| 1. |
- Bengtsson, Viveca Wallin, et al.
(author)
-
Periodontitis related to cardiovascular events and mortality : a long-time longitudinal study
- 2021
-
In: Clinical Oral Investigations. - : Springer Science and Business Media Deutschland GmbH. - 1432-6981 .- 1436-3771. ; 25:6, s. 4085-4095
-
Journal article (peer-reviewed)abstract
- Objective: The present study assessed if individuals ≥ 60 years of age with periodontitis are more likely to develop stroke or ischemic heart diseases, or at a higher risk of death for 17 years. Material and methods: At baseline individuals ≥ 60 received a dental examination including a panoramic radiograph. Periodontitis was defined as having ≥ 30% sites with ≥ 5-mm distance from the cementoenamel junction to the marginal bone level. Medical records were annually reviewed from 2001 to 2018. Findings from the medical records identifying an ICD-10 code of stroke and ischemic heart diseases or death were registered. Results: Associations between periodontitis and incidence of ischemic heart disease were found in this 17-year follow-up study in all individuals 60–93 years (HR: 1.5, CI: 1.1–2.1, p = 0.017), in women (HR: 2.1, CI: 1.3–3.4, p = 0.002), and in individuals 78–96 years (HR: 1.7, CI: 1.0–2.6, p = 0.033). Periodontitis was associated with mortality in all individuals (HR: 1.4, CI: 1.2–1.8, p = 0.002), specifically in men (HR: 1.5, CI: 1.1–1.9, p = 0.006) or in ages 60–72 years (HR: 2.2, CI: 1.5–3.2, p = 0.000). Periodontitis was more prevalent among men (OR: 1.8, CI: 1.3–2.4, p = 0.000). Conclusions: Individuals with periodontitis have an increased risk for future events of ischemic heart diseases and death. Clinical relevance: Improving periodontal health in older individuals may reduce overall mortality and ischemic heart diseases. Both dental and medical professionals should be aware of the associations and ultimately cooperate. © 2021, The Author(s).
|
|
| 2. |
- Criten, Sladjana, et al.
(author)
-
Oral health status among 60-year-old individuals born in 1941-1943 and 1954-1955 and 81-year-old individuals born in 1922-1924 and 1933-1934, respectively : a cross-sectional study
- 2022
-
In: Clinical Oral Investigations. - : Springer Berlin/Heidelberg. - 1432-6981 .- 1436-3771. ; :11, s. 6733-6742
-
Journal article (peer-reviewed)abstract
- Objective This study aimed to analyze the oral health status of four different birth cohorts: two cohorts of 60-year-olds born in 1941-1943 and 1954-1955 and 2 cohorts of 81-year-olds born in 1920-1922 and 1933-1934. Material and methods The study was based on data from an ongoing longitudinal population project, The Swedish National Study on Aging and Care (SNAC). Oral health status was repeatedly examined clinically and radiographically in 2001-2003 and 2014-2015, including 60- and 81-year-olds, in total 412 individuals. Statistical analyses were performed using independent-samples t test and Pearson's chi(2) test. Results More individuals were dentate in 2014-2015 compared to 2001-2003 in the two age groups: 60 and 81 years (p < 0.001 for both). The mean number of teeth increased in the 60-year-olds from 24.2 to 27.0 and in the 81-year-olds from 14.3 to 20.2. The numbers of at least one intact tooth increased for both age groups (p < 0.001 and p < 0.004, respectively). In the age groups 81 years, there was an increase in having at least one PPD >= 6 mm (p < 0.016) and bone loss >= 5 mm (p < 0.029) between the two examinations. No such differences were found in the age groups of 60 years. Conclusion Over 13 years, oral health improved for both 60- and 81-year-old age groups. The most significant changes were in the 81-year-olds where oral health had improved except for periodontal status.
|
|
| 3. |
- Henricsson, Sara, et al.
(author)
-
Self-perceived oral health and orofacial appearance in an adult population, 60 years of age
- 2023
-
In: International Journal of Dental Hygiene. - : John Wiley & Sons. - 1601-5029 .- 1601-5037.
-
Journal article (peer-reviewed)abstract
- Objective: The study aimed to compare self-perceived oral health and orofacial appearance in three different cohorts of 60-year-old individuals. Method: A cross-sectional design, based on data obtained from a questionnaire used in the Swedish National Study of Aging and Care. The sample comprised 478 individuals, from baseline, 2001-2003 (n = 191), 2007-2009 (n = 218) and 2014-2015 (n = 69). Comparisons were made within and between the cohorts, with bivariate analysis and Fisher's exact test. Statistical significance was considered at p < 0.05. Results: The result showed that a low number of the participants reported self-perceived problems with oral health. Of the problems reported, a higher proportion in cohort 2014-2015 (39.3%) experienced problems with bleeding gums. The experience of bleeding gums increased between the cohorts 2001-2003 and 2014-2015 (p = 0.040) and between 2007-2009 and 2014-2015 (p = 0.017). The prevalence of discomfort with sensitive teeth was experienced in 7%-32%. Twice as many women compared to men experienced discomfort in all cohorts (no significant differences between the cohorts). Satisfaction with dental appearance was experienced in 75%-84%. Twice as many women compared to men were dissatisfied with their dental appearance in 2001-2003 (p = 0.011) and with discoloured teeth (p = 0.020). No significant differences could be seen between the cohorts regarding discomfort with dental appearance or discoloured teeth. Conclusion: The 60-year-olds irrespective of birth cohort, perceived their oral health and orofacial appearance as satisfactory.
|
|
| 4. |
- Henricsson, Sara, et al.
(author)
-
Self-perceived oral health and orofacial appearance in older adults - an 18-year follow-up study in Karlskrona, Sweden
- 2024
-
In: Acta Odontologica Scandinavica. - : MJS publishing. - 0001-6357 .- 1502-3850. ; 83, s. 255-263
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: To analyze whether self-perceived oral health and orofacial appearance change with increasing age. METHODS: This longitudinal study is based on data from a questionnaire used in the Swedish National Study of Aging and Care. The sample comprises 160 participants 60 years of age at baseline 2001-2003. The same participants were re-examined at 66-, 72-, and 78 years of age. To analyze whether perceptions of oral health and orofacial appearance changed with increasing age, Cochran's Q test was conducted. Statistical significance was considered at p ≤ 0.05, and the calculated value Q must be equal to or greater than the critical chi-square value (Q ≥ 7.82). Significance values have been adjusted for the Bonferroni correction for multiple tests. RESULTS: Self-perceived mouth dryness, both day (Q = 7.94) and night (Q = 23.41), increased over the 18-year follow-up. When divided by gender, significant differences were only seen for mouth dryness at nighttime. A decrease in sensitive teeth was perceived with increasing age, and an increase in self-perceived satisfaction with dental appearance, and a decrease in self-perceived problems with dental gaps between the ages of 60 and 78. These changes were, however, not statistically significant. Men experienced a higher proportion of discomfort with discolored teeth at age 78 than at 60 (Q = 9.09). CONCLUSIONS: Self-perceived oral health and orofacial appearance were relatively stable, with few changes over an 18-year follow-up.
|
|
| 5. |
- Holmer, Helene, et al.
(author)
-
Improved general and oral health in diabetic patients by an okinawan-based nordic diet : A pilot study
- 2018
-
In: International Journal of Molecular Sciences. - : MDPI AG. - 1661-6596 .- 1422-0067. ; 19:7
-
Journal article (peer-reviewed)abstract
- Periodontal disease, periodontitis as well as the preceding gingivitis, has been associated with both obesity and diabetes. Studies have shown that diet changes can lead to a lower incidence of such inflammation. The aim of the present case series over four weeks was to study the effects on medical and dental conditions in patients with type 2 diabetes of the consumption of the Okinawan-based Nordic Diet (OBND®). Medical and dental examinations were performed to estimate the general health and gingivitis/periodontitis. Serum cytokine levels were assessed using Luminex technology. Eight of ten study participants completed the study. All participants lost weight (p = 0.012). Six out of seven that were treated with insulin could reduce their insulin intake after two weeks with OBND®. The reduction was about 16 units which corresponds to a 34% relative reduction compared to the starting point (range 15–63%). Fasting blood glucose values fell (p = 0.035). Hemoglobin A1c (HbA1c) (p = 0.01), triglycerides (p = 0.05), and low-density lipoprotein (LDL) (p = 0.05) were also reduced. Bleeding on probing changed from ~28% before any dietary changes to ~13% after two weeks with OBND® (p = 0.01). The reduction in gingival bleeding was as substantial as might be expected from one session of professional tooth cleaning. Markers of inflammation were also reduced. The OBND® thus showed significant promise in alleviating the impact of diabetes on dental as well as general health.
|
|
| 6. |
- Olsson, Viktoria, et al.
(author)
-
Sensory acceptance of a diet designed to counteract obesity, diabetes and periodontaldisease
- 2017
-
Conference paper (other academic/artistic)abstract
- A modified Nordic diet, developed by Igelösa Life Science AB, was tested in a clinical pilot study including ten individuals with type 2 diabetes during two weeks. The diet was based on locally produced, traditional ingredients such as intact grains, vegetables, legumes, root vegetables, fish, poultry, fruit and nuts. The intake of sugar, red meat and dairy products was restricted. One of the aims of the study was to study the sensory acceptance of the diet.The study was designed as a case-series. The diet was provided, ready-made and free of charge, to both the experimental subjects (N=10) and their partners (N=5). Two subjects were excluded due to heath implications, not related to the diet. The sensory acceptance was measured through questionnaire data and two focus groups (before and after the 2-week test period, 20 minutes each). Partners were invited to participate in the focus group interviews.Data from the questionnaire showed a high degree of liking for most meals. The result of the focus groups indicated the importance of the every-day meal as a social activity. They further expressed satisfaction with sensory properties and the perceived health benefits of the Igelösa diet but also some frustration regarding small portions, too little salt and somewhat unfamiliar ingredients.Sensory acceptance for diets nutritionally designed for weight reduction and/or maintenance is a key factor. Despite the low number of participants, the pilot study indicate that the Igelösa diet is well accepted. An innovation of the study was that both the experimental subjects and their partners received the diet. The participants stated that this was supportive, facilitating adherence and promoting long-term impact on health. Habits, such as poor diet, can only be defeated by a concerted team effort and our work provide a glimpse of the potential benefits of this shared approach.
|
|
| 7. |
- Olsson, Viktoria, et al.
(author)
-
Sensory acceptance of a diet designed to counteract obesity, diabetes and periodontaldisease
- 2017
-
Conference paper (other academic/artistic)abstract
- A modified Nordic diet, developed by Igelösa Life Science AB, was tested in a clinical pilot study including ten individuals with type 2 diabetes during two weeks. The diet was based on locally produced, traditional ingredients such as intact grains, vegetables, legumes, root vegetables, fish, poultry, fruit and nuts. The intake of sugar, red meat and dairy products was restricted. One of the aims of the study was to study the sensory acceptance of the diet. The study was designed as a case-series. The diet was provided, ready-made and free of charge, to both the experimental subjects (N=10) and their partners (N=5). Two subjects were excluded due to heath implications, not related to the diet. The sensory acceptance was measured through questionnaire data and two focus groups (before and after the 2-week test period, 20 minutes each). Partners were invited to participate in the focus group interviews. Data from the questionnaire showed a high degree of liking for most meals. The result of the focus groups indicated the importance of the every-day meal as a social activity. They further expressed satisfaction with sensory properties and the perceived health benefits of the Igelösa diet but also some frustration regarding small portions, too little salt and somewhat unfamiliar ingredients. Sensory acceptance for diets nutritionally designed for weight reduction and/or maintenance is a key factor. Despite the low number of participants, the pilot study indicate that the Igelösa diet is well accepted. An innovation of the study was that both the experimental subjects and their partners received the diet. The participants stated that this was supportive, facilitating adherence and promoting long-term impact on health. Habits, such as poor diet, can only be defeated by a concerted team effort and our work provide a glimpse of the potential benefits of this shared approach.
|
|
| 8. |
- Renvert, Stefan, 1951-, et al.
(author)
-
Periodontitis in older Swedish individuals fails to predict mortality
- 2015
-
In: Clinical Oral Investigations. - 1432-6981 .- 1436-3771. ; 19:2, s. 193-200
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: This study aims to assess mortality risk and its association to health aspects in dentate individuals 60 years of age and older.MATERIALS AND METHODS: Medical and periodontal data from 870 dentate individuals (age range 60-96) participating in the Swedish National Study on Aging and Care in Blekinge (SNAC-Blekinge) with survival statistics over 6 years were studied.RESULTS: During 6 years of follow-up, 42/474 of the individuals (8.9 %), who at baseline were between age 60 and 75, and 134/396 individuals of the individuals (33.9 %), who at baseline were ≥75 years, died. Surviving dentate individuals had more teeth (mean 19.3, S.D. ± 7.9) than those who died (mean 15.9, S.D. ± 7.3; mean diff 3,3; S.E. mean diff 0.7; 95 % CI 2.0, 4.6; p = 0.001). A self-reported history of high blood pressure (F = 15.0, p < 0.001), heart failure (F = 24.5, p < 0.001, observed power = 0.99), older age (F = 34.7, p < 0.001), male gender (F = 6.3, p < 0.01), serum HbA1c with 6.5 % as cutoff level (F = 9.3, p = 0.002) were factors associated with mortality. A medical diagnosis of heart disease, diabetes, any form of cancer, or periodontitis failed to predict mortality.CONCLUSIONS: A self-reported history of angina pectoris, chronic heart failure, elevated serum HbA1c, and few remaining teeth were associated with mortality risk. A professional diagnosis of cardiovascular disease, diabetes, cancer, or periodontitis was not predictive of mortality.CLINICAL RELEVANCE: Self-health reports are important to observe in the assessment of disease and survival in older individual.
|
|
| 9. |
- Renvert, Stefan, et al.
(author)
-
Periodontitis in older Swedish individuals fails to predict mortality
- 2015
-
In: Clinical Oral Investigations. - : Springer Verlag. - 1432-6981 .- 1436-3771. ; 19:2, s. 193-200
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: This study aims to assess mortality risk and its association to health aspects in dentate individuals 60 years of age and older. MATERIALS AND METHODS: Medical and periodontal data from 870 dentate individuals (age range 60-96) participating in the Swedish National Study on Aging and Care in Blekinge (SNAC-Blekinge) with survival statistics over 6 years were studied. RESULTS: During 6 years of follow-up, 42/474 of the individuals (8.9 %), who at baseline were between age 60 and 75, and 134/396 individuals of the individuals (33.9 %), who at baseline were ≥75 years, died. Surviving dentate individuals had more teeth (mean 19.3, S.D. ± 7.9) than those who died (mean 15.9, S.D. ± 7.3; mean diff 3,3; S.E. mean diff 0.7; 95 % CI 2.0, 4.6; p = 0.001). A self-reported history of high blood pressure (F = 15.0, p < 0.001), heart failure (F = 24.5, p < 0.001, observed power = 0.99), older age (F = 34.7, p < 0.001), male gender (F = 6.3, p < 0.01), serum HbA1c with 6.5 % as cutoff level (F = 9.3, p = 0.002) were factors associated with mortality. A medical diagnosis of heart disease, diabetes, any form of cancer, or periodontitis failed to predict mortality. CONCLUSIONS: A self-reported history of angina pectoris, chronic heart failure, elevated serum HbA1c, and few remaining teeth were associated with mortality risk. A professional diagnosis of cardiovascular disease, diabetes, cancer, or periodontitis was not predictive of mortality. CLINICAL RELEVANCE: Self-health reports are important to observe in the assessment of disease and survival in older individual.
|
|
| 10. |
- Wallin Bengtsson, Viveca, et al.
(author)
-
A cross-sectional study of the associations between periodontitis and carotid arterial calcifications in an elderly population
- 2016
-
In: Acta Odontologica Scandinavica. - : John Wiley & Sons. - 0001-6357 .- 1502-3850. ; 74:2, s. 115-20
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate if the presence of periodontitis is associated with carotid arterial calcifications diagnosed on panoramic radiographs in an elderly population.MATERIALS AND METHODS: Study individuals were randomly selected from the Swedish civil registration database representing the aging population (60-96 years) in Karlskrona, Sweden. Bleeding on probing (BOP) and the deepest probing measurement at each tooth were registered. The proportions of teeth with a probing depth ≥ 5 mm and the proportion of teeth with bleeding on probing were calculated. Analog panoramic radiographs were taken and the proportion of sites with a distance ≥ 5 mm between the alveolar bone level and the cement-enamel junction (CEJ) were assessed. A diagnosis of periodontitis was declared if a distance between the alveolar bone level and the CEJ ≥ 5 mm could be identified from the panoramic radiographs at > 10% of sites, probing depth of ≥ 5 mm at one tooth or more and with BOP at > 20% of teeth.RESULTS: Readable radiographs were obtained from 499 individuals. Carotid calcification was identified in 39.1%. Individuals were diagnosed with periodontitis in 18.4%. Data analysis demonstrated that individuals with periodontitis had a higher prevalence of carotid calcifications (Pearson χ(2) = 4.05 p < 0.05) and with a likelihood of 1.5 (95% CI = 1.0, 2.3, p < 0.05).CONCLUSIONS: Data analysis demonstrated a significant association between periodontitis and carotid calcification.
|
|
| 11. |
- Wallin Bengtsson, Viveca, et al.
(author)
-
Alpha-1-antitrypsin deficiency and periodontitis, a pilot study
- 2009
-
In: Journal of clinical periodontology. ; 39:supplement 9, s. 88-88
-
Journal article (other academic/artistic)abstract
- Proteases are capable of tissue breakdown. Plasma and gingival crevicular fluid (GCF) contain antiproteases, such as alfa-1-antitirypsin (AAT). Lack of AAT may lead to periodontal destruction. The aim was to study if periodontal parameters and elastase in GCF and plasma are different in AAT deficient subjects compared to subjects without AAT deficiency. Material & methods: 30 subjects were included, 20 of whom with severe AAT deficiency. Ten of them suffered from chronic obstructive pulmonary disease (group 1) and 10 were asymptomatic (group 2). Ten control subjects (group 3) were recruited from a public dental clinic. The examination comprised GCF, Gingival index (GI), Plaque Index (PlI), probing pocket depth (PPD) and radiography. GCF was collected with paper strips (Periopaper®). Plasma AAT concentration was measured by nephelometry and AAT in GCF with ELISA. Elastase activity and protein in plasma and GCF were determined by spectrophotometry. Results: The mean values for GI, PlI, PPD and the radiological measurements did not show any statistically significant differences between the groups. AAT in GCF and plasma did not show any significant difference between group 1 and 2 but a statistical difference in comparison with group 3. Elastase in GCF and plasma did not show any difference between the three groups. In conclusion no differences were found between AAT deficient subjects and healthy controls in this limited material.
|
|
| 12. |
- Wallin Bengtsson, Viveca, et al.
(author)
-
Alpha-1 antitrypsin deficiency and periodontitis, a pilot study
- 2011
-
In: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 35:1, s. 33-40
-
Journal article (peer-reviewed)abstract
- Målet med studien var att undersöka om parodontala parametrar och elastas i gingivalvätska (GCF) skilde sig hos individer med alfa-1-antrypsin-brist (AAT-brist) jämfört med individer med normal AAT-halt. I studien ingick 30 individer, varav 20 med allvarlig AAT-brist, fenotyp PiZZ. Tio individer med AAT- brist led av kronisk obstruktiv lungsjukdom (KOL) (grupp 1) och 10 var symptomfria (grupp 2). Tio individer med normal AAT-halt, fenotyp PiMM (grupp 3), utgjorde kontrollgrupp och rekryterades från en allmäntandvårdsklinik. Undersökningen bestod av insamling av GCF, gingivalindex (GI), plackindex (PlI), fickdjupsmätning (PPD) och röntgen. GCF samlades in med hjälp av pappers-strips (Periopaper®). AAT i plasma mättes med nefelometri och AAT i GCF mättes med ELISA. Elastasaktivitet och proteinmängd i GCF bestämdes med spektrofotometri. Medelvärden för GI, PlI, PPD och röntgenmätningar visade inga statistiskt signifikanta skillnader mellan grupperna. AAT i plasma och GCF visade mycket låga värden i grupp 1 och 2 utan några signifikanta skillnader mellan grupperna men en signifikant skillnad i jämförelse med grupp 3. Elastas i gingivalvätska visade inga skillnader mellan de tre grupperna. Sammanfattningsvis visade varken parodontala värden eller elastas i GCF några skillnader hos individer med AAT- brist, fenotyp PiZZ, jämfört med individer med normal AAT-halt, fenotyp PiMM, i detta material.
|
|
| 13. |
- Wallin-Bengtsson, Viveca, et al.
(author)
-
Alpha-1-antitrypsin deficiency and periodontitis, a pilot study
- 2011
-
In: Swedish Dental Journal. - 0347-9994. ; 35:1, s. 33-40
-
Journal article (peer-reviewed)abstract
- The aim of this study was to investigate if periodontal parameters and elastase in gingival crevicular fluid (GCF) are different in alpha-1-antitrypsin deficient (AATD) subjects compared to subjects with normal AAT level. Thirty subjects were included, 20 of whom with severe AATD, phenotype PiZZ. Ten AATD subjects suffered from chronic obstructive pulmonary disease (COPD, group 1) and 10 were asymptomatic (group 2). Ten control subjects, phenotype PiMM, (group 3) were recruited from a public dental clinic. The examination comprised of sampling of GCF, Gingival Index (GI), Plaque Index (PII), probing pocket depth (PPD) and radiography. GCF was collected with paper strips (Periopaper (R)). Plasma AAT concentration was measured by nephelometry and AAT in GCF with ELISA. Elastase activity and protein in GCF were determined by spectrophotometry. The mean values for GI, PII, PPD and the radiological measurements did not show any statistically significant differences between the groups. AAT in plasma and GCF demonstrated very low values in groups 1 and 2 with no significant difference between these groups but a statistical difference in comparison with group 3. Elastase in GCF did not show any difference between the three groups. In conclusion, neither the periodontal parameters nor the elastase in GCF were different in AATD subjects, phenotype PiZZ, when compared to subjects with normal AAT level, phenotype PiMM, in this material.
|
|
| 14. |
- Wallin Bengtsson, Viveca, et al.
(author)
-
Assessment of carotid calcifications on panoramic radiographs in relation to other used methods and relationship to periodontitis and stroke : a literature review.
- 2014
-
In: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 72:6, s. 401-12
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: To assess the literature on carotid calcifications defined from panoramic radiographs (PMX) and concurrent diagnosis of stroke and periodontitis.MATERIALS AND METHODS: A literature search screening for publications using search terms such as PMX and carotid calcification, stroke and periodontitis was performed in November 2012.RESULTS: A total of 189 articles were retrieved, among which 30 were included in the review. The sensitivity for PMX findings of carotid calcifications (CC) compared to a diagnosis by Doppler sonography varied between 31.1-100%. The specificity for PMX findings of carotid calcifications compared to a diagnosis by Doppler sonography varied between 21.4-87.5%. Individuals with CC findings from PMX have more periodontitis and risk for stroke.CONCLUSIONS: There is a shortage of well-designed studies in older dentate individuals assessing the associations between periodontitis and radiographic evidence of CC and in relation to stroke or other cardiovascular diseases. STATEMENT OF CLINICAL RELEVANCE: Carotid calcifications are prevalent in patients with periodontitis and such individuals may have an increased risk for stroke. The absence of signs of carotid calcification on panoramic radiographs is indicative of no calcification of carotid arteries.
|
|
| 15. |
- Wallin Bengtsson, Viveca, et al.
(author)
-
Carotid calcifications in panoramic radiographs are associated with future stroke or ischemic heart diseases : a long-term follow-up study
- 2019
-
In: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 23:3, s. 1171-1179
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To assess if carotid calcifications detected in panoramic radiographs are associated with future events of stroke, and/or ischemic heart diseases over 10-13 years in individuals between 60 and 96 years.MATERIALS AND METHODS: Baseline (2001-2004) panoramic radiographs were assessed for evidence of carotid calcifications from individuals with no previous history of stroke and/or ischemic heart diseases. A radiopaque nodular mass adjacent to the cervical vertebrae, at or below the intervertebral space C3-C4, was interpreted as carotid calcification. Annual medical records were searched for ICD 10 codes through 2014.RESULTS: Signs of carotid calcification was demonstrated in 238/635 (37.5%) of the study individuals. Signs of carotid calcification was associated with future stroke and/or ischemic heart diseases (χ2 = 9.1, OR 1.6, 95% CI 1.2, 2.2, p < 0.002). In individuals 60-72 years, a significant association between radiographic signs of carotid calcification and stroke and/or ischemic heart diseases (χ2 = 12.4, OR 2.4, 95% CI 1.5, 4.0, p < 0.000) (adjusted for high blood pressure, diabetes type 2, BMI; OR 1.9, 95% CI 1.1, 3.5, p = 0.03). Individuals (60-72 years) with radiographic evidence of carotid calcifications had a mean cumulative stroke and/or ischemic heart diseases survival time of 12.1 years compared to those without such evidence (13.0 years) (log rank Mantel-Cox χ2 = 10.7, p = 0.001).CONCLUSIONS: Evidence of carotid calcifications in panoramic radiographs is associated with an event of stroke and/or ischemic heart diseases in 60-96-year-old individuals.CLINICAL RELEVANCE: Radiographic evidence of carotid calcifications is associated with stroke and/or ischemic heart diseases. Patients with signs of carotid calcifications should therefore be referred for medical examination.
|
|
| 16. |
- Wallin Bengtsson, Viveca, et al.
(author)
-
Carotid calcifications in panoramic radiographs are associated with future stroke or ischemic heart diseases : a long-term follow-up study
- 2019
-
In: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 23:3, s. 1171-1179
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To assess if carotid calcifications detected in panoramic radiographs are associated with future events of stroke, and/or ischemic heart diseases over 10-13 years in individuals between 60 and 96 years. MATERIALS AND METHODS: Baseline (2001-2004) panoramic radiographs were assessed for evidence of carotid calcifications from individuals with no previous history of stroke and/or ischemic heart diseases. A radiopaque nodular mass adjacent to the cervical vertebrae, at or below the intervertebral space C3-C4, was interpreted as carotid calcification. Annual medical records were searched for ICD 10 codes through 2014. RESULTS: Signs of carotid calcification was demonstrated in 238/635 (37.5%) of the study individuals. Signs of carotid calcification was associated with future stroke and/or ischemic heart diseases (χ2 = 9.1, OR 1.6, 95% CI 1.2, 2.2, p < 0.002). In individuals 60-72 years, a significant association between radiographic signs of carotid calcification and stroke and/or ischemic heart diseases (χ2 = 12.4, OR 2.4, 95% CI 1.5, 4.0, p < 0.000) (adjusted for high blood pressure, diabetes type 2, BMI; OR 1.9, 95% CI 1.1, 3.5, p = 0.03). Individuals (60-72 years) with radiographic evidence of carotid calcifications had a mean cumulative stroke and/or ischemic heart diseases survival time of 12.1 years compared to those without such evidence (13.0 years) (log rank Mantel-Cox χ2 = 10.7, p = 0.001). CONCLUSIONS: Evidence of carotid calcifications in panoramic radiographs is associated with an event of stroke and/or ischemic heart diseases in 60-96-year-old individuals. CLINICAL RELEVANCE: Radiographic evidence of carotid calcifications is associated with stroke and/or ischemic heart diseases. Patients with signs of carotid calcifications should therefore be referred for medical examination.
|
|
| 17. |
- Wallin Bengtsson, Viveca
(author)
-
Periodontitis, carotid calcifications and future cardiovascular diseases in older individuals
- 2019
-
Doctoral thesis (pop. science, debate, etc.)abstract
- Background. Periodontitis is a chronic inflammatory disease with a microbiological etiology affecting the supporting tissues of the tooth. The disease affects approximately 50% of the adult population. The prevalence of periodontitis increases with age. The complex bacterial infection, as well as an exaggerated host inflammatory reaction, may trigger subclinical atherosclerosis. Aims. The overall aim of the present thesis was to study the associations between periodontitis, cardiovascular diseases and mortality. The specific aims were: I) to evaluate the use and value of panoramic radiographs in assessing carotid calcifications in relation to other used methods (gold standards) and to assess the literature on carotid calcifications defined from panoramic radiographs and concurrent diagnosis of stroke and periodontitis, II) to evaluate if periodontitis is associated with the presence of carotid arterial calcifications diagnosed on panoramic radiographs in an elderly population, III) to assess if carotid calcifications detected on panoramic radiographs are associated with future events of stroke, and/or ischemic heart diseases over 10–13 years in individuals between 60 and 96 years, IV) to assess if individuals ≥ 60 years of age with periodontitis are more likely to develop stroke or ischemic heart diseases or are at higher risk of death over a period of 17 years. Methods: A literature review based on peer-reviewed studies was performed evaluating the use of panoramic radiographs in assessing carotid calcifications compared to other methods. In study II, III, IV older individuals, 60 years and older participating in the Swedish National Study of Aging and Care (SNAC) were included in the studies. A dental hygienist performed a dental clinical and radiographic examination. Probing depths (PD) and bleeding on probing (BOP) was registered. From radiographic panoramic images, the distances between the alveolar bone level and the cement enamel junction (CEJ) were measured. In study II, a diagnosis of periodontitis was declared, using a composite definition; if a distance between the alveolar bone level and the CEJ ≥5 mm on panoramic radiographs at >10% of sites and PD ≥5 mm at one or more teeth and with BOP >20% of teeth. In study IV, an indicator of a history of periodontal disease was declared if a distance between the alveolar bone level and the CEJ ≥5 mm on panoramic radiographs at ≥30% of sites. Evidence of a radiopaque nodular mass in the intervertebral space at or below the vertebrae C3-C4 was identified as carotid calcification. In addition, a medical research team performed the medical examinations, and a medical doctor (JB) reviewed all medical records for information about events of stroke and ischemic heart diseases. Stroke and ischemic heart diseases were registered according to the ICD 10 codes: ICD 60-69 for stroke and ICD: 20-25 for ischemic heart diseases. Study I was a review of the literature, in study II, a cross-sectional study design was employed. In studies III and IV, a longitudinal prospective studydesign was used. Results: On the use of panoramic radiographs in assessing carotid calcifications in relation to other used methods, the sensitivity and specificity varied between studies published. Furthermore, only a small number of studies were found concerning carotid calcifications and stroke. These studies were primarily retrospective. Four studies were found on the association between periodontitis and carotid calcification. Study II identified that older individuals with periodontitis had a significantly higher prevalence of carotid calcifications than individuals who did not have a diagnosis of periodontitis. In study III, a significant association was found between carotid calcifications on panoramic radiographs and 13- year incidence of stroke using a logistic regression analysis adjusted for confounders (BMI, diabetes type 2, hypertension) in the 60-72 years. A statistically significant crude association between radiographic evidence of carotid calcifications and incidence of ischemic heart diseases was found in individuals between 60-72 years. Such an association was, however, not identified among individuals older than 72 years. In study IV, Cox regression analysis was used, adjusted for confounders (age group, BMI >30, diabetes type 2, gender, hypertension, history of AMI, history of stroke, periodontitis, smoking) and with a definition of periodontitis as having a distance between the alveolar bone level and the CEJ ≥5 mm in panoramic radiographs at ≥ 30% of sites. Periodontitis increased the risk for ischemic heart diseases in all individuals, in women and in the 78-96 years age group (OO). Associations between periodontitis, and mortality were found in all individuals, in men and in the 60-72 years age group (YO) in the long term follow-up. Conclusions: 1. 1. Study I identified that there are studies which have assessed the value of panoramic radiographs in relation to other used methods (gold standards). The sensitivity and the specificity varied, with the specificity being more often higher. Few studies have considered the relationship between radiographic evidence of carotid calcifications and stroke. Four studies identified a relationship between a diagnosis of periodontitis and carotid calcifications on panoramic radiographs. 2. Study II identified a significant association between periodontitis and carotid calcification in individuals 60-96 years. 3. Study III identified that signs of carotid calcifications assessed from panoramic radiographs from the 60-96-year-old individuals were consistent with an incident of stroke and/or ischemic heart diseases over 13 years follow-up. 4. Study IV identified that periodontitis was associated with future ischemic heart diseases in all individuals, in women and in the 78- 96 years age group. Periodontitis was associated with mortality in all indviduals, in men and in the 60-72 years age group.
|
|
| 18. |
- Wallin-Bengtsson, Viveca, et al.
(author)
-
Supra- and sub-gingival instrumentation of periodontitis with the adjunctive treatment of a chloramine : a one-year randomized clinical trial study
- 2023
-
In: Acta Odontologica Scandinavica. - : Informa Healthcare. - 0001-6357 .- 1502-3850.
-
Journal article (peer-reviewed)abstract
- Periodontitis is a bacterial-induced disease and for this reason controlling the microbiota is a necessity. Therapy includes self-performed daily oral hygiene in combination with supra- and sub-gingival instrumentation. An adjunctive antimicrobial agent may improve the outcome. Aims: To assess whether a chloramine (Perisolv®) has an adjunctive effect to non-surgical periodontal therapy and whether non-surgical periodontal therapy affects quality of life. Material and Methods: Thirty-eight patients were randomized to a test or a control group. Clinical indices were performed at baseline and at three and twelve months. In the test group, Perisolv® was applied initially and after the sub-gingival instrumentation in pathological pockets. Oral health-related quality of life was measured with the Oral Health Impact Profile (OHIP) instrument at baseline and twelve months. Results: In both groups, an initial probing pocket depth (PPD) of > 4 mm and bleeding on probing (BOP) were statistically reduced (p < 0.002 and p< 0.002 respectively) at twelve months and after adjustment for Bonferroni. There were no significant differences between the test and the control group in terms of the number of PPD, BOP or plaque index, or in the mean OHIP score. Conclusions: Chloramine did not have an adjunctive effect, but the overall therapy was significantly efficacious both clinically and in terms of quality of life. Trial registration: Registered at www.clinicaltrials.gov: NCT05757921.
|
|
