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  • Asa'ad, Farah, 1983, et al. (author)
  • Polymorphism in epigenetic regulating genes in relation to periodontitis, number of teeth, and levels of high-sensitivity C-reactive protein and glycated hemoglobin: The Tromsø Study 2015-2016.
  • 2023
  • In: Journal of Periodontology. - 0022-3492 .- 1943-3670. ; 94:11, s. 1324-37
  • Journal article (peer-reviewed)abstract
    • Background: The aim of this study was to investigate the association between periodontitis and four single nucleotide polymorphisms (SNPs) in genes involved in epigenetic regulation of DNA, and between these same SNPs and tooth loss, high-sensitivity C-reactive protein (hs-CRP), and glycated hemoglobin (HbA1c) levels. Methods: We included participants with periodontal examination (n = 3633, aged: 40-93 years) from the Tromsø Study seventh survey (2015-2016), Norway. Periodontitis was defined according to the 2017 AAP/EFP classification system as no periodontitis, grades A, B, or C. Salivary DNA was extracted and genotyping was performed to investigate four SNPs (rs2288349, rs35474715, rs34023346, and rs10010325) in the sequence of the genes DNMT1, IDH2, TET1, and TET2. Association between SNPs and periodontitis was analyzed by logistic regression adjusted for age, sex, and smoking. Subgroup analyses on participants aged 40-49 years were performed. Results: In participants aged 40-49 years, homozygous carriage of minor A-allele of rs2288349 (DNMT1) was associated with decreased susceptibility to periodontitis (grade A: odds ratio [OR] 0.55; p = 0.014: grade B/C OR 0.48; p = 0.004). The minor A-allele of rs10010325 (TET2) was associated with increased susceptibility to periodontitis (grade A OR 1.69; p = 0.035: grade B/C OR 1.90; p = 0.014). In the entire sample, homozygous carriage of the G-allele of rs35474715 (IDH2) was associated with having ≤24 teeth (OR 1.31; p = 0.018). Homozygous carriage of the A-allele of TET2 was associated with hs-CRP≥3 mg/L (OR 1.37; p = 0.025) and HbA1c≥6.5% (OR 1.62; p = 0.028). Conclusions: In this Norwegian population, there were associations between polymorphism in genes related to DNA methylation and periodontitis, tooth loss, low-grade inflammation, and hyperglycemia.
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  • Axelsson, Per, 1933 (author)
  • Commentary: periodontitis is preventable
  • 2014
  • In: Journal of Periodontology. - Chicago : Wiley. - 0022-3492 .- 1943-3670. ; 85:10, s. 1303-7
  • Journal article (peer-reviewed)
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  • Becker, W, et al. (author)
  • Histologic findings after implantation and evaluation of different grafting materials and titanium micro screws into extraction sockets: case reports.
  • 1998
  • In: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 69:4, s. 414-21
  • Journal article (peer-reviewed)abstract
    • The purpose of this study was to compare extraction socket healing in 8 patients after implantation with either xenogenic bovine bone (n=5 sites), demineralized freeze-dried bone (DFDBA) (n=3 sites), autologous bone (n=3 sites), or human bone morphogenetic proteins in an osteocalcein/osteonectin carrier (hBMP/NCP) (n=2 sites). Three of the patients received 6 commercially pure micro screws which were fixed into extraction sockets, after which the sockets were implanted with either bovine bone (n=3 sites), DFDBA (n=2 sites) or intraoral autologous bone (n=1 site). Biopsies of the extraction sockets were taken from 3 to 6 months after treatment (average, 4.6 months). For comparison of healing between the implanted materials, histologic evaluation and bone scores were determined. Bone scores of 0 indicated an absence of new bone, with dead implanted bone particles entrapped within connective tissue, while a score of 3 indicated the entire field consisted of vital bone. Biopsies from bovine bone sockets revealed dead implanted particles surrounded by connective tissue. Isolated sections showed host bone in contact with the bovine bone particles. Bone scores ranged from 0 to 3. Biopsies from DFDBA-implanted sites revealed dead particles entrapped with dense connective tissue. The bone scores ranged from 0 to 1. Biopsies from sites implanted with hBMP/NCP revealed a combination of woven and lamellar bone with bone scores of 3. Five of the 6 micro screws were processed and evaluated. One screw was mobile at the time of removal and was not evaluated. Bone scores were used to compare new bone formation adjacent to the micro screws. Bone scores ranged from 0 to 2. A score of 0 indicated non-vital implant material in contact with host bone and connective tissue in contact with implant; 2 indicated vital bone in contact with the majority of the implant surface. Retrieved sockets with micro screws implanted with bovine bone (n=2) demonstrated a connective tissue interface between the screws and the surrounding tissues (bone score 0). The adjacent tissues showed dead bovine particles entrapped within fibrous tissue. Retrieved screws implanted with DFDBA (n=2) were surrounded by connective tissue, with dead bone particles enmeshed within fibrous tissue (bone score 0). The screw implanted with intra-oral autologous bone was primarily surrounded by vital bone with a connective tissue interface (bone score 1). Three implant threads were in contact with bone. The results of this study indicate that bovine bone, DFDBA, and intraoral autologous bone do not promote extraction socket healing. Sockets implanted with hBMP/NCP contained vital woven and lamellar bone. Xenogenic bovine bone and DFDBA did not contribute to bone to micro screw contacts and are not recommended for enhancement of vital bone to implant contacts. Intraoral autogenous bone also does not appear to significantly contribute to bone to implant contacts. Intraoral autologous bone, xenogenic bone, and DFDBA appear to interfere with normal extraction socket healing.
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  • Becker, William, et al. (author)
  • Implant stability measurements for implants placed at the time of extraction : a cohort, prospective clinical trial
  • 2005
  • In: Journal of Periodontology. - Chicago : American academy of periodontology. - 0022-3492 .- 1943-3670. ; 76:3, s. 391-397
  • Journal article (peer-reviewed)abstract
    • Background: Studies indicate that implants placed at the time of extraction have high success rates. Implants must be stable at the time of insertion. Presently there are no data indicating the degree of implant stability when implants are placed at the time of extraction. This study evaluated changes in stability of implants from implant placement to abutment connection utilizing resonance frequency analysis (RFA). The unit of measurement was the international stability quotient (ISQ).Methods: Prior to treatment, patients were given medical history and dental evaluations. Periapical and panogram radiographs were taken. Fifty-two patients requiring extraction of one or two teeth and implant placement immediately after extraction were enrolled in this study. Under conscious sedation and local anesthesia or local anesthesia alone, teeth were atraumatically removed and the extraction sockets were debrided. A total of 73 dental implants (57 in the maxilla, 16 in the mandible) were placed. Using a one-stage approach, all implants were placed within the patient's alveolar envelope and were never placed directly into extraction sockets. All implants were placed into contained extraction sites. Bone augmentation procedures were not performed. After implant insertion, the RFA electronic transducer was attached to the head of the implant with the retaining screw. The device was attached to a computer designed to register RFA scores in ISQ units. RFA measurements were taken at implant placement and abutment connection. Bone qualities, quantity, implant length and width as well as site of placement were recorded.Results: The average interval between implant insertion and abutment connection was 5.6 months (SD 2.05). Two implants were lost between implant insertion and 1 year. At 2 to 3 years, the cumulative survival was 97.2%. Resonance frequency measurements at implant placement showed a mean primary stability of 62.0 (SE 1.1; range 43 to 83 ISQ) and a mean secondary stability after 1 year of 64.0 (SE 1.2; range 40 to 98 ISQ) for all implants. The increase was marginally significant (generalized estimating equation z-statistic = 1.79; P value = 0.07).Conclusions: Implants placed at the time of extraction and inserted into native bone and not directly into extractions sockets have a high degree of initial stability as evidenced by RFA measurements. Implants with initial high ISQ levels revealed a slight drop in levels over time, while implants with levels lower than 60 had increases in levels between implant insertion and abutment connection. At 2 to 3 years the cumulative survival rate was 97.2%.
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  • Becker, William, et al. (author)
  • Minimally invasive flapless implant placement: follow-up results from a multicenter study.
  • 2009
  • In: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 80:2, s. 347-52
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: The placement of implants using a minimally invasive flapless approach has the potential to reduce operative bleeding and postoperative discomfort and minimize crestal bone loss. This article presents follow-up data on a prospective clinical study of implants placed using a flapless procedure. METHODS: The original study reported on 57 patients (33 female patients with an age range of 24 to 86 years; 24 male patients with an age range of 27 to 81 years) recruited from three clinical centers (Tucson, Arizona; Gothenburg, Sweden; and Tel Aviv, Israel) who received 79 implants. After an average of 3 years and 8 months, the patients were contacted and invited to return to their respective clinics for reexamination. Thirty-seven patients with 52 implants returned for a follow-up examination; the remaining 20 patients (27 implants) were not available for reexamination and were considered study drop-outs. RESULTS: The cumulative survival rate at the 3- to 4-year follow-up examination remains at 98.7%, reflecting the loss of one implant. The mean probing depth at abutment connection was 2.2 mm, as reported in the initial study (examination 2 at approximately 2 years postplacement); it was 2.4 mm at the 3- to 4-year second follow-up examination. This change was not clinically or statistically significant. Bleeding score changes also were not significant between the two intervals. The average crestal bone level was -0.7 mm at examination 2 and -0.8 mm at examination 3, a change that approached significance (P <0.06). CONCLUSIONS: Minimally invasive flapless surgery offers patients the possibility of high implant predictability with clinically insignificant crestal bone loss for up to 4 years. Proper diagnosis and treatment planning are key factors in achieving predictable outcomes.
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  • Bertl, Kristina, et al. (author)
  • Are colored periodontal probes reliable to classify the gingival phenotype in terms of gingival thickness?
  • 2022
  • In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 93:3, s. 412-422
  • Journal article (peer-reviewed)abstract
    • Background: This cross-sectional study assessed the potential of colored periodontal probes (CPP) to classify gingival phenotype in terms of gingival thickness (GT).Methods: Buccal GT in 3 anterior teeth in each of 50 patients was measured by transgingival sounding and classified by 3 different methods by 8 examiners. Specifically, the diagnostic potential of visual judgement and transparency of a standard periodontal probe (SPP) to discriminate thin and thick gingiva, and of CPP to discriminate thin, medium, thick, or very thick gingiva was assessed.Results: GT ranged from 0.57-2.37mm. Using CPP resulted in a medium judgement in 87% of the cases, on average, and only between 1-10 cases/examiner were judged as thick or very thick. Considering 1mm GT as relevant cut-off value, all methods showed a high positive predictive value (≥0.82) to identify thick cases, but also a high false omission rate (≥0.73) indicating that many cases classified as thin were actually thick. Further, 88% of the cases being ≤1mm, were not classified as thin with CPP; this was inferior to SPP, for which, however, still 64% of the cases being ≤1mm thick were wrongly classified. The highest, yet moderate agreement among examiners was achieved by SPP (κ = 0.427), while visual judgement and CPP showed only fair (κ = 0.211) and slight agreement (κ = 0.112), respectively.
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  • Bertl, Kristina, et al. (author)
  • Does the time-point of orthodontic space closure initiation after tooth extraction affect the incidence of gingival cleft development? A randomized controlled clinical trial.
  • 2020
  • In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 91:5, s. 572-581
  • Journal article (peer-reviewed)abstract
    • Background: Gingival clefts (GC) develop frequently during orthodontic space closure and may compromise the treatment outcome. This study assessed whether the time-point of orthodontic space closure initiation, after permanent tooth extraction, affects the incidence of GC. Methods: In 25 patients requiring bilateral premolar extraction due to orthodontic reasons, one premolar, chosen at random, was extracted 8 weeks before space closure initiation (“delayed movement”, DM), while the contralateral premolar was extracted one week before (“early movement”, EM) (“treatment group”). Presence/absence of GC after 3 and 6 months (“time-point”) was recorded and any association with various parameters (i.e., treatment group, time-point, gender, jaw, craniofacial growth, gingival biotype, buccal bone dehiscence after extraction, space closure) was statistically assessed. Results: Twenty-one patients contributing with 26 jaws were finally included in the analysis. Overall, GC were frequent after 3 (DM: 53.9%; EM: 69.2%) and 6 months (DM: 76.9%; EM: 88.5%). EM (p=0.014) and larger space closure within the study period (p=0.001) resulted in a significantly higher incidence of GC. Further, there was a tendency for GC development in the presence of buccal bone dehiscence (p=0.052) and thin gingival biotype (p=0.054). “Fast movers” (herein cases with a tooth movement ≥ 1mm per month) developed a GC in > 90% of the cases already after 3 months. “Slow movers” developed a GC only in 25 and 70% after 3m and FE, respectively. Conclusions: GC development is a frequent finding during orthodontic space closure and seems to occur more frequently with early tooth movement initiation and in “fast movers”.
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  • Bertl, Kristina, et al. (author)
  • Patients with inflammatory bowel disease have more oral health problems and higher costs of professional dental care than healthy controls : The Periodontitis Prevalence in ulcerative Colitis and Crohn disease (PPCC) case-control study
  • 2024
  • In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 95:2, s. 159-174
  • Journal article (peer-reviewed)abstract
    • Background: To describe the frequency and impact of oral lesions and professional dental care costs in patients with inflammatory bowel disease (IBD) (i.e., Crohn disease [CD] or ulcerative colitis [UC]) compared to matched controls).Methods: IBD patients and matched controls were surveyed on general anamnestic information, eating and drinking habits, and oral health- and dental care-related questions; IBD patients were additionally surveyed on oral lesions. Problems related to oral lesions and the amount of money spent for professional dental care in the past 12 months were defined as primary outcome parameters.Results: Answers from 1108 IBD patients and 3429 controls were analyzed. About 30% of the patients indicated having had problems with oral lesions, with CD patients having 46% higher odds and having them more often in a generalized form compared to UC patients. Further, self-reported severe periodontitis increased the odds of having oral lesions by almost 2.3-times. However, only about 12.5% of IBD patients were informed by their physician about oral lesions and about 10% indicated receiving treatment for them. Compared to controls, IBD patients required more often dental treatment and spent more money; specifically, UC and CD patients had 27 and 89% higher odds, respectively, for having spent ≥3000 DKK (ca. 440 USD) at the dentist compared to controls.Conclusions: IBD patients have more often oral health problems and higher expenses for professional dental care compared to matched controls. This included problems with IBD-related oral lesions, but these are rarely addressed by the medical or dental team.Keywords: Crohn disease; case-control studies; colitis; dental care; inflammatory bowel diseases; surveys and questionnaires; ulcerative.
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  • Bertl, Kristina, et al. (author)
  • Relative Composition of Fibrous Connective and Fatty/Glandular Tissue in Connective Tissue Grafts Depends on the Harvesting Technique but not the Donor Site of the Hard Palate
  • 2015
  • In: Journal of Periodontology. - : American Academy of Periodontology. - 0022-3492 .- 1943-3670. ; 86:12, s. 1331-1339
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Whether the composition of palatal connective tissue grafts (CTGs) varies depending on donor site or harvesting technique in terms of relative amounts of fibrous connective tissue (CT) and fatty/glandular tissue (FGT) is currently unknown and is histologically assessed in the present study. METHODS: In 10 fresh human cadavers, tissue samples were harvested in the anterior and posterior palate and in areas close to (marginal) and distant from (apical) the mucosal margin. Mucosal thickness, lamina propria thickness (defined as the extent of subepithelial portion of the biopsy containing ≤25% or ≤50% FGT), and proportions of CT and FGT were semi-automatically estimated for the entire mucosa and for CTGs virtually harvested by split-flap (SF) preparation minimum 1 mm deep or after deepithelialization (DE). RESULTS: Palatal mucosal thickness, ranging from 2.35 to 6.89 mm, and histologic composition showed high interindividual variability. Lamina propria thickness (P >0.21) and proportions of CT (P = 0.48) and FGT (P = 0.15) did not differ significantly among the donor sites (anterior, posterior, marginal, apical). However, thicker palatal tissue was associated with higher FGT content (P <0.01) and thinner lamina propria (P ≤0.03). Independent of the donor site, DE-harvested CTG contained a significantly higher proportion of CT and a lower proportion of FGT than an SF-harvested CTG (P <0.04). CONCLUSION: Despite high interindividual variability in terms of relative tissue composition in the hard palate, DE-harvested CTG contains much larger amounts of CT and much lower amounts of FGT than SF-harvested CTG, irrespective of the harvesting site.
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  • Bogren, Anna, 1963, et al. (author)
  • Clinical and microbiologic changes associated with the combined use of a powered toothbrush and a triclosan/copolymer dentifrice: a 3-year prospective study.
  • 2007
  • In: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 78:9, s. 1708-17
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Different means are available for self-performed oral hygiene. The aim of this study was to evaluate the clinical and microbiologic effects of a preventive homecare program including the combined use of a powered toothbrush and a triclosan/copolymer-containing dentifrice. METHODS: A total of 160 adult subjects without signs of destructive periodontal disease were recruited for this 3-year randomized controlled trial. The subjects were assigned to a homecare program using an oscillating/rotating powered toothbrush and a triclosan/copolymer/fluoride-containing dentifrice (test) or a manual toothbrush and a standard fluoride-containing dentifrice (control). Supragingival polishing and reinforcement of homecare procedures were provided every 6 months. Plaque, bleeding on probing (BOP), and probing depth (PD) were scored at baseline and after 1, 2, and 3 years. Subgingival plaque samples were taken from the mesial aspect of each tooth at baseline and after 1, 2, and 3 years and were analyzed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization. All data analyses were based on "intention-to-treat" with the subject as the statistical unit. RESULTS: Compared to baseline, no significant changes in clinical parameters were observed during the 3 years, except for a reduction in the mean PD at the 2- and 3-year follow-up examinations (P <0.05). No significant differences were found between the two groups with regard to plaque, BOP, or PD or in the mean counts of the 40 species at any time point. CONCLUSION: The study failed to prove additional benefits of the combined use of a powered toothbrush and a triclosan/copolymer-containing dentifrice in adult subjects without signs of destructive periodontal disease.
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  • Bogren, Anna, 1963, et al. (author)
  • Locally Delivered Doxycycline During Supportive Periodontal Therapy: A 3-Year Study.
  • 2008
  • In: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 79:5, s. 827-835
  • Journal article (peer-reviewed)abstract
    • Background: Adjunctive locally delivered antibiotics during maintenance may favor the control of periodontal infections. This study evaluated the long-term clinical and microbiologic effects of yearly locally delivered controlled-release doxycycline as an adjunct to mechanical debridement. Methods: A total of 128 periodontal maintenance patients having at least four teeth with probing depth (PD) >/=5 mm were randomly assigned to local application of doxycycline gel at baseline and 1 and 2 years as an adjunct to mechanical debridement (test) or mechanical debridement only (control). Supportive periodontal therapy (mechanical debridement, polishing, and oral hygiene reinforcement) was provided every 6 months. Plaque, bleeding on probing (BOP), PD, and relative attachment level (RAL) were scored at baseline; 3 months; and 1, 2, and 3 years. Subgingival plaque samples were taken at each examination and analyzed for their content of 40 bacterial species. Data analyses were performed on an intention-to-treat basis with the subject as the statistical unit. Results: Significant reductions in BOP, PD, RAL, and the mean counts of a number of target species between baseline and 3 years were documented for both treatment groups, whereas plaque scores remained unchanged. A statistically significant difference in favor of the adjunctive doxycycline therapy was found between the two groups only at the 3-month examination for BOP, PD, and RAL and for a minority of bacterial species at 2 years. Conclusion: Although short-term effects on clinical parameters were found with the adjunctive use of locally delivered doxycycline, repeated applications annually had no clinical or microbiologic effects beyond those observed with mechanical debridement alone in maintenance patients.
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  • Buranawat, B, et al. (author)
  • Evaluation of a Beta-Calcium Metaphosphate Bone Graft Containing Bone Morphogenetic Protein- 7 (OP-1) in Rabbit Maxillary Defects.
  • 2014
  • In: Journal of periodontology. - : Wiley. - 1943-3670 .- 0022-3492. ; 85:2, s. 298-307
  • Journal article (peer-reviewed)abstract
    • Background: Calcium phosphate based materials have been widely used as bone substitutes and more recently are being exploited together with growth factors as bone tissue engineering scaffolds regulating cell behavior. The aim of the study was to evaluate the in vitro and in vivo response to a newly developed calcium metaphosphate bone graft, with and without bone stimulating growth factor. Materials and methods: Porous scaffolds of β calcium metaphosphate (CMP) were developed and extensively tested in vitro. Subsequently, CMP grafts with osteogenic protein 1 (OP-1) (test) and, without (control) were implanted into experimental rabbit maxillary bone defects. Animals were sacrificed 2, 4, and 8 weeks and samples examined with micro-computed tomography (µCT) and processed for histomorphometric analysis. Results: At 8 weeks the scaffolds containing OP-1 induced greater bone formation (P=0.018) than CMP alone, based on histomorphometric evaluation, % Bone area [Test 57.1±5.6 and Control 49.4±7.7] and micro-CT analysis, % Bone volume density (BV/TV) [Test 63.46±5.61 and Control 51.20±6.71]. Thus, this data indicated that both test and control CMP grafts showed a good degree of bone formation. Furthermore, the CMP materials showed signs of resorption from 4 weeks and no graft materials were observed at 8 weeks. Conclusion: In vitro the OP-1 loaded graft demonstrated a release profile and bioactivity over a 28 day period. In vivo testing confirmed enhanced bone formation of the OP-1 loaded graft after 8 weeks of healing.
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  • Carcuac, Olivier, 1974, et al. (author)
  • Modified-free gingival graft technique for treatment of gingival recession defects at mandibular incisors: A randomized clinical trial
  • 2023
  • In: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 94:6, s. 722-730
  • Journal article (peer-reviewed)abstract
    • BackgroundThe aim of this study was to evaluate clinical and patient-reported outcomes following surgical root coverage at RT1 gingival recession defects at mandibular incisors, using either a conventional free gingival graft (FGG) or a modified FGG (ModFGG). MethodsTotal of 30 patients with RT1 gingival recessions at mandibular incisors were enrolled and randomly allocated to either a control (FGG) or test group (ModFGG). Evaluations of clinical changes (recession depth, height of keratinized tissue) and patient satisfaction were performed over a follow-up period of 12 months. Post-surgical changes of keratinized tissue height (shrinkage) were assessed from 1 month and onward. ResultsModFGG resulted in more pronounced root coverage at 1 year compared to FGG (91.8% vs. 60.7%, p < 0.001). Height of keratinized tissue was improved by 4.2 and 2.2 mm (p < 0.001), respectively, with significantly less shrinkage in ModFGG. Post-surgical morbidity was significantly lower for ModFGG at 2 weeks and patient satisfaction was significantly higher 12 months after treatment (9.1 vs. 5.4; p < 0.001). ConclusionsModFGG represents a valid approach for the management of RT1 recession defects at mandibular incisors. The technique is superior to traditional FGG in terms of root coverage, the gain of keratinized tissue height, and patient satisfaction.
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25.
  • Carlsson, G, et al. (author)
  • Periodontal disease in patients from the original Kostmann family with severe congenital neutropenia
  • 2006
  • In: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 77:4, s. 744-751
  • Journal article (peer-reviewed)abstract
    • Patients with Kostmann syndrome (severe congenital neutropenia [SCN]) typically normalize their absolute neutrophil count (ANC) upon granulocyte colony-stimulating factor (G-CSF) therapy. However, although they no longer experience life-threatening bacterial infections, they frequently still have recurrent gingivitis and even severe periodontitis, often starting in early childhood. METHODS: We studied the periodontal disease in the four surviving patients belonging to the family originally described by Kostmann. Their odontological records, x-rays, color photos, bacterial cultures, serum antibodies to oral bacteria, and histopathological examinations were reviewed. The data were also correlated to previous investigations on their antibacterial peptides and molecular biology. RESULTS: Three patients had periodontal disease, despite normal ANC and professional dental care, and had neutrophils deficient in antibacterial peptides. One of these patients also had a heterozygous mutation in the neutrophil elastase gene, had severe periodontal disease and overgrowth of the periodontal pathogen Actinobacillus actinomycetemcomitans in the dental flora, and 15 permanent teeth had been extracted by the age of 27. One bone marrow-transplanted patient had no periodontal disease. CONCLUSIONS: Normalized ANC levels are not sufficient to maintain normal oral health in SCN patients, and because neutrophils are important for first-line defense and innate immunity, the deficiency of the antibacterial peptide LL-37 probably explains their chronic periodontal disease. Professional dental care is still important for SCN patients, despite treatment with G-CSF and normal ANC levels. Whether antibacterial peptides play a role in the pathogenesis of periodontitis in other patients remains to be elucidated.
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26.
  • Chai, Wen Lin, et al. (author)
  • Development of a novel model for the investigation of implant-soft tissue interface.
  • 2010
  • In: Journal of periodontology. - : Wiley. - 1943-3670 .- 0022-3492. ; 81:8, s. 1187-95
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: In dental implant treatment, the long-term prognosis is dependent on the biologic seal formed by the soft tissue around the implant. The in vitro investigation of the implant-soft tissue interface is usually carried out using a monolayer cell-culture model that lacks a polarized-cell phenotype. This study developed a tissue-engineered three-dimensional oral mucosal model (3D OMM) to investigate the implant-soft tissue interface. METHODS: A 3D OMM was constructed using primary human oral keratinocytes and fibroblasts cultured on a skin-derived scaffold at an air-liquid interface. A titanium implant was inserted into the engineered oral mucosa and further cultured to establish epithelial attachment. The 3D OMM was characterized using basic histology and immunostaining for cytokeratin (CK) 10 and CK13. Histomorphometric analyses of the implant-soft tissue interface were carried out using a light-microscopy (LM) examination of ground sections and semi-thin sections as well as scanning electron microscopy (SEM). RESULTS: Immunohistochemistry analyses suggests that the engineered oral mucosa closely resembles the normal oral mucosa. The LM and SEM examinations reveal that the 3D OMM forms an epithelial attachment on the titanium surface. CONCLUSION: The 3D OMM provided mimicking peri-implant features as seen in an in vivo model and has the potential to be used as a relevant alternative model to assess implant-soft tissue interactions.
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28.
  • Dierens, Melissa, et al. (author)
  • Long-Term Follow-Up of Turned Single Implants Placed in Periodontally Healthy Patients After 16 to 22 Years : Microbiologic Outcome
  • 2013
  • In: Journal of Periodontology. - : Amer Acad Periodontology. - 0022-3492 .- 1943-3670. ; 84:7, s. 880-894
  • Journal article (peer-reviewed)abstract
    • Background: Survival rates in implant dentistry today are high, although late failures do occur for many reasons, including peri-implant infections. The primary objective of this study is to investigate microbiota around single turned implants after 16 to 22 years. Secondary objectives are to compare teeth and implants and to correlate microbiologic, radiographic, and clinical parameters. Methods: A total of 46 patients with single implants were invited for a clinical examination. Clinical datawere collected from implants and contralateral natural teeth. Radiographic bone level was measured around implants. Microbiologic samples were taken from implants, contralateral teeth, and the deepest pocket per quadrant. Samples were analyzed with DNA-DNA hybridization including 40 species. Statistical analysis was performed using Wilcoxon signed-rank tests, McNemar tests, and Spearman correlation coefficients with a 0.05 significance level. Results: Mean follow-up was 18.5 years (range 16 to 22 years). Tannerella forsythia (1.5 x 10(5)) and Veillonella parvula (1.02 x 10(5)) showed the highest concentrations around implants and teeth, respectively. Porphyromonas gingivalis, Prevotella intermedia, and T. forsythia were significantly more present around implants than teeth. Mean counts were significantly higher around implants than teeth for Parvimonas micra, P. gingivalis, P. intermedia, T. forsythia, and Treponema denticola. Total DNA count was correlated to interproximal bleeding index (r = 0.409) and interproximal probing depth (r = 0.307). No correlations were present with plaque index or radiographic bone level. Conclusions: In the present study, bacterial counts around single implants in periodontally healthy patients are rather low. Although pathogenic bacteria are present, some in higher numbers around implants than teeth (five of 40), the majority of implants present with healthy peri-implant tissues without progressive bone loss.
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29.
  • Dogan, B, et al. (author)
  • Characteristics of periodontal microflora in acute myocardial infarction.
  • 2005
  • In: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 76:5, s. 740-748
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Periodontitis has been linked to increased risk of cardiovascular diseases. Systemic reactions associated with cardiovascular events may depend on characteristics of the subgingival microflora in periodontitis. Our objectives were to compare the numbers of cultivable bacteria, composition of subgingival microflora and clonal distribution of Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans) in two groups of patients with generalized chronic periodontitis (GCP), one with an acute myocardial infarction (AMI-GCP) and the other one without AMI (non-AMI-GCP). METHODS: In all, 150 dentate individuals were screened for suitability to this study. Subgingival bacterial samples were collected from 11 AMI-GCP and 11 non-AMI-GCP patients who had been selected using strict inclusion criteria in an attempt to exclude confounding factors and to increase comparability of periodontal conditions by matching for periodontal probing depths and attachment levels. Culture methods were used to determine the total viable counts and occurrence and proportions of six periodontal bacterial species and yeasts. Polymerase chain reaction (PCR) technique was used to detect A. actinomycetemcomitans and Porphyromonas gingivalis (P. gingivalis). Intraspecies characterization of A. actinomycetemcomitans included serotyping and genotyping. RESULTS: The mean proportions of P. gingivalis (P = 0.05) and Tannerella forsythensis (T. forsythensis) (P = 0.01) were significantly lower, but the numbers of Micromonas micros (M. micros) and A. actinomycetemcomitans were up to nine times higher and the mean total number of cultivable bacteria per sample higher (P <0.01) in AMI-GCP than in non-AMI-GCP. CONCLUSION: The findings that no target subgingival species were overrepresented but the total bacterial number was higher in AMI-GCP than non-AMI-GCP patients may provide support to the hypothesis that elevated numbers of bacteria in close vicinity to sterile parenteral area present a risk for systemic health.
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30.
  • Dogan, B, et al. (author)
  • Subgingival microflora in Turkish patients with periodontitis.
  • 2003
  • In: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 74:6, s. 803-814
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: No information exists on periodontitis-associated subgingival microbiota from Turkey. We determined the occurrence, interspecies relationships, and clonal characteristics for a group of periodontal bacteria in a Turkish study population. METHODS: Subgingival microbial samples were obtained from patients with localized (LAgP, N = 18) or generalized (GAgP, N = 17) types of aggressive periodontitis, generalized chronic periodontitis (GCP, N = 14), and non-periodontitis subjects (N = 20). Culture methods were used to recover 6 periodontal bacterial species and yeasts, and a polymerase chain reaction technique was used to detect Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Intraspecies characterization of A. actinomycetemcomitans was carried out by serotyping and genotyping. RESULTS: All species, except for Micromonas micros (formerly Peptostreptococcus micros) occurred more frequently (P < 0.05) in periodontitis than non-periodontitis subjects. Detection frequencies for Tannerella forsythensis (formerly Bacteroides forsythus) and Campylobacter rectus differed among the periodontitis subgroups; the lowest frequency occurred in LAgP. The mean proportions of A. actinomycetemcomitans, P. gingivalis, and C. rectus were higher (P < 0.008) in GAgP than in non-periodontitis subjects. Significant positive associations were seen between 7 of the 22 possible combinations (P < 0.05). A. actinomycetemcomitans serotype c (34%) and non-serotypeable isolates (34%) were the most common antigenic types among the 305 strains analyzed. Eleven arbitrarily primed (AP)-PCR genotypes were distinguished among 273 isolates from 29 subjects. Yeasts were found in 23% of the 69 subjects. CONCLUSIONS: The results on the Turkish study population were generally in line with earlier reports on the occurrence and interspecies relationships of certain bacteria in periodontitis. However, A. actinomycetemcomitans was not overrepresented in LAgP, and the serotype distribution resembled that reported from the East. The high frequency of non-serotypeable isolates suggests local characteristics of the species.
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31.
  • Domic, Danijel, et al. (author)
  • Accuracy of cone beam computed tomography is limited at implant sites with a thin buccal bone : A laboratory study
  • 2021
  • In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 92:4, s. 592-601
  • Journal article (peer-reviewed)abstract
    • Background: To evaluate whether buccal bone thickness (BBT), implant diameter, and abutment/crown material influence the accuracy of cone beam computed tomography (CBCT) to determine the buccal bone level at titanium implants.Methods: Two implant beds (i.e., narrow and standard diameter) were prepared in each of 36 porcine bone blocks. The implant beds were positioned at a variable distance from the buccal bone surface, thus resulting in 3 BBT groups (i.e., > 0.5-1.0; > 1.0-1.5; > 1.5-2.0 mm). In half of the blocks, a buccal bone dehiscence of random extent ("depth") was created and implants were mounted with different abutment/crown material (i.e., titanium abutments with a metal-ceramic crown and zirconia abutments with an all-ceramic zirconia crown). The distance from the implant shoulder to the buccal bone crest was measured on cross-sectional CBCT images and compared to the direct measurements at the bone blocks.Results: While abutment/crown material and implant diameter had no effect on the detection accuracy of the buccal bone level at dental implants in CBCT scans, BBT had a significant effect. Specifically, when BBT was ≤ 1.0 mm, a dehiscence was often diagnosed although not present, i.e., the sensitivity was high (95.8%), but the specificity (12.5%) and the detection accuracy (54.2%) were low. Further, the average measurement error of the distance from the implant shoulder to the buccal bone crest was 1.6 mm.Conclusions: Based on the present laboratory study, BBT has a major impact on the correct diagnosis of the buccal bone level at dental titanium implants in CBCT images; in cases where the buccal bone is ≤ 1 mm thick, detection of the buccal bone level is largely inaccurate. This article is protected by copyright. All rights reserved.
  •  
32.
  • Donati, Mauro, 1966, et al. (author)
  • B-1a cells in experimental gingivitis in humans.
  • 2009
  • In: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 80:7, s. 1141-5
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Although previous studies revealed the presence of autoreactive B cells (B-1a cells) in periodontitis lesions, no evidence was provided for an active role of such cells in the host response to microbial challenge. The aim of the present investigation was to study the reaction of B-1a cells to de novo plaque formation in subjects who were treated for severe chronic periodontitis. METHODS: Fifteen white subjects with generalized, severe chronic periodontitis volunteered. Surgical periodontal therapy was performed in all quadrants of each subject after a period of infection control. After 6 months of healing (baseline), two gingival biopsies were harvested from each patient (probing depth <4 mm and no bleeding on probing; healed sites). The experimental gingivitis model was applied, and plaque accumulation was allowed for 3 weeks. Two additional biopsies were collected and prepared for immunohistochemical analysis on day 21. RESULTS: The biopsies retrieved after 3 weeks of plaque accumulation contained larger proportions of CD19+ and CD5+ cells (B-1a cells) than biopsies representing baseline (healed sites) (7.38% +/- 2.80% versus 5.96% +/- 2.48%). The tissue fraction of cells carrying the markers for CD3 (T cells), CD19 (B cells), and Bcl2 (apoptosis-associated marker) were significantly larger in tissue samples collected after 3 weeks of plaque accumulation than in specimens from baseline (healed sites). CONCLUSION: Autoreactive B cells (B-1a cells) are involved in the host response to microbial challenge in subjects with chronic periodontitis.
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33.
  • Donati, Mauro, 1966, et al. (author)
  • Local expression of interleukin-10 and mCD14 in relation to the -1087 IL-10 and -159 CD14 gene polymorphisms in chronic periodontitis.
  • 2008
  • In: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 79:3, s. 517-24
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Associations between different gene polymorphisms and severe chronic periodontitis have been demonstrated. However, the influence of such genetic variations on the production of related proteins needs to be clarified. The aim of the present investigation was to study the local expression of interleukin (IL)-10 and membrane-bound CD14 (mCD14) in relation to the -1087 IL-10 and -159 CD14 gene polymorphisms in subjects with chronic periodontitis. METHODS: Fifty-three white subjects with generalized and severe chronic periodontitis volunteered. Twenty milliliters of blood was collected by venipuncture from each subject. DNA was isolated, and genotype analysis of the -1087 IL-10 and -159 CD14 gene polymorphisms was performed using polymerase chain reaction and restriction endonuclease mapping techniques. A gingival biopsy from one randomly selected diseased proximal site was also obtained from each subject. The biopsies were embedded, snap frozen, and prepared for immunohistochemical analysis. The inflammatory lesion was identified in the sections, and the proportions of IL-10+ and CD14+ cells were determined. RESULTS: The proportion of IL-10+ cells in the peripheral area of the periodontitis lesions was significantly larger in subjects with the -1087 IL-10 GG genotype than in subjects with the AG or AA genotype. However, the local expression of the mCD14 receptor did not vary between subjects with different -159 CD14 genotypes. CONCLUSIONS: It is suggested that IL-10 expression in chronic periodontitis lesions is associated with a distinct genotype. The observation adds to our understanding of interactions between genetic and environmental factors in the development of human diseases.
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34.
  • Dyab, Ahed, et al. (author)
  • Human gingival fibroblasts are a source of B cell-activating factor during periodontal inflammation
  • 2024
  • In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 95:7, s. 673-681
  • Journal article (peer-reviewed)abstract
    • Background: Host-modulating therapy is a possible treatment for individuals that respond poorly to conventional periodontal therapy. B cells, abundant in periodontitis lesions, require the cytokines B cell-activating factor (BAFF) and A proliferation-inducing ligand (APRIL) for survival and maturation. Although mRNA levels of BAFF and APRIL are increased in tissue from periodontitis lesions, it is unknown if periodontal resident cells express BAFF and/or APRIL during periodontal inflammation. In this study, we aim to analyze the expression of BAFF and APRIL in human gingival fibroblasts after stimulation with proinflammatory cytokines. Furthermore, we perform protein analysis in tissues and serum from periodontitis patients and healthy controls.Methods: Human gingival fibroblasts were cultured and stimulated with the proinflammatory cytokines’ tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β). The mRNA expression of BAFF and APRIL was analyzed by real-time quantitative polymerase chain reaction (qPCR), and the protein was detected in tissue sections using immune staining. Serum levels of BAFF were analyzed with enzyme-linked immunosorbent assay (ELISA).Results: In gingival fibroblasts, TNF-α upregulated BAFF mRNA, but APRIL was unaffected. IL-1β affected neither BAFF nor APRIL expression. BAFF protein was detected in the oral epithelium and in cells of the underlying connective tissue in periodontitis tissue, and BAFF protein was increased in the serum of periodontitis patients.Conclusion: Periodontal resident cells express BAFF during periodontal inflammation and participate in providing a favorable milieu for the survival and action of B cells.
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35.
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36.
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37.
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38.
  • Esberg, Anders, et al. (author)
  • Serum proteins associated with periodontitis relapse post-surgery: A pilot study
  • 2021
  • In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 92:12, s. 1805-1814
  • Journal article (peer-reviewed)abstract
    • Background: The knowledge of which genes and proteins that are connected to the susceptibility to gingivitis with subsequent local tissue degradation seen in periodontitis is insufficient. Changes of serum proteins associated with recurrence of bleeding on probing (BOP) and increased periodontal pocket depths (PPD) after surgical treatment of periodontitis could reveal molecules that could be early signals of tissue destruction and/or of importance for systemic effects in other tissues or organs.Methods: We performed a longitudinal pilot study and followed 96 inflammation-related proteins over time in serum from patients who underwent surgical treatment of periodontitis (n= 21). The samples were taken before (time 0), and then at 3, 6, and 12 months after surgery. Changes in protein levels were analysed in relation to the clinical outcome measures, that is, proportion of surfaces affected by BOP and PPD. Results: Changes in treatment outcomes with early signs of relapse in periodontitis after surgical treatment, for example, increased BOP and PPDs, were during 12-months follow up associated with increased serum levels of high-sensitivity C-reactive protein (hs-CRP) and programmed death-ligand 1 (PD-L1), and reduced serum levels of cystatin-D protein.Conclusion: This study shows that clinical signs of recurrence of periodontitis after surgery are reflected in serum, but larger studies are needed for verification. Our novel findings of an association between increased PD-L1- and decreased cystatin D-levels and recurrence in periodontitis are interesting because PD-L1 has been shown to facilitate bacterial infections and chronic inflammation and cystatin D to inhibit tissue destruction. Our results justify mechanistic studies regarding the role of these molecules in periodontitis.
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39.
  • Fadel, Hani T, 1979, et al. (author)
  • Caries risk and periodontitis in patients with coronary artery disease.
  • 2011
  • In: Journal of periodontology. - : Wiley. - 1943-3670 .- 0022-3492. ; 82:9, s. 1295-303
  • Journal article (peer-reviewed)abstract
    • ACKGROUND: There is considerable variation in studies on the oral health of patients with coronary artery disease (CAD). The aims of this investigation are to study the caries risk profile using the Cariogram computer program and the periodontal disease severity in patients with CAD. METHODS: A total of 127 participants (54 test and 73 control) were included. Participants were asked about their general health and daily habits. Clinical examinations, radiographs, and salivary sampling were performed. Cariologic data were entered into the computer program for risk-profile illustration. The onset of CAD conditions was also documented. RESULTS: Compared with controls, participants with CAD consumed less sugar, used fluoride toothpaste less frequently, and had significantly less favorable periodontal parameters (P <0.005). Generally, differences in cariologic parameters between the two groups were not significant. Significantly more participants with CAD exhibited low salivary-secretion rates than controls. The actual chance (percentage) of avoiding new cavities according to the Cariogram was low in the test and control groups (31% and 40%, respectively; P <0.05). Only gingival recession was correlated with the onset of CAD. CONCLUSIONS: Test and control groups had a relatively high caries risk. More severe periodontal disease was observed in participants with CAD.
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40.
  • Fadel, Hani T, 1979, et al. (author)
  • Profiles of Dental Caries and Periodontal Disease in Individuals With or Without Psoriasis.
  • 2013
  • In: Journal of periodontology. - : Wiley. - 1943-3670 .- 0022-3492. ; 84:4, s. 477-485
  • Journal article (peer-reviewed)abstract
    • Background: Psoriasis is a chronic inflammatory skin disease. Studies of oral health in psoriasis patients are limited. The aim was to assess the experience and risk of caries and periodontal disease in psoriatics and non-psoriatics. Material and Methods: The material consisted of 89 individuals with mild to moderate chronic plaque psoriasis and 54 non-psoriatics, recruited at the University Hospital in Gothenburg. Psoriasis arthritis was diagnosed in 25 of the psoriatics. All participants answered questionnaires and were subjected to saliva sampling and oral radiological and clinical examinations. Two computer applications were used for illustration of oral disease risk profiles. Results: Psoriatics had lower salivary pH, fewer remaining teeth, fewer sites with probing pocket depth ≤4 mm and a lower radiographic alveolar bone level than non-psoriatics (p<0.05). Most of the differences remained significant after controlling for confounders. Differences in alveolar bone levels were no longer significant, particularly after introducing "gender" into the regression model. Similar numbers of decayed and filled teeth, sites with deep pockets, sites that bled on probing and risk profiles were observed. Individuals with psoriasis arthritis exhibited a lower stimulated salivary secretion rate than non-psoriatics (p<0.05). Conclusions: There were no differences in profiles of caries and periodontal disease experience and risk between individuals with and without psoriasis. Fewer remaining teeth were observed in psoriatics. However, the exact reason for tooth loss could not be identified. Meanwhile, the reduced salivary pH in psoriatics and salivary secretion in psoriasis arthritis individuals, may pose a risk for future caries.
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41.
  • Fardal, Øystein, et al. (author)
  • Periodontal and general health in long-term periodontal maintenance patients treated in a Norwegian private practice : a descriptive report from a compliant and partially compliant survivor population
  • 2013
  • In: Journal of Periodontology. - : John Wiley & Sons Inc.. - 0022-3492 .- 1943-3670. ; 84:10, s. 1374-1381
  • Journal article (peer-reviewed)abstract
    • Background There is weak evidence to support the benefit of periodontal maintenance therapy in preventing tooth loss. In addition, the effects of long-term periodontal treatment on general health are unclear. Materials/Methods Compliant and partially compliant patients (15-25 years follow-up) in private practice were observed for oral and systemic health changes. Results 219 compliant patients (128 females, 91 males) were observed for 19.1 years (range 15-25, SD ± 2.8). Age at reassessment was 64.6 years (range 39-84 SD ±9.0). 145 patients were stable (0-3 teeth lost), 54 were downhill (4-6 teeth lost) and 21 patients extreme downhill (>6 teeth lost). 16 patients developed hypertension, 13 developed diabetes II, and 15 suffered myocardial infarcts (MI). A minority developed other systemic diseases. Risk factors for MI included overweight (OR 9.04,95% CI:2.9-27.8, p=0.000), family history with cardiovascular disease (OR 3.10, 95 % CI:1.07-8.94, p=0.029), diabetes I at baseline (p=0.02) and developing diabetes II (O.R. 7.9, 95 % CI: 2.09-29.65, p=0.000). 25 partially compliant patients (8 females, 17 males) were observed for 19 years. This group had a higher proportion of downhill and extreme downhill cases and MI. Conclusion Patients who left the maintenance program in a periodontal specialist practice in Norway had a higher rate of tooth loss than compliant patients. Compliant maintenance patients in specialist practice in Norway have a similar risk of developing diabetes type II as the general population. A rate of 0.0037 myocardial infarcts per patient per year was recorded for this group. Due to the lack of external data, it is difficult to assess how this compares with untreated periodontal patients.
  •  
42.
  • Farina, R., et al. (author)
  • Change in the Gingival Margin Profile After the Single Flap Approach in Periodontal Intraosseous Defects
  • 2015
  • In: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 86:9, s. 1038-1046
  • Journal article (peer-reviewed)abstract
    • Background: The aim of the present study is to evaluate the association of patient-related and site-specific factors, as well as the adopted treatment modality, with the change in buccal (bREC) and interdental (iREC) gingival recession observed at 6 months after treatment of periodontal intraosseous defects with the single flap approach (SFA). Methods: Sixty-six patients contributing 74 intraosseous defects accessed with a buccal SFA and treated with different modalities were selected retrospectively. A two-level (patient and site) model was constructed, with the 6-month changes in bREC and iREC as the dependent variables. Results: 1) Significant 6-month increases in bREC (-0.6 +/- 0.7 mm) and iREC (-0.9 +/- -1.1 mm) were observed. 2) bREC change was significantly predicted by presurgery interproximal probing depth (PD) and depth of osseous dehiscence at the buccal aspect. 3) iREC change was significantly predicted by presurgery interproximal PD and the treatment modality, with defects treated with SFA in combination with a graft material and a bioactive agent being less prone to iREC increase compared to defects treated with SFA alone. Conclusions: After buccal SFA, greater post-surgery increase in bREC must be expected for deep intraosseous defects associated with a buccal dehiscence. The combination of a graft material and a bioactive agent in adjunct to the SFA may limit the postoperative increase in iREC.
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43.
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44.
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45.
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46.
  • Figuero, Elena, et al. (author)
  • Quantification of Periodontal Pathogens in Vascular, Blood, and Subgingival Samples From Patients With Peripheral Arterial Disease or Abdominal Aortic Aneurysms
  • 2014
  • In: Journal of Periodontology. - : American Academy of Peridontology. - 0022-3492 .- 1943-3670. ; 85:9, s. 1182-1193
  • Journal article (peer-reviewed)abstract
    • Background: The aim of this investigation is to quantify periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus, and Tannerella forsythia) in vascular, blood, and subgingival samples. As a secondary objective, two molecular bacterial identification methods (nested polymerase chain reaction [PCR] and quantitative PCR [qPCR]) are compared. Methods: Seventy consecutive patients provided a vascular lesion, a blood sample, and 36 subgingival samples. Bacterial DNA was extracted, and qPCR was used to determine the prevalence and amounts of the target pathogens in each sample. Nested PCR was performed only in the samples from vascular lesions. Periodontal examination was performed in 42 patients. Mann-Whitney U or x(2) tests were used to compare microbiologic results according to periodontal diagnosis. Results: All targeted periodontal pathogens (A. actinomycetemcomitans, P. gingivalis, T. forsythia, or C. rectus) were detected in subgingival samples, with a prevalence rate of 72.2%, 47.2%, 74.3%, and 82.9%, respectively. In 7.1% and 11.4% of vascular and blood samples, bacterial DNA was detected. One patient was positive for A. actinomycetemcomitans in the three types of samples. No differences were found in the levels of targeted bacteria when comparing patients with and without periodontitis. Prevalence rates obtained with nested PCR were significantly higher than those obtained with qPCR. Conclusions: The presence of A. actinomycetemcomitans was demonstrated in vascular, blood, and subgingival samples in one of 36 patients. These results, although with a very low frequency, may support the hypothesis of a translocation of periodontal pathogens from subgingival microbiota to the bloodstream and then to atheromatous plaques in carotid or other peripheral arteries. Nested PCR is not an adequate method for identifying DNA of periodontal pathogens in low quantities because of the high number of false-negative results.
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47.
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48.
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49.
  • Fredriksson, Margareta I. (author)
  • Effect of Priming in Subpopulations of Peripheral Neutrophils From Patients With Chronic Periodontitis
  • 2012
  • In: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 83:9, s. 1192-1199
  • Journal article (peer-reviewed)abstract
    • Background: Patients with periodontal disease are reported to generate more reactive oxygen species (ROS) than matched controls, suggesting increased inflammatory defense activity. The purpose of this study is to determine whether there are subpopulations of peripheral neutrophils in patients with chronic periodontitis (CP) that generate different levels of intracellular ROS when primed with tumor necrosis factor-alpha (TNF-alpha) or the chemokine interleukin-8 (IL-8, CXCL8) compared to controls. Methods: Venous blood was collected from 13 patients with CP despite careful maintenance over 2 to 8 years and from 13 healthy age- and sex-matched controls. Neutrophils were separated from whole blood over a Percoll gradient and then activated via the Fc gamma receptor with opsonized Staphylococcus aureus after priming with TNF-alpha or IL-8. The samples were analyzed by flow cytometry using the fluorescent probe dihydrorhodamine 123. Generation of ROS was measured as the intensity of fluorescence (IFL). Results: Two subpopulations were found in both patients and controls: one with low and one with high generation of IFL. The subpopulation with high generation of IFL in patients with CP was more responsive to IL-8 (P<0.05) than the same subpopulation in healthy controls. No other differences in generation of ROS or priming effects were found between patients with CP and controls. Generation of ROS was dependent on nicotinamide adenine dinucleotide phosphate oxidase, and the intracellular ROS was primarily the oxygen anion. Conclusion: Patients with CP had a subpopulation of peripheral neutrophils that were more responsive to IL-8 priming than controls. J Periodontol 2012;83:1192-1199.
  •  
50.
  • Fretwurst, T., et al. (author)
  • Immunohistological composition of peri-implantitis affected tissue around ceramic implants-A pilot study
  • 2021
  • In: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 92:4, s. 571-579
  • Journal article (peer-reviewed)abstract
    • Background: Aim of the pilot study was the histologic classification of the inflamed peri-implant soft tissue around ceramic implants (CI) in comparison with titanium implants (TI). Methods: Peri-implant tissue were retrieved from 15 patients (aged 34 to 88 years, seven males/eight females) with severe peri-implantitis (eight CI, seven TI). The peri-implant soft tissue samples were retrieved from the sites during scheduled removal of the implant and prepared for immunohistochemical analysis. Monoclonal antibodies (targeting CD3, CD20, CD138, and CD68) were used to identify T- and B-cells, plasma cells and macrophages. Quantitative assessment was performed by one histologically trained investigator. Linear mixed regression models were used. Results: A similar numerical distribution of the cell population was found in peri-implantitis around CI compared with TI. CD3 (TI, 17% to 85% versus CI, 20% to 70% of total cell number) and CD138 (TI, 1% to 73% versus CI, 12% to 69% of total cell number) were predominantly expressed. Notably, patient-individual differences of numerical cell distribution were detected. Co-localization of B- and T-lymphocytes was observed. Conclusions: Peri-implantitis around CI in comparison with TI seems to have a similar histological appearance. Differences in cellular composition of peri-implantitis lesions might also depend on the patient's specific immune status and not only on the material used.
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