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| 10. |
- Hugoson, Anders, et al.
(author)
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Distribution of periodontal disease in a Swedish adult population 1973, 1983 and 1993
- 1998
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 25:7, s. 542-548
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Journal article (peer-reviewed)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.
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| 11. |
- Hugoson, Anders, et al.
(author)
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Oral hygiene and gingivitis in a Swedish adult population 1973, 1983 and 1993
- 1998
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 25:10, s. 807-812
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Journal article (peer-reviewed)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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- Lundgren, T, et al.
(author)
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Saliva composition in children and young adults with Papillon-Lefèvre syndrome
- 1996
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In: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 23:12, s. 1068-72
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Journal article (peer-reviewed)abstract
- The aim of the present study was to evaluate the salivary secretion rate and composition in a group of 16 children and young adults (6-27 years) with Papillon-Lefèvre Syndrome (PLS), and to compare the findings with a group (n = 16) of healthy controls. Unstimulated and stimulated whole saliva was collected at least 2 h after meals and the secretion rate determined. The stimulated saliva was assessed for buffer capacity, total protein, peroxidase and hexosamine, while the unstimulated samples were evaluated for total protein, lysozyme, thiocyanate, lactoferrin and salivary IgA. Both the unstimulated (p < 0.01) and stimulated (p < 0.05) saliva secretion rates were significantly lower among the PLS patients compared with the controls. Furthermore salivary buffer capacity was significantly (p < 0.01) lower in the PLS patients. The total protein content in saliva was comparatively high in the study group, while the concentrations of immunoglobulins and non-immunoglobulins were within normal ranges. When calculating the output of the assessed antimicrobial factors, the mean peroxidase level in stimulated whole saliva was found to be significantly (p < 0.01) lower in the PLS patients than in the healthy controls. In conclusion, the present study indicates an impaired water secretion and a somewhat altered saliva gland function in children and young adults with PLS.
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| 16. |
- Lundgren, T, et al.
(author)
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Subgingival microbial profile of Papillon-Lefèvre patients assessed by DNA-probes
- 1998
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In: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 25:8, s. 624-9
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Journal article (peer-reviewed)abstract
- The prevalence of 18 selected bacterial species was assessed by means of "checkerboard" DNA-DNA hybridisation in a group of 12 Saudi-Arabian adolescents with Papillon-Lefèvre syndrome. A total of 36 tooth sites were investigated. The patients exhibited severe periodontal disease with deep pockets. All 12 patients harboured the putative bacterial pathogens P. intermedia, F. nucleatum, P. micros and S. intermedius while T. denticola, B. forsythus, P. nigrescens, E. corrodens, S. noxia and C. rectus were recovered from 11 patients. P. gingivalis was recovered from 9 patients and 18 sites while corresponding figures for A. actinomycetemcomitans were 8 and 19, respectively. A number of the investigated species (B. forsythus, T. denticola, P. intermedia, C rectus) reached high levels (> or =10(6) cells) in more than 1/2 of the patients. On the other hand, bacteria such as A. actinomycetemcomitans and P. gingivalis were infrequently encountered at high levels in these subgingival samples. In conclusion, the analysis failed to demonstrate a PLS-specific profile of the subgingival infection, since the bacterial composition of the sampled sites closely resembled that characterising deep pockets in adult periodontitis patients.
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| 17. |
- Lundgren, T, et al.
(author)
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Systemic retinoid medication and periodontal health in patients with Papillon-Lefèvre syndrome
- 1996
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In: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 23:3 Pt 1, s. 176-9
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Journal article (peer-reviewed)abstract
- Periodontal health in relation to systemic retinoid medication was evaluated retrospectively in patients with Papillon-Lefèvre Syndrome (PLS). The material consisted of 18 children/young adults ranging from 8 to 28 years of age, all with a confirmed diagnosis of PLS. 9 participants, comprising a medication group, had been on long-term (range 1.5-9 years) retinoid medication for their cutaneous lesions. The remaining 9 served as controls. Regardless of whether or not retinoid medication was received, every patient experienced an early and devastating periodontitis, with atypical edematous and erythematous gingiva, suppuration from deep gingival pockets and premature loss of teeth. No correlation could be found between the severity of skin involvement and the severity of periodontal involvement. An improvement with age could be seen for the cutaneous lesions but not for the periodontal condition. Systemic medication with retinoids had a favorable therapeutic effect on cutaneous lesions, and no severe complication/side effect could be seen after several years of continuous use. However, from the results of this study it can be concluded that, at least in a situation with poor compliance of daily oral home-care, no positive effect on the periodontal health in patients with PLS could be seen by the retinoid medication.
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| 18. |
- Mayfield, L., et al.
(author)
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Root conditioning using EDTA gel as an adjunct to surgical therapy for the treatment of intraosseous periodontal defects
- 1998
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 25:9, s. 707-714
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Journal article (peer-reviewed)abstract
- The aim of this clinical study was to compare the treatment outcome following root surface conditioning using an EDTA gel preparation in conjunction with surgical therapy with that following conventional flap surgery in periodontal intraosseous defects. 36 patients, each of them contributing one intraosseous defect ≥4 mm in depth participated. Defect sites had a probing pocket depth ≥5 mm and bled on probing following hygienic treatment phase. No furcation involvement or endodontic complications were present. In the EDTA group, 18 consecutive patients, defects were treated by root conditioning with EDTA gel for 3 minutes in combination with surgical therapy. In the control group, 18 patients, conventional flap surgery was performed without root conditioning. Chlorhexidine rinsings 0.2% were prescribed following surgery for 2-3 weeks with modified oral hygiene instruction. A strict recall program was implemented including professional prophylaxis and oral hygiene reinforcement every 4-6 weeks until 6-month re-evaluation. Baseline probing pocket depths and defect depths of 7.1±1.3 mm and 6.9±1.6 mm in the EDTA group and 7.6±1.9 mm and 6.6±1.7 mm, respectively, in the control group were measured. 6-month clinical results showed a significant probing attachment level gain of 1.8±1.5 mm and 1.0±1.7 mm in the EDTA and control groups respectively. A probing bone gain of 1.0±1.3 mm in the EDTA group was measured with a non-significant gain of 0.4±1.2 mm in the control group. Radiographic analysis confirmed these results. There were no statistically significant differences in treatment outcome between the group treated by root conditioning in combination with flap surgery and conventional flap surgery alone.
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| 19. |
- Norderyd, Ola, et al.
(author)
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Risk of severe periodontal disease in a Swedish adult population : A longitudinal study
- 1999
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 26:9, s. 608-615
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Journal article (peer-reviewed)abstract
- The aim of this study was to identify risk factors for severe periodontal disease progression in a Swedish adult population between the years 1973 and 1988-91. In 1973, a random sample of 474 dentate adults living in Jönköping County was examined clinically and radiographically. A questionnaire on demographic and socio-economic status, general health, and dental care habits was also used. During the years 1988-1991, 361 of the individuals examined in 1973 were re-examined. A total of 506 (6%) teeth or in average 1.4 teeth per subject were lost between the 2 examinations. 4 subjects had become completely edentulous. The mean loss of teeth in the different age groups 20-60 years was 0.2, 0.9, 1.4, 2.3, and 2.6, respectively. The periodontal bone level decreased by age both in 1973 and in 1988-91. The mean annual progression rate was 0.06 mm for all 357 individuals and varied between 0.04 and 0.07 mm per subject in the different age groups. The presence of periodontal disease progression was defined as bone loss of >20% at a proximal site between the 2 examinations. The most prevalent tooth types with bone loss of >20% at proximal sites were the maxillary and mandibular 2nd molars and the 1st maxillary molar, representing a % of 18.0, 12.8, and 13.5, respectively. The degree of association between severe periodontal disease progression and explanatory variables was investigated using logistic regression models. The dependent variable was no progression of periodontal disease or severe periodontal disease progression, i.e., subjects with periodontal bone loss >20% at ≥6 sites. Age was found to be correlated with severe periodontal disease progression by an odds ratio of 1.05 (CI: 1.02-1.07). The frequency of females in the group with severe bone loss was 58% and higher than in the non-progressing group, 50%. Only 9% in the group with no bone loss smoked as compared to 38% in the group of individuals with severe periodontal bone loss. % supragingival plaque, gingival inflammation, and deepened periodontal pockets (≥4 mm) at baseline were related to severe periodontal disease progression by odds ratios of 1.03 (CI: 1.02-1.05), 1.01 (1.00-1.03), and 1.03 (1.00-1.05), respectively. In the multivariate logistic regression model, age (odds ratio 1.13 (CI: 1.06-1.19)), smoking (odds ratio 20.25 (5.07-80.83)), and % pockets ≥4 mm (odds ratio 1.15 (1.04-1.27)) remained significantly associated with severe disease progression. Furthermore, female gender and differences in income level appeared in the multivariate analysis to be related with severe bone loss, with odds ratios of 3.19 (CI: 1.02-9.97) and 8.46 (CI: 1.97-36.37), respectively.
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| 20. |
- Norderyd, Ola, et al.
(author)
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Risk of severe periodontal disease in a Swedish adult population. A cross-sectional study
- 1998
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 25:12, s. 1022-1028
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Journal article (peer-reviewed)abstract
- In this study, potential risk factors for severe periodontal disease were identified in a cross-sectional sample from the county of Jönköping, Sweden. 547 adults 20-70 years of age were categorised clinically and radiographically by level of periodontal disease experience. These levels were used to divide the sample into groups - individuals without any reduction in periodontal bone level (60%) and those with severe periodontal bone loss (13%) - which were then used in univariate and multivariate logistic regression analyses as dependent variable. Demographic, socio-economic, general health, smoking habits, clinical, and dental care variables were used in the different regression analyses. In the univariate model, age (20-70 years) was found to be correlated with more severe periodontal disease experience (odds ratio: 1.13; 95% CI: 1.10-1.17). The association with periodontal disease was more pronounced for the older age groups (50, 60, and 70 years). A negative financial situation was also related to severe periodontal bone loss when regressed univariately (odds ratio 2.20 [95%: 1.04-4.68]). Moderate-heavy smoking (≥10 cigarettes/day) appeared to be associated with severe periodontal destruction with an odds ratio of 9.78 (95% CI: 3.62-36.42). Of the clinical variables in the univariate model, higher mean levels of supragingival dental plaque and the presence of subgingival calculus were related to more severe periodontal disease with odds ratios of 1.02 (95%: 1.01-1.03) and 2.96 (95%: 1.50-5.88), respectively. When the same variables were regressed multivariately, age (continuous) (odds ratio 1.17 [95% CI: 1.12-1.22]), moderate-heavy smoking (odds ratio 11.84 [95% CI: 4.19-33.50]), and higher mean levels of plaque (odds ratio 1.02 [95% CI: 1.00-1.03]) remained significant. Light smoking (1-9 cigarettes/day) was not significantly associated with severe periodontal disease in the 2 regression models. The present study demonstrated that smoking, greater age, and higher mean levels of plaque are potential risk factors for severe periodontal disease in this specific population.
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| 21. |
- Thorstensson, H, et al.
(author)
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Medical status and complications in relation to periodontal disease experience in insulin-dependent diabetics.
- 1996
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 23:3 Pt 1, s. 194-202
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Journal article (peer-reviewed)abstract
- The aim of this study was to define a population of diabetics exhibiting an increased risk of developing severe periodontitis by comparing the medical status of 2 groups of diabetics, 1 with no/minor periodontal disease and 1 with severe periodontal disease. The case-control study consisted of 2 parts, a baseline study and a follow-up study. 39 case-control pairs were selected. They were adult, long-duration, insulin-dependent diabetics matched according to sex, age and diabetes duration. One individual in each pair (the CASE) exhibited severe periodontal disease while the other (the CONTROL) exhibited gingivitis or only minor alveolar bone loss. The median age of the cases was 58 years (range 36 to 70 years) and of the controls 59 years (range 37 to 69 years). The median disease duration in cases and controls was 24 years and 25 years, respectively. The median follow-up time was 6 years. The medical variables analysed were weight, insulin dose, systolic and diastolic blood pressure, vibratory threshold, triglycerides, total-cholesterol, HDL-cholesterol, creatinine, HbA1, proteinuria, ECG, retinopathy, stroke, transient ischemic attacks (TIA), angina, myocardial infarct, heart failure, hypertension, intermittent claudication, foot ulcer, death, cause of death, and smoking habit. Biochemical analyses and clinical variables used as a routine in the monitoring of diabetics failed to differentiate between diabetics with severe and minor periodontal disease. In the follow-up study, significantly higher prevalences of proteinuria and cardiovascular complications such as stroke, TIA, angina, myocardial infarct and intermittent claudication were found in the case group. An association between renal disease, cardiovascular complications and severe periodontitis seems to exist. This indicates that a closer cooperation between the diabetologist and the dentist is necessary in monitoring the diabetic patient.
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| 22. |
- Thorstensson, H, et al.
(author)
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Some suspected periodontopathogens and serum antibody response in adult long-duration insulin-dependent diabetics.
- 1995
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 22:6, s. 449-458
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Journal article (peer-reviewed)abstract
- The subgingival microflora and serum antibody response were examined in long-duration insulin-dependent diabetics and age- and sex-matched non-diabetics. The material consisted of 9 diabetics aged 40-49 years and 19 aged 50-59 years, 13 non-diabetics aged 40-49 years and 21 aged 50-59 years. The bacterial species studied (Actinobacillus actinomycetemcomitans, Campylobacter rectus, Capnocytophaga spp, Eikenella corrodens, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia) were recovered in diabetics as well as in non-diabetics. Significantly more diabetics in both age groups harboured P. gingivalis compared to non-diabetics. Prevalence of P. gingivalis was associated with deepened periodontal pockets among non-diabetics but not among diabetics. In diabetics and non-diabetics, the serum antibody titres for most antigens were similar.
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