| 1. |
- Berglund, Johan, et al.
(author)
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Osteoporosis and peridontitis in older subjects participating in the Swedish National Survey on Aging and Care (SNAC-Blekinge)
- 2011
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In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 69:4, s. 201-207
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Research review (peer-reviewed)abstract
- Abstract Objective. We assessed the relationships between (I) ultrasonography calcaneus T-scores (PIXI) and mandibular cortex characteristics on oral panoramic radiographs in older subjects; and (II) osteoporosis and periodontitis. Material and methods. We examined 778 subjects (53% women) aged 59-96 years. Periodontitis was defined by alveolar bone loss assessed from panoramic radiographs. Results. PIXI calcaneus T-values ≤-2.5 (osteoporosis) were found in 16.3% of women and in 8.1% of men. PIXI calcaneus T-values <-1.6 (osteoporosis, adjusted) were found in 34.2% of women and in 21.4% of men. The age of the subjects and PIXI T-values were significantly correlated in women (Pearson's r = 0.37, P < 0.001) and men (Pearson's r = 0.19, P < 0.001). Periodontitis was found in 18.7% of subjects defined by alveolar bone level ≥5 mm. Subjects with osteoporosis defined by adjusted PIXI T-values had fewer remaining teeth [mean difference 4.1, 95% confidence interval (CI) -1.1 to -6.5, P < 0.001]. The crude odds ratio (OR) of an association between the panoramic assessment of mandibular cortex erosions as a sign of osteoporosis and the adjusted T-value (T-value cut-off <-1.6) was 4.8 (95% CI 3.1-7.2, P < 0.001; Pearson χ(2) = 60.1, P < 0.001). A significant OR between osteoporosis and periodontitis was only found in women for the T-value cut-off ≤-2.5 (crude OR 1.8, 95% CI 1.1-3.3, P < 0.03). Conclusions. An association between osteoporosis and periodontitis was only confirmed in women. The likelihood that the mandibular cortex index agrees with adjusted PIXI T-values is significant.
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| 2. |
- Gonda, Tomoya, et al.
(author)
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Predictors of multiple tooth loss among socioculturally diverse elderly subjects
- 2013
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In: International Journal of Prosthodontics. - : Quintessence Publishing Company. - 0893-2174 .- 1139-9791. ; 26:2, s. 127-134
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Journal article (peer-reviewed)abstract
- Purpose: This study identifies clinical factors that predict multiple tooth loss in a socioculturally diverse population of older adults. Materials and Methods: A total of 193 participants from English-, Chinese-, or Punjabi-speaking communities in Vancouver, British Columbia, with low incomes and irregular use of dental services were followed for 5 years as part of a clinical trial of a 0.12% chlorhexidine mouthrinse. The participants were interviewed and examined clinically, including panoramic radiographs, at baseline and annually for 5 years. Binary logistic regression was used to test the hypothesis that there was no difference between incidence of multiple (≥ 3) tooth loss in older people with various biologic, behavioral, prosthodontic, and cultural variables over 5 years. Results: Multiple tooth loss, which was distributed similarly among the groups in the trial, occurred in 39 (20%) participants over 5 years. The use of removable prostheses was the best predictor of loss, followed by the number of carious surfaces and number of sites with gingival attachment loss > 6 mm. The pattern of prediction was consistent across the three linguocultural groups. Conclusion: The use of removable dentures was the dominant predictor of multiple tooth loss in the three communities, but that tooth loss was not significantly associated with the cultural heritage of the participants.
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| 3. |
- Persson, G. Rutger, et al.
(author)
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Prediction of hip and hand fractures in older persons with or without a diagnosis of periodontitis
- 2011
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In: Bone. - : Elsevier BV. - 1873-2763 .- 8756-3282. ; 48:3, s. 552-556
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Journal article (peer-reviewed)abstract
- Purpose: In a prospective study, we assessed if a diagnosis of osteoporosis and periodontitis could predict hip and hand fractures in older persons. Materials and methods: Bone density was assessed by a Densitometer. Periodontitis was defined by evidence of alveolar bone loss. Results: 788 Caucasians (52.4% women, overall mean age: 76 years, S.D. +/- 9.0, range: 62 to 96) were enrolled and 7.4% had a hip/hand fracture in 3 years. Calcaneus PIXI T-values < - 1.6 identified osteoporosis in 28.2% of the older persons predicting a hip/hand fracture with an odds ratio of 3.3:1 (95% CI: 1.9, 5.7, p < 0.001). Older persons with osteoporosis had more severe periodontitis (p < 0.01). Periodontitis defined by >= 30% of sites with >= 5 mm distance between the cemento-enamel junction (CEJ) and bone level (ABL) was found in 18.7% of the older persons predicting a hip/hand fracture with an odds ratio of 1.8:1 (95% CI: 1.0, 3.3, p < 0.05). Adjusted for age, the odds ratio of a hip/hand fracture in older persons with osteoporosis (PIXI T-value <-2.5) and periodontitis was 12.2:1 (95% CI: 3.5, 42.3, p < 0.001). Conclusions: Older persons with osteoporosis and periodontitis have an increased risk for hip/hand fractures. (C) 2010 Elsevier Inc. All rights reserved.
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| 4. |
- Renvert, Stefan, et al.
(author)
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A history of frequent dental care reduces the risk of tooth loss but not periodontitis in older subjects
- 2011
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In: Swedish Dental Journal. - : Swedish Dental Association and the Swedish Dental Society. - 0347-9994. ; 35:2, s. 69-75
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Research review (peer-reviewed)abstract
- Objectives: Information on the significance of dental care in older adults is limited. We hypothesized that regular dental visits has an effect on the number of remaining teeth and periodontal conditions in older subjects. Materials and Methods:1020 randomly selected individuals age 60-96 from the Swedish National Study on Aging and Care Blekinge received a comprehensive oral health examination. Results: Dentate women and men had, on average 18.4 teeth (SD +7.6,) and 18.9 teeth (SD + 7.5) respectively (NS). In the youngest group (60 and 66 years old) with less than one dental visit per year, 37 % had <20 teeth, compared with 73 % among those with at least annual visits. Among the old-old, comparable figures were 1.8 % and 37 % respectively. Across age groups, bleeding on probing was 23 %. When adjusting for age, and number of teeth GLM univariate analysis failed to demonstrate an effect of dental visit frequency on alveolar bone loss (p = 0.18), the number of periapical lesions (p = 0.65), or the number of endodontically treated teeth (p = o.41). Frequent dental visitors had more teeth than infrequent visitors (p = 0.001). Conclusions: Tooth loss and alveolar bone loss severity increase with age. Individuals with regular dental visits retained more teeth but the frequency of dental visits had no impact on plaque deposits, gingival inflammation, or alveolar bone levels.
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| 5. |
- Renvert, Stefan, et al.
(author)
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Access to dental care reduces the risk of tooth loss in older subjects
- 2009
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Conference paper (other academic/artistic)abstract
- Background: The significance of access to dental care on oral conditions in older subjects is limited. We hypothesized that dental care control for aging effects on oral and periodontal conditions. Materials and methods: 1020 randomly selected subjects between age 60 and 96 from the Swedish National Study on Aging and Care Blekinge study received comprehensive medical and dental examinations. Results: Dentate women and men had, on average,18.4 teeth (S.D. ± 7.6), and 18.9 teeth (S.D.±7.5) (P = 0.37) respectively. In the youngest age group with infrequent dental visits 37% had > 20 teeth, and 73% had > 20 teeth if they had annual visits. Among old-old infrequent dental visitors 1.8% had > 20 teeth and 37% had > 20 teeth with annual visits. Across age groups, the overall % bleeding on probing was 23%. When adjusting for age, GLM univariate analysis failed to demonstrate an effect of frequency of dental visits and ABL scores (P = 0.18) but frequent dental visitors had significantly more teeth than infrequent visitors (P = 0.001). Conclusions: Tooth loss and extent of alveolar bone loss increase with age. Frequent dental visits seem to preserve teeth but has no impact on the amounts of deposits, gingival inflammation, or alveolar bone levels.
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| 6. |
- Renvert, Stefan, et al.
(author)
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Analysis of periodontal risk profiles in adults with or without a history of myocardial infarction
- 2004
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In: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 31:1, s. 19-24
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Journal article (peer-reviewed)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.
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| 7. |
- Renvert, Stefan, et al.
(author)
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Heel DXA T-scores and panoramic radiographs in the prediction of hip and hand fractures
- 2009
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In: Journal of Clinical Periodontology. - : wiley.
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Conference paper (other academic/artistic)abstract
- Introduction: We assessed if DXA (Dual Energy X-ray Absorptiometry) and panoramic radiographs were predictive of hip and or hand fractures over 3 years in older subjects. Methods: DXA heel measurements and mandibular panoramic bone scores (MPBS) from panoramic radiographs were performed in 418 women (mean age: 77.5 years, S.D ± 9.3 and 370 men (mean age: 76.4, S.D ± 9.5). Results: 4.5% subjects (34/788) had a hip and 3.7% (27/788) a hand fracture. A DXA T -score < - 2.5 (osteoporosis) in women and men was found in 16.3% and 8.1% respectively. Subjects with osteoporosis had fewer remaining teeth (mean diff: 4.4, 95% CI: 2.3–6.5, P < 0.001). A DXA T-score < -2.5 was predictive of a hip or hand fracture odds ratio 2.6:1(95%CI: 1.3-5.3, P < = 0.008). The odds ratio (OR) that a MPBS = 1 agreed with a DXA T-score <- 2.5 was 5.4:1 (95% CI: 2.6 – 11.4.2, P <0.001; Cochran c2 = 36.5, P < 0.001). The MPBS score = 1 had an OR of 3.3:1 (95%CI: 1.9–5.9, P < 0.001) in fracture prediction. Conclusions: The MPBS scores were consistent with the DXA T scores. Both methods have similar predictive value in assessing risk for future hip and hand fractures in older subjects. Subjects with osteoporosis had fewer remaining teeth.
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| 8. |
- Renvert, Stefan, et al.
(author)
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Tooth loss and periodontitis in older individuals : results from the Swedish national study on aging and care.
- 2013
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In: Journal of Periodontology. - : American Academy of Periodontology. - 0022-3492 .- 1943-3670. ; 84:8, s. 1134-1144
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Journal article (peer-reviewed)abstract
- Background: Due to the increasing number of older people, there is a need for studies focused on this population. The aims of the present study are to assess oral and systemic conditions in individuals aged 60 to 95 years with access to dental insurance. Methods: Probing depths (PDs), tooth loss, alveolar bone levels, and systemic health were studied among a representative cohort of older individuals. Results: A total of 1,147 individuals in young-old (aged 60 or 67 years), old (aged 72 or 78 years), and old-old (aged ≥81 years) age groups were enrolled, including 200 individuals who were edentulous, in this study. Annual dental care was received by 82% of dentate individuals. Systemic diseases were common (diabetes: 5.8%; cardiovascular diseases: 20.7%; obesity: 71.2%; elevated C-reactive protein [CRP]: 98.4%). Serum CRP values were unrelated to periodontal conditions. Rates of periodontitis, defined as ≥30% of sites with a distance from cemento-enamel junction to bone of ≥5 mm, were 11.2% in women in the young-old age group and 44.9% in men in the old-old age group. Individuals in older age groups had a higher likelihood of periodontitis defined by bone loss and cutoff levels of PD ≥5 mm (odds ratio: 1.8; 95% confidence interval: 1.2 to 2.5; P <0.01). A total of 7% of individuals in the old-old age group had ≥20 teeth and no periodontitis. Systemic diseases, dental use, or smoking were not explanatory, whereas age and sex were explanatory for periodontitis. Conclusions: The prevalence of periodontitis increased with age. Sex seems to be the dominant explanatory factor for periodontitis in older individuals. Despite frequent dental visits, overall oral health in the oldest age cohort was poor.
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| 9. |
- Ademovski, Seida Erovic, et al.
(author)
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The effect of periodontal therapy on intra-oral halitosis : a case series
- 2016
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 43:5, s. 445-452
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Journal article (peer-reviewed)abstract
- AIM: The aim of this study was to evaluate the effects of non-surgical periodontal therapy on intra-oral halitosis 3 months after therapy.MATERIAL AND METHODS: Sixty-eight adults with intra-oral halitosis were included in a case series. Intra-oral halitosis was evaluated at baseline, and at 3 months after treatment using the organoleptic scores (OLS), Halimeter® , and a gas chromatograph.RESULTS: Significant reductions for OLS (p < 0.01), total sum of volatile sulphur compounds (T-VSC) (p < 0.01) and methyl mercaptan (MM) (p < 0.05) values were found after treatment. Hydrogen sulphide (H2 S) levels were not significantly reduced. The numbers of probing pockets 4 mm, 5 mm and 6 mm were significantly reduced as a result of therapy (p < 0.001). Bleeding on probing (BOP) and plaque indices were also significantly reduced (p < 0.001). For the 34 individuals with successful periodontal treatment (BOP<20% and a ≥50% reduction of total pocket depth) reductions in OLS (p < 0.01) and T-VSC scores (p < 0.01) were found. Eleven individuals were considered effectively treated for intra-oral halitosis presenting with a T-VSC value <160 ppb, a H2 S value <112 ppb and a MM value <26 ppb.CONCLUSION: Non-surgical periodontal therapy resulted in reduction of OLS, MM and T-VSC values 3 months after therapy. Few individuals were considered as effectively treated for intra-oral halitosis.
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| 10. |
- Aghazadeh, Ahmad, et al.
(author)
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A single-centre randomized controlled clinical trial on the adjunct treatment of intra-bony defects with autogenous bone or a xenograft : results after 12 months
- 2012
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In: Journal of Clinical Periodontology. - : Wiley Blackwell. - 0303-6979 .- 1600-051X. ; 39:7, s. 666-673
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Journal article (peer-reviewed)abstract
- Background Limited evidence exists on the efficacy of regenerative treatment of peri-implantitis. Material and Methods Subjects receiving antibiotics and surgical debridement were randomly assigned to placement of autogenous bone (AB) or bovine-derived xenograft (BDX) and with placement of a collagen membrane. The primary outcome was evidence of radiographic bone fill and the secondary outcomes included reductions of probing depth (PD) bleeding on probing (BOP) and suppuration. Results Twenty-two subjects were included in the AB and 23 subjects in the BDX group. Statistical analysis failed to demonstrate differences for 38/39 variables assessed at baseline. At 12 months, significant better results were obtained in the BDX group for bone levels (p < 0.001), BOP (p = 0.004), PI (p = 0.003) and suppuration (p < 0.01). When adjusting for number of implants treated per subject, a successful treatment outcome PD = 5.0 mm, no pus, no bone loss and BOP at 1/4 or less sites the likelihood of defect fill was higher in the BDX group (LR: 3.2, 95% CI: 1.010.6, p < 0.05). Conclusions Bovine xenograft provided more radiographic bone fill than AB. The success for both surgical regenerative procedures was limited. Decreases in PD, BOP, and suppuration were observed.
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