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- Heitz-Mayfield, Lisa J A, et al.
(author)
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Clinical course of chronic periodontitis : II. Incidence, characteristics and time of occurrence of the initial periodontal lesion
- 2003
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 30:10, s. 902-8
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Journal article (peer-reviewed)abstract
- AIM: The purpose of this study was to assess the initiation and progression of periodontal disease during adult life.MATERIALS AND METHODS: In a 26-year longitudinal investigation of the initiation and progression of chronic periodontitis that started in 1969 and included 565 men of Norwegian middle class, 223 who had participated in some, but not all, intermediate examinations presented at the last survey in 1995. Fifty-four individuals were available for examination in all seven surveys.RESULTS: Covering the age range from 16 to 60 years, the study showed that at 16 years of age, 5% of the participants had initial loss of periodontal attachment (ILA > or = 2 mm) at one or more sites. Both the subject incidence and the site incidence increased with time, and by 32 years of age, all individuals had one or more sites with loss of attachment. As age progressed, new lesions affected sites, so that as these men approached 60 years of age approximately 50% of all available sites had ILA. An assessment of the intraoral distribution of the first periodontal lesion showed that, regardless of age, molars and bicuspids were most often affected. At and before the age of 40 years, the majority of ILA was found in buccal surfaces in the form of gingival recession. By 50 years, however, a greater proportion of sites presented with attachment loss attributed to pocket formation or a combination of pocket formation and gingival recession. As individuals neared 60 years of age, approximately half of the interproximal areas in posterior teeth had these lesions.CONCLUSION: This investigation has shown that, in a well-maintained population who practises oral home care and has regular check-ups, the incidence of incipient periodontal destruction increases with age, the highest rate occurs between 50 and 60 years, and gingival recession is the predominant lesion before 40 years, while periodontal pocketing is the principal mode of destruction between 50 and 60 years of age.
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- Persson, G. Rutger, et al.
(author)
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Antimicrobial therapy using a local drug delivery system (Arestin) in the treatment of peri-implantitis. I : Microbiological outcomes
- 2006
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In: Clinical Oral Implants Research. - 0905-7161 .- 1600-0501. ; 17:4, s. 386-393
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To assess the microbiological outcome of local administration of minocycline hydrochloride microspheres 1 mg (Arestin) in cases with peri-implantitis and with a follow-up period of 12 months.MATERIAL AND METHODS: After debridement, and local administration of chlorhexidine gel, peri-implantitis cases were treated with local administration of minocycline microspheres (Arestin). The DNA-DNA checkerboard hybridization method was used to detect bacterial presence during the first 360 days of therapy.RESULTS: At Day 10, lower bacterial loads for 6/40 individual bacteria including Actinomyces gerensceriae (P<0.1), Actinomyces israelii (P<0.01), Actinomyces naeslundi type 1 (P<0.01) and type 2 (P<0.03), Actinomyces odontolyticus (P<0.01), Porphyromonas gingivalis (P<0.01) and Treponema socranskii (P<0.01) were found. At Day 360 only the levels of Actinobacillus actinomycetemcomitans were lower than at baseline (mean difference: 1x10(5); SE difference: 0.34x10(5), 95% CI: 0.2x10(5) to 1.2x10(5); P<0.03). Six implants were lost between Days 90 and 270. The microbiota was successfully controlled in 48%, and with definitive failures (implant loss and major increase in bacterial levels) in 32% of subjects.CONCLUSIONS: At study endpoint, the impact of Arestin on A. actinomycetemcomitans was greater than the impact on other pathogens. Up to Day 180 reductions in levels of Tannerella forsythia, P. gingivalis, and Treponema denticola were also found. Failures in treatment could not be associated with the presence of specific pathogens or by the total bacterial load at baseline. Statistical power analysis suggested that a case control study would require approximately 200 subjects.
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- Salvi, Giovanni E, et al.
(author)
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Adjunctive local antibiotic therapy in the treatment of peri-implantitis II : clinical and radiographic outcomes.
- 2007
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In: Clinical Oral Implants Research. - 0905-7161 .- 1600-0501. ; 18:3, s. 281-285
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Journal article (peer-reviewed)abstract
- AIM: To monitor over 12 months clinical and radiographic changes occurring after adjunctive local delivery of minocycline microspheres for the treatment of peri-implantitis.MATERIAL AND METHODS: In 25 partially edentulous subjects, 31 implants diagnosed with peri-implantitis were treated. Three weeks after oral hygiene instruction, mechanical debridement and local antiseptic cleansing using 0.2% chlorhexidine gel, baseline (Day 0) parameters were recorded. Minocycline microspheres (Arestin) were locally delivered to each implant site with bone loss and a probing pocket depth (PPD) >or=5 mm. Rescue therapy with Arestin was allowed at Days 180 and 270 at any site exhibiting an increase in PPD>or=2 mm from the previous visit. The following clinical parameters were recorded at four sites/implant at Day 0, 10, 30, 60, 90, 180, 270 and 360: PPD, clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PlI).RESULTS: Six implants in six subjects were either rescued or exited because of persisting active peri-implantitis. Successful implants showed a statistically significant reduction in both PPD and percentage of sites with BOP between baseline and Day 360 (P<0.05). At mesial implant sites, the mean PPD reduction amounted to 1.6 mm (95% CI: 0.9-2.2 mm, P<0.001) and was accompanied by a statistically significant reduction of the BOP value (P<0.001). Binary regression analysis showed that the clinical parameters and smoking history could not discriminate between successfully treated and rescued or exited implants at any observation time point.CONCLUSION: Non-surgical mechanical treatment of peri-implantitis lesions with adjunctive local delivery of microencapsulated minocycline led to positive effects on clinical parameters up to 12 months.
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- Schätzle, Marc, et al.
(author)
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Clinical course of chronic periodontitis : III. Patterns, variations and risks of attachment loss
- 2003
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 30:10, s. 909-18
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Journal article (peer-reviewed)abstract
- AIM: The purpose of this study was to assess the rate of attachment loss during various stages of adult life in a well-maintained middle-class population.MATERIAL AND METHODS: The data originated from a 26-year longitudinal study of Norwegian males who had received regular and adequate dental care and practised daily oral home care. The initial examination in 1969 included 565 individuals aged between 16 and 34 years. Subsequent examinations took place in 1971, 1973, 1975, 1981, 1988 and 1995. Thus, the study covers the age range of 16-59 years. The rate of the annual attachment loss was calculated as the difference between the individual mean attachment loss between two examinations divided by the years between examinations. The mean annualized relative risk of attachment loss was calculated as the frequency distribution of sites with initial periodontal attachment loss (loss of attachment at the first time of occurrence > or = 2 mm) and healthy sites (loss of attachment always < 2 mm). For comparison of significant changes in annual attachment loss rates between the age groups and mean annualized relative risks of attachment loss as they proceeded through adult life, the Wilcoxon Mann-Whitney U-test was used.RESULTS: The mean overall individual attachment loss during 44 years (between 16 and 59 years) totaled 2.44 mm (range 0.14-2.44 mm), averaging an annual mean rate of 0.05 mm/year. The highest annual rate of attachment loss occurred before 35 years of age (0.08-0.1 mm/year), after which the mean annual rate decreased to about 0.04-0.06 mm/year for the next three decades of life leading to 60 years. The mean annualized relative risk of initial attachment loss increased significantly from adolescence (1.2%) to the maximum at 30-34 years of age (6.9%). After the age of 34 years, the risk of initial attachment loss decreased again, but after the age of 40 years, another continuous increase was observed.CONCLUSIONS: Over a 26-year period, 25% of the subjects went through adult life with healthy and stable periodontal conditions. The remaining 75% developed slight to moderately progressing periodontal disease with progression rates varying between 0.02 and 0.1 mm/year with a cumulative mean of loss of attachment of 2.44 mm as they approached 60 years of age. The annual mean rate and the mean annualized risk of initial attachment loss were highest between 16 and 34 years of age. Only 20% of the sites continued to lose further attachment during the remainder of the observation period, and less than 1% of the sites showed substantial loss of attachment (> 4 mm).
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