The carboxylic acids are known to be produced by the bacteria in the dental plaque. The purpose of the present study is to investigate the concentrations of carboxylic acids in the whole saliva and the gingival crevicular fluid (GCF) of periodontal patients. The effects of these acids on human gingival fibroblasts were also examined.
Nine males and 9 females patients were divided into two groups (Group A and Group B), according to the differences in probing depth (PD) and alveolar bone loss. Patients of Group A had gingivitis or slight adult periodontitis (PD4mm, alveolar bone loss33%), whereas patients of Group B had moderate to advanced adult periodontitis (PD>4mm, alveolar bone loss>33%). Carboxylic acids in the whole saliva and the GCF which were collected from the patients of Group A and Group B were examined using high performanced liquid chromatography. The effects of two carboxylic acid salts (butyrate and formate) on the proliferation of human gingival fibroblasts from normal human gingiva were also examined by cell culture.
Results obtained were as follows.
1. The concetrations of four carboxylic (acids acetic, propionic, succinic and butyric acids) in the GCF collected from patients of Group B were significantly higher than that of Group A. On the contrary, all carboxylic acid contents in the whole saliva were not significantly different between the patients of Group A and Group B.
2. Formate (1 or 3mM) showed only a small degree of inhibition against the proliferation of human gingival fibroblasts, but butyrate (3mM) almost completly (95.2%) inhibited the proliferation of human gingival fibroblasts.
3. The results of the present study may indicate that the carboxylic acids are involved in the initiation and development of the periodontal disease and that they can be one of the indicators in the diagnosis of the periodontal disease.

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The purpose of this study was to determine the protein patterns in gingival crevicular fluid relation to the isoelectic focusing protein patterns of GCF and to clinical evaluations. GCF was collected with filter paper from 105 subjecfs. The probing depth, the gingival index (LÖe & Silness) and the plaque index (Silness & LÖe) as clinical evaluations
The results follow:
1. The main isoelectic focusing protein patterns of GCF were between pH 5.5 and 7.5. In comparison, the GCF and the serum fron the same patients showed patterns to similer serum albumin.
2. Between of GCF pH 5.5 and 7.5 the protein patterns thaf ranged over 60% was pI 5.65, 6.45, 6.55, 6.75 and 7.00.
The frequencies of the ranges of protein patterns and clinical evaluation were comparcd by the X² test. pI 5.65, 6.45, 6.55 and 6.75 and PD were significantl different. as were pI 6.45, 6.55 and 6.75 and GI. But each pI and PIl. were not significantly different.

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The purpose of this study was to investigate the changes in concentration of glycosaminoglycans (GAGs) and to investigate the incorporation of ³Hglucosamine into GAGs in vitro in the epithelium and subepithelium connective tissue separated from the gingiva during a period of experimental periodontitis.
Periodontitis was induced by placement of a silk ligature below the gingival margin in dog molars . The GAGs extracted from gingival samples obtained 0, 7, 21, 60 and 90 days before and after the ligature placement were separated by cellulose acetate membrane electrophoresis for both qualitative and quantitative analysis.
Hyaluronic acid content of the epithelium was decreased significantly at the acute phase of inflammation. In the connective tissue, the amounts of dermatan sulfate and hyaluronic acid were higher, but chondroitin sulfate and heparan sulfate levels lower than in the control. The incorporation of ³Hglucosamine into GAGs in the epithelium was greater than that in connective tissue at the acute phase . The greatest incorporation of ³H-glucosamine was found in chondroitin sulfate at the acute phase, and did not return to the basal level at the chronic phase.
These findings suggest that the biochemical response of GAGs in the epithelium to inflammation might be different from that in connective tissue .

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Oral implantation has been a controversial dental therapeutic procedure. Many implant materials and designs are presently in progress of study to evaluate the long term response of peri-implant tissues, together with anticipated loading considerations.
The purpose of this examination was to make clear whether a fibrous layer would form between bone and Titanium alloy and apatite-coated Titanium implants under stressed and unstressed conditions, during the healing phase after implantation.
The in vivo evaluation of 10 implants were made on two dogs. The upper 2nd and 3rd and lower 3rd and 4th premolar teeth were extracted and the sockets allowed to heal for 3 months. The implants in the unstressed condition were completely submerged, and in the stressed condition they were left with their top 2 mm above the surface of the bone, so that after suturing the top of the implant was exposed to the oral environment.
After the postoperative healing phase of 3 months, the animals were killed and the specimens were preparated for histological, SEM examinations and EDX analysis of the interface zone between bone and the implants. Histological examination showed a direct contact between the apatite-coated implant and new bone, so that the implant became anchored to bone without an intervening soft tissue layer and a similar result was obtained between the Titanium implant and bone in the unstressed condition. However the high magnification electron micrographs showed a thin connective tissue between the beadblasted surface of the Titanium implant and bone, and this peri-implant tissue could be detached from the implant.
In the stressed condition, a thin layer of fibrous tissue was interposed between the Titanium implant and bone. The high magnification electromicroscopical views of the interface zone between the bone and these implants showed coarse fiber bundles developed perpendicular to the Titanium surface and their terminal ends were confluent with the rugged Titanium surface presumably as a result of micromovement during the 3 months healing phase.
In this study, an adequate space for a development of fibro-anchorage was about 20.200 μm in width.
If occlusal stresses were within permissible range in healing period, the relative motion of the implant and bone was then optimal for the formation of a fibro-anchorage. It could be suggested that an ideal stress transfer from the Titanium implant to bone might be achieved by this fibro-anchorage.

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It is believed that gingivitis at puberty is exaggerated by alterations of the hormonal balance. We have suggested that estradiol promotes the gingivitis at puberty while progesterone reduces it (J. Hiroshima Univ. Dent. Soc. 19: 1987). But the mechanisms of these hormones which influence gingival inflammation are not kown yet.
Therefore, we hypothesized that one of the possible mechanisms of sex hormones on gingival inflammation is through their action on polymorphonuclear leucocytes (PMNs) function because PMNs play an important role in periodontal disease. The purpose of this study was to investigate the effect of sex hormones on PMNs function, especially their migration in vitro.
PMNs and plasma were obtained from heparinized peripheral blood of 23 healthy adults. PMNs were preincubated at 37.. for 15 minutes with progesterone or 17 β-estradiol at designated concentrations. After preincubation, PMNs migration was measured using 48-well chemotaxis microchamber with N-formylmethionyl-leucyl-phenylalanine (FMLP) as chemoattractant. The levels of estradiol and progesterone in the plasma were determined using Direct Radioimmunoassay Kits and the correlation between sex hormone levels and PMNs migration was investigated.
PMNs migration to 10^-6 M FMLP was enhanced significantly by progesterone at the concentrations of 200ng/ml while it was reduced by estradiol at 0.4 ng/ml and 2.0ng/ml. Random migration of PMNs was enhanced significantly by progesterone at 20ng/ml while it was reduced by estradiol at 0.4ng/ml. Significant positive correlation was found between progesterone level in plasma and the PMNs migration in vitro. Estradiol level in plasma did not have any cor relation with the PMNs migration in vitro .
These results suggest that sex hormones have different effects on PMNs migration, i. e., progesterone enhances the migration and estradiol reduces it.

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The lymphocyte subsets in the peripheral blood of 8 individuals, aged 25 to 57 yr, with moderate to advanced adult periodontitis were analyzed before and after treatment by means of flow cytometry, and then compared with the findings in 20 normal adults (aged 30 to 45 yr). The results were as follows: the percentage of OKT-8⁺ (CD 8) in the patients (20.25±7.15%) was lower than that in normal individuals (31.50±6.03%, P<0.01) while the OKT-4/OKT-8 ratio (2.34.± 1.18) was higher than the corresponding ratio in the controls (1.23±0.37) ; however, there was no siginificant difference in the percentages of OKT-3⁺ (CD 3), OKT-4⁺ (CD 4) and Leu-12⁺ (CD 19) between patients and normal subjects. The percentages of OKT-3⁺, OKT-4⁺, OKT-8⁺, Leu-12⁺ and OKT-4/OKT-8 after the periodontal therapy did not show a significant difference compared with the data obtained before treatment. These results indicate that the decrease in suppressor/cytotoxic T-cell population may be a kind of pathological disposition of the initiation and/or course of adult periodontitis.

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Phenytoin (PHT), administered as an anticonvulsant, has a side effect gingiva overgrowth in approximately 50% of patients. The present study was attempted to explore the biochemical mechanism on non-collagenous protein biosynthesis as affected by PHT.
Responder cells (RES A 3, RES C 2) of a patient with gingival overgrowth were obtained by the method of Kawase et al. Normal human gingival fibroblasts (Gin-1), purchased from ATCC, were also used. All cells were inoculated at 1×10⁴ cells/cm² 12 multi-well plate or 60 mm tissue culture (dish), and then cultured for 4, 8 and 12 days with or without PHT (5 μg/ml). Prior to harvesting at the indicated times, cells were incubated with 1⁴C-amino acids (1.25 μCi/ml) for 24 hours. The ¹⁴C-labeled proteins were isolated from the cell layers including extracellular maxtrix, following Kurkinen et al. with a minor change. Each ¹⁴C-labeled fraction was dissolved in 3 ml of Aquasol-2 and the radioactivity by a liquid scintillation counter.
The DNA content of cell layers affected by PHT was increased on Gin-1, RES A 3 and RES C 2 at the post-confluence, resulting also in an increase in cell number. Two morphologically different phenotypes of responder cells were observed, differing in nuclear and cell sizes. At 12 days culture, RES A 3, were stimulated by PHT, showed increased synthesis of both total extractable proteins (EP) and binding proteins (BP) labeled with ¹⁴C-amino acids.
Therefore, at least two distinct phenotypic responder cells are present in the PHT-induced overgrowth gingiva, alter the synthesis of non-collagenous proteins.

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Previous studies have revealed that periodontally involved exposed roots show evidence of biologic toxicity possibly due to endotoxin from subgingival micro-organisms.
Eleven periodontally involved teeth and five periodontally healthy teeth comprised the meterial. The teeth were rinsed in ultrasonic cleaner containing pyrogen-free water for one hour. The samples were taken from the solution after 1, 5, or 60 minutes. With the aim of removing residual endotoxin on the roots not eliminated by rinsing, each tooth was subjected to extraction of endotoxin with 45% phenol in water for 90 minutes at 65... After extraction of endotoxin, the root surface of the involved teeth was further planed with a hand scaler. Endotoxin was extracted from the particles removed from the root surfaces. All samples were tested for endotoxin by limulus amoebocyte lysate assay.
The amount of endotoxin from involved teeth was 4, 500±2, 000 ng per tooth and from healthy teeth it was 370±120 ng per tooth. The amount of residual endotoxin on roots from involved teeth. was 32±20 ng per tooth and from healthy teeth it was 1.2±1.1 ng per tooth. The amount of endotoxin collected from particles removed from previously rinsed involved root surfaces was 1.5 ng per tooth. The rate of removal of endotoxin by water rinsing of a tooth was 64±25% in 1 minute, 85±16% in 5 minutes, 99±0.6% in 60 minutes.
From these findings, water rinsing of the exposed root was considered effective for removing endotoxin from the root surface.

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We examined in vitro the inhibitory effects of ovomacroglobulin on collagenolytic activity in Bacteroides gingivalis (B. gingivalis) culture supernatant, in human peripheral blood polymorphonuclear leucocytes (PMN), and in gingival crevicular fluid (GCF) from periodontitis patients. Measurement of collagenolytic activity was conducted with a CollagenoKit CLN-100 using FITC-conjugated type I collagen. The FITCconjugated collagen was reacted with the sample in solution, and the residue was selectively degenerated at 35., and removed with ethanol. The fluorescence of the removed residue was then measured.
The collagenolytic activity from B. gingivalis displayed dose dependent inhibition as high as 81.4% following addition of ovomacroglobulin at 224 μg/ml. The collagenolytic activity from human peripheral blood PMN showed, as a result of addition of 1, 600 μglml of ovomacroglobulin, inhibition as high as 62%. 4, %. The collagenolytic activity from human GCF, which was obtained from patients with different degrees of periodontal disease, exhibited as high as 71.0 % inhibition after addition of 1, 600 μg/ml ovomacroglobulin. Ovomacroglobulin showed almost the same level of inhibition obtained from a₂-macroglobulin, which was measured as a positive control.
It was also recognized by SDS-PAGE that collagenolytic activity was inhibited after preincubation with added ovomacroglobulin. This collagenolytic activity, which dissolved the collagen substrate, was derived from B. gingivalis and human GCF.
The above results demonstrate that ovomacroglobulin inhibits collagenolytic activity from B. gingivalis, human PMN, and human GCF.

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The purpose of this study was to evaluate the periodontal tissues around the 47 abutment teeth in patients with advanced periodontitis for 5 years maintenance periods.
The periodontal and prosthetic treatment were carried out and 16 Konus telescope dentures were applied for 11 patients. During 5 years maintenance therapy, periodontal conditions were observed once a year assessing probing depth, attachment level, tooth mobility index, gingival index, marginal alveolar bone height, width of periodontal ligament and loss of lamina dura.
The results showed that increase of probing depth in 0.61mm and attachment loss in 0.78mm were observed for 5 years. A slight gingival inflammation occurred and tooth mobility increased in some extent. Enlargement of periodontal ligament space and loss of lamina dura in 40% of abutment teeth were observed for 5 years. There were six decayed teeth, six teeth, from which a intracoronal crown was removed, and two extracted teeth in 47 abutment teeth.
In conclusion, the periodontal tissues around abutment teeth in Konus telescope denture changed slightly at one year after denture placement, after which, the periodontal tissues were well maintained.

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In periodontal diseases, due to lack of subjective symptoms, disease awareness and professional consultations are often dismissed even by subjects with already established periodontal lesions. The purpose of this study was to gain data concerning the relationship between bleeding induced by interdental stimulating and some of the clinical indices used in routine periodontal examinations in order to consider if wooden interdental cleaners, which are available to patients themselves, could be used as a means of arousing disease awareness. Furthermore, the buccolingual insertion of interdental cleaners was confirmed together with reconsiderations on its role as a means of proximal plaque control.
180 interdental sites of 30 new out-patients suspected of gingivitis or periodontitis consisted the material. As comparative indices to interdental stimulating, Bleeding on Probing (BOP), Probing Depth (PD), Gingival Index (GI) and Gingival Crevic ular Fluid (GCF) measurement were selected. The interdental cleaning efficiency was reconsidered by assessment of interproximal plaque removal.
As a result, bleeding was induced both by interdental stimulating and probing in 106 of the 180 experimental sites and was the majority. In relation to PD, concerning pockets less than 1.5mm, bleeding was not induced by interdental stimulating. 58.8% of 3 mm pockets and all of the pockets deeper than 5 mm bled on interdental stimulating. Concerning the relationship with the GI, no site evaluated GI. 0 bled on interdental stimulating. 12.9% of sites evaluated GI. 1, 73.3% of sites evaluated GI. 2, and all of the sites evaluated GI. 3 bled on interdental stimulating. 39.0% of sites with GCF measurement of 0-21, 51.9% of sites with GCF measurement of 21.40 and 93.8% of sites with GCF measurement of over 81 showed bleeding on interdental stimulating. Evaluation of plaque removal showed that wooden interdental cleaners were sufficiently effective in the interdental area, bucco-lingually.
Through this study, it was verified that the examination of interdental gingival inflammation utilizing wooden interdental cleaners is closely related to evidence of proximal gingival inflammation. Adding to its conveniency in simplicity and handiness, wooden interdental cleaners have been shown to be effective in proximal plaque removal. Wooden interdental cleaners may be looked forward as

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The purpose of this study was to investigate the prevalence and treatment needs of periodontal disease in the 1, 150 university students (male: 726, female: 424) by using simplified Community Periodontal Index of Treatment Needs (CPITN-S).
The results were as follows:
1. Approximately 85% of all the subjects have something wrong in periodontal tissue. If examined in detail;
1) Code 4: a group (1.6%) who had a deep pocket more than 6mm.
2) Code 3: a group (20.1%) who had a shallow pocket 4 to 5mm.
3) Code 2: a group (55.9%) who had supra-or subgingival calculus.
4) Code 1: a group (7.5%) who had bleeding on probing only.
2. As for treatment needs (TN), approximately 78% of the subjects need to receive professional prophylaxis and more complex treatment including periodontal surgery (TN2.3).
3. Average time required to examine one subject was about one minute, so we could cut down the measuring time. From this point, we have understood that simplified CPITN was greatly effective to curtail the time for the primary screening of periodontal disease in the young age group.

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The purpose of this study was twofold. The first objective was to measure the periodontal status and perceptions of oral health in adolescents. The second objective was to determine the effects that a program of dental health education would have on their periodontal status and perceptions of oral health. The dental health education with a 90-minute lecture had been given to eleventh-grade students (352) in the previous year. The dental health education program was not carried out in tenth-grade students (442) yet. The oral examination was performed by a dentist for both grades. The examination time was about ten seconds per person. The students' periodontal status was scored as“excellent (+2), “ ” good (+1), “ ”questionable (0), “ ”poor (-1), “or”very poor (-2) ” according to the criteria of an Oral Rating Index (ORI) System proposed by the present authors. The level of students' perceptions was assessed by the cognition score of our dental health test (10 items concerning dental attitudes and behavior). Main results were as follows:
1. Only 6% of the 10-th grade students were judged as having“ excellent (+2) ” oral health. Thirty-six percent were“very poor (-2) ”or“poor (-1) ”periodontal status.
2. The mean cognition score and the mean ORI score of the 11-th grade students were significantly greater for each sex group than those of the 10-th grade students.
3. The cognition score showed a clear relationship to the ORI score in each grade and in all. The behavioral component of the cognition score was more closely related to the ORI score. These findings suggest that the dental health education contributes to the improvement of periodontal status as well as that of perceptions. Furthermore, the ORI may be utilized for a screening system to evaluate adolescents' periodontal status quickly and effectively.

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The present study was designed to elucidate the blood reflux into cartridge under infiltration anesthesia. When imitation examination was carried out using pontamine blue dye solution in 7 kinds of syringes for the use of cartridge, dye reflux was observed in all of them. Compared 4 kinds of cartridges on the market, dye reflux was observed in all except one. The amounts of protein in residual anesthetic solution of cartridges after infiltration anesthesia were quantitatively measured by dye binding method. Human hemoglobin was also measured by enzyme immunoassay (EIA). The detection rates of protein and human hemoglobin were 26.2% (85/324) and 24.2% (24/99), respectively. From these facts that blood reflux cannot be avoided in the cartridge system, it is necessary to prohibit the reuse of residual anesthetic solution of cartridge as quickly as possible to avert the risk of cross infection of HB and AIDS virus.

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In an attempt to determine how the degree of the experimental calculus removal on the metallic plate and its roughness after scaling would be affected by ultrasonics under high or low frequency, quantitative measurement and morphological observation were made.
The results obtained were as follows:
1. On the calculus removal, larger effect was obtained by high frequency unit than low frequency.
2. On the roughness of the metallic plate after scaling, larger defect was observed by high frequency unit than low frequency.
3. Scanning electron microscopically, strip like defects were observed under low frequency unit, while exfoliation of the metallic plate in addition to the strip like defects were observed under high frequency.

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A Breath Detector was developed and its clinical application was investigated.
It is very difficult to judge how one's own breath smells. The sense of smell is the most unreliable of the senses and has still not been scientifically clarified.
Everyone who tried to accurately express the strength and the character of some smell will be puzzled to see the difficulty of expression. A smell on one's breath is actually impossible to expressed on the same scale as for weight or length. On a laboratory basis, it is certainly possible to clarify the concentration and the mass of some odor by using graphic or numerical values with Gas chromatography. However such measuring methods at laboratories are not available in our daily clinical life when it is required to check easily, anytime and anywhere.
In consideration of the above, We believe that this Breath Detector with a built-in small special gas sensor will act a substitute for an analyzer, and that the device can express how strong the smell on one's breath is. Therefore we recommend Breath Detector as a product many patients have been waiting for.

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A breath detector was developed and its clinical application was investigated. 20 patients that included self-halitosis patients and periodontally diseased patients with halitosis were the subjects of this investigation. Measuring by breath detector was tried third time and most high score was taken for one's smell revel. The same time mouth air was analyzed by gas chromatograph. The amount of volatile sulphur compounds in mouth air was made a comparison between the two methods. The intensity of halitosis by olfactory panel were divided into four groups, (-) good, (±) slight, (+) warn, (++) severe. And we investigated that breath detector's judgement and olfactory panel were in agreement or not.
A breath detector was very sensitive for volatile sulphur compounds as well as gas chromatograph. It was therefore concluded that breath detector seemed to be potentially useful in clinical objective evaluation of halitosis and periodontal diagnosis.

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The association of periodontopathic bacteria in the subgingival plaque with human periodontal disease has been well established. However, past attempts at reducing the level of pathogenic bacteria by using antibiotics as well as other antibacterial substance, so far, have not been fully successful. In this study, the effect of topical application of ofloxacin (OFLX), a synthetic antibiotic, was evaluated in relation to the clinical parameters. For this purpose, the new developed controlled release strips containing OFLX (PT-01), in which there were structually immediate and sustained-releasing portions, were used. 147 adult patients suffering from moderate to severe periodontitis were selected for this study. The patients had received no periodontal treatment previously and had taken no antibiotics within the preceding 6 months. Three different sites with a deep probing pocket depth (≥ 5mm) were randomly selected in each patient, and were divided into three groups, i. e., PT-01 applied site (T), placebo-applied site (P) and control site (C). Periodontal treatments consisted of oral hygiene instruction and supragingival scaling on day 0 and 7, and subgingival scaling and root planing on day 14. PT-01 was applied in the periodontal pocket weekly on day 0 to 35, and clinical parameters on each site were recorded weekly. The results showed that, during first 14 days, significant reduction in the percentage of the sites which showed bleeding on probing, pus discharge or mobility of the tooth was observed in the PT-01 applied site. However in placebo and/or control group, no significant change in any parameters was observed in this period. While, after subgingival scaling and root planing, significant improvement was found at all sites in every clinical parameter. Especially, PT-01 applied sites showed significant improvement in the gingival index and bleeding on probing, compared to placebo-applied or control sites. These results suggest that weekly insertion of PT-01 in the periodontal pocket along with the subgingival scaling and root planing could have significant effect on the improvements in the gingival inflammation. Taken together, weekly application of PT-01 might have ameliorating effect as adjuncts of mechanical subgingival plaque control in the periodontal treatment.

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The recognization that destructive periodontal diseases may be caused by specific microorganisms has led to an increased interest and usage of antimicrobial agents in periodontal therapy. In this study, the effect of topical application of ofloxacin (OFLX), a synthetic antibiotic, was microbiologically evaluated.
The new developed controlled release strips containing OFLX (PT-01), in which there were structually immediate- and sustained-releasing portions, were applied to the periodontal pockets of 27 adult subjects with periodontitis. Three different sites with a deep probing pocket depth (. 5mm) were randomly selected in each patient, and were divided into three groups, i. e., PT-01 applied site (T), placebo-applied site (P) and control site (C). Periodontal treatments consisted of oral hygiene instruction and supragingival scaling on day 0 and 7, and subgingival scaling and root planing on day 14. PT-01 was weekly applied on day 0 to 35, and the subgingival plaque samples from each site were collected on day 0, 14, 21 and 42. The dynamics of subgingival microflora was investigated by dark field microscopy for determination of the %s of spirochetes, motile rods and coccoid cells, and anaerobic and aerobic cultivations for the determinations of the total number of subgingival bacteria, black-pigmented Bacteroides BPB), Fusobacterium species and Actinobacillus actinomycetemcomitans.
The results showed that the significant reduction of %s of spirochetes and motile rods and significant increase of % coccoid cells were found in only PT-01 applied sites during first 14 days. In this period, the total number of cultivable bacteria, BPB and Fusobacterium species were also significantly reduced in T sites. While, after subgingival scaling and root planing were performed, significant changes in the proportions and numbers of the subgingival microflora were found in all sites. Especially, PT-01 applied site showed significant improvement in the %s of spirochetes and motile rods as well as the total number of the bacteria. Moreover, the further microbiological deteminations of the each isolate revealed that no detectable amounts of A. actinomycetemcomitans could be found from any samples in this study.
These results suggested that weekly application of PT-01 in the periodontal pocket could have significant effects on the qualitative and quantitative improvements in the subgingival microflora. It was also suggested that the application of PT-01 might have ameliorating effect as adjuncts of mechanical subgingival plaque control in the periodontal treatment.

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An air-powder abrasive device used to remove stain and debris adherent to tooth surface is now available for use by dentist. Air Flow ® was evaluated for its effectiveness in removing stains and debris from teeth. Split design in anteriors was used, and half was treated with the device and the contralateral side with a brush cone and tooth polishing paste. Time required by each method to remove stain and debris completely was recorded and compared.
A gingival trauma index was assessed according to the method of Weaks L.M. et al. (1984). Air-powder abrasive system removed stain and debris in less time than brush cone technique (P<0.001). The system was also most effective in removing stains in pit, fissure and contact areas. The device caused a significant increase (P<0.01) in gingival irritation immediately posttreatment, but there was no statistically and clinically significance in the effect on the gingiva at 7 days posttreatment between two techniques.
In vitro study, the effect of the device on root surfaces was also assessed. 5, 10, 20, 40 and 60 seconds exposure of a fixed point on root surfaces to the device produced defects 137, 245, 308, 945 and 1, 394 μm in depth, respectively. The resulting surface was smooth and all cementum was removed. And the average loss of root structure as a function of the exposure time was also assessed. The average losses were 0.2, 0.6, 1.7, 1.8, 2.0, 2.1, 2.3 and 2.4 mg by 5, 10, 15, 20, 30, 40, 50 and 60 seconds exposures, respectively.
Root surface roughness, resulting from hand curette, ultrasonic curette and air-powder abrasive system was examined histologically. The hand curette produced smooth root surface. The ultrasonic instrument produced a surface characterized by irregular ridges. The air powder abrasive system was found to produce a root surface favorably comparable to manual root planing and remove cementum from areas of difficult treatment, such as furcations.

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For a patient who had a deep periodontal pocket without an attached gingiva on labial central area of left upper canine, a free gingival graft from the palate was done. After that, a flap was reflected and the cause of the lesion was determined.
It became clear that there was a vertical fracture of the root and a composite resin (Clearfil-SC®) was used to fill the fractured area.
It has been 2 1/2 years since the therapy and the prognosis is good.

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