 21 sites treated with the addition of SRP+EPAP (test). All examinations were performed before treatment, 1 month after treatment, and 3 months after treatment. Depth of the periodontal pocket, gingival recession, clinical attachment level, plaque index, and bleeding of probing were measured as clinical parameters. RESULTS: In both test and control groups, there was a significant decrease in the depth of the periodontal pocket, plaque index, bleeding of probing, increased gingival recession, and gain of clinical attachment level at 1 month and 3 months after treatment. However, there was no significant clinical difference between the test group and the control group. Clinical result was improved after 1 month compared to the baseline; in contrast, results at 3 months after treatment were worse than at 1 month after treatment. CONCLUSION: In this study, we cannot suggest that SRP + EPAP is clinically more effective than SRP alone as non-surgical periodontal treatments. Periodic periodontal therapy, at intervals of at least every three months, is important for sustaining effects of this treatment.
Chronic Periodontitis ; Clinical Study ; Dental Scaling ; Erythritol ; Gingival Recession ; Hemorrhage ; Humans ; Periodontal Pocket ; Periodontitis ; Root Planing ; Treatment Outcome

The purpose of this study was to evaluate the validity of dental hygienist job according to judgment standard of medical practice in medical law. In this study, we conducted a self-administered questionnaire survey to evaluate the validity of dental hygienist job for 12 professors of dental college in Gangneung-Wonju National University from November 10 to 20, 2017. We investigated whether the dental hygienist job conforms to the three criteria of medical practice such as disease prevention and treatment, patient care, and health hazard. The response rates were scored and classified into four categories according to the final score. As a result of this study, dental hygienist job are classified into four categories according to judgment standard of medical practice. The higher the level of the category, the higher the degree of difficulty, and the higher the level of expertise and skills required. More than 50% of respondents answered that measuring the gingival pocket, bleeding on probing, professional tooth cleaning, oral health education, counseling after dental treatment are all three criteria for medical treatment. And these were classified into Level 4 group which requires the difficulty and expertise in the final score 4.3. It is necessary to develop and utilize standardized guidelines on the level of knowledge, education, and qualification standards required for dental practice in order to effectively allocate work among the dental personnel while ensuring the health rights of patients in the dental clinic field in Korea. In addition, there is a need to evaluate the various aspects of cost effectiveness, dental health service productivity, and health promotion contribution to dental hygienist jobs, And based on this evidence, it is necessary to continue to expand and adjust the dental hygienist job and to reorganize the dental workforce system.
Cost-Benefit Analysis ; Counseling ; Dental Clinics ; Dental Health Services ; Dental Hygienists* ; Education ; Efficiency ; Gingival Pocket ; Health Promotion ; Hemorrhage ; Humans ; Judgment* ; Jurisprudence* ; Korea ; Oral Health ; Patient Care ; Surveys and Questionnaires ; Tooth

Dogs commonly serve as a model for various human conditions, including periodontal diseases. The aim of this study was to identify the anaerobic bacteria that colonize the subgingival areas in dogs and humans by using rapid real-time polymerase chain reaction (RT-PCR)-based tests and to compare the results obtained in each species. Bacterial microflora evaluations, both quantitative and qualitative, were performed by applying ready-made tests on twelve dogs and twelve humans. Five samples were collected from each subject's deepest gingival pockets and joined to form a collective sample. The results of the study revealed interspecies similarities in the prevalences of Porphyromonas (P.) gingivalis, Treponema denticola, Tannerella forsythia, and Fusobacterium nucleatum. Red complex bacteria comprised the largest portion of the studied bacterial complexes in all study groups, with P. gingivalis being the most commonly isolated bacterium. The results show similarities in the prevalence of bacterial microflora in dogs and humans. Microbiological analysis of gingival pockets by using rapid real-time PCR-based tests in clinical practice, both veterinary and human, can facilitate the choice of appropriate pharmacological treatment and can provide a basis for subsequent verification of the treatment's effectiveness.
Animals ; Bacteria ; Bacteria, Anaerobic ; Colon ; Dogs ; Forsythia ; Fusobacterium nucleatum ; Gingival Pocket ; Humans* ; Periodontal Diseases* ; Porphyromonas ; Prevalence ; Real-Time Polymerase Chain Reaction ; Treponema denticola

PURPOSE: The present study has two aims; firstly, it attempts to verify the presence of oxidative stress by estimating the reactive oxygen species (ROS) levels in periodontal pockets > or =5 mm as compared to controls. The second aim is to evaluate the effect of lycopene as a locally delivered antioxidant gel on periodontal health and on the gingival crevicular fluid (GCF) levels of 8-hydroxydeoxyguanosine (8-OHdG), a marker of oxidative injury. METHODS: Thirty-one subjects participated in this study. In the pretreatment phase, the ROS levels in pockets > or =5 mm were measured by flow cytometry. Three sites in each subject were randomly assigned into each of the following experimental groups: sham group, only scaling and root planing (SRP) was done; placebo group, local delivery of placebo gel after SRP; and lycopene group, local delivery of lycopene gel after SRP. Clinical parameters included recording site-specific measures of GCF 8-OHdG, plaque, gingivitis, probing depth, and clinical attachment level. RESULTS: The gel, when delivered to the sites with oxidative stress, was effective in increasing clinical attachment and in reducing gingival inflammation, probing depth, and 8-OHdG levels as compared to the placebo and sham sites. CONCLUSIONS: From this trial conducted over a period of 6 months, it was found that locally delivered lycopene seems to be effective in reducing the measures of oxidative stress and periodontal disease.
Antioxidants ; Carotenoids ; Deoxyguanosine ; Flow Cytometry ; Gingival Crevicular Fluid ; Gingivitis ; Inflammation ; Oxidative Stress ; Periodontal Diseases ; Periodontal Pocket ; Periodontitis ; Reactive Oxygen Species ; Root Planing ; Salicylamides

This study is to prepare the in situ forming sustained-release injection which can perform sustained release behavior at the periodontal site for 7 days and to evaluate its in vitro and in vivo properties. After preparation of in situ forming sustained-release injection the in situ time was studied. And the surface of the solid injection was characterized by SEM. The rheological curve at 0 degrees C, 25 degrees C, 37 degrees C was determined and the impact of the temperature on the viscosity was examined. The in vitro release behavior was investigated. At last, rabbit periodontitis model was established to study its pharmacokinetics. The injection was stable, hard to stratify and decompose. The in situ forming time was about 6 seconds. It can easily adhere into periodontal pockets. There were lots of holes on the surface of the solid injection for the drug to diffuse. The drug releasing curves could be fit by Korsmeyer-Peppas equation. The drug smoothly released for 7 days at pH 7.4 PBS buffer with a very slight burst release and maintained a certain concentration. In vivo pharmacokinetics results indicated that after administration with the in situ forming injection, achievement of tinidazole (TNZ) concentration in gingival crevicular fluid (GCF) was more comparable and long-lasting than usual solution of TNZ management and relatively constant TNZ levels were attained until 168 h. All these results supported the prospect of tinidazole in situ forming sustained-release injection in clinical applications.
Animals ; Antitrichomonal Agents ; administration & dosage ; pharmacokinetics ; Delayed-Action Preparations ; Drug Carriers ; Drug Compounding ; methods ; Endotoxins ; Gingival Crevicular Fluid ; metabolism ; Injections ; Periodontal Pocket ; metabolism ; Periodontitis ; chemically induced ; metabolism ; Polyesters ; chemical synthesis ; pharmacokinetics ; Polyethylene Glycols ; chemical synthesis ; pharmacokinetics ; Rabbits ; Random Allocation ; Rheology ; Tinidazole ; administration & dosage ; pharmacokinetics

OBJECTIVETo describe the periodontal condition of population in Qinghai province and provide basic data for the diseases prevention.

METHODSReferring to the guideline for the third national oral health survey, the method of multistage, stratified, equal capacity, simple random sampling was carried out in population of 12, 35-44, and 65-74 years old in Qinghai province. Gingival bleeding, calculus, periodontal pocket and loss of attachment of population were investigated.

RESULTS1) In 12, 35-44, 65-74 age groups, the prevalence of gingival bleeding was 98.74%, 97.84%, 92.23%, the prevalence of calculus was 89.76%, 99.87%, 92.87%. 2) In 35-44 age group, the prevalence of shallow periodontal pocket was 34.64%, the prevalence of deep periodontal pocket was 5.58%. In 65-74 age group, the prevalence of shallow periodontal pocket was 50.45%, the prevalence of deep periodontal pocket was 13.12%. 3) In 35-44 age group, the prevalence of 4-5, 6-8, 9-11, 12 mm or more loss of attachment was 40.74%, 18.78%, 4.82%, 1.78%. In 65-74 age group, the prevalence of 4-5, 6-8, 9-11, 12 mm or more loss of attachment was 71.21%, 51.34%, 20.51%, 7.01%.

CONCLUSIONThe oral health condition of population in Qinghai province is very poor. The periodontal pocket and loss of attachment was severely. The disease prevention should be strengthen in Qinghai province.

Adult ; Dental Calculus ; Dental Health Surveys ; Female ; Gingival Hemorrhage ; Humans ; Middle Aged ; Periodontal Attachment Loss ; Periodontal Diseases ; Periodontal Index ; Periodontal Pocket ; Prevalence

Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine (IL-1beta, IL-6, IL-1ra, tumor necrosis factor-alpha, and prostaglandin E2). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of PGE2 was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood PGE2. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15 % vs. 3.3 %, OR 5.118, p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.
Alleles ; Arteries ; C-Reactive Protein ; Cardiovascular Diseases ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease* ; Coronary Stenosis ; Coronary Vessels ; Cytokines ; Dinoprostone ; DNA ; Epidemiologic Studies ; Genotype ; Gingival Crevicular Fluid ; Gram-Negative Bacterial Infections ; Hemorrhage ; Humans ; Inflammation ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1* ; Interleukin-6 ; Korea* ; Multigene Family ; Periodontal Diseases ; Periodontal Index ; Periodontal Pocket ; Periodontitis* ; Polymerase Chain Reaction ; Risk Factors ; Tooth ; Tumor Necrosis Factor-alpha

Gingival recession is exposure of the root surface with apical shift in the position of gingiva. The incidence of gingival recession is 8% in children and 100% after the age of 50. Recession tends to be found in patients with healthy gingiva, but more frequentely found in patients with periodontal disease, and it often causes mucogingival defects. Buccal surface of premolar is the area not only for severe gingival recession and cervical abrasion, but also the area of numbers of buccal frenum and less keratinized gingiva. Therefore, the goal of this study was to observe the patients with periodontitis and examine whether there are clinical relations between gingival recession and cervical abrasion of premolar and other factors related with the condition of periodontal health. Generally healthy 218 patients who had periodontal disease such as gingivitis and periodontitis, aged between 18 and 78, were examined for depth of periodontal poket, width of attached gingiva, gingival recession, cervical abrasion, and frenum of mid-buccal surface of premolar at the Department of Periodontics in Dankook University Dental Hospital and following is the result. 1.The average gingival recession and cervical abrasion of premolar with periodontal disease was 0.76mm and 0.29mm and each has 43% and 14% of incidence. Also the width of attached gingiva of mid-buccal surface was 1.77mm. The average periodontal pocket depth is 2.0mm and 47% of frenum were related. The frenum more frequently seen was narrow single shaped frenum, and the interdistance of the frenum was mostly over 4mm. 2.With statistical significance(P<0.05), the incidence of gingival recession increased with age and was related much more with female than male, the first premolar than the second premolar, and with narrow attached gingiva and frenum. 3.With statistical significance(P<0.05), the incidence of cervical abrasion increased with age and was related with the area of the first premolar and narrow attached gingiva, but the sexual and frenum differences were not statistically significant (P>0.05). 4.The severity of gingival recession increased with age and was more related with female than male, the first premolar than the second premolar. And the area of narrow attached gingiva and frenum showed more gingival recession and the distance of frenum was more highly related than shape, and they were statistically significant (P<0.05). 5. With statistical significance(P<0.05), the severity of cervical abrasion increase with age and was observed at the first premolar and narrow attached gingiva. But the sexual and frenum differences were not statistically significant (P>0.05).
Bicuspid ; Child ; Female ; Gingiva ; Gingival Recession* ; Gingivitis ; Humans ; Incidence ; Male ; Periodontal Diseases ; Periodontal Pocket ; Periodontics ; Periodontitis