Plaque control by brushing of teeth plays an important role in the prevention and treatment of periodontal diseases. This study was designed to evaluate the plaque removal efficacy of two types of sonic toothbrushes. Twenty dentists with clinically healthy gingiva and without restorative materials or carious teeth participated in this study. Plaque scores (the modified Plaque Control Record of O\_c00096Leary) were recorded before and after the brushing trials. Section 1: Subjects brushed their teeth using each toothbrush (manual toothbrush: MT group, Sonicare^® Elite with standard brush head : ES group, Sonicare^® Elite with minibrush head : EM group) for 2 minutes and 4 minutes.
Section 2 : The same subjects brushed their teeth using the new type of sonic toothbrush (Sonicare^® FlexCare with standard brushhead : FS group, Sonicare^® FlexCare with minibrush head : FM group) for 4 minutes.
The results indicated that the highest rate of plaque removal was obtained after brushing with EM for 4 minutes. Moreover, the plaque removal efficiency of brushing with FM was statistically significantly greater than that of brushing with ES for 4 minutes. The subjects\_c00096 brushing experience with Sonicare^® FlexCare seemed to be more favorable than that with Sonicare^® Elite. The brushing time of 2 minutes was considered to be too short to detect any significant advantage of the minibrush head. However, when the brushing time was lengthened, the minibrush head reached the proximal surfaces and buccal molar teeth more effectively.
The Sonicare^® FlexCare (smaller, lighter, and lesser vibration) not only allowed superior plaque removal, but also gave a pleasant brushing experience, which may be a significant factor in long-term use.
Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 53(4):235-242,2011.

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Some patients respond poorly to periodontal treatment, whereas others respond well to treatment, but fail to maintain improved periodontal status. We hypothesized that the initial response of the periodontal pockets to periodontal treatment is correlated with the recurrence rate of deep pockets during maintenance. The objective of this longitudinal study was to verify this hypothesis in patients with chronic periodontitis. All patients underwent initial periodontal treatment, followed by periodontal surgery if deep pockets and bleeding on probing (BOP) persisted. Data from all treated sites (n=895) in 19 patients exhibiting recurrent deep pockets during maintenance care were analyzed. Recurrent deep pockets were defined as pockets with a probing pocket depth (PPD) of \_mB42 4 mm at the first visit, which had decreased to a depth of \_mB43 3 mm after the periodontal treatment, but increased again to \_mB42 4 mm during maintenance care. All treated sites were classified into two groups: a recurrent group (n=82) and a stable group (n=813). Clinical parameters during treatment were evaluated in both groups. Number of roots (single or multi), BOP (positive/negative) and tooth mobility (positive/ negative) also served as classification parameters. A logistic regression model was utilized to estimate the probability of recurrence of deep pockets in relation to the extent of decrease of the PPD following initial periodontal treatment. The results of this study revealed that sites demonstrating only slight decrease of the PPD after initial periodontal treatment showed a high likelihood of showing recurrent deep pockets during maintenance care. The degree of the PPD following initial periodontal treatment may be a risk indicator during maintenance care.
Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 53(4) : 243-253, 2011.

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Successful maintenance with non-surgical periodontal treatment, including initial preparation and prosthetic treatment, for 20 years in a patient diagnosed as a case of severe generalized chronic periodontitis is reported.
The clinical course of this patient suggests that the long junctional epithelium improves with scaling and that root planing could remain stable for a long period of time.
Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 53(4) : 254-262, 2011.

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I report on a patient diagnosed as having generalized aggressive periodontitis, who showed significant clinical improvement with initial periodontal therapy, which included oral hygiene instructions, scaling and root planing (SRP), and supportive periodontal therapy(SPT) at short intervals, without surgical periodontal therapy.
The patient, in good general health, was a 27-year-old male and non-smoker, who visited our clinic with the chief complaint of bleeding from gums at the time of brushing and discoloration caused by dental caries on the mesial site of the left-upper lateral incisor.
The first examination, including inspection and X-ray imaging, revealed swelling and redness of the interdental papilla and marginal gingiva, and horizontal bone loss of moderate severity in the entire mouth, and partial vertical bone loss. Accumulation of large amounts of subgingival calculus was also seen.
As a result of periodontal tissue examination, the percentage of teeth with a periodontal pocket probing depth(PD) of over 4 mm was very high, being 63.0%. The percentage of teeth showing bleeding on probing(BOP) was also very high, being 59.4%. However, O'Leary's plaque control record(PCR) was relatively low, at 21.1%.
He began to take interest in his own oral health after receiving education on periodontitis. He came to be actively involved in the treatment of periodontitis by obtaining further knowledge about periodontitis, therefore, the initial preparations could be conducted smoothly.
Since the patient refused the surgical periodontal therapy out of fear, initial preparations, such as scaling and root planing, were chosen for debridement of deep pockets. I tried debridement in periodontal pockets with a PD of more than 4mm, followed by careful self care of the high-risk parts and SPT every month. Two years after the start of the therapy, marked improvement of the periodontal condition was observed, such that the percentage of teeth with a PD of over 4 mm became 21.9% and that of teeth showing BOP became 9.4%.
Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 53(4) : 263-271, 2011.

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