1. |
- Jannesson, Lillemor, et al.
(författare)
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Effect of oxybenzone on PGE2-production in vitro and on plaque and gingivitis in vivo.
- 2004
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Ingår i: Journal of clinical periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 31:2, s. 91-4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To study the effect of oxybenzone on prostaglandin E2 (PGE2) production in cell culture and to evaluate the effect of an oxybenzone-containing dentifrice on plaque and gingivitis in a 6-week clinical trial. MATERIAL AND METHODS: Human embryo palatal mesenchyme (HEPM) cells were used for testing the inhibition of IL-1beta-stimulated PGE2-production in vitro by different concentrations of oxybenzone. For the in vivo study, a total of 66 individuals with a Quigley & Hein plaque index of at least 1.5 and an Ainamo & Bay gingival index of at least 0.2 were included in a double-blind clinical trial with two cells and a parallel design. Two compositions of fluoride dentifrice were used, one with the addition of 0.5% oxybenzone, and one without. Plaque and gingival index were obtained at three time points: (1) at baseline, (2) after 3 weeks, and (3) after 6 weeks. RESULTS: A dose-dependent inhibition of PGE2-production was found in the HEPM cell culture following oxybenzone exposure. In the clinical trial, a 25% reduction of gingival index was observed in the oxybenzone group (p<0.001) after 6 weeks as compared with 2% for the placebo group. CONCLUSIONS: These findings indicate that PGE2-production is reduced by oxybenzone in vitro and that the use of oxybenzone in a dentifrice reduces gingivitis in vivo.
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2. |
- Ravon, Nicolas A, et al.
(författare)
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Signs of carotid calcification from dental panoramic radiographs are in agreement with Doppler sonography results.
- 2003
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Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 30:12, s. 1084-1090
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Duplex ultrasonography (DS) is a frequently used noninvasive method for assessing carotid artery stenosis. The level of agreement between panoramic radiographs (PMX) findings of radiopacities in the area of C3-C4 and DS results has not been established.AIMS: (1) to examine the level of agreement between DS results and PMX signs of carotid calcification and (2) to evaluate the association between periodontitis and DS results.MATERIAL AND METHODS: Eighty-three subjects who had received a DS assessment at the University of Washington Medical Center within 36 months volunteered for a periodontal examination, including assessments of probing pocket depth (PPD), attachment level (PAL), evidence of bleeding on probing and bone loss from PMX. Two examiners independently analyzed the radiographs for evidence of carotid calcifications. The distance between the cemento-enamel junction (CEJ) to bone level (BL) CEJ-BL was used to assess alveolar bone loss as a criteria for periodontitis.RESULTS: Twenty-nine subjects (34.9%) presented with positive DS readings. The Mantel-Haentszel common odds ratio estimate for a positive DS score and periodontitis (> 30% of teeth with distance CEJ-BL > or = 4.0 mm) was 38.4 (95% CI: 10.6-138.7, p < 0.0001). For nonsmokers only (n = 72) the odds ratio was 43.0 (95% CI: 16.7-1178.0, p < 0.0001). Evidence of bleeding on probing was 16% of sites both in the DS-positive and -negative subjects. Subjects with a positive DS result had significantly more teeth with clinical evidence of attachment loss > or = 5.0 mm (p < 0.001). The odds ratio of having periodontitis (CEJ-BL > or = 4.0 mm at > or = 30% of the teeth) and medical records confirmed diagnosis of either a stroke or an infarct or both was 7.8 (95% CI: 2.6-23.8, p < 0.001).CONCLUSIONS: Subjects with positive DS readings of the carotid arteries due to calcified arterial plaque are accurately detected by means of conventional PMX. The likelihood of being DS positive and having radiographic evidence of periodontitis is high. A dose-response relationship between the extent of carotid calcification and severity of periodontitis was demonstrated, supporting the hypothesis of an association between periodontitis and cardiovascular diseases.
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3. |
- Renvert, Stefan, 1951-, et al.
(författare)
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Analysis of periodontal risk profiles in adults with or without a history of myocardial infarction
- 2004
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Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 31:1, s. 19-24
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: An association between periodontitis and cardiovascular diseases has been suggested.AIMS: To study whether a combination of clinical variables in a functional risk diagram enhanced the ability to differentiate between subjects with or without an immediate history of acute myocardial infarction (AMI).MATERIAL AND METHODS: A functional periodontal pentagon risk diagram (PPRD) with five periodontal risk vectors was created. The surface of individual PPRDs was calculated using data from 88 subjects with recent AMI and 80 matched control subjects with no history of AMI.RESULTS: Age, gender, number of remaining teeth (mean value: 21.1 versus 21.6 teeth), smoking status, and pocket probing depth (PPD) distribution did not differ by group. Gingival recession was greater in control subjects (mean difference: 5.7, SD: +/- 1.9, p<0.01, 95% CI: 1.8-9.6). Bone loss > or = 4.0 mm was at all levels studied was significantly greater in subjects with AMI and bone loss > or = 50% (> or = 4 mm) was the best individual predictor of AMI (beta = 2.99, p < 0.000, 95% CI: 7.5-53.4). Only PPRD scores were associated with AMI status when factors not included in the PPRD were studied (beta = 22.1, SE: 5.9, p < 0.0001, 95% CI: 10.3-33.7). The best association between AMI status and study variables was the combination of > or = 4 mm of bone loss > or = 50%, proportion of bleeding on probing (%BOP), %PPDs > or = 6 mm, and tooth loss (Nagelkirke r2 = 0.46).CONCLUSIONS: The combination of five periodontal parameters in a PPRD added predictive value, suggesting that comprehensive data should be used in studies of associations between periodontitis and heart diseases. Radiographic evidence of bone loss was the best individual parameter.
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4. |
- Renvert, Stefan, et al.
(författare)
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Analysis of periodontal risk profiles in adults with or without a history of myocardial infarction
- 2004
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Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 31:1, s. 19-24
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: An association between periodontitis and cardiovascular diseases has been suggested. AIMS: To study whether a combination of clinical variables in a functional risk diagram enhanced the ability to differentiate between subjects with or without an immediate history of acute myocardial infarction (AMI). MATERIAL AND METHODS: A functional periodontal pentagon risk diagram (PPRD) with five periodontal risk vectors was created. The surface of individual PPRDs was calculated using data from 88 subjects with recent AMI and 80 matched control subjects with no history of AMI. RESULTS: Age, gender, number of remaining teeth (mean value: 21.1 versus 21.6 teeth), smoking status, and pocket probing depth (PPD) distribution did not differ by group. Gingival recession was greater in control subjects (mean difference: 5.7, SD: +/- 1.9, p<0.01, 95% CI: 1.8-9.6). Bone loss > or = 4.0 mm was at all levels studied was significantly greater in subjects with AMI and bone loss > or = 50% (> or = 4 mm) was the best individual predictor of AMI (beta = 2.99, p < 0.000, 95% CI: 7.5-53.4). Only PPRD scores were associated with AMI status when factors not included in the PPRD were studied (beta = 22.1, SE: 5.9, p < 0.0001, 95% CI: 10.3-33.7). The best association between AMI status and study variables was the combination of > or = 4 mm of bone loss > or = 50%, proportion of bleeding on probing (%BOP), %PPDs > or = 6 mm, and tooth loss (Nagelkirke r2 = 0.46). CONCLUSIONS: The combination of five periodontal parameters in a PPRD added predictive value, suggesting that comprehensive data should be used in studies of associations between periodontitis and heart diseases. Radiographic evidence of bone loss was the best individual parameter.
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5. |
- Renvert, Stefan, 1951-, et al.
(författare)
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Patient-based assessments of clinical periodontal conditions in relation to alveolar bone loss
- 2004
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Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 31:3, s. 208-213
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Limited subject-based information exists on the relationship between clinical and radiographic periodontal data.AIMS: To use subject-based data to assess the extent of concurrence between clinical and radiographic information, and to study what clinical information best predicts alveolar bone loss (ABL). Material and Methods: Subject-based data on smoking habits, bleeding on probing, plaque scores, pocket probing depth (PD), and evidence of alveolar BL were obtained, and functional periodontal pentagon risk diagrams (PPRDs) were studied from 168 consecutive subjects attending a medical clinic.RESULTS: The mean age of the subjects was 62.7 years (SD+/-9.0). The average number of teeth was 21.3 (SD+/-8.0) with on average 5.6 molars remaining (SD+/- 3.9). In this subject cohort, 33.1% had never smoked, 44.2% had quit smoking, and 22.7% were currently smokers. Mean plaque and bleeding scores were high or 60.2% (SD+/-24.0) and 53.1% (SD+/-23.6), respectively. PDs >or=6.0 mm were found in 55.9% of the subjects. Binary logistic regression analysis demonstrated that tooth loss and proportional plaque scores were the predominant factors included in the equations associated with ABL. Wald coefficients varied between 3.99 and 9.15, and with p-values between 0.05 and 0.01. When included, the PPRD score became the exclusive factor at several cut-off levels (Wald's coefficients between 19.8 and 15.6, p<0.001). Consequently, the best receiver operator curve was identified for the PPRD at the >40% cut-off ABL level (area under the curve: 0.81; 95% CI: 0.74-0.89; p<0.001).CONCLUSIONS: The number of teeth lost and the proportion of plaque scores provided significant predictive factors for ABL. The functional PPRD demonstrated an exclusive and highly predictable association with ABL. Subject-based proportional data for PDs >4.0 mm provided poor substitute measures for the extent of ABL.
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6. |
- Renvert, Stefan, et al.
(författare)
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Patient-based assessments of clinical periodontal conditions in relation to alveolar bone loss
- 2004
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Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 31:3, s. 208-213
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Limited subject-based information exists on the relationship between clinical and radiographic periodontal data. AIMS: To use subject-based data to assess the extent of concurrence between clinical and radiographic information, and to study what clinical information best predicts alveolar bone loss (ABL). Material and Methods: Subject-based data on smoking habits, bleeding on probing, plaque scores, pocket probing depth (PD), and evidence of alveolar BL were obtained, and functional periodontal pentagon risk diagrams (PPRDs) were studied from 168 consecutive subjects attending a medical clinic. RESULTS: The mean age of the subjects was 62.7 years (SD+/-9.0). The average number of teeth was 21.3 (SD+/-8.0) with on average 5.6 molars remaining (SD+/- 3.9). In this subject cohort, 33.1% had never smoked, 44.2% had quit smoking, and 22.7% were currently smokers. Mean plaque and bleeding scores were high or 60.2% (SD+/-24.0) and 53.1% (SD+/-23.6), respectively. PDs >or=6.0 mm were found in 55.9% of the subjects. Binary logistic regression analysis demonstrated that tooth loss and proportional plaque scores were the predominant factors included in the equations associated with ABL. Wald coefficients varied between 3.99 and 9.15, and with p-values between 0.05 and 0.01. When included, the PPRD score became the exclusive factor at several cut-off levels (Wald's coefficients between 19.8 and 15.6, p<0.001). Consequently, the best receiver operator curve was identified for the PPRD at the >40% cut-off ABL level (area under the curve: 0.81; 95% CI: 0.74-0.89; p<0.001). CONCLUSIONS: The number of teeth lost and the proportion of plaque scores provided significant predictive factors for ABL. The functional PPRD demonstrated an exclusive and highly predictable association with ABL. Subject-based proportional data for PDs >4.0 mm provided poor substitute measures for the extent of ABL.
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11. |
- 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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12. |
- Aghazadeh, Ahmad, et al.
(author)
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A single-center 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. - 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 Materials and methods Subjects receiving antibiotics and surgical debridement were randomly assigned to placement of autogenous bone (AB) or bovine derived xenograft (BDX) 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 22 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 sites the likelihood of defect fill was higher in the BDX group (LR: 3.2, 95 % CI: 1.0 to 10.6, p < 0.05). Conclusions Bovine xenograft provided more radiographic bone fill than autogenous bone. The success for both surgical regenerative procedures was limited. Decreases in PD, BOP, and suppuration were observed.
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13. |
- 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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15. |
- Akhi, Ramin, et al.
(author)
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Cross-reactive saliva IgA antibodies to oxidized LDL and periodontal pathogens in humans.
- 2017
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In: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 44:7, s. 682-691
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Journal article (peer-reviewed)abstract
- AIM: Oxidized low-density lipoproteins (oxLDL) are formed as a result of lipid peroxidation and are highly immunogenic and proatherogenic. In this study, saliva antibodies binding to oxLDL, Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) were characterized and their cross-reactivity was evaluated.MATERIALS AND METHODS: Resting and stimulated saliva samples were collected from 36 healthy adults (mean age 26 years). Saliva IgA, IgG and IgM autoantibody levels to copper oxidized LDL (CuOx-LDL) and malondialdehyde acetaldehyde-modified LDL (MAA-LDL) were determined with chemiluminescence immunoassay.RESULTS: Saliva IgA and IgG antibodies binding to MAA-LDL and CuOx-LDL were detected in all samples and they were associated with the saliva levels of IgA and IgG to P. gingivalis and A. actinomycetemcomitans. Competitive immunoassay showed that saliva antibodies to MAA-LDL cross-reacted specifically with P. gingivalis. The autoantibody levels to oxLDL in saliva were not associated with the autoantibody levels to oxLDL in plasma or with saliva apolipoprotein B 100 levels.CONCLUSIONS: Saliva contains IgA and IgG binding to oxLDL, which showed cross-reactive properties with the periodontal pathogens Porphyromonas gingivalis (P.g). The data suggest that secretory IgA to P.g may participate in immune reactions involved in LDL oxidation through molecular mimicry.
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16. |
- Al-Otaibi, M, et al.
(author)
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Subgingival plaque microbiota in Saudi Arabians after use of miswak chewing stick and toothbrush
- 2004
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 31:12, s. 1048-53
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Journal article (peer-reviewed)abstract
- BACKGROUND: The chewing stick, the miswak, is used in many developing countries as the traditional means for oral hygiene. It is prepared from the roots, twigs and stem of Salvadora persica or other alternative local plants. OBJECTIVES: To compare the effects of the chewing stick miswak (from S. persica) and toothbrush on subgingival plaque microflora among Saudi Arabian individuals. Further, to investigate whether components extracted from S. persica may interfere with the subgingival plaque micro-organisms. MATERIAL AND METHODS: Fifteen healthy Saudi Arabian male volunteers aged 21-36 years were included in a single-blind, randomized cross-over study. The participants were taught how to use each device properly. Plaque sampling for DNA test was performed at the baseline, 1 week after professional tooth cleaning, and after 3 weeks of either miswak or toothbrush use. Identification and quantification of microbial species were performed by the checkerboard method, using whole genomic, digoxigenin-labelled DNA probes. Inhibition zones around miswak were examined on agar plates with Actinobacillus actinomycetemcomitans and the leukotoxicity of this bacterium was analyzed in a bioassay with macrophages+/-extracts of miswak. RESULTS: Miswak and toothbrushing had a similar influence on the levels of the subgingival microbiota. However, A. actinomycetemcomitans was significantly more reduced by miswak (p<0.05) than by toothbrushing. These results were supported by our in vitro results which, indicated that extracts from S. persica might interfere with the growth and leukotoxicity of A. actinomycetemcomitans. CONCLUSIONS: In contrast to toothbrush use, miswak use significantly reduced the amount of A. actinomycetemcomitans in the subgingival plaque.
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17. |
- Albrektsson, Tomas, 1945, et al.
(author)
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State of the art in oral implants.
- 1991
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In: Journal of clinical periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 18:6, s. 474-81
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Research review (peer-reviewed)abstract
- Uncontrolled oral implant devices are still being widely used. The documentation of most oral implant systems is poorly backed up or not followed up for an adequate time period. Success rates are being quoted without reference to any defined success criteria. Frequently used oral implant designs such as the Core-Vent, IMZ and Calcitek hydroxyapatite coated implants are in neither case supported by any adequate clinical reports from minimally 5-years of follow-up. Other implant systems such as the ITI, some subperiosteal designs and the Tübingen implant demonstrate well-controlled and acceptable 5-year data but are not followed up in a sufficient number or have demonstrated less good results in the 10-year evaluation. The Small transosteal staple has been adequately reported for more than 10 years of follow-up, whereas the Brånemark implant is the only endosseous design that has demonstrated acceptable 15-year success rates.
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18. |
- Almohandes, Ahmed, et al.
(author)
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Surgical treatment of experimental peri-implantitis using mechanical and chemical decontamination procedures: A pre-clinical in vivo study
- 2022
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In: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 49:5, s. 518-525
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Journal article (peer-reviewed)abstract
- Aim: To evaluate the effect of surgical treatment of experimental peri-implantitis at implants with different surface characteristics using mechanical and chemical decontamination methods. Materials and Methods: Following extraction of mandibular premolars, four implants with two different surface characteristics (A, moderately rough and B, smooth) were placed in each side of the mandible of six dogs. Experimental peri-implantitis was induced. Surgical treatment of the peri-implantitis sites was carried out using four implant surface decontamination protocols: (i) deposition of a citric acid gel, (ii) mechanical cleaning using a rotating titanium brush, (iii) a combination of the mechanical and chemical procedures, and (iv) saline (control). Clinical and radiographic examinations were performed. Block biopsies were obtained 6months after therapy and prepared for histological analysis. Results: Irrespective of the treatment group, treatment resulted in 0.63 ± 0.92 and 0.65 ± 0.67 mm radiographic bone gain around implants A and B, respectively. Histological analyses revealed that persisting soft tissue inflammation as assessed using an infiltrated connective tissue (ICT) score was significantly lower at implant type B than at implant type A for all treatment groups. The test decontamination procedures did not demonstrate better results regarding resolution of peri-implantitis lesions, as indicated by the ICT scores, than the control procedure. The control treatment resulted in significantly superior outcomes of resolution of peri-implantitis lesions than the citric acid regimen. Conclusions: It is concluded that decontamination procedures including citric acid gel or rotating titanium brush did not improve outcomes following surgical treatment of experimental peri-implantitis. Results were, however, influenced by the implant surface characteristics. © 2022 John Wiley & Sons A/S.
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19. |
- Araújo, Mauricio G, 1966, et al.
(author)
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Dimensional ridge alterations following tooth extraction. An experimental study in the dog.
- 2005
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In: Journal of clinical periodontology. - 0303-6979. ; 32:2, s. 212-8
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study dimensional alterations of the alveolar ridge that occurred following tooth extraction as well as processes of bone modelling and remodelling associated with such change. MATERIAL AND METHODS: Twelve mongrel dogs were included in the study. In both quadrants of the mandible incisions were made in the crevice region of the 3rd and 4th premolars. Minute buccal and lingual full thickness flaps were elevated. The four premolars were hemi-sected. The distal roots were removed. The extraction sites were covered with the mobilized gingival tissue. The extractions of the roots and the sacrifice of the dogs were staggered in such a manner that all dogs contributed with sockets representing 1, 2, 4 and 8 weeks of healing. The animals were sacrificed and tissue blocks containing the extraction socket were dissected, decalcified in EDTA, embedded in paraffin and cut in the buccal-lingual plane. The sections were stained in haematoxyline-eosine and examined in the microscope. RESULTS: It was demonstrated that marked dimensional alterations occurred during the first 8 weeks following the extraction of mandibular premolars. Thus, in this interval there was a marked osteoclastic activity resulting in resorption of the crestal region of both the buccal and the lingual bone wall. The reduction of the height of the walls was more pronounced at the buccal than at the lingual aspect of the extraction socket. The height reduction was accompanied by a "horizontal" bone loss that was caused by osteoclasts present in lacunae on the surface of both the buccal and the lingual bone wall. CONCLUSIONS: The resorption of the buccal/lingual walls of the extraction site occurred in two overlapping phases. During phase 1, the bundle bone was resorbed and replaced with woven bone. Since the crest of the buccal bone wall was comprised solely of bundle this modelling resulted in substantial vertical reduction of the buccal crest. Phase 2 included resorption that occurred from the outer surfaces of both bone walls. The reason for this additional bone loss is presently not understood.
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20. |
- Araujo, M. G., et al.
(author)
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Peri-implant health
- 2018
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In: J Clin Periodontol. - : Wiley. - 0303-6979. ; 45
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Journal article (peer-reviewed)abstract
- ObjectiveThe aim is to define clinical and histologic characteristics of peri-implant tissues in health and describe the mucosa-implant interface. ImportanceAn understanding of the characteristics of healthy peri-implant tissues facilitates the recognition of disease (i.e., departure from health). FindingsThe healthy peri-implant mucosa is, at the microscopic level, comprised of a core of connective tissue covered by either a keratinized (masticatory mucosa) or non-keratinized epithelium (lining mucosa). The peri-implant mucosa averages about 3 to 4mm high, and presents with an epithelium (about 2mm long) facing the implant surface. Small clusters of inflammatory cells are usually present in the connective tissue lateral to the barrier epithelium. Most of the intrabony part of the implant appears to be in contact with mineralized bone (about 60%), while the remaining portion faces bone marrow, vascular structures, or fibrous tissue. During healing following implant installation, bone modeling occurs that may result in some reduction of the marginal bone level. ConclusionsThe characteristics of the peri-implant tissues in health are properly identified in the literature, including tissue dimensions and composition. Deviation from the features of health may be used by the clinician (and researcher) to identify disease, including peri-implant mucositis and peri-implantitis.
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21. |
- Araújo, Mauricio G, 1966, et al.
(author)
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Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog.
- 2005
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In: Journal of clinical periodontology. - 0303-6979. ; 32:6, s. 645-52
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study dimensional alterations of the alveolar ridge that occurred following implant placement in fresh extraction sockets. MATERIAL AND METHODS: Five beagle dogs were included in the study. In both quadrants of the mandible, incisions were made in the crevice region of the third and fourth pre-molars. Buccal and minute lingual full-thickness flaps were elevated. The mesial root of the four pre-molars root was filled and the teeth were hemi-sected. Following flap elevation in (3)P(3) and (4)P(4) regions, the distal roots were removed. In the right jaw quadrants, implants with a sand blasted and acid etched (SLA) surface were placed in the fresh extraction sockets, while in the left jaws the corresponding sockets were left for spontaneous healing. The mesial roots were retained as surgical control teeth. After 3 months, the animals were examined clinically, sacrificed and tissue blocks containing the implant sites, the adjacent tooth sites (mesial root) and the edentulous socket sites were dissected, prepared for ground sectioning and examined in the microscope. RESULTS: At implant sites, the level of bone-to-implant contact (BC) was located 2.6+/-0.4 mm (buccal aspect) and 0.2+/-0.5 mm (lingual aspect) apical of the SLA level. At the edentulous sites, the mean vertical distance (V) between the marginal termination of the buccal and lingual bone walls was 2.2+/-0.9 mm. At the surgically treated tooth sites, the mean amount of attachment loss was 0.5+/-0.5 mm (buccal) and 0.2+/-0.3 mm (lingual). CONCLUSIONS: Marked dimensional alterations had occurred in the edentulous ridge after 3 months of healing following the extraction of the distal root of mandibular pre-molars. The placement of an implant in the fresh extraction site obviously failed to prevent the re-modelling that occurred in the walls of the socket. The resulting height of the buccal and lingual walls at 3 months was similar at implants and edentulous sites and vertical bone loss was more pronounced at the buccal than at the lingual aspect of the ridge. It is suggested that the resorption of the socket walls that occurs following tooth removal must be considered in conjunction with implant placement in fresh extraction sockets.
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24. |
- Axelsson, Per, 1933, et al.
(author)
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The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance.
- 2004
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In: Journal of clinical periodontology. - 0303-6979. ; 31:9, s. 749-57
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Journal article (peer-reviewed)abstract
- BACKGROUND: The biofilm that forms and remains on tooth surfaces is the main etiological factor in caries and periodontal disease. Prevention of caries and periodontal disease must be based on means that counteract this bacterial plaque. OBJECTIVE: To monitor the incidence of tooth loss, caries and attachment loss during a 30-year period in a group of adults who maintained a carefully managed plaque control program. In addition, a comparison was made regarding the oral health status of individuals who, in 1972 and 2002, were 51-65 years old. MATERIAL AND METHODS: In 1971 and 1972, more than 550 subjects were recruited. Three hundred and seventy-five subjects formed a test group and 180 a control group. After 6 years of monitoring, the control group was discontinued but the participants in the test group was maintained in the preventive program and was finally re-examined after 30 years. The following variables were studied at Baseline and after 3, 6, 15 and 30 years: plaque, caries, probing pocket depth, probing attachment level and CPITN. Each patient was given a detailed case presentation and education in self-diagnosis. Once every 2 months during the first 2 years, once every 3-12 months during years 3-30, the participants received, on an individual need basis, additional education in self-diagnosis and self-care focused on proper plaque control measures, including the use of toothbrushes and interdental cleaning devices (brush, dental tape, toothpick). The prophylactic sessions that were handled by a dental hygienist also included (i) plaque disclosure and (ii) professional mechanical tooth cleaning including the use of a fluoride-containing dentifrice/paste. RESULTS: Few teeth were lost during the 30 years of maintenance; 0.4-1.8 in different age cohorts. The main reason for tooth loss was root fracture; only 21 teeth were lost because of progressive periodontitis or caries. The mean number of new caries lesions was 1.2, 1.7 and 2.1 in the three groups. About 80% of the lesions were classified as recurrent caries. Most sites, buccal sites being the exception, exhibited no sign of attachment loss. Further, on approximal surfaces there was some gain of attachment between 1972 and 2002 in all age groups. CONCLUSION: The present study reported on the 30-year outcome of preventive dental treatment in a group of carefully monitored subjects who on a regular basis were encouraged, but also enjoyed and recognized the benefit of, maintaining a high standard of oral hygiene. The incidence of caries and periodontal disease as well as tooth mortality in this subject sample was very small. Since all preventive and treatment efforts during the 30 years were delivered in one private dental office, caution must be exercised when comparisons are made with longitudinal studies that present oral disease data from randomly selected subject samples.
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27. |
- Barone, A., et al.
(author)
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Clinical and Histological changes after ridge preservation with two xenografts: preliminary results from a multicentre randomized controlled clinical trial
- 2017
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In: Journal of Clinical Periodontology. - : Wiley. - 0303-6979. ; 44:2, s. 204-214
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Journal article (peer-reviewed)abstract
- Objectives: To evaluate and compare clinical and histological changes after ridge preservation procedures with those of spontaneous healing. Materials and Methods: Ninety patients were enrolled in the present randomized controlled clinical trial and underwent single-tooth extraction in the premolar/molar areas. Thirty sites were grafted with collagenated cortico-cancellous (coll), 30 sites with cortical (cort) porcine bone and 30 sites underwent natural healing. Primary (vertical and horizontal bone changes after 3 months) and secondary outcomes (histomorphometric after 3 months) were evaluated at implant placement. Results: The vertical bone changes at the grafted sockets were significantly (Rho < 0.0001) lower (0.30 mm for cort group and 0.57 mm for coll group) when compared to non-grafted sockets (2.10 mm for nat group). Moreover, the width reduction of the coll (0.93 mm) and cort (1.33 mm) groups was significantly lower (Rho < 0.0001) than the non-grafted group (3.60 mm). The analysis of subgroups attested that when premolar and molar sites were compared, the buccal bone loss appeared to be dependent both on tooth position and grafting material employed. Conclusion: The ridge preservation procedures had significantly better outcomes when compared to natural healing. The biomaterials did not differ for maintenance of bone width; even though, the bone height seemed to be better preserved with the cortical porcine bone.
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- Berglundh, Tord, 1954, et al.
(author)
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Aspects of adaptive host response in periodontitis.
- 2005
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In: Journal of clinical periodontology. - 0303-6979. ; 32:Suppl 6, s. 87-107
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Research review (peer-reviewed)abstract
- OBJECTIVE: To review host response in periodontitis with respect to cellular composition of lesions, T cell receptor (TCR) gene expression, cytokine profiles of T-helper (Th) cells and autoimmune components. MATERIAL AND METHODS: The studies included were confined to human material (biopsies, gingival crevicular fluid, blood from subjects with periodontitis). RESULTS AND CONCLUSIONS: In periodontitis lesions, plasma cells are the most common cell type and represent about 50% of all cells, while B cells comprise about 18%. The proportion of B cells is larger than that of T cells and Th cells occur in larger numbers than T cytotoxic cells. Polymorphonuclear cells and macrophages are found in fractions of less than 5% of all cells. Lesions in aggressive and chronic forms of periodontitis exhibit similar cellular composition. Differences in disease severity, however, may reflect increases in plasma cell and B cell densities. B cells serve as important antigen-presenting cells in periodontitis. The periodontitis lesion expresses a unique TCR gene repertoire that is different from that in blood. The role of superantigens in periodontitis is unclear. There are few studies using comparative designs and unbiased quantitative methods regarding Th-1 and Th-2 cells in periodontitis. The relative dominance of B cells and plasma cells in periodontitis lesions cannot entirely be explained by enhanced Th-2 functions but maybe because of an imbalance between Th-1 and Th-2. Autoimmune reactions are evident in periodontitis lesions. The role of auto-antibodies in the regulation of host response in periodontitis, however, needs to be clarified. Auto-reactive B cells occur in larger proportions in subjects with periodontitis than in healthy controls.
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- Berglundh, Tord, 1954, et al.
(author)
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Bone reactions to longstanding functional load at implants: an experimental study in dogs.
- 2005
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In: Journal of clinical periodontology. - 0303-6979. ; 32:9, s. 925-32
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The aims of the present investigation were (i) to study marginal bone level alterations following implant installation, abutment connection and functional loading and (ii) to analyse bone tissue reactions to functional load. MATERIAL AND METHODS: Six beagle dogs, about 1-year old, were used. All mandibular pre-molars were extracted. Three months later four implants of the Astra Tech Implants Dental System were installed in one side of the mandible and four standard fixtures of the Brånemark System were placed in the contralateral side of the mandible. Abutment connection was performed 3 months later and a plaque control programme was initiated. Three months after abutment connection fixed partial dentures (FPDs) made in gold were cemented to the maxillary canines and pre-molars. FPDs were also connected to the three posterior implants in each side of the mandible, while the mesial implant in each side was used as an unloaded control. Radiographs were obtained from all implant sites following implant installation, abutment connection and FPD placement. Ten months after the FPD placement the radiographic examination was repeated. The animals were sacrificed and biopsies from all implant sites were obtained and prepared for histological analysis. RESULTS: The radiographic analysis revealed that largest amount of bone loss occurred following implant installation and abutment connection and that this loss was more pronounced at Brånemark than at Astra implants. The bone level alterations that were observed at implants exposed to 10 months of functional load in both implant systems were small and did not differ from control sites. The histological analysis revealed that implants exposed to functional load exhibited a higher degree of bone-to-implant contact than control implants in both implant systems. CONCLUSION: It is suggested that functional load at implants may enhance osseointegration and does not result in marginal bone loss.
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31. |
- Berglundh, Tord, 1954, et al.
(author)
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Histopathological observations of human periimplantitis lesions.
- 2004
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In: Journal of clinical periodontology. - 0303-6979. ; 31:5, s. 341-7
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of the present study was to analyze some characteristics of advanced and progressive periimplantitis lesions in man. MATERIAL AND METHODS: Soft tissue biopsies were obtained from 12 implants in six patients. The implants had been in function between 4 and 21 years and were, with one exception, located in the maxilla. The radiographic examination performed prior to biopsy revealed that all sites exhibited advanced bone loss. Further, clinical signs of severe inflammation, such as suppuration, swelling and/or fistula formation were detected in the majority of sites and seven of the 12 implants were found to be mobile at biopsy. Each biopsy was following fixation embedded in epoxy resin and sections were prepared for histometric and morphometric analysis. RESULTS AND CONCLUSION: It was demonstrated (i). that all soft tissue units harbored large inflammatory cell infiltrates (ICT) that extended to a position apical of a pocket epithelium and (ii). that about 60% of the lesions were occupied by inflammatory cells, among which plasma cells dominated. Numerous amounts of PMN cells occurred not only in the pocket epithelium and adjacent connective tissue areas, but were also present in peri-vascular compartments in more central areas of the ICT.
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32. |
- Berglundh, Tord, 1954, et al.
(author)
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Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions
- 2018
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In: J Clin Periodontol. - : Wiley. - 0303-6979 .- 1600-051X. ; 45
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Journal article (peer-reviewed)abstract
- A classification for peri-implant diseases and conditions was presented. Focused questions on the characteristics of peri-implant health, peri-implant mucositis, peri-implantitis, and soft- and hard-tissue deficiencies were addressed. Peri-implant health is characterized by the absence of erythema, bleeding on probing, swelling, and suppuration. It is not possible to define a range of probing depths compatible with health; Peri-implant health can exist around implants with reduced bone support. The main clinical characteristic of peri-implant mucositis is bleeding on gentle probing. Erythema, swelling, and/or suppuration may also be present. An increase in probing depth is often observed in the presence of peri-implant mucositis due to swelling or decrease in probing resistance. There is strong evidence from animal and human experimental studies that plaque is the etiological factor for peri-implant mucositis. Peri-implantitis is a plaque-associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. Peri-implantitis sites exhibit clinical signs of inflammation, bleeding on probing, and/or suppuration, increased probing depths and/or recession of the mucosal margin in addition to radiographic bone loss. The evidence is equivocal regarding the effect of keratinized mucosa on the long-term health of the peri-implant tissue. It appears, however, that keratinized mucosa may have advantages regarding patient comfort and ease of plaque removal. Case definitions in day-to-day clinical practice and in epidemiological or disease-surveillance studies for peri-implant health, peri-implant mucositis, and peri-implantitis were introduced. The proposed case definitions should be viewed within the context that there is no generic implant and that there are numerous implant designs with different surface characteristics, surgical and loading protocols. It is recommended that the clinician obtain baseline radiographic and probing measurements following the completion of the implant-supported prosthesis.
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41. |
- Bertl, Kristina, et al.
(author)
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A root canal filling per se does not have a significant negative effect on the marginal periodontium
- 2015
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 42:6, s. 520-529
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Journal article (peer-reviewed)abstract
- Aim: To evaluate the periodontal status of single-rooted endodontically treated teeth (ET), correcting for patient- and tooth-related factors. Methods: Clinical parameters (BoP,PD,CAL) of 240 ET and 240 contralateral vital teeth (VT), before and after non-surgical periodontal treatment, were extracted retrospectively from the journals of 175 patients. Possible patientrelated (age, gender, smoking status) and tooth-related (interproximal restoration, root canal filling’s extent, post, tooth type) confounders were tested. Results: At baseline, frequency of BoP at an interproximal site at ET versus VT was 70.4% versus 65.0%, respectively. The frequency of teeth with interproximal PD ≥5 mm and CAL ≥5 mm was 47.9% versus 42.9% and 54.6% versus 49.6% at ET and VT, respectively. Interproximal PD and CAL at ET versus VT were 3.86 versus 3.61 mm and 4.11 versus 3.95 mm. After correcting for tooth-related factors, no significant differences were observed between ET and VT. An improper restoration had a significant (p < 0.001) negative effect on BoP [OR 3.49 (95%CI: 1.95–6.27)], PD [36.81% (95%CI: 18.52–57.92)] and CAL [27.01% (95% CI: 12.67–43.18)]. No significant differences between ET and VT were observed regarding clinical outcome of non-surgical periodontal therapy. Conclusions: Presence of a root canal filling per se does not have a significant negative influence on the marginal periodontium, when correcting for the quality of the interproximal restoration.
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42. |
- Bertl, Kristina, et al.
(author)
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Health-related quality of life aspects of the ‘Periodontitis prevalence in ulcerative colitis and Crohn's disease’ (PPCC) cohort
- 2023
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 50:12, s. 1601-1620
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Journal article (peer-reviewed)abstract
- Aim: To assess whether oral health problems affect disease-specific quality of life (QoL) of inflammatory bowel disease (IBD) patients, and vice versa, whether IBD affects oral-health-related QoL.Materials and Methods: Individuals reporting IBD and matched controls were surveyed on general anamnestic information, oral-health-related questions and the Oral Health Impact Profile (OHIP)-5. IBD patients were additionally surveyed on years since diagnosis, disease activity and severity as well as health-related QoL (Short Inflammatory Bowel Disease Questionnaire, sIBDQ). OHIP-5 and sIBDQ were defined as primary outcome parameters, and several predictors and confounders were used in adjusted univariable and multivariable regression analyses.Results: Answers from 1108 IBD patients and 3429 controls were analysed. Compared with controls, IBD patients reported significantly more frequently an oral impact on daily life and worse oral-health-related QoL, with Crohn's disease (CD) patients being more severely affected than ulcerative colitis (UC) patients. The diagnosis of UC and CD, having <20 teeth, severe periodontitis and stressful daily-life experience were associated with a higher prevalence of poor oral-health-related QoL. Among IBD patients, an impaired IBD-specific, health-related QoL was significantly associated with the diagnosis of CD and depression, IBD activity and severity, having <20 teeth, presence of oral lesions and stressful daily-life experience, while a longer time since diagnosis was significantly associated with an improved IBD-specific, health-related QoL.Conclusions: The results of the present study indicate, for the first time, that oral health problems are associated with an impairment of IBD-specific health-related QoL, and vice versa, IBD is associated with an impaired oral health-related QoL. This emphasizes the potential advantages of including dental professionals in the multi-disciplinary treatment teams of IBD patients.
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43. |
- Bertl, Kristina, et al.
(author)
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How old is old for implant therapy in terms of early implant losses?
- 2019
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 46:12, s. 1282-1293
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Journal article (peer-reviewed)abstract
- Objectives: To assess, retrospectively, whether older age has an impact on implant osseointegration when compared with younger age. Methods: All patients ≥65 years old at implant installation, in an university setting over a time-period of 11.5 years, with complete anamnestic data and follow-up until prosthetic restoration were included and any early implant loss (EIL; i.e., lack of osseointegration prior to or at time-point of prosthetic restoration) was recorded. Further, one implant, from each of the elderly patients was attempted matched to one implant in a younger patient (35 to <55 years old at implant installation) from the same clinic based on: (1) gender, (2) implant region, (3) smoking status, and (4) bone grafting prior to/simultaneously with implant installation. The potential impact of various local and systemic factors on EIL in the entire elderly population, and in the matched elderly and younger patient group were statistically assessed. Results: Four-hundred-forty-four patients ≥65 years old (range 65.1-91.3; 56.8% female) receiving 1517 implants were identified; 10 patients had one EIL each (implant/patient level: 0.66/2.25%). Splitting this patient cohort additionally into 4 age groups [65-69.9 (n=213), 70-74.9 (n=111), 75-79.9 (n=80), ≥80 (n=40)] EIL was on the implant level 0.41, 0.83, 0.34, and 2.26%, respectively, (p=0.102) and on the patient level 1.41, 2.70, 1.25, and 7.50%, respectively, (p=0.104); multilevel analysis showed weak evidence of association of increasing age with higher EIL rate (p = 0.090). Matching was possible in 347 cases, and 5 (1.44%) and 9 (2.59%) EIL in the elderly and younger patients, respectively, were observed (p=0.280). EIL could not be associated with any systemic condition or medication intake. Conclusions: Elderly patients ≥65 years old presented a similarly low EIL rate as younger patients 35 to <55 years old, while patients ≥80 years old may have a slight tendency for a higher EIL rate. Hence, aging does not seem to compromise osseointegration, and if at all, then only slightly and at a later stage of life.
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44. |
- Bertl, Kristina, et al.
(author)
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Hyaluronan in Non-Surgical and Surgical Periodontal Therapy. A Systematic Review.
- 2015
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In: Journal of Clinical Periodontology. - : Wiley. - 1600-051X .- 0303-6979. ; 42:3, s. 236-246
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Journal article (peer-reviewed)abstract
- AIM: To evaluate the effect of hyaluronan (HY) application as monotherapy or as adjunct to non-surgical and/or surgical periodontal therapy. METHODS: Literature search was performed according to PRISMA guidelines with the following main eligibility criteria: (a) English or German language; (b) preclinical in-vivo or human controlled trials; (c) effect size of HY evaluated histologically or clinically. RESULTS: Two preclinical in-vivo studies on surgical treatment and 12 clinical trials on non-surgical and/or surgical treatment were included. Most of the studies were highly heterogeneous, regarding with HY product used and application mode, and of high risk of bias, thus not allowing meta-analysis. The majority of clinical studies described a beneficial, occasionally statistically significant, effect of HY on bleeding on probing (BoP) and pocket depth (PD) reduction (2.28-19.5% and 0.2-0.9mm, respectively), comparing to controls; no adverse effects were reported. CONCLUSIONS: HY application as adjunct to non-surgical and surgical periodontal treatment seems to have a beneficial, generally moderate, effect on surrogate outcome variables of periodontal inflammation, i.e., BoP and residual PD, and appears to be safe. The large heterogeneity of included studies, does not allow recommendations on the mode of application or effect size of HY as adjunct to non-surgical and surgical periodontal treatment.
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45. |
- Bertl, Kristina, et al.
(author)
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Periodontitis prevalence in patients with ulcerative colitis and Crohn's disease - PPCC : a case–control study
- 2022
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In: Journal of Clinical Periodontology. - : Wiley-Blackwell. - 0303-6979 .- 1600-051X. ; 49:12, s. 1262-1274
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Journal article (peer-reviewed)abstract
- Aim: The aim of this questionnaire-based, case-control study was to assess whether self-reported oral health and periodontitis in ulcerative colitis (UC) and Crohn's disease (CD) patients differ from that in matched controls without inflammatory bowel disease (IBD).Methods: A survey including questions on general anamnestic information, IBD diagnosis, and oral health was distributed online. Self-perceived overall health of teeth and gums, severe periodontitis, and tooth loss were defined as outcome parameters.Results: Analyses were based on answers from 1108 IBD patients and 3429 controls. IBD patients reported significantly worse oral health and more periodontal problems compared to controls. Regression analyses corrected for relevant confounders showed for UC and CD patients significantly increased odds for fair or poor self-perceived overall health of teeth and gums (OR 2.147 and 2.736, respectively) and for severe periodontitis (OR 1.739 and 2.574, respectively) compared to controls; CD patients presented additionally 91% higher odds for having <20 remaining teeth.Conclusions: UC and CD patients have significantly increased odds for worse self-perceived oral health and severe periodontitis compared to controls, with CD patients being more severely affected and losing more teeth. It is strongly recommended that IBD patients are kept under close surveillance to prevent periodontitis development and/or mitigate its progression.
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46. |
- Bertl, Kristina, et al.
(author)
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The impact of a “successfully treated stable periodontitis patient status” on patient‐related outcome parameters during long‐term supportive periodontal care
- 2022
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 49:2, s. 101-110
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Journal article (peer-reviewed)abstract
- Aim: To assess the importance of achieving a successfully treated stable periodontitis patient status (PPS) during long-term supportive periodontal care (SPC).Methods: This retrospective cohort study included 100 periodontitis patients, who continued for ≥ 7.5 years after active periodontal treatment with SPC and were judged as overall adherent. The effect of various predictors on 3 patient-related outcome parameters was assessed: number of 1) diseased teeth at last SPC, 2) teeth lost due to periodontitis, and 3) teeth lost due to any reason.Results: One fifth of the patients were classified as stable after active periodontal treatment. After a mean follow-up of 10.77 years, 24 patients lost 38 teeth due to periodontitis. An unstable PPS and a higher number of diseased teeth per patient at first SPC, and inadequate oral hygiene levels over time significantly increased the risk for a higher number of diseased teeth per patient at last SPC and for more lost teeth due to periodontitis. However, high adherence to SPC appeared to mitigate the negative effect of an unstable PPS, especially regarding tooth loss due to periodontitis. Further, tooth loss due to any reason was about 3-times higher than tooth loss due to periodontitis and was affected by a larger number of predictors.Conclusions: Successfully treated patients with a stable PPS maintained a low number of diseased teeth and barely lost teeth during long-term SPC compared to patients not achieving a stable PPS after active periodontal therapy.
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