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1.
  • 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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4.
  • 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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5.
  • 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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6.
  • 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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  • 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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9.
  • 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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10.
  • 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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11.
  • 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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  • Kamma, J J, et al. (författare)
  • Association of early onset periodontitis microbiota with aspartate aminotransferase activity in gingival crevicular fluid.
  • 2001
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 28:12, s. 1096-1105
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The objective of this study was to determine the relationship between the activity of the enzyme aspartate aminotransferase (AST) in gingival crevicular fluid (GCF) using the colorimetric PerioGard (PTM) test and the subgingival microflora in early onset periodontitis lesions.MATERIAL AND METHODS: The study population consisted of 25 otherwise healthy individuals exhibiting early onset periodontitis (EOP). In each patient four experimental sites were identified comprising one deep periodontal pocket (PD >5 mm) randomly chosen in each quadrant. Bacterial samples were obtained from the experimental sites, consecutively cultured anaerobically and in 10% CO(2) using selective and nonselective media. Isolates were characterized to species level by conventional biochemical tests and various identification kits. Clinical measurements as well as AST activity, assessed either as positive or negative using the PTM, were recorded at the same sites.RESULTS: Sixty-two sites exhibited AST positive and 38 AST negative activity. Analysis of bacterial counts using the ANOVA (Mann Whitney U-test) showed that Streptococcus intermedius, Peptostreptococcus micros, Campylobacter concisus, Bacteroides forsythus, Camplobacter gracilis, Campylobacter rectus and Selenomonas sputigena were significantly higher in sites with AST-positive activity. The odds ratio of having high prevalence of S. intermedius, P. micros, C. concisus, B. forsythus, C. gracilis, C. rectus and S. sputigena in the presence of a positive AST site was very high (range: 3.5-17.0). Streptococcus sanguis, Actinomyces naeslundii, Gemella morbillorum, Capnocytophaga gingivalis, Veillonella parvula, Fusobacterium varium, Eubacterium lentum and Prevotella oralis were detected in significantly higher proportions in sites with AST negative activity and manifested a negative odds ratio in the presence of AST positive sites. The logistic regression analysis revealed that smoking and bleeding upon probing showed a significant association with AST activity, while plaque and suppuration were not found to be significant predictors of AST activity. The co-infection of Porphyromonas gingivalis, B. forsythus and P. micros, or P. gingivalis, B. forsythus and C. rectus were found to be significantly associated with the AST activity (p<0.001). AST positive sites revealed significantly higher occurrence of co-infections by P. gingivalis, B. forsythus, S. sputigena or by P. gingivalis, B. forsythus, S. intermedius than AST negative sites (p<0.001). P. gingivalis, B. forsythus, A. naeslundii co-infection was found significantly higher in the AST negative sites (p<0.001).CONCLUSIONS: The present study found a high level of agreement between the presence of putative periodontal pathogens and positive AST scores at periodontal sites that clinically were considered to be potentially disease active. Prospective studies should be performed to confirm the findings.
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  • Lundgren, Tord, et al. (författare)
  • Periodontal treatment of patients with Papillon-Lefèvre syndrome : a 3-year follow-up
  • 2004
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 31:11, s. 933-938
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND/AIM: Conventional mechanical periodontal treatment of Papillon-Lefevre syndrome (PLS) has often been reported to fail. This study describes the outcome of a non-surgical periodontal therapy including antimicrobial treatment of nine patients diagnosed with PLS. The patients originate from a total of 15 children and adolescents with PLS for which clinical characteristics are presented.METHODS: Clinical examination including conventional periodontal measurements. Initial treatment including oral hygiene instruction, scaling and root planing and systemic amoxicillin-metronidazole therapy for 6 weeks. After that the patients were enrolled in a 3-month recall maintenance program. In addition to this mechanical supportive maintenance treatment, tetracycline was prescribed and used continuously for 1.5 years.RESULTS/CONCLUSION: On five patients who were showing acceptable standard of oral hygiene and also compliance with the antibiotic medication, development of periodontitis on erupting teeth was prevented and disease activity on the previously periodontally involved teeth controlled during a 3-year period. Poor results of treatment were observed for three patients, all siblings. These patients failed to comply with the medication and also failed to improve their oral hygiene.
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15.
  • Lundgren, T, et al. (författare)
  • Periodontal treatment of patients with Papillon-Lefèvre syndrome : a 3-year follow-up.
  • 2004
  • Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 31:11, s. 933-8
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND/AIM: Conventional mechanical periodontal treatment of Papillon-Lefevre syndrome (PLS) has often been reported to fail. This study describes the outcome of a non-surgical periodontal therapy including antimicrobial treatment of nine patients diagnosed with PLS. The patients originate from a total of 15 children and adolescents with PLS for which clinical characteristics are presented.METHODS: Clinical examination including conventional periodontal measurements. Initial treatment including oral hygiene instruction, scaling and root planing and systemic amoxicillin-metronidazole therapy for 6 weeks. After that the patients were enrolled in a 3-month recall maintenance program. In addition to this mechanical supportive maintenance treatment, tetracycline was prescribed and used continuously for 1.5 years.RESULTS/CONCLUSION: On five patients who were showing acceptable standard of oral hygiene and also compliance with the antibiotic medication, development of periodontitis on erupting teeth was prevented and disease activity on the previously periodontally involved teeth controlled during a 3-year period. Poor results of treatment were observed for three patients, all siblings. These patients failed to comply with the medication and also failed to improve their oral hygiene.
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16.
  • Moser, Peter, et al. (författare)
  • Maintenance of periodontal attachment levels in prosthetically treated patients with gingivitis or moderate chronic periodontitis 5-17 years post therapy.
  • 2002
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 29:6, s. 531-539
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The present retrospective analysis was performed to evaluate the long-term results of initial periodontal and fixed prosthodontic treatment in patients with gingivitis or moderate chronic periodontitis during post-therapeutic irregular maintenance of 5-17 years.MATERIAL AND METHODS: Thirty-four patients participated in the study. Baseline data were taken from the patients' records when the periodontal and the prosthetic treatment was finished. A follow-up examination was performed in conjunction with the radiographic examination including assessment of plaque, bleeding on probing, probing pocket depth, recession and probing attachment loss. Information regarding the oral hygiene habits of the subjects as well as the amount of dental and initial therapy received between the observation time was obtained from the patients' records.RESULTS: The results from the clinical trial revealed that during the mean examination period of 11 years only 31 teeth were lost. The remaining restored and non-restored teeth did not show any significant differences in attachment loss (from 2.9 mm to 3.0 mm) in spite of a higher plaque value at the follow-up examination (from 42% to 48%). The BoP remained stable in the same time period and scored 31% to 28%.CONCLUSIONS: The periodontal attachment levels were maintained during a prolonged period despite irregular maintenance care. This indicates that in a population of obviously decreased susceptibility to chronic periodontitis, it is possible that fixed reconstructions will not - even under suboptimal supportive care - jeopardize the periodontal status.
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  • Persson, GR, et al. (författare)
  • Perceived risk of deteriorating periodontal conditions
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 30:11, s. 982-989
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • BACKGROUND: Interpretation of risk for periodontitis is critical for treatment planning. How periodontists assess risk for periodontitis is unclear. PURPOSE: To study (1) what factors periodontists use when assessing the risks for worsening periodontal conditions anticipating that no treatment would be provided, and (2) if risk assessment is consistent and independent of specialty background training. MATERIAL AND METHODS: Medical history, clinical dental data, full-mouth intra-oral radiographs, and slide pictures were obtained from each of 51 subjects, and the information was provided to 23 examiners. RESULTS: The mean age of the study subjects was 51.5 years (SD +/- 17.7, range 23-81), with 28 women included. In 10 of the subjects, only gingivitis was identified, while 22 subjects had advanced chronic periodontitis. Risk scores assigned for 2 and 4 years differed significantly between European- and US-trained periodontists (p < 0.001) and between graduate students in training and periodontists from either the US or Europe (p < 0.01) (Wilcoxon n-pair test), with European periodontists scoring the lowest risks. Risk scores were correlated between groups (p < 0.01 with rho range 0.82-0.89) (Spearman’s rank correlation). The best-fit model (r2 = 0.86) to assess perceived risk for worsening periodontal conditions based on data from all examiners combined included the following variables: (1) overall horizontal alveolar bone loss (p < 0.000), (2) age-adjusted proportional radiographic bone height score for the worst site (p < 0.000), and (3) proportion of pocket probing depths > or = 6.0 mm. CONCLUSIONS: Differences exist on the scale of risk values based on specialty training. Consistency in scoring patterns exists. The examiners based their assigned risk scores almost exclusively on measures of existing disease severity, including radiographic bone loss and numbers of periodontal pockets > or = 6.0 mm, and excluding most known risk factors such as smoking, diabetes, and poor oral hygiene.
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18.
  • Persson, G. Rutger, et al. (författare)
  • Periodontitis and perceived risk for periodontitis in elders with evidence of depression.
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 30:8, s. 691-6
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Depression and periodontitis are common conditions in older adults. There is some evidence that these two conditions may be related.AIMS: To study a population of dentate elders and assess the prevalence of depression, self-assessment of risk for periodontitis and tooth loss, in relation to periodontal disease status.MATERIAL AND METHODS: Data were obtained from 701 older subjects (mean age 67.2 years (SD+/-4.6), of whom 59.5% were women. Self-reports of a diagnosis of depression, scores of the Geriatric Depression Scale (GDS), and self-assessment of risk for future tooth loss and periodontitis were compared with a diagnosis of periodontitis based on probing depth, and bone loss assessed from panoramic radiographs. Other systemic diseases and smoking habits were also determined and studied in relation to depression.RESULTS: A history of depression was reported by 20% of the subjects. GDS scores >/=8 were reported by 9.8% of the elders. Periodontitis was identified in 48.5% of the subjects. Depression was associated with heart attack (p<0.05), stroke (p<0.01), high blood pressure (p<0.02), all combined cardiovascular diseases (p<0.001), chronic pain (p<0.01), osteoarthritis (p<0.001), and osteoporosis (p< 0.001) but not with periodontitis (p=0.73). Subjects with depression had a higher self-reported risk score for future tooth loss (p<0.02). No group difference emerged for self-perceived risk for periodontitis. Logistic regression analysis demonstrated that a past history of tooth loss (p<0.001), self-perceived risk for periodontitis (p<0.02), the number of years with a smoking habit (p<0.02), and male gender (p<0.02) were associated with a diagnosis of periodontitis but neither measure of depression could be included in an explanatory model for periodontitis.CONCLUSIONS: Evidence of depression (self-report or by GDS) is not associated with risk for periodontitis in older subjects but is associated with tooth loss and chronic conditions associated with pain.
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19.
  • Persson, Rigmor E, et al. (författare)
  • Assessment of periodontal conditions and systemic disease in older subjects. : Focus on diabetes mellitus
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 30:3, s. 207-13
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: An increased risk for periodontitis has been associated both with type-1 or insulin dependent diabetes (IDDM) and with type-2 or non-insulin dependent diabetes (NIDDM).AIMS: 1) To describe and analyze periodontal conditions in older low-income ethnic diverse subjects with or without a diagnosis of diabetes. 2) To assess to what extent diabetes mellitus is associated with periodontal status, and 3) how periodontitis ranks as a coexisting disease among other diseases in subjects with diabetes mellitus.MATERIAL AND METHODS: Radiographic signs of alveolar bone loss were studied in 1101 older subjects 60-75 years old (mean age 67.6, SD+/-4.7). The number of periodontal sites and the proportions of teeth with probing depth (PD) > or =5 mm, clinical attachment levels (CAL) > or =4 mm were studied in a subset of 701 of the subjects.RESULTS: IDDM was reported by 2.9% and NIDDM by 9.2% of the subjects. The number of remaining teeth did not differ by diabetic status. The number of sites with PD > or =5 mm and the proportion of PD with > or =5 mm was significantly smaller in the non-diabetic group (chi2=46.8, p<0.01, and chi2=171.1, p<0.001, respectively). Statistical analysis failed to demonstrate group differences for the number and proportions of sites with CAL > or =4 mm and for radiographic findings of alveolar bone loss. Combining all periodontal parameters revealed that the Mantel-Haenszel common odds of having IDDM/NIDDM and periodontitis was 1.8 : 1 (95% CI: 1.1-3.1, p<0.03). The common odds ratio estimate of an association between heart disease and diabetes was 3.6 : 1 (95% CI: 2.1-2.6, p<0.001).CONCLUSIONS: Probing depth differences between IDDM/NIDDM vs. non-diabetic subjects may reflect the presences of pseudo-pockets and not progressive periodontitis in many subjects with diabetes mellitus. Periodontitis is not a predominant coexisting disease in older subjects with diabetes mellitus.
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20.
  • Persson, Rigmor E, et al. (författare)
  • Assessment of periodontal conditions and systemic disease in older subjects. I. Focus on osteoporosis.
  • 2002
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 29:9, s. 796-802
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Osteoporosis (OPOR) is a common chronic disease, especially in older women. Patients are often unaware of the condition until they experience bone fractures. Studies have suggested that OPOR and periodontitis are associated diseases and exaggerated by cytokine activity. Panoramic radiography (PMX) allows studies of mandibular cortical index (MCI), which is potentially diagnostic for OPOR.AIMS: i). To study the prevalence of self-reported history of OPOR in an older, ethnically diverse population, ii). to assess the agreement between PMX/MCI findings and self-reported OPOR, and iii). to assess the likelihood of having both a self-reported history of OPOR and a diagnosis of periodontitis.MATERIALS AND METHODS: PMX and medical history were obtained from 1084 subjects aged 60-75 (mean age 67.6, SD +/- 4.7). Of the films, 90.3% were useful for analysis. PMXs were studied using MCI. The PMXs were used to grade subjects as not having periodontitis or with one of three grades of periodontitis severity.RESULTS: A positive MCI was found in 38.9% of the subjects, in contrast to 8.2% self-reported OPOR. The intraclass correlation between MCI and self-reported OPOR was 0.20 (P < 0.01). The likelihood of an association between OPOR and MCI was 2.6 (95%CI: 1.6, 4.1, P < 0.001). Subjects with self-reported OPOR and a positive MCI had worse periodontal conditions (P < 0.01). The Mantel-Haentzel odds ratio for OPOR and periodontitis was 1.8 (95%CI: 1.2, 2.5, P < 0.001).CONCLUSIONS: The prevalence of positive MCI was high and consistent with epidemiological studies, but only partly consistent with a self-reported history of osteoporosis with a higher prevalence of positive MCI in Chinese women. Horizontal alveolar bone loss is associated with both positive self-reported OPOR and MCI.
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21.
  • Persson, Rigmor E, et al. (författare)
  • Assessment of periodontal conditions and systemic disease in older subjects. II. Focus on cardiovascular diseases.
  • 2002
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 29:9, s. 803-10
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Panoramic radiographs (PMX)s may provide information about systemic health conditions.AIMS: i). To study clinical periodontal conditions and collect self-reported health status in a cohort of 1084 older subjects; ii). to study signs of alveolar bone loss and carotid calcification from panoramic radiographs obtained from these subjects; and iii). to study associations between study parameters.MATERIAL AND METHODS: PMXs from 1064 adults aged 60-75 (mean age 67.6, SD +/- 4.7) were studied. Signs of alveolar bone loss, vertical defects, and molar furcation radiolucencies defined periodontal status. Medical health histories were obtained via self-reports. Signs of carotid calcification were identified from panoramic radiographs.RESULTS: The PMX allowed assessment of 53% of the films (Seattle 64.5% and Vancouver 48.4%). A self-reported history of a stroke was reported by 8.1% of men in Seattle and 2.9% of men in Vancouver (P < 0.01). Heart attacks were reported by 12% of men in Seattle and 7.2% in Vancouver (N.S.). PMX evidence of periodontitis was found in 48.5% of the subjects, with carotid calcification in 18.6%. The intraclass correlation score for PMX findings of carotid calcification and stroke was 0.24 (95% CI: 0.10-0.35, P < 0.001). The odds ratio for PMX carotid calcification and periodontitis was 2.1 (95% CI: 1.3-3.2, P < 0.001), and for PMX carotid calcification and stroke 4.2 (95% CI: 1.9-9.1, P < 0.001). The associations disappeared when smoking was accounted for. A history of a heart attack was associated with stroke, gender, age, and PMX scores of alveolar bone loss.CONCLUSIONS: PMXs may provide valuable information about both oral conditions and signs of carotid calcification, data that are consistent with self-reported health conditions. Alveolar bone loss as assessed from PMXs is associated with cardiovascular diseases.
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22.
  • Roos-Jansåker, Ann-Marie, et al. (författare)
  • Treatment of peri-implant infections : a literature review
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 30:6, s. 467-485
  • Forskningsöversikt (refereegranskat)abstract
    • Objectives: The purpose of the present paper is to review available information on the treatment of peri-implant mucositis and peri-implantitis.Materials and Methods: The results of animal research and human studies are presented. Proposed strategies for the treatment of peri-implantitis presented in the literature are also included.Results: Most of the information accessible at this time derives from case reports. The reports provide evidence that efforts to reduce the submucosal infection may result in short-term improvements of the peri-implant lesion. They also indicate that regenerative procedures in intrabony peri-implant defects can result in the formation of new bone.Conclusions: Several uncertainties remain regarding the treatment of peri-implantitis. Properly conducted long-term follow-ups of consecutively treated cases would seem to be a realistic avenue for accumulation of more information. This may assist in establishing the predictability, magnitude and stability of improvements that can be achieved.
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23.
  • Roos-Jansåker, Ann-Marie, et al. (författare)
  • Treatment of peri-implant infections : a literature review
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 30:6, s. 467-485
  • Forskningsöversikt (refereegranskat)abstract
    • Objectives: The purpose of the present paper is to review available information on the treatment of peri-implant mucositis and peri-implantitis. Materials and Methods: The results of animal research and human studies are presented. Proposed strategies for the treatment of peri-implantitis presented in the literature are also included. Results: Most of the information accessible at this time derives from case reports. The reports provide evidence that efforts to reduce the submucosal infection may result in short-term improvements of the peri-implant lesion. They also indicate that regenerative procedures in intrabony peri-implant defects can result in the formation of new bone. Conclusions: Several uncertainties remain regarding the treatment of peri-implantitis. Properly conducted long-term follow-ups of consecutively treated cases would seem to be a realistic avenue for accumulation of more information. This may assist in establishing the predictability, magnitude and stability of improvements that can be achieved.
  •  
24.
  • Roos‐Jansåker, Ann‐Marie, et al. (författare)
  • Treatment of peri-implant infections : a literature review
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 30:6, s. 467-85
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The purpose of the present paper is to review available information on the treatment of peri-implant mucositis and peri-implantitis.MATERIALS AND METHODS: The results of animal research and human studies are presented. Proposed strategies for the treatment of peri-implantitis presented in the literature are also included.RESULTS: Most of the information accessible at this time derives from case reports. The reports provide evidence that efforts to reduce the submucosal infection may result in short-term improvements of the peri-implant lesion. They also indicate that regenerative procedures in intrabony peri-implant defects can result in the formation of new bone.CONCLUSIONS: Several uncertainties remain regarding the treatment of peri-implantitis. Properly conducted long-term follow-ups of consecutively treated cases would seem to be a realistic avenue for accumulation of more information. This may assist in establishing the predictability, magnitude and stability of improvements that can be achieved.
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25.
  • Sanai, Yasaman, et al. (författare)
  • Presence and antibiotic resistance of Porphyromonas gingivalis, Prevotella intermedia, and Prevotella nigrescens in children.
  • 2002
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 29:10, s. 929-934
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND/AIMS: Only limited information exists about the prevalence in children of pathogens associated with periodontitis. The aim of the present study was to determine by culture whether 8-11-year-old children carry Porphyromonas gingivalis, Prevotella intermedia, and/or P. nigrescens in samples from the gingiva and/or the buccal mucosa taken before, and after caries treatment and oral hygiene instruction. A second aim was to assess the proportion of subjects who had gram-negative anaerobes carrying the tet(Q) and erm(F) genes, suggesting antibiotic resistance to tetracycline or erythromycin.METHOD: A total of 150 children provided gingival and buccal swab bacterial samples that were cultured for P. gingivalis, P. intermedia, and P. nigrescens. The species was verified using DNA-DNA hybridization with species-specific probes made from the variable region of the 16S rRNA sequences. Antibiotic-resistant genes, tet(Q) and erm(F), were identified using specific DNA-DNA hybridization with specific DNA probes.RESULTS: A total of 116 isolates of black-pigmented bacteria were cultured from 47 (31%) of 150 children. Five isolates were identified as P. gingivalis, 29 as P. intermedia, 33 as P. nigrescens, and 49 as other species. In general, the bacteria were not culturable at more than one time period. We found that 55% of these 47 children harbored black pigmented bacteria that carried either one or both of the two antibiotic-resistant genes studied (tet(Q), and erm(F)).CONCLUSION: The present study demonstrated that children not exposed to regular dental treatment carry bacteria outside the gingival sulcus that have been associated with periodontitis, and that standard treatment procedures may not clear the presence of the putative pathogens. In addition, antibiotic-resistant genes are common in identifiable gram-negative anaerobes, including putative pathogens.
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26.
  • Schätzle, Marc, et al. (författare)
  • Clinical course of chronic periodontitis : I. Role of gingivitis
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 30:10, s. 887-901
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The purpose of this study was to determine the influence of long-standing gingival inflammation on periodontal attachment loss. On the basis of repeated examinations, the present report describes the influence of gingival inflammation on the initiation of periodontitis from 16 to 59 years of age.MATERIAL AND METHODS: The data originated from a 26-year longitudinal study of Norwegian males, who practiced daily oral home care and received state-of-the-art dental care. The initial examination included 565 individuals. Subsequent examinations took place in 1971, 1973, 1975, 1981, 1988 and 1995. Thus, the study covers the age range of 16-59 years. All tooth sites were divided into four categories according to their history of gingival inflammation over the entire observation period: sites always scoring GI = 0, GI = 1 and GI = 2 sites (GI = gingival index). Sites disclosing various GI scores at different observation periods were not considered.RESULTS: The mean cumulative attachment loss for non-inflamed (GI = 0) sites in individuals approaching 60 years of age was 1.94 mm. Sites always scoring GI = 1 yielded 2.42 mm, and sites that always scored GI = 2 exhibited 3.31 mm of periodontal attachment loss. At interproximal sites of all three groups where gingival trauma was assumed to be minimal or non-existent, only very few sites expressed attachment loss due to gingival recession (2-4%). At interproximal sites always scoring GI = 0, 20% loss of attachment was in the form of pocket formation by 59 years of age. The GI = 1 and the GI = 2 cohorts exhibited attachment loss with pocket formation in 28% and 54%, respectively.CONCLUSION: This study has shown that, as men approach 60 years of age, gingival sites that throughout the 26 years of observation bled on probing had approximately 70% more attachment loss than sites that were consistently non-inflamed (GI = 0). Before 40 years of age, there was a slight increase in periodontal attachment loss due to pocket formation, but after this, the frequency increased significantly. Loss of attachment due to gingival recession was very small in all three groups. The fact that sites with non-inflamed gingiva also exhibited some loss of attachment and pocket formation may be explained by fluctuation in the variations of tissue status during long observation intervals combined with the presence of subclinical inflammation.
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27.
  • Schätzle, Marc, et al. (författare)
  • Clinical course of chronic periodontitis : III. Patterns, variations and risks of attachment loss
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 30:10, s. 909-18
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The purpose of this study was to assess the rate of attachment loss during various stages of adult life in a well-maintained middle-class population.MATERIAL AND METHODS: The data originated from a 26-year longitudinal study of Norwegian males who had received regular and adequate dental care and practised daily oral home care. The initial examination in 1969 included 565 individuals aged between 16 and 34 years. Subsequent examinations took place in 1971, 1973, 1975, 1981, 1988 and 1995. Thus, the study covers the age range of 16-59 years. The rate of the annual attachment loss was calculated as the difference between the individual mean attachment loss between two examinations divided by the years between examinations. The mean annualized relative risk of attachment loss was calculated as the frequency distribution of sites with initial periodontal attachment loss (loss of attachment at the first time of occurrence > or = 2 mm) and healthy sites (loss of attachment always < 2 mm). For comparison of significant changes in annual attachment loss rates between the age groups and mean annualized relative risks of attachment loss as they proceeded through adult life, the Wilcoxon Mann-Whitney U-test was used.RESULTS: The mean overall individual attachment loss during 44 years (between 16 and 59 years) totaled 2.44 mm (range 0.14-2.44 mm), averaging an annual mean rate of 0.05 mm/year. The highest annual rate of attachment loss occurred before 35 years of age (0.08-0.1 mm/year), after which the mean annual rate decreased to about 0.04-0.06 mm/year for the next three decades of life leading to 60 years. The mean annualized relative risk of initial attachment loss increased significantly from adolescence (1.2%) to the maximum at 30-34 years of age (6.9%). After the age of 34 years, the risk of initial attachment loss decreased again, but after the age of 40 years, another continuous increase was observed.CONCLUSIONS: Over a 26-year period, 25% of the subjects went through adult life with healthy and stable periodontal conditions. The remaining 75% developed slight to moderately progressing periodontal disease with progression rates varying between 0.02 and 0.1 mm/year with a cumulative mean of loss of attachment of 2.44 mm as they approached 60 years of age. The annual mean rate and the mean annualized risk of initial attachment loss were highest between 16 and 34 years of age. Only 20% of the sites continued to lose further attachment during the remainder of the observation period, and less than 1% of the sites showed substantial loss of attachment (> 4 mm).
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28.
  • Schätzle, Marc, et al. (författare)
  • The clinical course of chronic periodontitis : IV. Gingival inflammation as a risk factor in tooth mortality
  • 2004
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 31:12, s. 1122-7
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The purpose of this study was to assess the long-term influence of gingival inflammation on tooth loss.MATERIAL AND METHODS: The data originated from a 26-year longitudinal study of Norwegian males, who practiced adequate daily oral home care and received "state-of-the-art" dental care. The initial examination in 1969 included 565 individuals aged between 16 and 34 years. Subsequent examinations took place in 1971, 1973, 1975, 1981, 1988 and 1995. Thus, the study covers the age range of 16-59 years. The teeth were divided into three tooth groups (I-III) reflecting the history of inflammation of the surrounding gingiva (gingival index (GI) scores) over 26 years: (I) teeth with surrounding gingival units scoring a minimum of one site with GI=0 and a maximum of three sites with GI=1, (II) teeth with surrounding gingival units scoring a minimum of one site with GI=1 and a maximum of three sites with GI=2 over the observation periods and (III) teeth with surrounding gingival units always scoring a minimum of GI=2 (bleeding on probing) at all sites over the observation period.RESULTS: At baseline (1969), out of possible 15,820 teeth (565 x 28), 15,383 teeth were present. Four hundred and thirty-seven teeth had already been missing for unknown reasons. By 1995, 13,159 teeth were reexamined, i.e. over the 26-year observation period only 126 (0.95%) teeth were lost. Only 16 (0.28%) of 5793 teeth belonging to GI-Severity Group I were lost. In the GI-Severity Group II, however, 78 (2.28%) out of 3348 teeth were lost, and 13 (11.21%) of 103 teeth with GI-Severity Group III were lost. Teeth with GI-Severity Group III yielded an odds ratio for tooth loss that was 46 times higher than that of teeth with GI-Severity Group I, and five times higher than that of teeth with GI-Severity Group II over 26 years. Furthermore, teeth with the GI-Severity Group II had a nine times higher risk for tooth loss than teeth with the GI-Severity Group I. The GI-Severity Group I retained 99.5% of the teeth after a tooth age of 51 years. The GI-Severity Group II retained 93.8% of the teeth after a tooth age of 50 years. However, in the GI-Severity Group III, 63.4% of the teeth were retained for a tooth age of 47 years.CONCLUSIONS: Teeth surrounded with inflammation-free gingival tissues were maintained for a tooth age of 51 years, while teeth consistently surrounded with inflamed gingivae yielded a 46-times higher risk to be lost. Only two-thirds of such teeth were maintained throughout the 26-year observation period. This documents the role of gingival inflammation as a risk factor for future tooth loss.
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29.
  • Schätzle, M, et al. (författare)
  • The influence of margins of restorations of the periodontal tissues over 26 years
  • 2001
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 28:1, s. 57-64
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The purpose of this investigation was to examine the long-term relationship between dental restorations and periodontal health.MATERIAL AND METHODS: The data derived from a 26-year longitudinal study of a group of Scandinavian middle-class males characterized by good to moderate oral hygiene and regular dental check-ups. At each of 7 examinations between 1969 and 1995, the mesial and buccal surfaces were scored for dental, restorative and periodontal parameters. The mesial sites of premolars and molars of 160 participants were observed during 26 years (1969-1995). A control group with 615 sound surfaces or filling margins located more than 1 mm from the gingival margin in all 7 surveys was compared with a test cohort with 98 surfaces which were sound or had filling margins located more than 1 mm from the gingival margin at baseline (1969) and had a subgingival filling margin 2 years after (1971).RESULTS AND CONCLUSIONS: The study confirmed the long held concept that restorations placed below the gingival margin are detrimental to gingival and periodontal health. In addition, this study suggests that the increased loss of attachment found in teeth with subgingival restorations started slowly and could be detected clinically 1 to 3 years after the fabrication and placement of the restorations. A subsequent "burn-out" effect was suggested.
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30.
  • Sims, Tom J, et al. (författare)
  • Serum IgG to heat shock proteins and Porphyromonas gingivalis antigens in diabetic patients with periodontitis.
  • 2002
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 29:6, s. 551-562
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Past studies have reported a correlation between the presence and severity of periodontitis and serum antibody titers to species-specific antigens of Porphyromonas gingivalis or to cross-reactive antigens, such as lipopolysaccharide (LPS) and heat shock proteins (HSP), shared between P. gingivalis and other bacteria. Our recent study of periodontal treatment outcome in insulin-dependent (type 1) diabetes mellitus patients with severe periodontitis (IDDMI/periodontitis) resulted in two key findings: 1. serum glutamic acid decarboxylase autoantibody (GAD65 Ab) levels were significantly associated with periodontal pocket depth change (PDC) and 2. serum IgG titers to P. gingivalis cells were positively associated with GAD65 Ab level in seropositive (GAD65 Ab +) patients. We have therefore hypothesized that profiles of serum autoantibody levels and IgG titers, to P. gingivalis-specific antigens may be useful in assessing risk for refractory periodontitis in such patients.AIM: To determine whether PDC resulting from non-surgical periodontal treatment can be predicted using profiles of baseline IgG titers to P. gingivalis-specific antigens, human HSP, and GAD65.METHODS: PDC was assessed two months after non-surgical periodontal treatment of 7 GAD65 Ab + and 11 GAD65 AbIDDM/periodontitis patients. Pretreatment titers to GAD65, recombinant human heat shock proteins (HSP90, HSP70, and HSP60), and various P. gingivalis antigens were measured using radioligand precipitation or enzyme-linked immunosorbent (ELISA) assays and compared to the same measurements for 154 recent-onset IDDM patients and 46 non-diabetic controls.RESULTS: Median titers (ELISA units) to HSP90 and HSP70 were significantly higher than non-diabetic controls for GAD65 Ab + (p degrees = 0.002) and GAD65 Ab- (p = 0.034) IDDM/periodontitis patients, respectively. Multivariate regression analysis indicated significant partial correlation of PDC with log-transformed titers to HSP90 (r = - 0.62, p = 0.008), HSP70 (r = + 0.62, p = 0.009), GAD65 (r = - 0.60, p = 0.01) and P. gingivalis LPS (r = - 0.5 1, p = 0.04). Furthermore, hierarchical clustering of baseline profiles of log-transformed HSP90, HSP70, and GAD65 Ab titers sorted patients into two distinct clusters with significantly different median PDC (1.45 min, n = 10 vs. 0.65 min, n = 8; p = 0.016, Mann-Whitney).CONCLUSION: Pretreatment profiles of serum antibody titers to HSP90, HSP70, GAD65, and P. gingivalis LPS may be useful for predicting which patients with IDDM/periodontitis will have a poor response to non-surgical periodontal therapy.
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31.
  • Sjögren, Petteri, et al. (författare)
  • Randomised controlled trials and publication trends in periodontal research during 1980–2000
  • 2002
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 29:12, s. 1112-1117
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives:  To study publication trends, as well as the number and proportion of randomised controlled trials covering different areas of periodontal research (RCT-Ps).Material and methods:  The study was based on Medline searches (MeSH terms) for the period 1980– 2000. The RCT-Ps (n = 675) were examined for relevance for different areas of periodontal research, journals of publication, and the countries of origin.Results:  In periodontal research the annual number of publications had increased from 162 in 1980 to 440 in 2000. Moreover, clinical trials in periodontal research (CT-Ps) had increased more than 10-fold, and RCT-Ps more than 15-fold. More than 4 out of 10 RCT-Ps covered the areas ‘periodontal surgery’ and ‘gingivitis and plaque treatment or prevention’. More than 6 out of 10 RCT-Ps in total and more than 8 out of 10 RCT-Ps about ‘periodontal surgery’, were published in two different journals. U.S.A was the most common country of origin of RCT-Ps, contributing to almost 4 out of 10 RCT-Ps during 1988– 2000.Conclusion:  The annual number of RCT-Ps increased substantially during 1980–2000, and a few clinical research areas predominated. Future research should give priority to areas where clinical evidence is scarce and where high-quality RCT-Ps are most needed.
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32.
  • Ullbro, Christer, et al. (författare)
  • Tissue plasminogen activator (t-PA) and placental plasminogen activator inhibitor (PAI-2) in gingival crevicular fluid from patients with Papillon-Lefèvre syndrome
  • 2004
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 31:9, s. 708-712
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Numerous patients with Papillon–Lefèvre syndrome (PLS) express a severe periodontal inflammation that results in premature loss of deciduous and permanent teeth. The plasminogen activating (PA) system is involved in physiological and pathological processes including epithelial healing, extracellular proteolysis and local inflammatory reactions. The aim of the study was to explore a possible role of the PA system in patients with PLS. Material and Methods: Samples of gingival crevicular fluid (GCF) were collected from areas with gingival infection in 20 patients with PLS and in 20 healthy controls. The concentration of tissue plasminogen activator (t-PA) and inhibitor (PAI-2) was measured with ELISA. Results: The median level of PAI-2 was significantly higher (p<0.01) in PLS patients than in the controls, while the median value of t-PA did not differ between the groups. No difference in t-PA or PAI-2 levels was found regarding age, gender or presence of active periodontal disease. Conclusion: The findings indicate an atypical activity of the PA system with a disturbed epithelial function in PLS patients, suggesting that the periodontal destruction seen in patients with PLS is secondary to a hereditary defect in the defense system.
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33.
  • Unell, L, et al. (författare)
  • Explanatory models for clinical and subjective indicators of periodontal disease in an adult population
  • 2000
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley and Sons. - 0303-6979 .- 1600-051X. ; 27:1, s. 22-29
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The aim of this study was to analyze indicators of periodontal disease using: (1) community periodontal index of treatment needs (CPITN), (2) subjectively reported change of front teeth position, and 3) subjectively reported gingival bleeding. Method: These 3 indicators were used in models with explanatory variables from 4 domains: (A) socio-economic attributes, (B) general health and health-related lifestyle, (C) dental attitudes and behaviors, and (D) dental status expressed as (number of teeth and DFT) for the clinically-determined dependent variables. In 1992, the study was carried out cross-sectionally in all 50-year olds in 2 Swedish counties using a questionnaire (n=6343) and clinical investigation of a 20% subsample (n=1040). Results: Multiple and logistic regression analysis showed that explanatory patterns varied for the clinical and subjective indicators. Use of tobacco had strong effects in all models as did high care utilization. There were few associations with socio-economic attributes. The 2 subjective indicators "changed front position" and "gingival bleeding" associated with attitudes, behaviors and subjective health. Number of teeth and DFT covaried with clinical indicators. Conclusions: The main conclusions from this study are: (1) that it is possible to find multivariate models with acceptable goodness of fit for prediction of occurrence of periodontal indicators, and (2) that the lack of relation between social attributes and the disease gives arguments for a biological provenance of periodontitis.
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34.
  • Hugoson, Anders, et al. (författare)
  • The relationship of some negative events and psychological factors to periodontal disease in an adult Swedish population 50 to 80 years of age
  • 2002
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 29:3, s. 247-53
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Clinical observations and epidemiological studies suggest that experiences of negative life events, especially those manifested as depression, may contribute to an increased susceptibility to periodontal disease. OBJECTIVE: In the present study, the prevalence of some negative life events and psychological factors and their relation to periodontal disease were investigated. The sample consisted of individuals 50-80 years of age from an extensive cross-sectional epidemiological study performed in 1993 in the city of Jönköping, Sweden. METHOD: 298 dentate individuals from the Jönköping study were randomly selected. Clinical and radiographic examinations included registration of the number of existing teeth, plaque index, gingival index, pocket depth, and alveolar bone loss. In addition, a questionnaire about socioeconomic status, life events, and psychological and stress-related factors was used. RESULTS: The results revealed that, in addition to the well-documented periodontal disease risk factors such as increased age, oral hygiene status, and smoking, the loss of a spouse (being a widow or widower) and the personality trait of exercising extreme external control were also associated with severe periodontal disease. CONCLUSION: The findings support recent studies suggesting that traumatic life events such as the loss of a spouse may increase the risk for periodontal disease. Above all, the present results indicate that an individual's ability to cope with stressful stimuli (coping behavior), as measured by the beliefs of locus of control of reinforcements may play a role in the progression of periodontal disease.
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35.
  • 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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36.
  • Karapataki, S, et al. (författare)
  • Healing following GTR treatment of bone defects distal to mandibular 2nd molars after surgical removal of impacted 3rd molars
  • 2000
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 27:5, s. 325-332
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The purpose of this study was to study the healing, following guided tissue regeneration (GTR) treatment, of bone defects distal to mandibular 2nd molars (M2s) after surgical removal of impacted mesioangularly or horizontally inclined third molars (M3s) in patients > or = 25 years. METHOD: 20 patients with bilateral soft tissue impacted M3s were included in the split-mouth study. The 2 sites to be treated in each patient were randomised before the 1st operation as to which would undergo the test procedure and which would be the control site. After surgical removal of M3 at test sites, a resorbable polylactic acid (PLA) barrier was attached to M2 to cover the post-surgical bone defect. The flap was then replaced and sutured to cover the barrier. Control sites underwent the same procedure, as did the test sites, with the exception that no barrier was placed. The clinical examinations performed were oral hygiene pre- and 12 months postoperatively and probing pocket depth 12 months postoperatively. The alveolar bone level (ABL) at the distal surface of the M2, as determined from radiographs taken at suture removal and 12 months postsurgery, was chosen to be the primary response variable. RESULTS: Most bone defects showed healing up to 10%-20% of the tooth length at both test and control sites. 2 test and 2 control sites showed no improvement in the bone level. The mean values of bone healing registered in mm from the cemento-enamel junction (CEJ) were 2.6 +/- 2.19 SD and 3.0 +/- 2.20 SD for test and control sites, respectively. Different factors affecting the healing result are discussed.
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37.
  • Laurell, Lars, et al. (författare)
  • Longitudinal study on the distribution of proximal sites showing significant bone loss
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 30:4, s. 346-352
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND, AIMS: In 1973, a random sample of 574 dentate individuals aged 15, 20, 30, 40, 50, and 60 years in the city of Jönköping, Sweden, were examined clinically and radiographically to assess oral health and overall treatment needs. Periodontal examination included registration of plaque, gingivitis, probing depths at four aspects of each tooth, and interproximal bone height measurements on full-mouth intraoral radiographs. In 1990, 17 years later, the same individuals were invited to participate in a new investigation. Of these, 433 (75%) agreed to participate in the investigation and were re-examined (Hugoson & Laurell 2000). The proximal alveolar bone height at all interproximal sites was measured and expressed as per cent of tooth length. Only teeth that were present in both 1973 and 1990 were included in the assessment of changes in bone score. From the age of 30 years, about 80% of the population had one or more sites with a bone loss of 2-3 mm or more. Seventeen per cent of the individuals had more than six such sites, indicating destructive periodontal disease. Bone loss occurred at sites both with and without previous bone loss. The present study was undertaken to test the hypothesis that sites with a bone loss of 10% or more of the tooth length (2-3 mm) during the 17 years were randomly distributed in the dentition. MATERIAL AND METHODS: Of the 13,197 sites examined in individuals 20-60 years at baseline, 1201 sites (9.0%) in 998 teeth with a bone loss corresponding to 10% or more of the tooth length were found and included in the analysis. A probability test for binomial distribution was used to test the null hypothesis that all teeth had the same risk of losing bone regardless of its position in the dentition. The valid risk for each tooth was 3.571% and the null hypothesis was rejected at the 95% confidence interval. RESULTS: Although all tooth types were affected by tooth loss, some teeth, namely 17, 16, 42, 41, and 31, showed a higher incidence of sites losing bone, whereas 46, 45, 44, and 36 had a lower incidence. Loser sites in smokers appeared more at random. CONCLUSION: Sites that will develop periodontal break-down over time may appear at random, although with higher risk at maxillary molars and lower incisors. For the early detection of destructive periodontitis, periodontal examination that includes all teeth should be made routine in every dental check-up.
  •  
38.
  • Ravon, Nicolas A, et al. (författare)
  • Signs of carotid calcification from dental panoramic radiographs are in agreement with Doppler sonography results.
  • 2003
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 30:12, s. 1084-1090
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Duplex ultrasonography (DS) is a frequently used noninvasive method for assessing carotid artery stenosis. The level of agreement between panoramic radiographs (PMX) findings of radiopacities in the area of C3-C4 and DS results has not been established.AIMS: (1) to examine the level of agreement between DS results and PMX signs of carotid calcification and (2) to evaluate the association between periodontitis and DS results.MATERIAL AND METHODS: Eighty-three subjects who had received a DS assessment at the University of Washington Medical Center within 36 months volunteered for a periodontal examination, including assessments of probing pocket depth (PPD), attachment level (PAL), evidence of bleeding on probing and bone loss from PMX. Two examiners independently analyzed the radiographs for evidence of carotid calcifications. The distance between the cemento-enamel junction (CEJ) to bone level (BL) CEJ-BL was used to assess alveolar bone loss as a criteria for periodontitis.RESULTS: Twenty-nine subjects (34.9%) presented with positive DS readings. The Mantel-Haentszel common odds ratio estimate for a positive DS score and periodontitis (> 30% of teeth with distance CEJ-BL > or = 4.0 mm) was 38.4 (95% CI: 10.6-138.7, p < 0.0001). For nonsmokers only (n = 72) the odds ratio was 43.0 (95% CI: 16.7-1178.0, p < 0.0001). Evidence of bleeding on probing was 16% of sites both in the DS-positive and -negative subjects. Subjects with a positive DS result had significantly more teeth with clinical evidence of attachment loss > or = 5.0 mm (p < 0.001). The odds ratio of having periodontitis (CEJ-BL > or = 4.0 mm at > or = 30% of the teeth) and medical records confirmed diagnosis of either a stroke or an infarct or both was 7.8 (95% CI: 2.6-23.8, p < 0.001).CONCLUSIONS: Subjects with positive DS readings of the carotid arteries due to calcified arterial plaque are accurately detected by means of conventional PMX. The likelihood of being DS positive and having radiographic evidence of periodontitis is high. A dose-response relationship between the extent of carotid calcification and severity of periodontitis was demonstrated, supporting the hypothesis of an association between periodontitis and cardiovascular diseases.
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39.
  • Renvert, Stefan, 1951-, et al. (författare)
  • Analysis of periodontal risk profiles in adults with or without a history of myocardial infarction
  • 2004
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 31:1, s. 19-24
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: An association between periodontitis and cardiovascular diseases has been suggested.AIMS: To study whether a combination of clinical variables in a functional risk diagram enhanced the ability to differentiate between subjects with or without an immediate history of acute myocardial infarction (AMI).MATERIAL AND METHODS: A functional periodontal pentagon risk diagram (PPRD) with five periodontal risk vectors was created. The surface of individual PPRDs was calculated using data from 88 subjects with recent AMI and 80 matched control subjects with no history of AMI.RESULTS: Age, gender, number of remaining teeth (mean value: 21.1 versus 21.6 teeth), smoking status, and pocket probing depth (PPD) distribution did not differ by group. Gingival recession was greater in control subjects (mean difference: 5.7, SD: +/- 1.9, p<0.01, 95% CI: 1.8-9.6). Bone loss > or = 4.0 mm was at all levels studied was significantly greater in subjects with AMI and bone loss > or = 50% (> or = 4 mm) was the best individual predictor of AMI (beta = 2.99, p < 0.000, 95% CI: 7.5-53.4). Only PPRD scores were associated with AMI status when factors not included in the PPRD were studied (beta = 22.1, SE: 5.9, p < 0.0001, 95% CI: 10.3-33.7). The best association between AMI status and study variables was the combination of > or = 4 mm of bone loss > or = 50%, proportion of bleeding on probing (%BOP), %PPDs > or = 6 mm, and tooth loss (Nagelkirke r2 = 0.46).CONCLUSIONS: The combination of five periodontal parameters in a PPRD added predictive value, suggesting that comprehensive data should be used in studies of associations between periodontitis and heart diseases. Radiographic evidence of bone loss was the best individual parameter.
  •  
40.
  • Renvert, Stefan, et al. (författare)
  • Analysis of periodontal risk profiles in adults with or without a history of myocardial infarction
  • 2004
  • Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 31:1, s. 19-24
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: An association between periodontitis and cardiovascular diseases has been suggested. AIMS: To study whether a combination of clinical variables in a functional risk diagram enhanced the ability to differentiate between subjects with or without an immediate history of acute myocardial infarction (AMI). MATERIAL AND METHODS: A functional periodontal pentagon risk diagram (PPRD) with five periodontal risk vectors was created. The surface of individual PPRDs was calculated using data from 88 subjects with recent AMI and 80 matched control subjects with no history of AMI. RESULTS: Age, gender, number of remaining teeth (mean value: 21.1 versus 21.6 teeth), smoking status, and pocket probing depth (PPD) distribution did not differ by group. Gingival recession was greater in control subjects (mean difference: 5.7, SD: +/- 1.9, p<0.01, 95% CI: 1.8-9.6). Bone loss > or = 4.0 mm was at all levels studied was significantly greater in subjects with AMI and bone loss > or = 50% (> or = 4 mm) was the best individual predictor of AMI (beta = 2.99, p < 0.000, 95% CI: 7.5-53.4). Only PPRD scores were associated with AMI status when factors not included in the PPRD were studied (beta = 22.1, SE: 5.9, p < 0.0001, 95% CI: 10.3-33.7). The best association between AMI status and study variables was the combination of > or = 4 mm of bone loss > or = 50%, proportion of bleeding on probing (%BOP), %PPDs > or = 6 mm, and tooth loss (Nagelkirke r2 = 0.46). CONCLUSIONS: The combination of five periodontal parameters in a PPRD added predictive value, suggesting that comprehensive data should be used in studies of associations between periodontitis and heart diseases. Radiographic evidence of bone loss was the best individual parameter.
  •  
41.
  • Renvert, Stefan, 1951-, et al. (författare)
  • Patient-based assessments of clinical periodontal conditions in relation to alveolar bone loss
  • 2004
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 31:3, s. 208-213
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Limited subject-based information exists on the relationship between clinical and radiographic periodontal data.AIMS: To use subject-based data to assess the extent of concurrence between clinical and radiographic information, and to study what clinical information best predicts alveolar bone loss (ABL). Material and Methods: Subject-based data on smoking habits, bleeding on probing, plaque scores, pocket probing depth (PD), and evidence of alveolar BL were obtained, and functional periodontal pentagon risk diagrams (PPRDs) were studied from 168 consecutive subjects attending a medical clinic.RESULTS: The mean age of the subjects was 62.7 years (SD+/-9.0). The average number of teeth was 21.3 (SD+/-8.0) with on average 5.6 molars remaining (SD+/- 3.9). In this subject cohort, 33.1% had never smoked, 44.2% had quit smoking, and 22.7% were currently smokers. Mean plaque and bleeding scores were high or 60.2% (SD+/-24.0) and 53.1% (SD+/-23.6), respectively. PDs >or=6.0 mm were found in 55.9% of the subjects. Binary logistic regression analysis demonstrated that tooth loss and proportional plaque scores were the predominant factors included in the equations associated with ABL. Wald coefficients varied between 3.99 and 9.15, and with p-values between 0.05 and 0.01. When included, the PPRD score became the exclusive factor at several cut-off levels (Wald's coefficients between 19.8 and 15.6, p<0.001). Consequently, the best receiver operator curve was identified for the PPRD at the >40% cut-off ABL level (area under the curve: 0.81; 95% CI: 0.74-0.89; p<0.001).CONCLUSIONS: The number of teeth lost and the proportion of plaque scores provided significant predictive factors for ABL. The functional PPRD demonstrated an exclusive and highly predictable association with ABL. Subject-based proportional data for PDs >4.0 mm provided poor substitute measures for the extent of ABL.
  •  
42.
  • Renvert, Stefan, et al. (författare)
  • Patient-based assessments of clinical periodontal conditions in relation to alveolar bone loss
  • 2004
  • Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 31:3, s. 208-213
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Limited subject-based information exists on the relationship between clinical and radiographic periodontal data. AIMS: To use subject-based data to assess the extent of concurrence between clinical and radiographic information, and to study what clinical information best predicts alveolar bone loss (ABL). Material and Methods: Subject-based data on smoking habits, bleeding on probing, plaque scores, pocket probing depth (PD), and evidence of alveolar BL were obtained, and functional periodontal pentagon risk diagrams (PPRDs) were studied from 168 consecutive subjects attending a medical clinic. RESULTS: The mean age of the subjects was 62.7 years (SD+/-9.0). The average number of teeth was 21.3 (SD+/-8.0) with on average 5.6 molars remaining (SD+/- 3.9). In this subject cohort, 33.1% had never smoked, 44.2% had quit smoking, and 22.7% were currently smokers. Mean plaque and bleeding scores were high or 60.2% (SD+/-24.0) and 53.1% (SD+/-23.6), respectively. PDs >or=6.0 mm were found in 55.9% of the subjects. Binary logistic regression analysis demonstrated that tooth loss and proportional plaque scores were the predominant factors included in the equations associated with ABL. Wald coefficients varied between 3.99 and 9.15, and with p-values between 0.05 and 0.01. When included, the PPRD score became the exclusive factor at several cut-off levels (Wald's coefficients between 19.8 and 15.6, p<0.001). Consequently, the best receiver operator curve was identified for the PPRD at the >40% cut-off ABL level (area under the curve: 0.81; 95% CI: 0.74-0.89; p<0.001). CONCLUSIONS: The number of teeth lost and the proportion of plaque scores provided significant predictive factors for ABL. The functional PPRD demonstrated an exclusive and highly predictable association with ABL. Subject-based proportional data for PDs >4.0 mm provided poor substitute measures for the extent of ABL.
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43.
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