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1.
  • Jansson, Henrik, et al. (författare)
  • Type 2 diabetes and risk for periodontal disease: a role for dental health awareness
  • 2006
  • Ingår i: Journal of Clinical Periodontology. - 1600-051X .- 0303-6979. ; 33:6, s. 408-414
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Several studies have found correlations between diabetes and an increased prevalence of periodontitis. Objective: To analyse, in a group of subjects with type 2 diabetes (T2D), (i) the association between medical characteristics and severe periodontal disease and (ii) dental care habits and knowledge of oral health. Methods: One hundred and ninety-one subjects with T2D were examined. Based on assessment of marginal bone height in panoramic radiographs, two periodontal subgroups were identified: one periodontally diseased (PD+) and one periodontally healthy (PD-) group. All subjects completed a questionnaire about their medical and oral health. Results: Twenty per cent of the subjects were classified as PD+. This was verified by clinical parameters. PD+ individuals had higher haemoglobin A1c (HbA1c) levels (p=0.033) and higher prevalences of cardiovascular complications (p=0.012). They were also less likely to be of Scandinavian origin (p=0.028) and more likely to smoke (p < 0.001) than the PD- group. The PD+ group rated their oral health as poor (p < 0.0001) and believed that T2D had an influence on their oral status (p < 0.0001). Conclusion: The best predictor for severe periodontal disease in subjects with T2D is smoking followed by HbA1c levels. T2D subjects should be informed about the increased risk for periodontal disease when suffering from T2D.
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2.
  • Hugoson, A, et al. (författare)
  • Periodontal disease in relation to smoking and the use of Swedish snus : epdemiological studies covering 20 years (1983-2003)
  • 2011
  • Ingår i: Journal of Clinical Periodontology. - : Wiley-Blackwell. - 0303-6979 .- 1600-051X. ; 38:9, s. 809-816
  • Tidskriftsartikel (refereegranskat)abstract
    • AbstractAim: The aim of the present study was to examine how deleterious current smokingand the use of Swedish moist snuff (snus) is for periodontal health compared with nontobaccousers.Materials and Methods: The studies comprised three epidemiological crosssectionalstudies, in 1983, 1993 and 2003, of stratified random samples aged 20, 30, 40,50, 60 and 70 years. The numbers of dentate participants were 550, 552 and 523,respectively. The participants were examined clinically and radiographically.Diagnostic criteria were the number of teeth, plaque, gingival status, probing pocketdepth (PPD)X4 mm, height of the alveolar bone level and classification by periodontaldisease experience. In addition, participants were asked about their tobacco habits.Results: Multiple logistic regression shows, after adjusting for age, gender andsociodemographic variables, that relative to non-tobacco users, cigarette smokers hadstatistically significant less gingivitis, a higher frequency of PPDX4mm and a higherincidence of severe periodontitis. There was no significant association betweengingivitis, frequency of PPDX4mm and periodontal disease experience and snus use.Conclusions: Cigarette smokers were found to have a statistically significant higherrisk of severe periodontitis than non-tobacco users and users of snus. Using snus didnot seem to be a risk factor for periodontitis
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3.
  • Roos-Jansåker, Ann-Marie, et al. (författare)
  • Submerged healing following surgical treatment of peri-implantitis : a case series
  • 2007
  • Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 34:8, s. 723-727
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The aim was to study a regenerative surgical treatment modality for peri-implantitis employing submerged healing. Material and Methods: Twelve patients, having a minimum of one osseointegrated implant with peri-implantitis, with a progressive loss of >= 3 threads (1.8 mm) following the first year of healing were involved in the study. After surgical exposure of the defect, granulomatous tissue was removed and the implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore((R))), a resorbable membrane (Osseoquest((R))) was placed over the grafted defect and a cover screw was connected to the fixture. The implant was then covered by flaps and submerged healing was allowed for 6 months. After 6 months the abutment was re-connected to the supra-structure. Results: A 1-year follow-up demonstrated clinical and radiographic improvements. Probing depth was reduced by 4.2 mm and a mean defect fill of 2.3 mm was obtained. Conclusion: Treatment of peri-implant defects using a bone graft substitute combined with a resorbable membrane and submerged healing results in defect fill and clinical healthier situations.
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4.
  • Aghazadeh, Ahmad, et al. (författare)
  • A single-center randomized controlled clinical trial on the adjunct treatment of intra-bony defects with autogenous bone or a xenograft : results after 12 months
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 39:7, s. 666-673
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Limited evidence exists on the efficacy of regenerative treatment of peri-implantitis Materials and methods Subjects receiving antibiotics and surgical debridement were randomly assigned to placement of autogenous bone (AB) or bovine derived xenograft (BDX) with placement of a collagen membrane. The primary outcome was: evidence of radiographic bone fill and the secondary outcomes included reductions of probing depth (PD) bleeding on probing (BOP) and suppuration. Results 22 subjects were included in the AB and 23 subjects in the BDX group. Statistical analysis failed to demonstrate differences for 38/39 variables assessed at baseline. At 12 months, significant better results were obtained in the BDX group for bone levels (p < 0.001), BOP (p = 0.004), PI (p = 0.003), and suppuration (p < 0.01). When adjusting for number of implants treated per subject, a successful treatment outcome PD≤ 5.0 mm, no pus, no bone loss and BOP at 1/4 sites the likelihood of defect fill was higher in the BDX group (LR: 3.2, 95 % CI: 1.0 to 10.6, p < 0.05). Conclusions Bovine xenograft provided more radiographic bone fill than autogenous bone. The success for both surgical regenerative procedures was limited. Decreases in PD, BOP, and suppuration were observed.
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5.
  • Aghazadeh, Ahmad, et al. (författare)
  • A single-centre randomized controlled clinical trial on the adjunct treatment of intra-bony defects with autogenous bone or a xenograft : results after 12 months
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - : Wiley Blackwell. - 0303-6979 .- 1600-051X. ; 39:7, s. 666-673
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Limited evidence exists on the efficacy of regenerative treatment of peri-implantitis. Material and Methods Subjects receiving antibiotics and surgical debridement were randomly assigned to placement of autogenous bone (AB) or bovine-derived xenograft (BDX) and with placement of a collagen membrane. The primary outcome was evidence of radiographic bone fill and the secondary outcomes included reductions of probing depth (PD) bleeding on probing (BOP) and suppuration. Results Twenty-two subjects were included in the AB and 23 subjects in the BDX group. Statistical analysis failed to demonstrate differences for 38/39 variables assessed at baseline. At 12 months, significant better results were obtained in the BDX group for bone levels (p < 0.001), BOP (p = 0.004), PI (p = 0.003) and suppuration (p < 0.01). When adjusting for number of implants treated per subject, a successful treatment outcome PD = 5.0 mm, no pus, no bone loss and BOP at 1/4 or less sites the likelihood of defect fill was higher in the BDX group (LR: 3.2, 95% CI: 1.010.6, p < 0.05). Conclusions Bovine xenograft provided more radiographic bone fill than AB. The success for both surgical regenerative procedures was limited. Decreases in PD, BOP, and suppuration were observed.
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6.
  • Al-Otaibi, M, et al. (författare)
  • Subgingival plaque microbiota in Saudi Arabians after use of miswak chewing stick and toothbrush
  • 2004
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 31:12, s. 1048-53
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The chewing stick, the miswak, is used in many developing countries as the traditional means for oral hygiene. It is prepared from the roots, twigs and stem of Salvadora persica or other alternative local plants. OBJECTIVES: To compare the effects of the chewing stick miswak (from S. persica) and toothbrush on subgingival plaque microflora among Saudi Arabian individuals. Further, to investigate whether components extracted from S. persica may interfere with the subgingival plaque micro-organisms. MATERIAL AND METHODS: Fifteen healthy Saudi Arabian male volunteers aged 21-36 years were included in a single-blind, randomized cross-over study. The participants were taught how to use each device properly. Plaque sampling for DNA test was performed at the baseline, 1 week after professional tooth cleaning, and after 3 weeks of either miswak or toothbrush use. Identification and quantification of microbial species were performed by the checkerboard method, using whole genomic, digoxigenin-labelled DNA probes. Inhibition zones around miswak were examined on agar plates with Actinobacillus actinomycetemcomitans and the leukotoxicity of this bacterium was analyzed in a bioassay with macrophages+/-extracts of miswak. RESULTS: Miswak and toothbrushing had a similar influence on the levels of the subgingival microbiota. However, A. actinomycetemcomitans was significantly more reduced by miswak (p<0.05) than by toothbrushing. These results were supported by our in vitro results which, indicated that extracts from S. persica might interfere with the growth and leukotoxicity of A. actinomycetemcomitans. CONCLUSIONS: In contrast to toothbrush use, miswak use significantly reduced the amount of A. actinomycetemcomitans in the subgingival plaque.
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7.
  • Albrektsson, Tomas, 1945, et al. (författare)
  • State of the art in oral implants.
  • 1991
  • Ingår i: Journal of clinical periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 18:6, s. 474-81
  • Forskningsöversikt (refereegranskat)abstract
    • Uncontrolled oral implant devices are still being widely used. The documentation of most oral implant systems is poorly backed up or not followed up for an adequate time period. Success rates are being quoted without reference to any defined success criteria. Frequently used oral implant designs such as the Core-Vent, IMZ and Calcitek hydroxyapatite coated implants are in neither case supported by any adequate clinical reports from minimally 5-years of follow-up. Other implant systems such as the ITI, some subperiosteal designs and the Tübingen implant demonstrate well-controlled and acceptable 5-year data but are not followed up in a sufficient number or have demonstrated less good results in the 10-year evaluation. The Small transosteal staple has been adequately reported for more than 10 years of follow-up, whereas the Brånemark implant is the only endosseous design that has demonstrated acceptable 15-year success rates.
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12.
  • Bratthall, G., et al. (författare)
  • Comparison of ready-to-use EMDOGAIN®-gel and EMDOGAIN® in patients with chronic adult periodontitis. A multicenter clinical study
  • 2001
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 28:10, s. 923-929
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The aim of this multicenter trial was to compare the clinical and radiographical outcome of a ready-to-use Emdogain®-gel (test) with the marketed Emdogain® (control). Methods: Subjects with bilateral infrabony defects ≥4 mm deep and ≥2 mm wide according to radiographs were selected. 88 subjects with probing pocket depth (PPD) ≥6 mm ≥1 month after supervised oral hygiene and scaling participated. At baseline plaque index, bleeding on probing, PPD and probing attachment level were recorded and reproducible radiographs for computer-based bone level measurements were taken. In each subject, 1 tooth was randomly treated with the test and 1 tooth with the control gel. Examinations were repeated 8 and 16 months post-operatively. Results: After 16 months, the mean test PPD was 4.1 mm and the mean control PPD 4.2 mm. The mean gain of attachment was 2.7 mm for test and 2.9 mm for the control sites, and the radiographic measurements demonstrated a mean gain of 1 mm for both test and control sites. Conclusion: This series of cases demonstrated a statistically significant reduction of pocket depths and gain of attachment and bone after 8 and 16 months with no difference between the 2 preparations.
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13.
  • Buhlin, K., et al. (författare)
  • Risk factors for atherosclerosis in cases with severe periodontitis
  • 2009
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 36:7, s. 541-549
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: Studies have reported on an association between cardiovascular disease (CVD) and periodontitis. The purpose of this case-control study was to provide an insight into this association by determining the plasma levels of some risk markers for CVD in cases with periodontitis.Materials and Methods: Sixty-eight cases with periodontitis, mean age 53.9 (SD 7.9) years, and 48 randomly selected healthy controls, mean age 53.1 (SD 7.9) years, were investigated. Fasting blood plasma was analysed for glucose, lipids, markers systemic inflammation, cytokines and antibodies against heat shock proteins (Hsp). The associations between periodontitis and the various substances analysed in plasma were calculated using a multivariate logistic regression model, which compensated for age, gender, smoking and body mass index.Results: The regression analyses revealed a significant association between periodontitis and high levels of C-reactive protein (CRP) [odds ratio (OR) 4.0, confidence interval (CI) 1.4-11.4] and fibrinogen (OR 8.7, CI 2.6-28.4), IL-18 (OR 6.5, CI 2.2-19.5), and decreased levels of IL-4 (OR 0.12, CI 0.0-0.5). The study showed increased levels of antibodies against Hsp65 (OR 2.8, CI 1-7.6) and 70 (OR 2.9, CI 1.1-7.8) and decreased levels of antibodies against Hsp60 (OR 0.3, CI 0.1-0.8).Conclusions: Periodontitis was associated with increased levels of CRP, glucose, fibrinogen and IL-18, and with decreased levels of IL-4. 
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14.
  • Christersson, L. A., et al. (författare)
  • Topical application of tetracycline‐HCl in human periodontitis
  • 1993
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 20:2, s. 88-95
  • Tidskriftsartikel (refereegranskat)abstract
    • Previous in vitro studies have suggested that tetracycline‐HCl (TTC‐HCl) is adsorbed and actively released from root dentin. The aim of the current study was to evaluate the binding to and release of TTC‐HCl from human root dentin surfaces in vivo, and to evaluate the clinical utility of TTC‐HCl irrigation as an adjunct to scaling and root planing. Experiment I utilized two contralateral mandibular single‐rooted teeth which were examined in four adults with severe generalized periodontitis. One tooth in each patient was carefully scaled and root planed, under local anesthesia, and the other used as an unsealed control. Each subgingival root surface was irrigated for 5 min with an aqueous TTC‐HCl solution at a concentration of 100 mg/ml. Gingival crevicular fluid samples were collected on paper strips for the next three weeks. The TTC‐HCl concentrations in each sample were determined by the inhibition zone of B. cereus cultured on agar plates. The TTC‐HCl concentrations in gingival crevicular fluid collected 15 min after irrigation were 3100±670 μg/ml from the scaled lesions and 4700±1300 μg/ml from the unsealed root surfaces. The antibiotic concentrations decreased logarithmically over the next 7 days; 1500±270 μ/g/ml and 1100±330μ/g/ml at 2 h. 880±350μ/g/ml and 1300±360 μ/g/ml at 6 h and 19±5μ/g/ml and 31±26 μ/g/ml at 1 week for scaled and unsealed root surfaces, respectively. Results for week two and three indicated an average of over 8 μg/ml. The TTC‐HCl concentrations in gingival crevicular fluid from scaled and unsealed root surfaces were not statistically different at any time point. The tetracycline irrigation resulted in release of tetracycline at concentrations well above therapeutic concentrations for at least 1 week. Experiment II comprised 11 patients with severe adult periodontitis. All subjects were scaled and root planed prior to baseline measurements. The patients were monitored by the following parameters: probing pocket depth (PPD), probing attachment level (PAL), gingival index (GI) and plaque index (PI). 54 contralateral teeth exhibiting residual pocket depths of 5 mm were selected. Within each pair identified for the study, teeth were randomly assigned as test or control sites. After baseline measurement, each subgingival root surface was irrigated for 5 min; either with an aqueous TTC‐HCl solution of 100 mg/ml (test), or a 0.9% NaCl solution (control). At 3 and 6 months post‐treatment, the PI was unchanged for both groups. The GI index was reduced (0.062 > p > 0.001) in a similar manner for both groups. PPD showed statistically significant (p < 0.001) mean/patient decrease of similar magnitudes, 2.3±1.0 mm (test), and ‐1.6±0.8 mm (control) at 3 months, and ‐2.1±1.1 mm (test), and ‐1.4±0.9 mm at 6 months (control), respectively. Also, PAL measurements indicated a statistically significant average gain/patient of 2.1±1.1 mm in the test group (p<0.00l) and again of 1.2±1.0 mm in the controls (p = 0.002) at 3 months, and 1.8±1.1 mm (test; p<0.001) and 1.0±0.9 mm (controls; p= 0.005) at 6 months. Comparisons of the changes, between the groups, indicated statistically greater gain of PAL in the test group at both the 3 (p= 0.042) and 6 months (p= 0.034) intervals. These results suggest that TTC‐HCl irrigation of root surfaces for long periods of time (5 min) results in a subsequent release of active antibiotic into the gingival fluid at therapeutic levels for at least 1 week. TTC‐HCl irrigation resulted in significantly greater attachment gain as compared to scaling and root planing alone over at least a month period of healing.
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15.
  • Chung, Whasun O, et al. (författare)
  • Distribution of erm(F) and tet(Q) genes in 4 oral bacterial species and genotypic variation between resistant and susceptible isolates.
  • 2002
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 29:2, s. 152-158
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Bacteroides forsythus, Porphyromonas gingivalis and Prevotella intermedia are Gram-negative anaerobic bacteria that are currently considered potential periopathogens. Prevotella nigrescens has recently been separated from P. intermedia and its rôle in periodontitis is unknown. The erm(F) gene codes for an rRNA methylase, conferring resistance to macrolides, lincosamides and streptogramin B (MLSB), and the tet(Q) gene for a ribosomal protection protein, conferring resistance to tetracycline. The presence of these resistance genes could impair the use of antibiotics for therapy.PURPOSE: The aim of this study was to determine the carriage of erm(F) and tet(Q), and genetic variability of 12 Porphyromonas gingivalis, 10 Prevotella intermedia, 25 Prevotella nigrescens and 17 Bacteroides forsythus isolates from 9 different patient samples.METHODS: We used polymerase chain reaction (PCR) for detecting antibiotic resistance genes, and pulsed-field gel electrophoresis (PFGE) for detecting genetic variability among the isolates.RESULTS: Thirty-one (48%) isolates were resistant to both erythromycin and tetracycline and carried the erm(F) and tet(Q) genes, eight (13%) were tetracycline resistant and carried the tet(Q) gene, 9 (14%) were erythromycin resistant and carried the erm(F) gene, and 12 (19%) isolates did not carry antibiotic resistance genes. PFGE was used to compare isolates from the same patient and isolates from different patient samples digested with XbaI. No association was found between antibiotic resistance gene carriage and PFGE patterns in any species examined. All isolates of the same species from the same patient had highly related or identical PFGE patterns. Isolates of same species from different patients had unique PFGE pattern for each species tested.CONCLUSION: All isolates of the same species from any one patient were genetically related to each other but distinct from isolates from other patients, and 66% of the patients carried antibiotic resistant isolates, which could impair antibiotic therapy.
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16.
  • Claesson, Rolf, et al. (författare)
  • Detection of the highly leucotoxic JP2 clone of Aggregatibacter actinomycetemcomitans in members of a Caucasian family living in Sweden
  • 2011
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 38:2, s. 115-121
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Carriers of the JP2 clone of Aggregatibacter actinomycetemcomitans exhibit an enhanced risk for developing aggressive periodontitis compared with individuals carrying non-JP2 clones. While the JP2 clone is almost exclusively detected among adolescents of African descent, reports on Caucasians colonized with the JP2 clone are remarkably few.Objective: The aim of this paper is to report on the history of periodontal disease and microbiological findings in a Caucasian family.Material and Methods: A. actinomycetemcomitans and other periodontitis-associated bacterial species in subgingival plaque samples were quantified by conventional culture technique. Leucotoxin promoter typing, serotyping and further characterizations of A. actinomycetemcomitans isolates were performed by PCR. DNA sequencing of the pseudogene, hbpA was performed to determine the origin of the detected JP2 clones. Further, genetically ancestry testing of family members was carried out.Results: The JP2 clone was detected in samples from two of the family members, a 33-year-old daughter and her 62-year-old mother. Relationship of their JP2 clones with JP2 clone strains from the Mediterranean area of Africa was indicated. Genotyping confirmed the Caucasian origin of all family members.Conclusions: Caucasian JP2 carriers exist and older subjects can carry the JP2 clone of A. actinomycetemcomitans.
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17.
  • Claffey, Noel, et al. (författare)
  • Surgical treatment of peri-implantitis
  • 2008
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 35:8 Suppl, s. 316-32
  • Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
    • OBJECTIVES: To review the literature on surgical treatment of peri-implantitis. MATERIAL AND METHODS: A search of PubMed and as well as a hand search of articles were conducted. Publications and articles accepted for publication up to November 2007 were included. RESULTS: A total of 43 studies were selected for the review. Only 13 of these were studies in humans and only one study directly addressed disease resolution. Thus the available evidence for surgical treatment of peri-implantitis is extremely limited. ANIMAL STUDIES: Re-osseointegration can occur on previously contaminated surfaces. The surface characteristics are decisive for regeneration and re-osseointegration. No single surface decontamination method appears to be distinctly superior. Open debridement with surface decontamination can achieve resolution. HUMAN STUDIES: Access surgery has been investigated in one study demonstrating that resolution occurred in 58% of the lesions. No single method of surface decontamination (chemical agents, air abrasives and lasers) was found to be superior. The use of regenerative procedures such as bone graft techniques with or without the use of barrier membranes has been reported with various degrees of success. However, it must be stressed that such techniques do not address disease resolution but rather merely attempt to fill the osseous defect.
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18.
  • Claffey, Noel, et al. (författare)
  • Surgical treatment of peri-implantitis
  • 2008
  • Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 35:8 Suppl, s. 316-32
  • Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
    • OBJECTIVES: To review the literature on surgical treatment of peri-implantitis. MATERIAL AND METHODS: A search of PubMed and as well as a hand search of articles were conducted. Publications and articles accepted for publication up to November 2007 were included. RESULTS: A total of 43 studies were selected for the review. Only 13 of these were studies in humans and only one study directly addressed disease resolution. Thus the available evidence for surgical treatment of peri-implantitis is extremely limited. ANIMAL STUDIES: Re-osseointegration can occur on previously contaminated surfaces. The surface characteristics are decisive for regeneration and re-osseointegration. No single surface decontamination method appears to be distinctly superior. Open debridement with surface decontamination can achieve resolution. HUMAN STUDIES: Access surgery has been investigated in one study demonstrating that resolution occurred in 58% of the lesions. No single method of surface decontamination (chemical agents, air abrasives and lasers) was found to be superior. The use of regenerative procedures such as bone graft techniques with or without the use of barrier membranes has been reported with various degrees of success. However, it must be stressed that such techniques do not address disease resolution but rather merely attempt to fill the osseous defect.
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19.
  • Cosyn, Jan, et al. (författare)
  • An analysis of the decision-making process for single implant treatment in general practice
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 39:2, s. 166-172
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose To study the frequency of and factors associated with the decision to perform single implant treatment after tooth extraction by general practitioners in a private, fee-for-service setting. Material and methods One hundred practitioners with a general dental practice in Ghent were randomly selected. Clinicians were asked to fill in a study form for every single extraction they performed during an 8-week period. The form related to the treatment decision and a number of patient- and clinician-related factors. Results Ninety-four general dentists (52 men, 42 women; mean age 49; range 24–68) agreed to participate and extracted 1180 single teeth. After exclusion of third molars and cases where the reason for tooth loss would generally prohibit replacement, 900 cases were identified. In 24% of these patients, there was no treatment decision and in 18% replacement was deemed unnecessary. When replacement was necessary (n = 526), removable partial denture (RPD), fixed partial denture (FPD), single implant treatment and resin-bonded bridge were chosen in 54%, 24%, 21% and 1% of the patients, respectively. Multinomial logistic regression was used to evaluate the decision-making process for single implant treatment against RPD and FPD. In relation to RPD, single implant treatment was more likely in highly educated patients with few missing teeth and no bone loss at adjacent teeth. In relation to FPD, single implant treatment was more likely in patients with intact adjacent teeth and when the tooth was extracted by a female dentist. Experience in implant prosthetics was positively associated with single implant treatment in all analyses. Conclusions Single implant treatment is not the most common procedure in daily practice to restore a single tooth gap. Patient's education, oral factors and clinician-related factors may affect the decision-making process, whereas medical factors may not.
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20.
  • Cosyn, Jan, et al. (författare)
  • Predictors of inter-proximal and midfacial recession following single implant treatment in the anterior maxilla : a multivariate analysis
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 39:9, s. 895-903
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose A number of factors have been associated with soft tissue recession following single implant treatment. However, given the cross-sectional design of most of these studies and crude associations based on univariate analyses, such factors may only be considered risk indicators. The objective of the present retrospective cohort study using multivariate analyses was to identify predictors of recession. Material and Methods Patients who had been treated by two periodontists and two prosthodontists in 2006 and 2007 for a single implant in the anterior maxilla were re-examined in 2009 and their records were scrutinized. Subjects treated via flap surgery with and without ridge re-contouring were considered. Outcome variables were inter-proximal and midfacial recession. Explanatory variables included demographic data, the surgical approach and a number of local factors that were evaluated on radiographs taken pre-operatively or at permanent crown installation (baseline). Results Data pertaining to 97/115 (60 females, 37 males; mean age 51, SD 13, range 23–80) patients were available for evaluation. Significant bone loss was observed between baseline and re-examination at the implant surface (0.2–0.3 mm, p < 0.001) and tooth surface (0.3–0.5 mm, p < 0.001). Surgery with ridge re-contouring demonstrated 0.2 mm additional bone loss at the distal tooth surface when compared to surgery without ridge re-contouring (p = 0.034). This could be explained by a disparity in possible papilla-opening procedures (three versus one or two). As a result, regression analyses identified surgery with ridge re-contouring as a predictor of inter-proximal recession (OR ≥ 3.4). Pre-operative bone level at the tooth surface was another predictor of inter-proximal recession (OR ≥ 2.1). Recession of the distal papilla was also affected by a missing contact point (OR = 221.9), the implant-to-tooth distance (OR = 0.3) and the distance of the bone peak to the contact point (OR = 2.9). Midfacial recession was only associated with a buccal shoulder position (OR = 17.2). Conclusions To optimize soft tissue levels around single implants, clinicians should limit papilla-opening procedures and pay utmost attention to a correct implant and contact point positioning.
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21.
  • Cosyn, Jan, et al. (författare)
  • Regenerative periodontal therapy of infrabony defects using minimally invasive surgery and a collagen-enriched bovine-derived xenograft : a 1-year prospective study on clinical and aesthetic outcome
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - : Wiley-Blackwell. - 0303-6979 .- 1600-051X. ; 39:10, s. 979-986
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To evaluate the clinical and aesthetic outcome of regenerative periodontal therapy (RPT) using minimally invasive surgery and a collagen-enriched bovine-derived xenograft (1); to identify risk factors for failure (clinical attachment level (CAL) gain ≤ 1 mm) and advanced gingival recession (REC) increase (>1 mm) (2). MATERIAL AND METHODS: Ninety-five non-smoking patients, with ≤ 25% full-mouth plaque and bleeding presenting ≥ 6 months after initial periodontal therapy with ≥ 1 isolated inter-dental infrabony defect were recruited. Patients were consecutively treated by the same clinician using minimally invasive surgery and a collagen-enriched bovine-derived xenograft. Clinical, radiographic and aesthetic data were collected before surgery and up to 1 year. Multivariate analyses were used to identify risk factors for failure and advanced REC increase. RESULTS: Eighty-four patients (39 men, 45 women; mean age 53) complied and demonstrated mean probing depth (PD) of 7.8 mm, CAL of 10.0 mm and defect depth of 5.2 mm before surgery. At 1 year, postsurgery mean PD reduction was 3.5 mm (range 0.0-8.0), CAL gain was 3.1 mm (range 0.0-7.0) and radiographic defect fill was 53% (range 0-100). Forty-nine percentage showed ≥ 4 mm CAL gain, whereas 15% were considered failures. Mean inter-dental and midfacial REC increase was 0.3 mm (range-2.0-2.0) and 0.5 mm (range-1.5-2.0) respectively. Midfacial REC increase and contour deterioration contributed most to a small, yet significant reduction in the Pink Esthetic Score from 10.06 to 9.42 (p = 0.002). Risk factors for failure included defects with a non-supportive anatomy (OR: ≥ 10.4), plaque (OR: 14.7) and complication(s) (OR: 12.0). Risk factors for advanced midfacial REC increase included defects with a non-supportive anatomy (OR: 58.8) and a thin-scalloped gingival biotype (OR: 76.9). CONCLUSIONS: RPT using minimally invasive surgery and a collagen-enriched bovine-derived xenograft demonstrated favourable clinical outcome after 1 year, even though soft tissue aesthetics could not be fully preserved. Defects with a non-supporting anatomy may be at risk for failure and advanced midfacial recession.
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22.
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23.
  • Duncan, W J, et al. (författare)
  • Ovine periodontitis as a potential model for periodontal studies. Cross-sectional analysis of clinical, microbiological, and serum immunological parameters.
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 30:1, s. 63-72
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: : To investigate infection and host immunity patterns in sheep with naturally occurring "broken-mouth" periodontitis.MATERIALS AND METHODS: : Eight periodontally healthy (HS) and eight periodontally diseased ewes (PDS) were selected. Subgingival plaque and sera were collected and examined for evidence of human periodontitis-associated pathogens. Serum IgG titers were measured by ELISA to multiple strains of Porphyromonas gingivalis, Bacteroides forsythus, Dichelobacter nodosus, Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Fusobacterium nucleatum as well as several purified antigens (cysteine proteases, LPS, K, and fimbriae).RESULTS: : Neither the organism Aa nor antigens to Aa were found in any animal. Most animals were positive for Pg, Bf, and Pi, but DNA probes detected no difference between HS and PDS relative to amounts of pathogens in subgingival plaque. PDS had significantly higher serum IgG titers to all Pg strains, to 50% of Bf strains, to the Pi and Fn strains, and to fimbriae and the two cysteine proteases (p-values ranging from 0.05 to 0.001). Regression analysis demonstrated a significant association between number of teeth lost and serum IgG antibody titers to whole-cell sonicate antigens of P. gingivalis strains (p<0.01) and body weight (p<0.01).CONCLUSIONS: : The presence of pathogens associated with periodontitis was reflected in differences in serum IgG titers between healthy and diseased sheep. This may have influenced animal body weight and might have systemic health and economic consequences. The data suggest that susceptible and non-susceptible sheep can be identified for periodontal research.
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24.
  • Duss, Christof, et al. (författare)
  • A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery
  • 2010
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 37:11, s. 988-997
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Chlorhexidine (CHX) rinsing after periodontal surgery is common. We assessed the clinical and microbiological effects of two CHX concentrations following periodontal surgery. Materials and methods In a randomized, controlled clinical trial, 45 subjects were assigned to 4 weeks rinsing with a 0.05 CHX/herbal extract combination (test) or a 0.1% CHX solution. Clinical and staining effects were studied. Subgingival bacteria were assessed using the DNA-DNA checkerboard. Statistics included parametric and non-parametric tests (p < 0001 to declare significance at 80% power). Results At weeks 4 and 12, more staining was found in the control group (p < 0.05 and p < 0.001, respectively). A higher risk for staining was found in the control group (crude OR: 2.3:1, 95% CI: 1.3 to 4.4, p < 0.01). The absolute staining reduction in the test group was 21.1% (9 5% CI: 9.4-32.8%). Probing pocket depth (PPD) decreases were significant (p < 0.001) in both groups and similar (p=0.92). No rinse group differences in changes of bacterial counts for any species were found between baseline and week 12. Conclusions The test CHX rinse resulted in less tooth staining. At the study endpoint, similar and high counts of periodontal pathogens were found.
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25.
  • Duss, Christof, et al. (författare)
  • A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery
  • 2010
  • Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 37:11, s. 988-997
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Chlorhexidine (CHX) rinsing after periodontal surgery is common. We assessed the clinical and microbiological effects of two CHX concentrations following periodontal surgery. Materials and methods In a randomized, controlled clinical trial, 45 subjects were assigned to 4 weeks rinsing with a 0.05 CHX/herbal extract combination (test) or a 0.1% CHX solution. Clinical and staining effects were studied. Subgingival bacteria were assessed using the DNA-DNA checkerboard. Statistics included parametric and non-parametric tests (p < 0001 to declare significance at 80% power). Results At weeks 4 and 12, more staining was found in the control group (p < 0.05 and p < 0.001, respectively). A higher risk for staining was found in the control group (crude OR: 2.3:1, 95% CI: 1.3 to 4.4, p < 0.01). The absolute staining reduction in the test group was 21.1% (9 5% CI: 9.4-32.8%). Probing pocket depth (PPD) decreases were significant (p < 0.001) in both groups and similar (p=0.92). No rinse group differences in changes of bacterial counts for any species were found between baseline and week 12. Conclusions The test CHX rinse resulted in less tooth staining. At the study endpoint, similar and high counts of periodontal pathogens were found.
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26.
  • Dörtbudak, Orhun, et al. (författare)
  • Periodontitis, a marker of risk in pregnancy for preterm birth.
  • 2005
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 32:1, s. 45-52
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Why chronic periodontitis may induce an inflammatory response with premature pregnancy termination is unclear.AIMS: (1) To assess if periodontitis predicts premature gestation; (2) to study amniotic fluid cytokines and periodontitis variables in early-stage pregnancy.MATERIAL AND METHODS: A periodontal examination and collection of amniotic fluid was performed (weeks 15-20) of pregnancy in 36 women at risk for pregnancy complications. Amniotic fluid (bacteria), vaginal smears and intra-oral plaque samples were studied. Cytokine levels in amniotic fluid were studied in relation to other study variables.RESULTS: Periodontitis was diagnosed in 20% of normal and in 83% of preterm birth cases (p<0.01). Bacteria were never found in the amniotic fluids studied. Sub-gingival plaque samples including bacteria in the orange and red complexes were found in 18% of full-term 100% of preterm cases (p<0.001) and total colony-forming units (CFUs) were higher in preterm birth (p<0.01). Amniotic levels of interleukin (IL)-6 and prostaglandin-E2 (PGE2) were higher in preterm cases (p<0.001). Amniotic IL-6 (r=0.56, p<0.01) and PGE2 (r=0.50, p<0.01) cytokine levels were correlated with CFU from sub-gingival plaque samples (r2=0.44). The odds ratio of preterm delivery and having periodontitis was 20.0 (95% confidence interval (CI): 2.0-201.7, p<0.01). The odds of >60 CFU in sub-gingival plaque and preterm birth was 32.5:1 (95% CI: 3.0-335.1, p<01).CONCLUSIONS: Pregnant women with findings of elevated amniotic fluid levels of PGE2, IL-6 and IL-8 in the 15-20 weeks of pregnancy and with periodontitis are at high risk for premature birth. The implication of this is that periodontitis can induce a primary host response in the chorioamnion leading to preterm birth.
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27.
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28.
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29.
  • Figueredo, CMS, et al. (författare)
  • Activity and inhibition of elastase in GCF.
  • 1998
  • Ingår i: JOURNAL OF DENTAL RESEARCH. - : Wiley. - 0022-0345. ; 25:7, s. 531-535
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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30.
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31.
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32.
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33.
  • Franke Stenport, Victoria, et al. (författare)
  • Enamel matrix derivative and titanium implants : An experimental pilot study in the rabbit
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - : Blackwell. - 0303-6979 .- 1600-051X. ; 30:4, s. 359-363
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The aim of present study was to evaluate if an enamel matrix derivative (Emdogain®) may enhance bone formation and osseointegration of titanium implants, using a well-documented rabbit model. Material and methods: Thirty-six threaded commercially pure titanium (cp.ti.) implants were inserted in six New Zealand white rabbits. One implant was placed in each femur and two in each tibia. Prior to implant insertion approximately 0.5 mL of Emdogain (EMD) (test) or the vehicle gel (PGA: propylene glycol alginate) (control) was injected into the surgically prepared implant site. The follow-up time was 6 weeks. Biomechanical evaluations by resonance frequency analysis (RFA) and removal torque measurements (RTQ) were performed. Histomorphometrical quantifications were made on ground sections by measurements of the percentage of bone-to-metal contact, bone area inside the threads as well as outside the threads (mirror image). Bone lengths along the implant surface were also measured and used for shear strength calculations. Results: The results demonstrated no beneficial effects from the EMD treatment on bone formation around titanium implants in any of the tested parameters. Significant differences were demonstrated with removal torque test and shear force calculations for the control implants. No other parameter demonstrated a statistically significant difference. Conclusion: The results of the present study may indicate that EMD does not contribute to bone formation around titanium implants. This observation may indicate that the bone formation that occurs after EMD treatment in periodontal defects is the result of functional adaptation. However, further research is required to evaluate the effect of EMD treatment on bone formation.
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34.
  • Friskopp, Johan, et al. (författare)
  • The anesthetic onset and duration of a new lidocaine/prilocaine gel intra-pocket anesthetic (Oraqix) for periodontal scaling/root planing
  • 2001
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 28:5, s. 453-458
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: A new non-injection anesthetic, lidocaine/prilocaine gel (Oraqix, AstraZeneca) in a reversible thermosetting system, has been developed to provide local anesthesia for scaling/root planing (SRP). The aim of this study was to determine the anesthetic onset and duration of the gel for SRP in patients with periodontitis.METHODS: 30 patients were randomized to either 30 s, 2 min, or 5 min of treatment with the gel prior to SRP of a tooth. The gel was applied to periodontal pockets with a blunt applicator. On completion of the SRP of each tooth (2-3 teeth treated/patient), the patients rated their pain on a 100-mm visual analogue scale (VAS).RESULTS: The median VAS pain score was 7.5 mm in the 30-s group, 28.5 mm in the 2-min group, and 15.5 mm in the 5-min group, with a significant difference between the 30-s and 2-min groups (p=0.03). In 2 patients in the 5-min group, but none in the other groups, the SRP was interrupted due to pain. The mean duration of anesthesia measured as pain on probing were 18.1, 17.3, and 19.9 min in the 30-s, 2-min, and 5-min groups, respectively. There were no reports of numbness of the tongue, lip, or cheek, neither were there any adverse local reactions in the oral mucosa. The gel was easy to apply and did not interfere with the SRP procedure.CONCLUSION: Oraqix provides anesthesia after an application time of 30 s, with a mean duration of action of about 17 to 20 min.
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35.
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36.
  • Grigoriadis, Anastasios, et al. (författare)
  • Adaptability of mastication in people with implant-supported bridges
  • 2011
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 38:4, s. 395-404
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: We aimed to determine whether people with implant-supported bridges in both jaws, thus lacking periodontal receptors, adjust jaw muscle activity to food hardness during mastication.Materials and Methods: Thirteen participants with implant-supported bridges in both jaws and 13 with natural dentition chewed and swallowed soft and hard gelatine-based model foods, while electromyographic (EMG) activity of the masseter and temporal muscles was recorded bilaterally together with the position of the mandible. Data were compared by using a mixed-design anova model and a P-value<0.05 was considered statistically significant.Results: The number of chewing cycles and the duration of the masticatory sequence increased with food hardness in both groups, whereas vertical and lateral amplitude of the jaw movements, and the jaw-opening velocity, increased significantly with food hardness only for the dentate group. Although both groups adapted the EMG activity to the hardness of the food, the implant participants showed a significantly weaker increase in EMG activity with increased food hardness early during the masticatory sequence than the dentate participants did. In addition, the implant group showed significantly less reduction of muscle activity during the progression of the masticatory sequence than the dentate group.Conclusions: People with implant-supported bridges show an impaired adaptation of the muscle activity to food hardness during mastication. We suggest that a lack of sensory signals from periodontal mechanoreceptors accounts for the impairment.
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37.
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38.
  • Hallström, Hadar, et al. (författare)
  • Systemic antibiotics and debridement of peri-implant mucositis : a randomized clinical trial
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 39:6, s. 574-581
  • Tidskriftsartikel (refereegranskat)abstract
    • Background This RCT compared non-surgical treatment of peri-implant mucositis with or without systemic antibiotics. Materials and Methods Forty-eight subjects received non-surgical debridement with or without systemic Azithromax ® (4 days), and were followed during 6 months. The checkerboard DNA-DNA hybridization method was used to analyse the microbiological material. Results Five subjects were excluded due to antibiotic medication during follow-up. At baseline,1 and 3 months no group differences were found. Statistical analysis failed to demonstrate differences in probing pocket depths (PPD) values at 6 months (Mean diff PPD: 0.5 mm, SE: ±0.4 mm, 95% CI: −0.2, 1.3, p = 0.16). Mean% implant bleeding decreased between baseline and month 6 from 82.6% to 27.3% in the test, and from 80.0% to 47.5% in the control group (p < 0.02). Throughout the study, no study group differences in bacterial counts were found. Conclusion No short-term differences were found between study groups. The clinical improvements observed at 6 months may be attributed to improvements in oral hygiene. The present study does not provide evidence for the use of systemic antibiotics in treatment of peri-implant mucositis.
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39.
  • Hallström, Hadar, et al. (författare)
  • Systemic antibiotics and debridement of peri-implant mucositis. A randomized clinical trial
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - : Wiley Blackwell. - 0303-6979 .- 1600-051X. ; 39:6, s. 574-581
  • Tidskriftsartikel (refereegranskat)abstract
    • Background This RCT compared non-surgical treatment of peri-implant mucositis with or without systemic antibiotics. Materials and Methods Forty-eight subjects received non-surgical debridement with or without systemic Azithromax (R) (4 similar to days), and were followed during 6 similar to months. The checkerboard DNA-DNA hybridization method was used to analyse the microbiological material. Results Five subjects were excluded due to antibiotic medication during follow-up. At baseline,1 and 3 similar to months no group differences were found. Statistical analysis failed to demonstrate differences in probing pocket depths (PPD) values at 6 similar to months (Mean diff PPD: 0.5 similar to mm, SE: +/- 0.4 similar to mm, 95% CI: -0.2, 1.3, p similar to 0.16). Mean% implant bleeding decreased between baseline and month 6 from 82.6% to 27.3% in the test, and from 80.0% to 47.5% in the control group (p similar to 0.02). Throughout the study, no study group differences in bacterial counts were found. Conclusion No short-term differences were found between study groups. The clinical improvements observed at 6 similar to months may be attributed to improvements in oral hygiene. The present study does not provide evidence for the use of systemic antibiotics in treatment of peri-implant mucositis.
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40.
  • Heitz-Mayfield, Lisa J A, et al. (författare)
  • Clinical course of chronic periodontitis : II. Incidence, characteristics and time of occurrence of the initial periodontal lesion
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 30:10, s. 902-8
  • Tidskriftsartikel (refereegranskat)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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41.
  • Holmlund, Anders, et al. (författare)
  • Bone resorbing activity and cytokine levels in gingival crevicular fluid before and after treatment of periodontal disease.
  • 2004
  • Ingår i: Journal of clinical periodontology. - 0303-6979 .- 1600-051X. ; 31:6, s. 475-82
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The aim of the present study was to investigate bone resorption activity (BRA), interleukin-1 alpha (IL-1 alpha), IL-1 beta and interleukin-1 receptor antagonist (IL-1ra) in gingival crevicular fluid (GCF) in sites with no signs of periodontal disease and in sites with horizontal or angular loss of periodontal bone. These assessments were performed before and after periodontal treatment. METHODS: GCFs were collected from 10 individuals with filter strips from two healthy sites and four sites with deep pathological periodontal pockets, two of which showed horizontal bone loss and two with angular bone loss. All diseased pockets were treated with flap surgery and systemic Doxyferm. Twelve months later GCF was collected again and treatment outcome evaluated. BRA in GCFs was assessed in a bone organ culture system by following the release of (45)Ca from neonatal mouse calvariae. The amounts of IL-1 alpha, IL-1 beta and IL-1ra in GCFs were quantified by enzyme-linked immunosorbent assay (ELISA). RESULTS: Treatment resulted in reduction of pocket depths with 3.5+/-0.5 mm in sites with angular bone loss and 2.8+/-0.3 mm in sites with horizontal bone loss. Initially, BRA, IL-1 alpha, IL-1 beta and IL-1ra were significantly higher in GCFs from diseased sites compared with healthy sites. No differences in BRA and cytokine levels were seen between GCFs from pockets with horizontal and angular bone losses. The levels of IL-1 alpha, IL-1 beta and IL-1ra were significantly reduced after treatment of diseased pockets. Pocket depths were significantly correlated to BRA only in pre-treatment sites with angular bone loss. BRA was correlated to Il-1 alpha, IL-1 beta, but not to IL-1ra, in diseased sites with angular bone loss, before and after treatment. The reductions of BRA in the individual sites, seen after treatment, were not correlated to the reductions of Il-1 alpha, IL-1 beta or IL-1ra. CONCLUSIONS: These data show that BRA and cytokine levels are increased in GCFs from sites with periodontal disease and that periodontal treatment results in reduction of the cytokines. Our findings further indicate that IL-1 alpha and IL-1 beta play important roles for the BRA present in GCFs, but that other factors also contribute to this activity.
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42.
  • Hugoson, Anders, et al. (författare)
  • Distribution of periodontal disease in a Swedish adult population 1973, 1983 and 1993
  • 1998
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 25:7, s. 542-548
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to compare changes in periodontal status in a Swedish poplation over a period of 20 years. Cross-sectional studies were carried out in Jönköping County in 1973, 1983, and 1993. Individuals were randomly selected from the following age groups: 20, 30, 40, 50, 60, and 70 years. A total of 600 individuals were examined in 1973, 597 in 1983, and 584 in 1993. The number of dentate individuals was 537 in 1973, 550 in 1983, and 552 in 1993. Based on clinical data and full mouth intra-oral radiographs, all individuals were classified into 5 groups according to the severity of the periodontal disease experience. Individuals were classified as having a healthy periodontium (group 1), gingivitis without signs of alveolar bone loss (group 2), moderate alveolar bone loss not exceeding 1/3 of the normal alveolar bone height (group 3), severe alveolar bone loss ranging between 1/3 and 2/3 of the normal alveolar bone height (group 4), or alveolar bone loss exceeding 2/3 of the normal bone height and angular bony defects and/or furcation defects (group 5). During these 20 years, the number of individuals in groups 1 and 2 increased from 49% in 1973 to 60% in 1993. In addition, there was a decrease in the number of individuals in group 3, the group with moderate periodontal bone loss. Groups 4 and 5 comprised 13% of the population and showed no change in general between 1983 and 1993. The individuals comprising these groups in 1993, however, had more teeth than those who comprised these groups in 1983; on the average, the individuals in disease group 4 had 4 more teeth and those in disease group 5, 2 more teeth per subject. In 1973, these 2 groups were considerably smaller, probably because of wider indications for tooth extractions and fewer possibilities for periodontal care which meant that many of these individuals had become edentulous and were not placed in a group. Individuals in groups 3, 4, and 5 were subdivided according to the number of surfaces (%) with gingivitis and periodontal pockets (≥4 mm). In 1993, 20%, 42%, and 67% of the individuals in groups 3, 4, and 5 respectively were classified as diseased and in need of periodontal therapy with >20% bleeding sites and >10% sites with periodontal pockets ≥4 mm. In conclusion, an increase in the number of individuals with no marginal bone loss and a decrease in the number of individuals with moderate alveolar bone loss can be seen. The prevalence of individuals in the severe periodontal disease groups (4, 5) was unchanged during the last 10 years; however, the number of teeth per subject increased.
  •  
43.
  • Hugoson, Anders, et al. (författare)
  • Effect of three different dental health preventive programmes on young adult individuals: a randomized, blinded, parallel group, controlled evaluation of oral hygiene behaviour on plaque and gingivitis.
  • 2007
  • Ingår i: Journal of clinical periodontology. - 0303-6979 .- 1600-051X. ; 34:5, s. 407-15
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To evaluate, in young adults, the effect of different preventive programmes on oral hygiene and to determine whether the variables investigated are predictors of gingival health. MATERIAL AND METHODS: This randomized, blinded, parallel, controlled clinical study examined the effectiveness of three dental health programmes. Four hundred subjects aged 20-27 years, 211 males and 189 females, participated in the study. They were recruited from a Public Dental Service clinic and from a private dental practice in Jönköping, Sweden. The effect of the programmes on plaque and gingivitis was evaluated over a 3-year period. The programmes included activities that were adapted for individuals as well as for groups. The plaque indices (PLI) and gingival indices (GI) were used to evaluate the programmes. RESULTS: All programmes resulted in a decrease in PLI and GI. The greatest decrease was found in the group that was followed-up every 2 months. Professional tooth cleaning was non-significant for the clinical result. Gingival health at baseline, participation in any of the test programmes, and knowledge of the dental diseases caries, gingivitis or periodontitis were significant predictors of good gingival health. CONCLUSIONS: The study confirms the efficacy of three different preventive programmes in reducing supragingival plaque and gingival inflammation. Professional tooth cleaning provided no clinical benefit beyond that derived from individual and group-based health education.
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44.
  • Hugoson, Anders, et al. (författare)
  • Has the prevalence of periodontitis changed during the last 30 years?
  • 2008
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 35:8 Suppl., s. 338-345
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: This paper reviews global trends in the change in prevalence of periodontitis over the last 30 years.MATERIAL AND METHODS: The epidemiology of periodontal disease is briefly reviewed together with the current classification system and the clinical and radiographic diagnostic methodology in periodontal disease.RESULTS: This review identifies the very limited number of studies that provide prevalence data over time, and this data is discussed in comparison with those stemming from a few corresponding studies from countries outside Europe.CONCLUSIONS: The data indicate a possible trend of a lower prevalence of periodontitis in recent years.
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45.
  • Hugoson, Anders, et al. (författare)
  • Oral hygiene and gingivitis in a Swedish adult population 1973, 1983 and 1993
  • 1998
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 25:10, s. 807-812
  • Tidskriftsartikel (refereegranskat)abstract
    • The periodontal condition of the inhabitants of Jönköping County, Sweden was followed for 20 years by means of 3 cross-sectional investigations performed in 1973, 1983, and 1993. The study comprised individuals in the age groups 20, 30, 40, 50, 60, and 70 years. The number of dentate individuals was 537 in 1973, 550 in 1983, and 552 in 1993. All individuals participating in the studies were examined clinically and radiographically. They also filled out a questionaire about dental care habits, socio-economic status, and general health. A clear reduction in the plaque score was seen between 1973 and 1983 in all age groups. With one exception, no further significant change in plaque levels was found between 1983 and 1993: the increase in plaque among the 20-year-olds was significant. In 1993 the mean % of surfaces with plaque was between 30% and 40% in all age groups. Gingivitis values corresponded well with the values of dental plaque; the same pattern with a clear reduction in gingivitis score was seen in all age groups between 1973 and 1983, and an increase in the mean frequency of gingival inflammation between 1983 and 1993 was seen in the 20-year age group. 30% of the individuals in this age group had more than 50% gingivitis in 1993 compared with 9% of the individuals in 1983. The 20-year-olds were further analyzed in a linear regression model using gingivitis as a dependent variable against some socio-economic, general health, and dental care variables associated with poor oral hygiene and gingivitis. In 1993, the most important explanatory variable was gender: significantly more males than females had higher gingivitis scores. The second most important explanatory variable was toothbrushing habits. Together they explained 10.9% of the variance. The multivariate analysis did not reveal approximal cleaning habits to be significant, probably due to their strong connection to gender and toothbrushing habits. In the 1983 sample, no significant explanatory variables were found. It was concluded from this data that it is important not only to renew but also to direct preventive guidelines more towards young adults who have no previous extensive experience of oral disease so that they will not be excluded from dental care and their dental health thereby jeopardised. In addition to preventive programmes aimed at the population as a whole, individual programmes based on risk targeting are also necessary to reduce the number of people developing dental disease and to increase the quality of dental care.
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46.
  • Hugoson, Anders, et al. (författare)
  • Trends over 30 years, 1973-2003, in the prevalence and severity of periodontal disease
  • 2008
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 35:5, s. 405-414
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The present investigation presents findings of the prevalence and distribution of gingivitis and periodontitis in a Swedish population over the 30 years 1973-2003. MATERIAL AND METHODS: Four cross-sectional epidemiological studies in 1973, 1983, 1993, and 2003 were performed in Jönköping, Sweden. Random samples of individuals aged 20, 30, 40, 50, 60, 70, and 80 years were examined clinically and radiographically. Diagnostic criteria were edentulousness, number of teeth, plaque, gingival status, probing pocket depth, gingival recession, alveolar bone level, and classification according to periodontal disease status. RESULTS: In all age groups, the number of edentulous individuals decreased dramatically and the number of teeth increased. Oral hygiene improved considerably. Over the 30 years, the proportion of periodontally healthy individuals increased from 8% in 1973 to 44% in 2003 and the proportion of individuals with gingivitis and moderate periodontitis decreased. There was a non-significant trend for the proportion of individuals with severe periodontal disease experience (Group 4) to decrease, while the proportion of individuals with advanced periodontitis (Group 5) remained unchanged. CONCLUSION: Oral hygiene and periodontal health improved significantly in the 20-80-year age groups over the 30 years 1973-2003.
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47.
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48.
  • Jannesson, Lillemor, et al. (författare)
  • Effect of oxybenzone on PGE2-production in vitro and on plaque and gingivitis in vivo.
  • 2004
  • Ingår i: Journal of clinical periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 31:2, s. 91-4
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To study the effect of oxybenzone on prostaglandin E2 (PGE2) production in cell culture and to evaluate the effect of an oxybenzone-containing dentifrice on plaque and gingivitis in a 6-week clinical trial. MATERIAL AND METHODS: Human embryo palatal mesenchyme (HEPM) cells were used for testing the inhibition of IL-1beta-stimulated PGE2-production in vitro by different concentrations of oxybenzone. For the in vivo study, a total of 66 individuals with a Quigley & Hein plaque index of at least 1.5 and an Ainamo & Bay gingival index of at least 0.2 were included in a double-blind clinical trial with two cells and a parallel design. Two compositions of fluoride dentifrice were used, one with the addition of 0.5% oxybenzone, and one without. Plaque and gingival index were obtained at three time points: (1) at baseline, (2) after 3 weeks, and (3) after 6 weeks. RESULTS: A dose-dependent inhibition of PGE2-production was found in the HEPM cell culture following oxybenzone exposure. In the clinical trial, a 25% reduction of gingival index was observed in the oxybenzone group (p<0.001) after 6 weeks as compared with 2% for the placebo group. CONCLUSIONS: These findings indicate that PGE2-production is reduced by oxybenzone in vitro and that the use of oxybenzone in a dentifrice reduces gingivitis in vivo.
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49.
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50.
  • Johannsen, Annsofi, et al. (författare)
  • Dental implants from the patients perspective : transition from tooth loss, through amputation to implants – negative and positive trajectories
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 39:7, s. 681-687
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim The aim of this study was to explore patients' expectations on and experiences from dental implant treatment through deep-interview technique. Material & Methods A qualitative study design was chosen and 17 patients were interviewed by open-ended questions. All patients in the study had a previous history of periodontal disease with, in most cases, many years of treatment. The interviews were transcribed; a coding process was used according to qualitative conventional content analysis. Results In the analysis, a core category was identified as “Transition from tooth loss, to ‘Amputation’, and to implants – negative and positive trajectories”. When the patients faced the fact that it was not possible to keep the teeth any longer, a period of fear, shame and denial, which also affected their social life negatively followed. After they received their implants and the chewing ability and appearance became better, it also improved their quality of life. Conclusion Treatment with dental implants improved function, enhanced self-esteem, social life and, thus quality of life. In clinical practice, information about dental implants and motivational strategies are needed during the period before getting dental implants. Follow-up is important thereafter, capturing both the pros and cons with implants.
  •  
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