| 1. |
- Baumgartner, Stefan, et al.
(författare)
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The impact of the stone age diet on gingival conditions in the absence of oral hygiene.
- 2009
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Ingår i: Journal of Periodontology. - 0022-3492 .- 1943-3670. ; 80:5, s. 759-768
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The objective of this study was to assess the oral microbiota and clinical data in subjects without access to traditional oral hygiene methods and who ate a diet available in the Stone Age.METHODS: Ten subjects living in an environment replicating the Stone Age for 4 weeks were enrolled in this study. Bleeding on probing (BOP), gingival and plaque indices, and probing depth (PD) were assessed at baseline and at 4 weeks. Microbiologic samples were collected at the mesio-buccal subgingival aspects of all teeth and from the dorsum of the tongue and were processed by checkerboard DNA-DNA hybridization methods.RESULTS: No subject had periodontitis. Mean BOP decreased from 34.8% to 12.6% (P <0.001). Mean gingival index scores changed from 0.38 to 0.43 (not statistically significant) and mean plaque scores increased from 0.68 to 1.47 (P <0.001). PD at sites of subgingival sampling decreased (mean difference: 0.2 mm; P <0.001). At week 4, the total bacterial count was higher (P <0.001) for 24 of 74 species, including Bacteroides ureolyticus, Eikenella corrodens, Lactobacillus acidophilus, Capnocytophaga ochracea, Escherichia coli, Fusobacterium nucleatum naviforme, Haemophilus influenzae, Helicobacter pylori, Porphyromonas endodontalis, Staphylococcus aureus (two strains), Streptococcus agalactiae, Streptococcus anginosis, and Streptococcus mitis. Bacterial counts from tongue samples were higher at baseline (P <0.001) for 20 species, including Tannerella forsythia (previously T. forsythensis), Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans; serotype a), and Streptococcus spp.CONCLUSIONS: The experimental gingivitis protocol is not applicable if the diet (e.g., Stone Age) does not include refined sugars. Although plaque levels increased, BOP and PD decreased. Subgingival bacterial counts increased for several species not linked to periodontitis, whereas tongue bacterial samples decreased during the study period.
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| 2. |
- Fischer, Carolin C, et al.
(författare)
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Influence of the menstrual cycle on the oral microbial flora in women : a case-control study including men as control subjects.
- 2008
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Ingår i: Journal of Periodontology. - 0022-3492 .- 1943-3670. ; 79:10, s. 1966-1973
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Tidskriftsartikel (refereegranskat)abstract
- UNLABELLED: Changes in the levels of female sex hormones during the menstrual cycle may cause cyclic differences in subgingival bacterial colonization patterns. The purpose of the present study was to test the hypothesis that hormonal changes in the menstrual cycle cause changes in the oral microbiota.METHODS: Bacterial plaque samples were collected in 20 systemically and periodontally healthy women using no hormonal contraceptives (test group) over a period of 6 weeks. Twenty age-matched systemically and periodontally healthy men were assigned to the control group. Samples were processed by checkerboard DNA-DNA hybridization assay, and 74 species were analyzed.RESULTS: No cyclic pattern of bacterial colonization was identified for any of the 74 species studied in women not using hormonal contraceptives. Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) (Y4) was common at the beginning of menstruation (mean: 32%) and increased during the following 2 weeks (36%) in women (P <0.05). No cyclic differences in bacterial presence were found among the men (P values varied between 0.14 and 0.98). Men presented with significantly higher bacterial counts for 40 of 74 species (P <0.001), including Staphylococcus aureus and Pseudomonas aeruginosa but not Porphyromonas gingivalis (P = 0.15) or Tannerella forsythia (previously T. forsythensis) (P = 0.42).CONCLUSIONS: During a menstruation period, cyclic variation in the subgingival microbiota of periodontally healthy women of child-bearing age who were not using oral hormonal contraceptives could not be confirmed. Male control subjects presented with higher levels of many species but also without a cyclic pattern.
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| 3. |
- Persson, G. Rutger, et al.
(författare)
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Cardiovascular disease and periodontitis : an update on the associations and risk
- 2008
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Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 35:8 Suppl, s. 362-379
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Associations between periodontitis and cardiovascular diseases have been recognized.MATERIAL AND METHODS: New literature since the last European Workshop on Periodontology has been reviewed.RESULTS: The lack of reliable epidemiological data on disease prevalence makes an assessment of the associations and risks between periodontitis and cardiovascular diseases difficult. Two recent meta-analysis reports have identified associations between periodontitis and cardiovascular diseases (odds ratios: 1.1-2.2). Different surrogate markers for both disease entities, including serum biomarkers, have been investigated. Brachial artery flow-mediated dilatation, and carotid intima media thickness have in some studies been linked to periodontitis. Studies are needed to confirm early results of improvements of such surrogate markers following periodontal therapy. While intensive periodontal therapy may enhance inflammatory responses and impair vascular functions, studies are needed to assess the outcome of periodontal therapies in subjects with confirmed cardiovascular conditions. Tooth eradication may also reduce the systemic inflammatory burden of individuals with severe periodontitis. The role of confounders remain unclear.CONCLUSIONS: Periodontitis may contribute to cardiovascular disease and stroke in susceptible subjects. Properly powered longitudinal case-control and intervention trials are needed to identify how periodontitis and periodontal interventions may have an impact on cardiovascular diseases.
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| 4. |
- Persson, G. Rutger, et al.
(författare)
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Tannerella forsythia and Pseudomonas aeruginosa in subgingival bacterial samples from parous women.
- 2008
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Ingår i: Journal of Periodontology. - 0022-3492 .- 1943-3670. ; 79:3, s. 508-516
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Information on the subgingival microbiota in parous women is limited. The present study assessed 74 bacterial species at periodontal sites.METHODS: Subgingival bacterial plaque was collected from women > or =6 months after delivery. Bacteria were assessed by the checkerboard DNA-DNA hybridization method. Gingivitis was defined as > or =20% of sites with bleeding on probing (BOP), and periodontitis was defined as radiographic evidence of bone loss and probing depths > or =5.0 mm.RESULTS: A total of 197 women (mean age: 29.4 +/- 6.8 years; range: 18 to 46 years) were included in the study. Gingivitis was identified in 82 of 138 subjects without evidence of periodontitis (59.4%). Periodontitis was found in 59 women (32%). Higher bacterial levels in subjects with gingivitis compared to those without evidence of gingivitis were observed for Actinomyces neuii, Bifidobacterium bifidum, Corynebacterium pseudogenitalis, Porphyromonas endodontalis, Prevotella bivia, and Pseudomonas aeruginosa (P <0.001 for each). Higher bacterial levels in subjects with periodontitis compared to those without periodontitis (BOP not accounted for) were found for 32 of 79 species (P <0.001) including Lactobacillus iners, Haemophilus influenzae, Porphyromonas gingivalis, Tannerella forsythia (previously T. forsythensis), Prevotella bivia, P. aeruginosa, and Staphylococcus aureus. Binary univariate logistic regression analysis identified that P. aeruginosa (P <0.001) and T. forsythia (P <0.05) were independently predictive of periodontal status. The odds ratio of having P. aeruginosa at levels > or =1 x 10(5) in the sample and periodontitis was 3.1 (95% confidence interval: 1.6 to 5.9; P <0.001).CONCLUSION: In addition to P. gingivalis and T. forsythia, a diverse microbiota, including P. aeruginosa, P. endodontalis, P. bivia, and S. aureus, can be found in subgingival plaque samples from women of child-bearing age with periodontitis.
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| 5. |
- Persson, G. Rutger, et al.
(författare)
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The impact of a low-frequency chlorhexidine rinsing schedule on the subgingival microbiota (the TEETH clinical trial).
- 2007
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Ingår i: Journal of Periodontology. - 0022-3492 .- 1943-3670. ; 78:9, s. 1751-1758
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Information on the efficacy of chlorhexidine (CHX) rinsing on the subgingival microbiota is limited. This study tested if intermittent CHX rinsing over 5 years had an impact on the subgingival microbiota.METHODS: Subgingival plaque samples were analyzed by the checkerboard DNA-DNA hybridization method in a double-blind randomized CHX rinse study.RESULTS: A total of 210 subjects were included. The mean age of the subjects was 71.7 (+/- 4.1) years, and 56.2% were women. Evidence of alveolar bone loss was found in 39% of subjects. Bacterial loads were not correlated significantly with probing depth. At year 5, subjects in the CHX rinse group with no evidence of bone loss presented with lower total bacterial counts than control subjects with no bone loss. The levels of the following bacteria were significantly lower in the CHX group: Lactobacillus acidophilus (P <0.05), Eikenella corrodens (P <0.05), Fusobacterium nucleatum sp. nucleatum (P <0.01), Treponema denticola (P <0.05), Leptotrichia buccalis (P <0.05), and Eubacterium saburreum (P <0.05). No differences in bacterial loads were found between CHX and control rinse subjects with alveolar bone loss.CONCLUSIONS: Older subjects with or without periodontitis carry a large variety of bacteria associated with periodontitis. Intermittent rinsing with CHX may provide a preventive benefit in reducing levels of bacteria but only in subjects without alveolar bone loss.
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| 6. |
- Persson, G. Rutger, et al.
(författare)
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The vaginal microflora in relation to gingivitis
- 2009
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Ingår i: BMC infectious diseases. - 1471-2334. ; 9, s. 6-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Gingivitis has been linked to adverse pregnancy outcome (APO). Bacterial vaginosis (BV) has been associated with APO. We assessed if bacterial counts in BV is associated with gingivitis suggesting a systemic infectious susceptibilty.METHODS: Vaginal samples were collected from 180 women (mean age 29.4 years, SD +/- 6.8, range: 18 to 46), and at least six months after delivery, and assessed by semi-quantitative DNA-DNA checkerboard hybridization assay (74 bacterial species). BV was defined by Gram stain (Nugent criteria). Gingivitis was defined as bleeding on probing at >or= 20% of tooth sites.RESULTS: A Nugent score of 0-3 (normal vaginal microflora) was found in 83 women (46.1%), and a score of > 7 (BV) in 49 women (27.2%). Gingivitis was diagnosed in 114 women (63.3%). Women with a diagnosis of BV were more likely to have gingivitis (p = 0.01). Independent of gingival conditions, vaginal bacterial counts were higher (p < 0.001) for 38/74 species in BV+ in comparison to BV- women. Counts of four lactobacilli species were higher in BV- women (p < 0.001). Independent of BV diagnosis, women with gingivitis had higher counts of Prevotella bivia (p < 0.001), and Prevotella disiens (p < 0.001). P. bivia, P. disiens, M. curtisii and M. mulieris (all at the p < 0.01 level) were found at higher levels in the BV+/G+ group than in the BV+/G- group. The sum of bacterial load (74 species) was higher in the BV+/G+ group than in the BV+/G- group (p < 0.05). The highest odds ratio for the presence of bacteria in vaginal samples (> 1.0 x 104 cells) and a diagnosis of gingivitis was 3.9 for P. bivia (95% CI 1.5-5.7, p < 0.001) and 3.6 for P. disiens (95%CI: 1.8-7.5, p < 0.001), and a diagnosis of BV for P. bivia (odds ratio: 5.3, 95%CI: 2.6 to 10.4, p < 0.001) and P. disiens (odds ratio: 4.4, 95% CI: 2.2 to 8.8, p < 0.001).CONCLUSION: Higher vaginal bacterial counts can be found in women with BV and gingivitis in comparison to women with BV but not gingivitis. P. bivia and P. disiens may be of specific significance in a relationship between vaginal and gingival infections.
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| 7. |
- Persson, Rigmor E, et al.
(författare)
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Smoking, a weak predictor of periodontitis in older adults.
- 2005
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Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 32:5, s. 512-517
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The impact of smoking habits on periodontal conditions in older subjects is poorly studied.AIMS: To assess if a history of smoking is associated with chronic periodontitis and medical history in older subjects.MATERIAL AND METHODS: The medical and dental history was collected from 1084 subjects 60-75 years of age. Smoking history information was obtained from self-reports. Periodontal variables [clinical probing depth (PD)>/=5.0 mm, clinical attachment levels (CALs) >/=4.0 mm], and radiographic evidence of alveolar bone loss were assessed.RESULTS: 60.5% had never smoked (NS), 32.0% were former smokers (FS) (mean smoke years: 26.1 years, SD+/-13.1), and 7.5% were current smokers (CS) (mean smoke years 38.0 years, (SD+/-12.1). The proportional distribution of CAL >/=4.0 mm differed significantly by smoking status (NS and CS groups) (mean difference: 12.1%, 95% confidence interval (CI): 1.5-22.6, p<0.02). The Mantel-Haenszel common odds ratio between smoking status (CS+FS) and periodontitis (>20% bone loss) was 1.3 (p<0.09, 95% CI: 0.9-2.0) and changed to 1.8 (p<0.02, 95% CI: 1.3-2.7) with 30 years of smoking as cutoff. A weak correlation between number of years of smoking and CAL>/=4.0 mm was demonstrated (r(2) values 0.05 and 0.07) for FS and CS, respectively. Binary logistic forward (Wald) regression analysis demonstrated that the evidence of carotid calcification, current smoking status, gender (male), and the number of remaining teeth were explanatory to alveolar bone loss.CONCLUSIONS: A clinically significant impact on periodontal conditions may require 30 years of smoking or more. Tooth loss, radiographic evidence of carotid calcification, current smoking status, and male gender can predictably be associated with alveolar bone loss in older subjects.
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| 8. |
- Renvert, Stefan, 1951-, et al.
(författare)
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Access to dental care reduces the risk of tooth loss in older subjects
- 2009
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Ingår i: Europerio 6. ; , s. 149-
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Konferensbidrag (refereegranskat)abstract
- Background: The significance of access to dental care on oral conditions in older subjects is limited. We hypothesized that dental care control for aging effects on oral and periodontal conditions. Materials and methods: 1020 randomly selected subjects between age 60 and 96 from the Swedish National Study on Aging and Care Blekinge study received comprehensive medical and dental examinations. Results: Dentate women and men had, on average,18.4 teeth (S.D. ± 7.6), and 18.9 teeth (S.D.±7.5) (P = 0.37) respectively. In the youngest age group with infrequent dental visits 37% had > 20 teeth, and 73% had > 20 teeth if they had annual visits. Among old-old infrequent dental visitors 1.8% had > 20 teeth and 37% had > 20 teeth with annual visits. Across age groups, the overall % bleeding on probing was 23%. When adjusting for age, GLM univariate analysis failed to demonstrate an effect of frequency of dental visits and ABL scores (P = 0.18) but frequent dental visitors had significantly more teeth than infrequent visitors (P = 0.001). Conclusions: Tooth loss and extent of alveolar bone loss increase with age. Frequent dental visits seem to preserve teeth but has no impact on the amounts of deposits, gingival inflammation, or alveolar bone levels.
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| 9. |
- Renvert, Stefan, et al.
(författare)
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Access to dental care reduces the risk of tooth loss in older subjects
- 2009
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The significance of access to dental care on oral conditions in older subjects is limited. We hypothesized that dental care control for aging effects on oral and periodontal conditions. Materials and methods: 1020 randomly selected subjects between age 60 and 96 from the Swedish National Study on Aging and Care Blekinge study received comprehensive medical and dental examinations. Results: Dentate women and men had, on average,18.4 teeth (S.D. ± 7.6), and 18.9 teeth (S.D.±7.5) (P = 0.37) respectively. In the youngest age group with infrequent dental visits 37% had > 20 teeth, and 73% had > 20 teeth if they had annual visits. Among old-old infrequent dental visitors 1.8% had > 20 teeth and 37% had > 20 teeth with annual visits. Across age groups, the overall % bleeding on probing was 23%. When adjusting for age, GLM univariate analysis failed to demonstrate an effect of frequency of dental visits and ABL scores (P = 0.18) but frequent dental visitors had significantly more teeth than infrequent visitors (P = 0.001). Conclusions: Tooth loss and extent of alveolar bone loss increase with age. Frequent dental visits seem to preserve teeth but has no impact on the amounts of deposits, gingival inflammation, or alveolar bone levels.
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| 10. |
- Renvert, Stefan, et al.
(författare)
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Heel DXA T-scores and panoramic radiographs in the prediction of hip and hand fractures
- 2009
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Ingår i: Europerio 6. ; , s. 9-
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Konferensbidrag (refereegranskat)abstract
- Introduction: We assessed if DXA (Dual Energy X-ray Absorptiometry) and panoramic radiographs were predictive of hip and or hand fractures over 3 years in older subjects. Methods: DXA heel measurements and mandibular panoramic bone scores (MPBS) from panoramic radiographs were performed in 418 women (mean age: 77.5 years, S.D ± 9.3 and 370 men (mean age: 76.4, S.D ± 9.5). Results: 4.5% subjects (34/788) had a hip and 3.7% (27/788) a hand fracture. A DXA T -score < - 2.5 (osteoporosis) in women and men was found in 16.3% and 8.1% respectively. Subjects with osteoporosis had fewer remaining teeth (mean diff: 4.4, 95% CI: 2.3–6.5, P < 0.001). A DXA T-score < -2.5 was predictive of a hip or hand fracture odds ratio 2.6:1(95%CI: 1.3-5.3, P < = 0.008). The odds ratio (OR) that a MPBS = 1 agreed with a DXA T-score <- 2.5 was 5.4:1 (95% CI: 2.6 – 11.4.2, P <0.001; Cochran c2 = 36.5, P < 0.001). The MPBS score = 1 had an OR of 3.3:1 (95%CI: 1.9–5.9, P < 0.001) in fracture prediction. Conclusions: The MPBS scores were consistent with the DXA T scores. Both methods have similar predictive value in assessing risk for future hip and hand fractures in older subjects. Subjects with osteoporosis had fewer remaining teeth.
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