The aim of this study was to analyze the effects of bone augmentation on the outcome of implant therapy in patients with periodontitis. Ninety-five patients in whom dental implants were placed after periodontal treatment were divided into the following four groups: None, comprising those who did not need bone augmentation; TR, comprising those who received bone augmentation with a barrier membrane only; Autologous bone graft(ABG)comprising those who received bone augmentation with an autogenous bone graft only; TR+ABG, comprising those who received bone augmentation with both a barrier membrane and autogenous bone grafting. The marginal bone level(MBL)was measured in radiographs, and the 5-year success rate of the implants based on a change in the MBL by 3.0 mm or 1.5 mm or less was calculated using the Kaplan-Meier method. The values were compared using the log-rank test. The 5-year success rate was 97.50% for the None group. 92.86% for the ABG group, 81.55% for the TR + ABG group, and 76.19% for the TR group, with a significant differences(p<0.0001). The change in MBL/year was 0.30 mm/year in the None group, mm/year in the ABG group, 0.49 mm/year in the TR+ABG group, and 0.54 mm/year in the TR group, a statistically significant differences(p<0.0001). Although the changes in the MBL were slight in the None and greater in the group which received bone augmentation, it is suggested that the use of a bone graft may bone resorption around implants in the case of bone augmentation with a barrier membrane. Nihon Shishubyo Gakkai Kaishi(J Jpn Soc Periodontol)54(1):18-30,2012.

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The purpose of this study was to evaluate the plaque removal effects of an electric interdental toothbrush and a conventional manual interdental toothbrush at the proximal surfaces of model teeth. The electric interdental toothbrush was composed of a main body with a motor that generated the vibrations and a PROSPEC^® interdental toothbrush attachment. The manual interdental toothbrush did not vibrate. The mean plaque removal rate of the electric interdental toothbrush was 26% and 32% after 5 and 10 cleanings, respectively, and these removal rates were significantly higher(p<0.01)than those for the manual interdental toothbrush. Based on these findings, it is concluded that the plaque removal effect of the electric interdental toothbrush was greater than that of the manual interdental toothbrush. Nihon Shishubyo Gakkai Kaishi(J Jpn Soc Periodontol)54(1):31-37, 2012.

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Basic fibroblast growth factor (FGF-2) is one of the major candidates as a periodontal tissue regenerating agent. A series of animal studies and clinical trials have demonstrated its efficacy and safety. In the present study, we surveyed the eight-year periodontal treatment and symptom records of 79 patients who had been administered investigational drugs containing 0%(placebo; vehicle alone), 0.03%, 0.1% or 0.3% human recombinant FGF-2 (Code No. KCB-1D) in the exploratory phase II clinical trial, to evaluate the long-term benefits of regenerative therapy using FGF-2. The treatments and symptoms caused by progression of local periodontitis and those not related to periodontitis were categorized as “events" or “censored", respectively. The number of events was 14, and survival analysis (generalized Wilcoxon test) revealed that 0.3% FGF-2 significantly prolonged the time to “event" as compared with vehicle alone (p=0.0345). In this study, no safety problem was observed Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 54(1):38−45,2012.

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Periodontal treatment requires a protracted period of time, especially in cases with advanced periodontitis. Although patient motivation is important, it is difficult to maintain the motivation throughout the treatment period. Herein, we present the case report of a patient who presented with severe gingival inflammation and attachment loss, and was diagnosed as having generalized advanced chronic periodontitis. The patient, a 61-year-old male, visited our clinic with the complaint of bleeding while brushing and diastema of the upper incisors. On examination, generalized inflammation of the marginal gingiva, hyperplastic gingiva, bleeding on probing, and calculus formation in the periodontal pockets were observed. Periodontal examination revealed a plaque control record of 60.7%, with periodontal pocket depths of greater than 6 mm detected in the molars and maxillary incisors. Radiographs obtained at the initial examination revealed extensive generalized horizontal bone defects in the maxilla and mandible. Initial periodontal treatment was undertaken, including introduction of meticulous oral hygiene and systematic scaling and planing of the root surfaces. Thereafter, periodontal flap surgery was carried out as corrective therapy in all the premolars and molars. Plaque control improved and was maintained during the initial treatment. However, the plaque control record after the flap surgery again deteriorated as compared with that noted immediately after the initial treatment, although the patient motivation had been maintained; the probable reason was that the shape of the gingiva had changed drastically after the surgery and the patient could not adapt his brushing to the change. Thus, I proposed a brushing method suitable for removing the remaining plaque, after which the plaque control record improved again. Supportive periodontal treatment is carried out every other month and good oral health has been maintained. With this case report, we wish to emphasize that patient-oriented dental hygiene instruction and maintenance of patient motivation are important to obtain good results of periodontal treatment. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 54 (1):54−59,2012.

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Abstract:A 54-year-old female was referred to our department in November 2001 with the chief complaint of malocclusion. The patient was diagnosed as having moderate chronic periodontitis with maxillary protrusion and mandibular anterior crowding. Following completion of the initial periodontal therapy, orthodontic and prosthetic treatment with extraction of teeth 15 and 41 was performed and supportive periodontal therapy (SPT) was started. The number of teeth present, the mean clinical attachment level, the probing depth (PD), sites with a PD of more than 4 mm, sites with bleeding on probing, and the plaque control record were 29 teeth, 3.6 mm, 3.1 mm, 51 sites (29.3%), 86 sites (49.4%), and 80.6%, respectively, before the treatment. Post treatment, in July 2011,the corresponding results were 25 teeth, 3.1 mm, 2.5 mm, 1 sites (0.7%), 32 sites (21.3%), and 0.7%, respectively. Follow-up after 10 yearsʼ SPT confirmed the stability of the orthodontic and esthetic results. A combination of orthodontic and periodontal treatment may contribute efficaciously to stabilize the periodontal health for a long time. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 54 (1):60−70, 2012.

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We report the case of a generalized chronic periodontitis patient with type 1 diabetes mellitus treated for 12 years who is currently under supportive periodontal therapy (SPT). Evaluation of the patientʼsperiodontal status was performed mainly by examining the average clinical attachment level (CAL),which was recorded on a six-point measurement scale per tooth. The patient was a 56-year-old female whose chief complaint was gingival bleeding on brushing,and tartar accumulation and hypersensitivity (Hys) of the anterior teeth. The patient responded well to basic periodontal therapy,with all periodontal pockets decreasing to<3 mm and improvement in Hys. Tooth no. 27 was transplanted in the space of tooth no. 36,and a bridge was fabricated to achieve left molar occlusion. The patientʼs SPT was interrupted for approximately 2 years, and attachment loss was observed on the transplanted tooth in which plaque control was difficult to perform. The patient suffered from hypoglycemia during glycemic control of hyperglycemia with a HbA1c of 8.2%. In spite of the poor glycemic control,the patientʼs average CAL reduced by 0.2 mm over 12 years,and attachment gain was observed. Necessity of continuous SPT and strict plaque control was suggested for this chronic periodontitis patient with type 1 diabetes mellitus. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 54(1):71−80,2012.

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