| 1. |
- Baelum, V, et al.
(författare)
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A global perspective on changes in the burden of caries and periodontitis : implications for dentistry.
- 2007
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 34:12, s. 872-906; discussion 940
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Tidskriftsartikel (refereegranskat)abstract
- The structure and contents of most oral health care systems and the contents of dental curricula reflect a deep-rooted tradition for attempting to cure oral diseases by refined technological means. However, better oral health conditions for the world's populations necessitate the application of up-to-date scientific knowledge to control the major oral diseases. This review points out that not only should the structure and contents of oral health care delivery systems be based on state-of-the-art knowledge about the biology of the oral diseases; they must also take into account the trends for change in caries and periodontal diseases within and between populations, and acknowledge the impact of changes in treatment philosophies for these trends. The oral disease profiles for populations in low- and high-income countries are briefly described, and it is concluded that the rapidly changing disease profiles observed in high-income countries necessitate re-thinking of the future role and organization of dentistry in such countries. The priorities for low- and middle-income countries must be to avoid repeating the mistakes made in the high-income countries. Instead, these societies might take advantage of setting priorities based on a population-based common risk factor approach. If such an approach is adopted, the training of personnel with oral health care competence must be rethought. The authors suggest three different cadres of dental care providers to be considered for an approach that allows health care planners in different populations around the world to prioritize appropriate oral health care with due respect for the socio-economic conditions prevailing.
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| 2. |
- Dahlén, Gunnar, 1944, et al.
(författare)
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Methodological issues in the quantification of subgingival microorganisms using the checkerboard technique.
- 2015
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Ingår i: Journal of microbiological methods. - : Elsevier BV. - 1872-8359 .- 0167-7012. ; 110, s. 68-77
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Tidskriftsartikel (refereegranskat)abstract
- The reproducibility and reliability of quantitative microbiological assessments using the DNA-DNA hybridization "checkerboard method" (CKB) were assessed. The data originated from 180 chronic periodontitis patients, who were enrolled in a clinical trial and sampled at baseline, and 3 and 12m post-therapy. The samples were divided into two portions allowing evaluation of reproducibility. In total, 531 samples were analyzed in a first run, using standard bacterial preparations of cells and 513 samples were accessible for analysis in the second, using standards based on purified DNA from the species. The microbial probe panel consisted of periodontitis marker bacteria as well as non-oral microorganisms. Three different ways of quantifying and presenting data; the visual scoring method, VSM, the standard curve method, SCM, and the percent method, PM, were compared. The second set of analyses based on the use of standard preparations of pure DNA was shown to be more consistent than the first set using standards based on cells, while the effect of storage time per se up to 2.5y seemed to be marginal. The best reproducibility was found for Tannerella forsythia, irrespective of quantification technique (Spearman's rho=0.587, Pearson's r≥0.540). The percent method (PM) based on percent of High Standard (10(6) cells) was more reliable than SCM based on a linear calibration of the High Standard and a Low Standard (10(5) cells). It was concluded that the reproducibility of the CBK method varied between different bacteria. High quality and pure specific DNA whole genomic probes and standards may have a stronger impact on the precision of the data than storage time and conditions.
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| 3. |
- Dahlén, Gunnar, 1944, et al.
(författare)
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Subgingival bacterial clusters and serum antibody response as markers of extent and severity of periodontitis in adult Chinese
- 2016
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836. ; 124:2, s. 179-187
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated the associations between clinical, microbiological, and antibody activity manifestations of periodontitis in 123 adult rural Chinese subjects with no dental intervention. All participants were registered for full-mouth clinical attachment level (CAL) and pocket probing depth (PD) measurements, and microbial samples were taken from four sites and analyzed for 18 different bacterial species using the checkerboard'. Serum from each individual was analyzed to determine the antibody activity against the same 18 species. Exploratory factor analysis disclosed two microbial factors - Factor 1, consisting of seven species associated with periodontal health (early colonizers'); and Factor 2, consisting of eight species associated with periodontitis (putative periodontopathogens') - which explained 87% of the variation among the microbial variables. Factor 2 was consistently associated with disease-severity measures, whereas the early colonizer' factor was not. The antibody response showed weak or no correlations with bacterial load or with disease severity. We conclude that the bacteria investigated are resident in the subgingival plaque; that their load and proportions in the pocket may be ecologically driven; and that the antibody response is based on bacterial carrier state rather than on disease. The different antibody-response pattern found between the individuals may suggest that each individual could be classified as a good or a weak immune responder.
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| 4. |
- Nascimento, G. G., et al.
(författare)
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Methodological issues in assessing the association between periodontitis and caries among adolescents
- 2018
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661. ; 46:3, s. 303-309
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We aimed to investigate the association between dental caries and periodontitis among adolescents participating in a case-control study of periodontitis. In addition, we compared 2 analytical approaches to estimate the association: conventional regression and structural equation modelling (SEM). Methods: Along with periodontal recordings, data were obtained on caries, just as subgingival plaque samples were collected. Sociodemographic information was collected with a questionnaire. We used factor analyses to express the many correlated clinical periodontal dimensions in a smaller number of factors. The association between caries (counts of enamel and dentin lesions, or dentin lesions only) and periodontitis was tested using negative binomial regression with robust variance (conventional regression) and weighted least squares (SEM) estimation. Results: Factor analysis revealed 2 different latent periodontal variables: "extent" and "severity" of periodontitis. Using conventional regression, the "extent" of periodontitis was positively associated with higher counts of dentin caries lesions, even after adjustments for maternal education and subgingival microbial composition (rate ratio 1.34; 95% CI 1.07-1.68). The "severity" of periodontitis was associated with lower counts of enamel and dentin caries lesions (rate ratio 0.85 95% CI 0.77-0.92). The SEM revealed a positive association between periodontitis extent and number of dentin caries lesions (coefficient 0.29; P < .0001). The "severity" of periodontitis was negatively associated with enamel and dentin caries (coefficient -0.44; P < .0001). Conclusions: We found an association between caries and periodontitis among adolescents. The "severity" of periodontitis was negatively associated with enamel/dentin caries, whereas the extent of periodontitis was positively associated with dentin caries irrespective of the analytical approach employed.
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| 5. |
- Nascimento, G. G., et al.
(författare)
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Periodontitis phenotypes and clinical response patterns to non-surgical periodontal therapy: reflections on the new periodontitis classification
- 2020
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722.
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to identify response patterns to non-surgical periodontal therapy and to investigate whether the new classification system for periodontitis reflects response to treatment after 1 yr. At baseline, data on sociodemographic status, smoking, and diabetes were obtained from participants with periodontal disease. Clinical periodontal data and subgingival plaque were also collected. Participants underwent non-surgical periodontal therapy, and after 3 and 12 months, clinical data were reassessed. Factor analyses, group-based-trajectory modeling, and mixed-effects regression models were used for data analysis. Factor analysis of the baseline periodontal parameters revealed two different periodontitis dimensions: 'moderate' and 'severe'. Two response patterns for each of these periodontitis dimensions were identified. Periodontal therapy had a beneficial effect on both 'moderate' and 'severe' periodontitis; however, individuals with higher levels of disease at baseline experienced greater treatment effect. Regarding the new classification system, while the staging component distinguished different levels of 'moderate' and 'severe' periodontitis before and after treatment, the grading component did not. This study shows the beneficial effect of non-surgical periodontal therapy on both 'moderate' and 'severe' periodontitis. However, the benefit was limited among individuals with low levels of disease. The new classification system did not adequately reflect the periodontal response to therapy in this patient group.
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| 6. |
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| 7. |
- Skottrup, P. D., et al.
(författare)
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Soluble urokinase-type plasminogen activator receptor is associated with signs of periodontitis in adolescents
- 2018
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 126:4, s. 292-299
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Tidskriftsartikel (refereegranskat)abstract
- Owing to its molecular stability in body fluids, soluble urokinase-type plasminogen activator receptor (suPAR) is used as a biomarker for the level of systemic inflammation. This study compares the suPAR levels in serum with those in the saliva of adolescents and evaluates their association with the periodontal conditions. Adolescents identified as screen positive (n = 87) or screen negative (n = 73) for periodontitis had saliva and serum samples taken, along with subgingival plaque samples. The concentrations of suPAR were determined in saliva and serum, and 18 microbial species and the immunoglobulin response to them was evaluated. Factor analyses were used to reduce the number of variables within each of the domains of clinical, microbiological, and immunological findings. The median salivary suPAR concentration was 13.18 [(interquartile range (IQR): 6.20-23.36] g l(-1) and was not associated with the serum suPAR levels (median 2.05; IQR: 1.62-2.46 g l(-1)). Linear regression analysis showed that the log(10)(salivary suPAR concentration) was statistically significantly positively associated with the clinical phenotype Periodontitis Extent' ( = 0.28; 95% CI: 0.16-0.39) along with Putative periodontopathogens' ( = 0.65; 95% CI: 0.51-0.79). The study represents the first determination of salivary suPAR concentration in a larger well-defined adolescent population. Our results suggest the potential for clinical use of suPAR in saliva as an inflammatory risk indicator/biomarker of periodontitis.
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