1. |
- Bogren, Anna, 1963, et al.
(author)
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A three-year prospective study of adult subjects with gingivitis. I: clinical periodontal parameters.
- 2007
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In: Journal of clinical periodontology. - 0303-6979. ; 34:1, s. 1-6
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Journal article (peer-reviewed)abstract
- AIM: The objective of this study was to monitor prospectively clinical parameters in subjects without signs of destructive periodontal disease who were involved in a primary prevention programme, and to determine the changes that occurred between yearly examinations over a 3-year period. MATERIAL AND METHODS: One hundred and twenty-six subjects aged at least 20 years with a maximum of two tooth sites with probing pocket depth (PPD)>4 mm and no proximal sites with clinical attachment loss participated in the study. Primary prevention was provided at baseline of the study and then every 6 months. Plaque, bleeding on probing (BoP) and PPD were scored at baseline, 1, 2 and 3 years. RESULTS: There were no significant changes in the plaque score over the 3 years. After year 1, the BoP score was significantly improved with 5.6%, while no further improvement in BoP was found at years 2 and 3. The mean PPD decreased from 2.3 to 2.1 mm over the 3 years (p<0.05). CONCLUSION: Although some individuals exhibiting minor signs of periodontal pathology may have benefited from the primary prevention, the overall clinical improvement was limited for such subjects in the present 3-year study.
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2. |
- Bogren, Anna, 1963, et al.
(author)
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Clinical and microbiologic changes associated with the combined use of a powered toothbrush and a triclosan/copolymer dentifrice: a 3-year prospective study.
- 2007
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In: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 78:9, s. 1708-17
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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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3. |
- Bogren, Anna, 1963, et al.
(author)
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Locally Delivered Doxycycline During Supportive Periodontal Therapy: A 3-Year Study.
- 2008
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In: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 79:5, s. 827-835
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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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4. |
- Bogren, Anna, 1963, et al.
(author)
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Long-term effect of the combined use of powered toothbrush and triclosan dentifrice in periodontal maintenance patients.
- 2008
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In: Journal of clinical periodontology. - 1600-051X. ; 35:2, s. 157-64
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Journal article (peer-reviewed)abstract
- AIM: To test the hypothesis of a superior clinical and microbiological effect of the combined use of powered toothbrush+triclosan-containing dentifrice compared with manual toothbrush+regular fluoride-containing dentifrice in periodontal maintenance patients. MATERIAL AND METHODS: A total of 128 periodontitis subjects involved in recall programmes were randomized to use either powered toothbrush with triclosan-dentifrice (test) or manual toothbrush and standard dentifrice (control). Supportive periodontal treatment was provided at baseline and every 6 months. Plaque, bleeding on probing (BoP), probing pocket depth (PPD) and relative attachment level (RAL) were scored at baseline, 1, 2 and 3 years. Subgingival plaque samples were taken and analysed for their content of 40 bacterial species at each examination interval. All analyses were performed by "intention-to-treat" protocol. RESULTS: Both groups showed significant reduction in BoP, PPD and in mean total counts of the 40 bacterial species between baseline and 3 years, while plaque score and RAL remained almost unchanged. No significant differences between the two prevention programmes were found for any of the clinical outcome variables or in mean counts of the various bacterial species. CONCLUSIONS: The study failed to demonstrate superior clinical and microbiological effects of powered toothbrush+triclosan dentifrice compared with manual toothbrush+standard fluoride-dentifrice in periodontitis-susceptible patients on regular maintenance therapy.
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5. |
- Bogren, Anna, 1963
(author)
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Studies on the prevention of periodontal diseases
- 2007
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Doctoral thesis (other academic/artistic)abstract
- Studies on the Prevention of Periodontal Diseases Anna Bogren Dental plaque contains bacteria that colonize the subgingival area and causes periodontal diseases. Effective plaque removal is therefore a key issue in the prevention of the development/progression of periodontal diseases. The main objective of the present series of investigations was to evaluate clinical and microbiological changes/effects of various prevention means in two subject samples with diverse experience of destructive periodontal disease. 160 adult subjects without clinical signs of destructive periodontal disease and 128 patients previously treated for periodontitis and involved in regular maintenance therapy were recruited. The individuals in the two subject samples received professional prophylaxis/supportive periodontal therapy every 6 months and were followed over a 3-year period. All participants were randomized to use either powered toothbrush combined with a triclosan-containing dentifrice or manual toothbrush and a standard fluoride dentifrice. The patients previously treated for periodontitis were furthermore randomly assigned to receive i) mechanical debridement plus locally applied doxycycline or ii) mechanical debridement alone, in sites with PPD ≥5 mm. Full mouth clinical registrations of plaque, bleeding on probing (BoP), probing pocket depth (PPD) and relative attachment level (RAL) were performed at baseline, 3 months 1, 2 and 3 years. At each examination interval subgingival plaque samples were taken at each tooth for analysis of the prevalence of 40 different bacterial species. The subjects without destructive periodontal disease improved their clinical periodontal conditions over the 3 years with a significant reduction in BoP score and in PPD. This improvement was accompanied by a shift in the subgingival microflora to a more host-compatible microbiota. There were no differences in these respects between the two home-care programs. The patients with a history of destructive periodontal disease showed significant reductions in BoP, PPD, and in mean counts of various bacterial species between baseline and 3 years while RAL remained unchanged. No significant differences were found in clinical or microbiological variables between the two home-care procedures. Short-term beneficial effects on clinical parameters were demonstrated with the adjunctive use of locally delivered doxycycline. Repeated application of the drug once annually had no long-term clinical or microbiological effects beyond those observed by subgingival mechanical debridement alone in this group of patients.
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6. |
- Goodson, J. M., et al.
(author)
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Control of periodontal infections: A randomized controlled trial I. The primary outcome attachment gain and pocket depth reduction at treated sites
- 2012
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In: Journal of Clinical Periodontology. - 0303-6979. ; 39:6, s. 526-536
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Journal article (peer-reviewed)abstract
- Objective To compare the treatment outcome of scaling and root planing (SRP) in combination with systemic antibiotics, local antibiotic therapy and/or periodontal surgery. Material and Methods One hundred and eighty-seven patients were assigned to eight groups treated by SRP plus none, one, two or three adjunctive treatments and monitored for 24 similar to months in a randomized controlled clinical trial using a 2 similar to 2 similar to 2 factorial design. Systemic amoxicillin similar to metronidazole (SMA), local tetracycline delivery (LTC) and periodontal surgery (SURG) were evaluated as adjuncts. Changes in clinical attachment level (CAL) and probing pocket depth (PPD) were statistically evaluated by ancova of main effects. Results Effects of adjunctive therapy to SRP were minimal at 3 similar to months. Between 3 and 6 similar to months PPD reduction occurred particularly in patients receiving periodontal surgery. After 6 similar to months, both CAL gain and PPD reduction reached a plateau that was maintained at 24 similar to months in all groups. The 24-month CAL gain was improved by SMA (0.50 similar to mm) while PPD was reduced by SMA (0.51 similar to mm) and SURG (0.36 similar to mm). Smoking reduced CAL gain and PPD reduction. Conclusion Patients receiving adjunctive therapies generally exhibited improved CAL gain and/or PPD reduction when compared with the outcome of SRP alone. Only additive, not synergistic effects of the various adjunctive therapies were observed.
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7. |
- Haffajee, A D, et al.
(author)
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Differences in the subgingival microbiota of Swedish and USA subjects who were periodontally healthy or exhibited minimal periodontal disease.
- 2005
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In: Journal of clinical periodontology. - 0303-6979. ; 32:1, s. 33-9
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Journal article (peer-reviewed)abstract
- BACKGROUND: Previous studies have shown differences in the mean proportions of subgingival species in samples from periodontitis subjects in different countries, which may relate to differences in diet, genetics, disease susceptibility and manifestation. The purpose of the present investigation was to determine whether there were differences in the subgingival microbiotas of Swedish and American subjects who exhibited periodontal health or minimal periodontal disease. METHOD: One hundred and fifty eight periodontally healthy or minimally diseased subjects (N Sweden=79; USA=79) were recruited. Subjects were measured at baseline for plaque, gingivitis, BOP, suppuration, pocket depth and attachment level at 6 sites per tooth. Subgingival plaque samples taken from the mesial aspect of each tooth at baseline were individually analyzed, in one laboratory, for their content of 40 bacterial species using checkerboard DNA-DNA hybridization (total samples=4345). % DNA probe counts comprised by each species was determined for each site and averaged across sites in each subject. Significance of differences in proportions of each species between countries was determined using ancova adjusting for age, mean pocket depth, gender and smoking status. p values were adjusted for multiple comparisons. Cluster analysis was performed to group subjects based on their subgingival microbial profiles using a chord coefficient and an average unweighted linkage sort. RESULTS: On average, all species were detected in samples from subjects in both countries. After adjusting for multiple comparisons, 5 species were in significantly higher adjusted mean percentages in Swedish than American subjects: Actinomyces naeslundii genospecies 1 (9.7, 3.3); Streptococcus sanguis (2.5, 1.2); Eikenella corrodens (1.7, 1.0); Tannerella forsythensis (3.5, 2.3) and Prevotella melaninogenica (6.3, 1.8). Leptotrichia buccalis was in significantly higher adjusted mean percentages in American (5.5) than Swedish subjects (3.0). Cluster analysis grouped 121 subjects into 8 microbial profiles. Twenty four of the 40 test species examined differed significantly among cluster groups. Five clusters were dominated by American subjects and 2 clusters by Swedish subjects. Fifty eight of 79 (73%) of the Swedish subjects fell into 1 cluster group dominated by high proportions of A. naeslundii genospecies 1, Prevotella nigrescens, T. forsythensis and P. melaninogenica. Other clusters were characterized by high proportions of Actinomyces gerencseriae, Veillonella parvula, Capnocytophaga gingivalis, Prevotella intermedia, Eubacterium saburreum, L. buccalis and Neisseria mucosa. CONCLUSIONS: The microbial profiles of subgingival plaque samples from Swedish and American subjects who exhibited periodontal health or minimal disease differed. The heterogeneity in subgingival microbial profiles was more pronounced in the American subjects, possibly because of greater genetic and microbiologic diversity in the American subjects sampled.
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8. |
- Haffajee, A D, et al.
(author)
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Subgingival microbiota of chronic periodontitis subjects from different geographic locations.
- 2004
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In: Journal of clinical periodontology. - 0303-6979. ; 31:11, s. 996-1002
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Journal article (peer-reviewed)abstract
- BACKGROUND: Most clinical studies assume that the subgingival microbiota is similar from one geographic location to another. The purpose of the present investigation was to examine the composition of the subgingival microbiota in chronic periodontitis subjects from four countries. METHOD: Subjects with chronic periodontitis (N, Sweden=101; USA=115; Brazil=58; Chile=26) were recruited. Subjects were measured at baseline for plaque, gingivitis, bleeding on probing (BOP), suppuration, pocket depth (PD) and attachment level (AL) at six sites per tooth. Subgingival plaque samples taken from the mesial aspect of each tooth at baseline were individually analyzed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization (total samples=6036). % DNA probe counts comprised by each species was determined for each site and averaged across sites in each subject. Significance of differences in proportions of each species among countries was determined using ancova adjusting for age, mean pocket depth, gender and smoking status. p-Values were adjusted for multiple comparisons. RESULTS: On average, all species were detected in samples from subjects in the four countries. Thirteen species differed significantly in adjusted mean proportions among countries even after adjusting for multiple comparisons. Porphyromonas gingivalis, one species that differed in proportions among countries, comprised adjusted means of 7.5, 11.9, 1.6 and 6.6% of the microbiota in subjects from Brazil, Chile, Sweden and USA (p<0.001), while mean proportions of Treponema denticola were 6.7, 4.2, 0.8 and 2.3, respectively (p<0.001). In contrast, a key periodontal pathogen, Tannerella forsythensis, exhibited mean proportions ranging from 6.2-8.5% and did not differ significantly among countries. Besides these species, prominent species in Brazil were Actinomyces naeslundii genospecies 1 and 2 (8.4%, 7.2%) and Prevotella intermedia (6.5%); in Chile, Prevotella melaninogenica (6.4%) and Neisseria mucosa (5.3%); in Sweden A. naeslundii genospecies 2 (8.4%), Capnocytophaga gingivalis (7.1%) and Peptostreptococcus micros (5.0%); in USA A. naeslundii genospecies 2 (7.5%), P. intermedia (6.8%) and C. gingivalis (6.1%). CONCLUSIONS: The microbial profiles of subgingival plaque samples from chronic periodontitis subjects in four countries showed surprisingly marked differences. These differences persisted after adjusting for age, mean pocket depth, gender and smoking status.
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9. |
- Socransky, Sigmund S, et al.
(author)
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Effect of periodontal therapy on the subgingival microbiota over a 2-year monitoring period. I. Overall effect and kinetics of change.
- 2013
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In: Journal of clinical periodontology. - : Wiley. - 1600-051X .- 0303-6979. ; 40:8, s. 771-780
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Journal article (peer-reviewed)abstract
- AIM: To examine the 2-year post-therapy kinetics of change in the composition of subgingival biofilms. MATERIAL AND METHODS: In this study, 178 chronic periodontitis subjects were recruited and clinically monitored at baseline, 3, 6, 12, 18 and 24months after therapy. All subjects received scaling and root planing and 156 one or more of periodontal surgery, systemically administered amoxicillin+metronidazole or local tetracycline at pockets ≥5mm. Subgingival biofilm samples taken from each subject at each time point were analysed for their content of 40 bacterial species using checkerboard DNA-DNA hybridization. The significance of changes in median species counts over time was sought using the Wilcoxon or Friedman tests and adjusted for multiple comparisons. RESULTS: Mean counts were significantly reduced from baseline to 2years for 30 of the 40 taxa. Marked reductions were observed for periodontal pathogens including Tannerella forsythia, Treponema denticola and Eubacterium nodatum. The kinetics of change differed from species to species. When data were subset according to baseline PD, patterns of change in the microbial profiles were generally similar. CONCLUSION: Periodontal therapy leads to a rapid reduction in periodontal pathogens, followed by a slower reduction in other taxa that can be sustained for at least 2years.
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10. |
- Teles, R P, et al.
(author)
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A three-year prospective study of adult subjects with gingivitis II: microbiological parameters.
- 2007
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In: Journal of clinical periodontology. - 0303-6979. ; 34:1, s. 7-17
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Journal article (peer-reviewed)abstract
- AIM: To investigate whether the clinical benefits obtained with a periodontal prevention programme in subjects with periodontal health or minimal disease were accompanied by beneficial changes in the subgingival microbiota. MATERIAL AND METHODS: One hundred and twenty-four subjects completed the study. Subjects were clinically and microbiologically monitored at baseline, 1, 2 and 3 years. Subgingival plaque samples were taken from the mesiobuccal aspect of every tooth and were analysed for the levels of 40 bacterial species using checkerboard DNA-DNA hybridization (total samples=13,477). The mean counts of each of the 40 test species were calculated for each subject at each time point. Significance of differences over time was sought using the Friedman test. p values were adjusted for multiple comparisons. RESULTS: All clinical parameters, at the microbiologically sampled sites, improved over time. The clinical changes were accompanied by statistically significant decreases in the mean counts of 35 of the 40 test species. Major reductions occurred by year 2 for Actinomyces, Capnocytophaga, Campylobacter, Fusobacterium and Prevotella species. At year 3, there was a modest re-growth of the majority of the species. CONCLUSIONS: The clinical improvements obtained through preventive measures were accompanied by a shift to a more host-compatible subgingival microbiota.
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