STRESS AND SEVERE PERIODONTITIS IN THAI POPULTION

N. Hongprasong1, V. Buatongsri2, P. Phantumvanit2, Y. Songpaisan2, & N. Clarke2

Fac. Of Dent. Chulalongkorn Univ.Fac. of Publ. Hlt.h. Mahidol Univ. & Fac. Of Dent. Univ. of Adelaide

J. Dent Res 1997; 76(5): 1213

Since severe periodontitis had been found in developed countries similar to those in developing countries, stress is convinced to be one of modifying factors of this disease. The purpose of this study was to examine whether stress relates to severe periodontitis in the risk group population. The urban group with CPITN4 was selected from workers in the banking and teaching professions (111) while rural group (248) was chosen from 4 villages in Chiangkam, Prayao province. The Spielberger Trait Anxiety index (20 questions with a potential score ranging from 0-60) was used as stress index and the relationship between stress and severe periodontitis was assessed. It was founded that in urban group had greater number of high stress than rural group (93.7% VS. 80.2%) although urban group had lesser number of severe periodontitis than those in rural area (17.0% VS 27.9%). There was no significant difference between the percentage of CPITN4 persons in low and high stress group in urban and rural areas (33.3% VS 27.85 and 38.2% VS 35.17%). It seems no relationship between stress and severe periodontitis, however other risk factors should be considered. Supported by Chulalongkorn University Rajadapised Sompoj Research Fund.

DISTRIBUTION OF SEVERE PERIODONTITIS DESTRUCTIVE CONDITION IN URBAN AND RURAL THAILAND

Y. Songpaisan1*, N. Hongprasong2, V. Buatongsri2, P. Phantumvanit2.

Mahido Univ, Thammasat & Chulalongkorn University, Bangkok 10330, Thailand.

J. Dent Res 1997; 76(5): 1219

The purpose of this report was to compare the periodontal status of rural and urban Thai population, The cross-sectional study for severe periodontal destructive condition was carried out in 35-55 years old Thai population, both males and females. All first and second molars and central incisors (12 teeth) of the total of 1,167 rural farmers from 4 villages in Payao province and 654 urban bank employee from Bangkok were examined using CPITN. The percentage of persons having at least one tooth with severe periodontal destructive condition, CPITN scored 4, was higher in rural (27.9%) than in urban (17.0%). Significant differences of the mean number of teeth in various CPITN scores were found among the 12 teeth examined, i.e. CPITN4 : rural = 4.3±1.92 v.s. urban =3.3±1.86 (p<0.001) and CPITN 3 : rural=5.4±2.09 v.s. rural =4.7±2.13 (p<0.001). The most common scored CPITN 4-teeth were the right second molars, i.e. #17(54.1%) and #47 (52.0%) whereas the lower incisors, i.e. #31 (3.1%) and #41 (8.9%) were the least affected. The study showed that severe periodontitis destructive condition was higher in rural population than in urban population. This seems to be similar to the destructive periodontal condition between in the developing countries and the industrialised countries which has been reported. Supported by Chulalongkorn University Rajadapisek Sompoj Research Fund.

RELATION BETWEEN SEVERE PERIODONTITIS AND SMOKING HABITS

P. Phantumvanit, N. Hongprasong1, V. Buatongsri2, Y. Songpaisan2, & N. Clarke2

Thammasat & Chulalongkorn Univ, Mahido Univ, Bangkok, Thailand; Univ of Adelaide, Adelaide. Australia.

J. Dent Res 1997; 76(5): 1219

The purpose of this Stuedy was to examine the relationship between smoking and the occurrence of severe periodontal breakdown in rural and urban Thai population. The retrospective epidemiological study was carried in 200 rural (Payao) and 111 urban (Bangkok) severe periodontitis (CPITN=4) subjects, both males and females. A set of questionnaires relating to smoking habits and number of cigarette smoking per day was completed by subjects. The findings showed that there were more smokers in rural (50.8%) than urban (30.4%) subjects (p<0.001). But most of the urban subjects smoked 10-20 cigarette/day (75.0%) whereas most of the rural subjects smoked less than 10 cigarette/day (84.9%). There was no significance difference between the percentage of CPITN 4-person in smoking and non-smoking subjects in both the urban (27.8 v.s. 28.5) and rural (34.8 v.s. 36.5) groups. However, the prevalence of severe periodontitis was significantly different between urban and rural subjects (p<0.001). The data indicates that severe periodontitis may not relate only to smoking habits but other risk factors that should be considered concurrently. Supported by Chulalongkorn University Rajadapisek Sompoj Research Fund.

Ultrastructure of Gingival Hyperplasia due to Dilantin

Suppipat N.1, Hongprasong N.1, Swasdison S.2

1Department of Periology, Faculty of Dentistry, Chulalongkorn University
2Department of Dental Pathology, Faculty of Dentistry, Chulalongkorn University

CU Dent J 1997;20:153-58

Dilantin is an anticonvulsant drug commonly used in the treatment of epilepsy. This drug induces gingival hyperplasia as a side effect in the patients. In this study, transmission electron microscopy had been used to investigate the ultrastructures of Dilantin-induced gingival hyperplasia and normal gingiva of the patients. The resulf showed that ultrastructures of gingival fibrobasts and interstitial collagen fibers of hyperplastic gingiva were similar to those of normalgingiva, but the amount of collagen fibers seemed to be greater and denser in the hyperplasic gingiva.

THE RELATIONSHIP BETWEEN STRESS AND PERIODONTAL DISEASE.

Chearskul P1, Piyasathit P2, Hongprasong N2

Department of Periodontology

CU Dental Research project 1998;45.

In the present society, the way of living and economical status puts a lot of stress on people . This study aims to detect the relationship between stress and periodontitis, and to compare the severity of the disease between persons having low and high stress. One hundred periodontitis patients and one hundred scaling patients from the Periodontal Department, Faculty of Dentistry, Chulalongkorn University who had at least 20 teeth, were asked to complete questionaire about personal history, medical history, socioeconomics and environmental status. The Modified Test Anxiety Inventory (TAI) by Spielberger was used to measure stress. Periodontal data was collected from their periodontal chart records. The severity of the disease was classified into 3 levels by the depth of periodontal pocket and clinical periodontal attachment level : slight (3-5 mm.), moderate (5-7 mm.) and severe (more than 7 mm.). Statistical analysis was done using c2 test (P<0.05) and relative risk (Odd ratio) by computerized program SPSS. Our results reveal that stress is not significantly related to periodontitis (P=0.06) and there is no difference in severity of the disease between low and high stress. But odd ratio is 7.45. In conclusion, the relationship between stress and periodontitis is not shown and the level of stress does not relate to the severity of the disease. But one with high stress will have more risk to develop periodontitis than one with low stress.

THE RELATIONSHIP BETWEEN SMOKING AND PERIODONTAL DISEASE

Silarujisun,. P.1, Moonsarapee,. S.2, Hongprasong,. N.2

Department of Periodontology

CU Dental Research project 1996;14.

Previous research data indicated that smoking is one of the significant risk factors in the development and progression of periodontal disease. So this study wanted to know the relationship between cigarette consumption and severity of periodontal disease, and to compare the severity of the disease among current smokers, former smokers, and non-smokers. One hundred and fifty periodontal patients from the Periodontal Department, Faculty of Dentistry, Chulalongkorn University who had at least 20 teeth with 4 molars, were asked to complete questionaire about smoking habits. Smoking consumption was classified to be light ( less than 10 cigarettes/day ) and heavy ( more than 10 cigarettes/day ) including the history of smoking for the former smokers. Periodontal data was collected from their periodontal chart records. The severity of the disease was classified by the depth of periodontal pocket: slight ( 4-5 mm. ) , moderate ( 6-7 mm. ) and severe ( more than 7 mm. ) . The data was statistically analysed using c2 test ( P<0.05 ) by computerised program SPSS. It is found that smoking and also the level of cigarette consumption are significantly related to the severity of the disease. Non-smokers have less severity of the disease than current smokers and former smokers while no difference in severity of the disease between current smokers and former smokers.In the conclusion, periodontal patients, who are current smokers or former smokers will have more susceptible to periodontal disease than non-smokers. And the level of cigarette consumption is also related to the severity of the disease.

Treatment of periodontal lesion by Guided Tissue Regeneration using rubber dam and bone graft material : Two Cases Report

Silparcha A.1, Hongprasong N.2

1Dental Department, Hua Chaen, Bangkok
2Department of Periodontology, Faculty of Dentistry, Chulalongkorn University

CU Dent J 1998;21:119-26

Treament of periodontal defects by guided tissue regeneration (GTR) needs to use a membrane barrier to prevent unwanted cells growing into the lesion while to promote the cells ie periodontal ligament cells and bone stem cells migrating to the root surface and regenerate the periodontium replacing the damage one. There are two types of membrane barrier : one is unresorbable, the another is resorbable, which are designed for specific pattern and have been released in the market with very good result especially when it is used with bone graft material. However, the trade membrane barriers are very complicate and the result might be not as good as it should be. Therefore rubber dam, used as a membrane barrier in such lesion, was reported. But there are only few studies. This is a case report of the treatment of multiple periodontal lesions in the same area in two patients by GTR using rubber dam as a membrane barrier and the cases have been followed up for 2 years. The result of the treatment is good as the treatment of the lesion by GTR with the commercial membrane barrier.

Treatment of class III furcation involvement in lower molars with GTR : Using rubber dam as a membrane barrier with bone graft

Wanichavatanaramluk P.1, Hongprasong N.2

1Dental Division, Vajira Hospital, Bangkok
2Department of Periodontology, Faculty of Dentistry, Chulalongkorn University

CU Dent J 1998;21: 185-92

Objectives The objective of this study was to evaluate the result of the treatment of Cl III furcation involvement by GTR using rubber dam as a membrane barrier with bone graft material. Materials and Methods Six volunteer adult periodontitis patients were involved in this study. After having root planing full mouth and good plaque control, patients still had Cl III furcation involvement with at least 5 mm. pocket depth. All the lesions had been treated by GTR procedure by using rubber dam as a membrane with bone graft material. Parameters, pocket depth, clinical attachment level, gingival recession including x-rays were measured at before and after surgery 6 and 12 months. Reentry was also performed in one of these cases. The changes of clinical parameters were accessed by paired t-test at p = 0.05. Results It is found that pocket depth and clinical attachment level were decreased significantly and mean attachment gain was 2.33±1.74 mm. with some bone formation. Clinically furcation area was closed by soft tissue all cases which made better home care possible. The result was confirmed when reentry was performed, some bone filled in the lesion but the roof of furcal area.
Conclusion It can be concluded that using rubber dam as a membrane barrier in GTR procedure give us a good result of the treatment of Cl III furcation involvement although there are some new bone formation in the lesion.

Comparison between the use of rubber dam as a membrane barrier with and without bone graft in the treatment of infrabony defects

Sukonpan C.1, Hongprasong N.2

1Dental Division, Theptarint Hospital, Bangkok
2Department of Periodontology, Faculty of Dentistry, Chulalongkorn University

CU Dent J 1998;21: 193-202

Objectives The objectives of this study are to prove that rubber dam can be used as a membrane barrier in GTR procedure and to compare the treatment of multiple bony defects by using rubber dam only to rubber dam with bone graft. Materials and Methods The four adult periodontitis patients having 2 multiple bony defect areas in the same jaw were selected, using each technique randomly. 5 areas with 19 lesions were treated by GTR with rubber dam only while 5 areas with 32 lesions were treated by GTR with rubber dam and bone graft . The clinical parameters, pocket depth (PD), clinical attachment level (CAL), gingival recession (GR) and x-rays were recorded before and after surgery 3 and 6 months. PD, CAL and GR values were analyzed by paired t-test for the same group and by unpaired t-test for the between group at p = 0.05. Results It is found that PD and CAL decreased significantly with slightly increased GR. Increased bone height can be seen in the 6 month x-ray films. There is no significant difference between two methods. Conclusion Attachment gains can be obtained by GTR procedure using rubber dam as a membrane barrier with or without bone graft.

COMPARISON OF THE TREATMENT OF MULTIPLE BONY DEFECTS BY GTR USING RUBBER DAM TO RUBBER DAM WITH BONE GRAFT.

C. Sukonpan1, N. Hongprasong2

Department of Periodontology

J. Dent Res 1999; 78(5): 1179

Guided tissue regeneration is the regenerative procedure introduced for the treatment of periodontal bony defect by using membrane barrier which prevent the unwanted cells growing into the healing area. The objective of this study to prove that we can use rubber dam as a membrane barrier and to compare the treatment of multiple bony defects by GTR using rubber dam only to rubber dam with bone graft. The four periodontitis patients having 2 multiple bony defect areas in the same jaw were selected, using each technique randomly. 5 areas with 19 lesions ware treated by GTR with rubber dam only while 5 areas with 32 lesions ware treated by GTR with rubber dam and bone graft. The clinical parameter, pocket depth, clinical attachment level and gingival recession, was recorded before treatment and after treatment 3 and 6 months. It is found that there was periodontal regeneration occurred in all cases. Pocket depth and clinical attachment level decreased significantly at 3 and 6 months with slightly gingival recession. There is no significant difference between two methods. In the conclusion, rubber dam can be used efficiently as a membrane barrier in GTR.

B-Glucuronidase in crevicular fluid of periodontitis with diabetes mellitus

Hongprasong N1, Benjavongkulchai E2, Polchai J3.

1Department of Periodontology, Faculty of Dentistry, Chulalongkorn University
2 Department of Biochemistry, Faculty of Dentistry, Chulalongkorn University
3 Student, Faculty of Dentistry, Chulalongkorn University

Master Degree Thesis, Academic Year 1999

The present study was designed to assess b-glucuronidase activity in gingival crevicular fluid (GCF) from periodontitis patients with and without type 2 diabetes mellitus (DM), and to correlate it with clinical parameters. Forty subjects (240 teeth) in this study were divided into 5 groups. Group 1, 2 and 3 patients were diagnosed as having periodontitis but group 1 had controlled DM, group 2 had uncontrolled DM and group 3 had no history of DM. Group 4 and 5 patients were diagnosed as having healthy periodontium but group 4 had DM and group 5 had no history of DM. The GCF was collected for 30 seconds with periopaper strips from the deepest pockets of the central incisor, first premolar and first molar from two quadrants of mouth. The volume of absorbed GCF was determined by Periotron 8000 and the crevicular b-glucuronidase activity was colorimetrically determined by a spectrophotometer. There was no statistically significant difference in crevicular b-glucuronidase activities among groups 1, 2 and 3. Mean crevicular b-glucuronidase activities in groups1,2 and 3 were 1.58 (±0.69), 1.53 (±0.67), 1.41 (±0.89) unit, respectively. However, groups 1, 2 and 3 had higher b-glucuronidase activity than groups 4 and 5 (p<0.05). Mean crevicular b-glucuronidase activities in groups 4 and 5 were 0.87(±0.28), 0.89 (±0.25) unit, respectively. There was no significant difference between groups 4 and 5. The result of this study indicates that diabetes mellitus shows no relationship with periodontitis but activity of b-glucuronidase in periodontitis patients is found to be higher than that of healthy periodontium patients. Activity of b-glucuronidase was shown to be positively correlated with pocket depth, gingival index , clinical attachment level and volume of GCF.

Silicone Sheeth II. Treatment of the Infrabony Defect by Using Silicone Sheeth as a Barrier Membrane Accompanied by Bone graft : A Case Report

Chanokpan Sukonpan 1, Somporn Swasdison 2, Nuanchavee Hongprasong 3

1 Dental Department, Teptarin Hospital Bangkok
2 Department of Pathology, Faculty of Dentistry, Chulalongkorn University, Bangkok
3 Department of Periodontics,Faculty of Dentistry,Chulalongkorn University, Bangkok

J.Dent.Assoc.Thai.Vol.51 No.5 Sep-Oct. 2001

The barrier membrance play an important role in the treatment of periodontitis by guided tissue regeneration (GTR) technique. The objective of this article is to report the usage of silicone sheet as a barrier membrane in the treatment of intrabony defects by GTR in a periodontitis patient with one year follow up.Initially, full-mouth scaling and root planing were performed. After the first evaluation, periodontal pockets not less than 5 millimeters in depth were found at the left mandibular canine and left mandibular first molar. these two teeth were then surgically treated by GTR technique using a silicone sheet as the barrier membrane and in conjunction with the bone graft. The patient was periodically followed up for one year. Comparative study of the pocket depth,attachment level and gingival recession before and one year after the treatment in the patient, the results showed that pocket depth and attachment level were decreased while gingival recession slightly increased. Radiographic pictures and surgical re-entry of the lesions indicated bony formation at the mesial part of the left mandibular canine and the furcal area of the left mandibular first molar. These ersults suggested that the silicone sheet can be effectively used as the barrier membrane in the treatment of periodontitis-affected teeth by guided tissue regeneration

The distribution of severe periodontitis in urban (Bangkok) and rural ( Payao province ) high risk to stress group of Thai population

Varaporn Buatongsri 1, Yupin Songpaisan2, Naulchavee Hongprasong1, Pratheep Phantumvanit1, Nigel Clarke3

1 Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
2 Faculty of Dentistry,Thammasat University, Bangkok,Thailand.
3 Faculty of Dentistry,The University of Adelaide South Australia,Australia

CU Dent J 2002; 25:1-7

Objective The purpose of this study was to compare the periodontal status of rural and urbanThai population who were at high risk in stress.
Materials and Methods the cross-sectional study for severe periodontal destructive condition was carried out in over 35 years old Thai population. All first, second molars and central incisors of the total 1167 rural farmers form 4 villages in Payao provinces and 654 urban bank employees and secondary school teachers in Bangkok were examined using CPITN index. Only those having at least one tooth with CPITN score 4 received a full month examination and answered questionnaired as well as stress index. The data was analyzed by using SPPS software.

Results It was found that there was 17% of urban population having at least one tooth with CPITN4 while there was 27.9% of rural population. The number of teeth and surfaces of CPITN4 in rural population were higher than thoes in urban significantly. According to stress index, it was found that both of urban and rural population had high stress. But those in urban had higher stress than those in rural area (93.7%vs 80.2%). There was not significantly higher of CPITN4 teeth in high strees group in urban when compared to those in rural area. However, the number of CPITN4 surfaces in rural population was higher than those in urban area.That most common CPITN4 tooth was the right second molar (54.1%) whereas the lower left incisor was the least effected (3.1%)

Conclusion The study showed that severe periodontitis was higher in the rural than in urbal population This seemed to be similar to the destructive periodontal condition between developing and develoded countries which has been reported.