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Lang NP, Schätzle M, Ramseier CA. Natural history of periodontal disease: The original Sri Lanka and Oslo studies. Periodontol 2000 2024. [PMID: 38520126 DOI: 10.1111/prd.12545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 03/25/2024]
Abstract
Susceptibility to periodontal disease depends on individual factors within the host response to the bacterial challenge. The study of these factors requires longitudinal studies of an undisturbed development of the disease process. On the basis of the original longitudinal studies on the natural histology of periodontal disease staged in Sri Lanka and Oslo/Norway, several analyses of periodontal parameters and tooth status have been performed. The main findings were that in the first 20 years of complete absence of oral hygiene practices or preventive services attachment was lost at various rates. Three groups of subjects could be identified: rapidly progressing (RP) (8%), moderately progressing (MP) (81%), and subjects with no disease progression (NP) (11%). In the second two decades, the RP subjects have lost most of their teeth and no NP patients were identified anymore. The progression rate in these two decades was much slower, and the tooth mortality decreased. It could be predicted that subjects who had lost more than 2 mm at age 30 would not maintain a functional dentition at age 60. The corresponding control population in Oslo was used to study the influence of gingival inflammation on the initiation and progression of periodontal disease. The pattern and rates of attachment loss were identified in a population that was exposed to optimal and regular preventive services from age 3 onward. In the observation period of 26 years, it could be demonstrated that gingival inflammation varied little throughout adult life and always bleeding sites occurred consistently in 10% to 20%. The role of ongoing gingivitis in the pathogenesis of attachment loss was identified and also reflected stability whenever it was absent. Tooth mortality was only found in subjects with ongoing gingivitis. After 50 years of tooth age, 63% of the teeth were still maintained, while 99.8% were maintained after 50 years when gingival inflammation had been absent. Consequently, continuous gingivitis represented a risk factor for tooth loss.
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2
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Moore GC, Smith KT, Christiansen MM, Anderson L, Moravec LJ, Okano DK, Samson KK, Ramer-Tait A, Beede K, Reinhardt RA, Killeen AC. Effect of interproximal home oral hygiene on clinical parameters and inflammatory biomarkers in patients receiving periodontal maintenance. J Periodontol 2023. [PMID: 36799307 DOI: 10.1002/jper.22-0631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND The purpose of this 6-week, single-blinded, randomized clinical trial was to determine if the use of an interproximal brush, with or without a tracking device, is more effective than an oral irrigator in improving interproximal probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), bleeding on probing (BOP), and inflammatory markers. METHODS Seventy-six patients with Stages III-IV, Grade B periodontitis and a 5-7 mm posterior interproximal PD with BOP were randomized: (1) interproximal brush alone (IB; n = 26), (2) interproximal brush with tracking device (TD; n = 23), (3) oral irrigator (OI; n = 27). Participants used devices once daily for 6 weeks. Clinical measurements (PD, CAL, PI, BOP, GI) and gingival crevicular fluid (GCF) samples were collected at baseline and 6 weeks. RESULTS All groups showed a significant reduction in PD and CAL (≥1.1 mm, p < 0.0001) and improvement in BOP (≥56%, p < 0.0001) and GI (≥82%, p < 0.001) at the experimental site with no differences among groups. The IB and IB+TD groups showed a significant reduction in PI (≥0.9, p ≤ 0.01). Interleukin (IL)-1β was reduced in all groups (p = 0.006), but IB+TB more than OI (p ≤ 0.05). IL-10 was reduced among all groups (p = 0.01), while interferon-gamma significantly increased (p = 0.01) in all groups. CONCLUSIONS IB and OI improved clinical parameters of PD and CAL and reduced inflammatory markers (BOP, GI, GCF IL-1β). IB had better interproximal plaque reduction. Tracking did not significantly improve clinical parameters compared with the IB and OI groups, suggesting future modifications are needed.
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Affiliation(s)
- Grace C Moore
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - Kevin T Smith
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - Mary M Christiansen
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - Laura Anderson
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - Lisa J Moravec
- Department of Dental Hygiene, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - David K Okano
- Department of Periodontics, University of Utah School of Dentistry, Salt Lake City, Utah, USA
| | - Kaeli K Samson
- Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Nebraska, USA
| | - Amanda Ramer-Tait
- Department of Food Science and Technology, University of Nebraska, Lincoln, Nebraska, USA
| | - Kristin Beede
- Department of Food Science and Technology, University of Nebraska, Lincoln, Nebraska, USA
| | - Richard A Reinhardt
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - Amy C Killeen
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
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3
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Ide M, Karimova M, Setterfield J. Oral Health, Antimicrobials and Care for Patients With Chronic Oral Diseases – A Review of Knowledge and Treatment Strategies. FRONTIERS IN ORAL HEALTH 2022; 3:866695. [PMID: 35747534 PMCID: PMC9210540 DOI: 10.3389/froh.2022.866695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
Periodontal and chronic oral mucosal diseases are significant life impacting conditions which may co-exist and synergistically act to cause more severe and widespread oral pathology with enhanced challenges in effective management. Clinicians regularly observe these effects and struggle to effectively manage both problems in many patients. There is limited understanding of many basic and applied scientific elements underpinning potentially shared aetiopathological features and management. Recent developments in translational science provide an opportunity to greater improve knowledge and subsequently care for patients with these problems.
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4
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Kim H, Momen-Heravi F, Chen S, Hoffmann P, Kebschull M, Papapanou PN. Differential DNA methylation and mRNA transcription in gingival tissues in periodontal health and disease. J Clin Periodontol 2021; 48:1152-1164. [PMID: 34101221 DOI: 10.1111/jcpe.13504] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/13/2021] [Accepted: 05/14/2021] [Indexed: 12/25/2022]
Abstract
AIM We investigated differential DNA methylation in gingival tissues in periodontal health, gingivitis, and periodontitis, and its association with differential mRNA expression. MATERIALS AND METHODS Gingival tissues were harvested from individuals and sites with clinically healthy and intact periodontium, gingivitis, and periodontitis. Samples were processed for differential DNA methylation and mRNA expression using the IlluminaEPIC (850 K) and the IlluminaHiSeq2000 platforms, respectively. Across the three phenotypes, we identified differentially methylated CpG sites and regions, differentially expressed genes (DEGs), and genes with concomitant differential methylation at their promoters and expression were identified. The findings were validated using our earlier databases using HG-U133Plus2.0Affymetrix microarrays and Illumina (450 K) methylation arrays. RESULTS We observed 43,631 differentially methylated positions (DMPs) between periodontitis and health, and 536 DMPs between gingivitis and health (FDR < 0.05). On the mRNA level, statistically significant DEGs were observed only between periodontitis and health (n = 126). Twelve DEGs between periodontitis and health (DCC, KCNA3, KCNA2, RIMS2, HOXB7, PNOC, IRX1, JSRP1, TBX1, OPCML, CECR1, SCN4B) were also differentially methylated between the two phenotypes. Spearman correlations between methylation and expression in the EPIC/mRNAseq dataset were largely replicated in the 450 K/Affymetrix datasets. CONCLUSIONS Concomitant study of DNA methylation and gene expression patterns may identify genes whose expression is epigenetically regulated in periodontitis.
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Affiliation(s)
- Hyunjin Kim
- Biomedical Informatics Shared Resource, Herbert Irving Comprehensive Cancer Center and Department of Systems Biology, Columbia University, New York, New York, USA.,Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Fatemeh Momen-Heravi
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Steven Chen
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Moritz Kebschull
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA.,School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
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5
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Pawelczyk-Madalińska M, Benedicenti S, Sălăgean T, Bordea IR, Hanna R. Impact of Adjunctive Diode Laser Application to Non-Surgical Periodontal Therapy on Clinical, Microbiological and Immunological Outcomes in Management of Chronic Periodontitis: A Systematic Review of Human Randomized Controlled Clinical Trials. J Inflamm Res 2021; 14:2515-2545. [PMID: 34163210 PMCID: PMC8214554 DOI: 10.2147/jir.s304946] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/01/2021] [Indexed: 12/17/2022] Open
Abstract
Background Due to the limitations of scaling and root planing (SRP) in chronic periodontitis (CP) management, research has been focused on utilising additional therapies to enhance conventional treatment methods. The present systematic review is aimed to appraise the accessible scientific evidence of in vivo human studies to establish the effectiveness of adjunctive diode (λ 808- λ 980nm) laser treatment to SRP in CP. Methodology This systematic review was conducted following the PRISMA statement guidelines. The review protocol is registered in PROSPERO (CRD 42021227695). The search strategies were based on structured electronic and manual (with appropriate keywords) and were conducted to collect the applicable published data on RCTs studies (in vivo human), spanning over ten years between August 2010 and August 2020. The articles were selected to address the following research focus question: “Does diode laser (λ 808- λ 980nm) therapy have superior effects as an adjunct to SPR, compared to SRP alone, in terms of clinical or microbiological or immunological profiles in the management of CP?” Results Fifteen articles met the eligibility criteria and are included in this review. A wide range of discrepancies and inconsistencies were shown in the outcomes of the laser and SPR treatment modality, compared to SRP alone. The data on standardised study protocol, optimal laser parameters and outcome measurements were inconclusive, and a high risk of bias in the majority of the studies observed, which are crucial in establishing a homogenous and reproducible protocol. Conclusion In light of the confined evidence-based data and critical evaluation of this systematic review, the efficacy of adjunctive diode laser treatment ranging between 808 and 980nm to SRP remains debatable. The observational quality of the present systematic review was emphasised after scrutinising the available data, and an attempt to propose a laser protocol for future RCTs consideration was a great challenge due to an absence of clear and standardised recommendations in delivering a reliable laser protocol which can be replicable by future investigators. RCTs with robust methodology are warranted.
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Affiliation(s)
- Magdalena Pawelczyk-Madalińska
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.,Department of Periodontology, Pomeranian Medical University, Szczecin, 70-204, Poland.,FAN-DENT Centrum Stomatologii i Periodontologii, Gdańsk, 80-257, Poland
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy
| | - Tudor Sălăgean
- Department of Land Measurements and Exact Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Cluj-Napoca, Romania
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy.,Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, UK
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Wang B, Mastrogiacomo S, Yang F, Shao J, Ong MMA, Chanchareonsook N, Jansen JA, Walboomers XF, Yu N. Application of BMP-Bone Cement and FGF-Gel on Periodontal Tissue Regeneration in Nonhuman Primates. Tissue Eng Part C Methods 2020; 25:748-756. [PMID: 31701811 DOI: 10.1089/ten.tec.2019.0160] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The ultimate challenge of tissue engineering research is the translation of experimental knowledge into clinical application. In the preclinical testing phase of any new therapy, animal models remain the gold standard. Therefore, the methodological choice of a suitable model is critical to meet the requirements for a safe clinical application of the developed treatment. For instance, we have shown in rats that the application of calcium phosphate cement (CPC)/propylene glycol alginate (PGA) with bone morphogenetic protein (BMP)-2 or fibroblast growth factor (FGF)-2 resulted in the regeneration of periodontal defects. However, it is debated whether using small models form a predictive method for translation to larger species. At the same time, the 3R framework is encouraged as guiding principles of the ethical use of animal testing. Therefore, based on the successful rat study, the objective of this study was to further investigate the periodontal regenerative efficacy of the CPC/BMP and PGA/FGF system in a periodontal defect model with a low number of nonhuman primates (NHPs). Three Macaca fascicularis-overstocked from breeding for other purposes-were used (reuse of animals and appropriateness of the experimental animal species according to 3R framework). Three-wall periodontal defects were surgically created in the mandible. In total, 10 defects were created and distributed over two groups: (1) control group: PGA+CPC (n = 5) and (2) experimental group: PGA/FGF+CPC/BMP (n = 5). After 3 months, tissue regeneration was evaluated by histomorphometry and radiographic measurements. Data showed that epithelial downgrowth, cementum, and ligament regeneration were significantly enhanced in the experimental group compared with the control group (n = 5; p = 0.013, p = 0.028, and p = 0.018, respectively). However, the amount of newly formed bone did not differ (p = 0.146). Overall, as a translational proof-of-principle study, the hybrid periodontal regenerative method of CPC/BMP+PGA/FGF promoted periodontal regeneration in NHPs. This study warrants the application of CPC/BMP/PGA/FGF in clinical trials. Impact Statement This study validated an earlier successful periodontal regeneration strategy from a rat model into a few spare nonhuman primates (NHPs). The hybrid periodontal regenerative method of calcium phosphate cement (CPC)/bone morphogenetic protein (BMP)-2/propylene glycol alginate (PGA)/fibroblast growth factor (FGF)-2 promoted periodontal regeneration in NHPs, which corroborated the previous rat results. This translational approach was a very practical option and thus reduced the number and species of experimental animals in translational research. These results found in NHPs indicate a consistent conclusion with the earlier findings in the rat model. It further warrants the application of CPC/BMP-2+PGA/FGF-2 in human clinical trials.
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Affiliation(s)
- Bing Wang
- Department of Dentistry-Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands.,School of Stomatology, Shandong University, Jinan, Shandong, China
| | - Simone Mastrogiacomo
- Department of Dentistry-Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands.,Laboratory of Functional and Molecular Imaging, NINDS, National Institutes of Health, Bethesda, Maryland
| | - Fang Yang
- Department of Dentistry-Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jinlong Shao
- Department of Dentistry-Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands.,School of Stomatology, Shandong University, Jinan, Shandong, China
| | - Marianne Meng Ann Ong
- National Dental Centre Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Nattharee Chanchareonsook
- National Dental Centre Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - John A Jansen
- Department of Dentistry-Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands
| | - X Frank Walboomers
- Department of Dentistry-Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Na Yu
- National Dental Centre Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
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7
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Zhang L, Deng S. Effects of astragaloside IV on inflammation and immunity in rats with experimental periodontitis. Braz Oral Res 2019; 33:e032. [PMID: 31038567 DOI: 10.1590/1807-3107bor-2019.vol33.0032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/19/2019] [Indexed: 01/22/2023] Open
Abstract
This study aimed to investigate the effects of astragaloside IV (AsIV) on inflammation and immunity in rats with experimental periodontitis. Periodontitis was established in 48 Wistar rats, which were then randomly divided into model and 10, 20 and 40 mg/kg AsIV groups, with 12 rats in each group. The latter 3 groups were treated with AsIV at doses of 10, 20 and 40 mg/kg, respectively. The control group (12 rats, without periodontitis) and model group were given the same amount of 5% sodium carboxymethyl cellulose. The treatment was performed once per day for 8 weeks. Before and after treatment, the tooth mobility scores of the rats were determined. After treatment, the salivary occult blood index (SOBI), plaque index (PLI), peripheral blood T lymphocyte subsets, and serum inflammatory factor and immunoglobulin levels were determined. The results showed that, after treatment, compared with that in model group, in 40 mg/kg AsIV group, the general state of rats was improved, while the tooth mobility score, SOBI and PLI were significantly decreased (p < 0.05); the peripheral blood CD4+ T cell percentage and CD4+/CD8+ ratio were significantly increased (p < 0.05), while the CD8+ T cell percentage was significantly decreased (p < 0.05); the serum tumor necrosis factor-α, interleukin-1β and interleukin-2 levels were significantly decreased (p < 0.05); the serum immunoglobulin A and immunoglobulin G levels were significantly decreased (p < 0.05). In conclusion, AsIV can alleviate inflammation and enhance immunity in rats with experimental periodontitis.
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Affiliation(s)
- Liqiong Zhang
- Huazhong University of Science and Technology, Tongji Medical College, The Central Hospital of Wuhan, Wuhan 430014, China
| | - Shaolin Deng
- Huazhong University of Science and Technology, Tongji Medical College, The Central Hospital of Wuhan, Wuhan 430014, China
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8
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Bawankar PV, Kolte AP, Kolte RA. Evaluation of stress, serum and salivary cortisol, and interleukin‐1β levels in smokers and non‐smokers with chronic periodontitis. J Periodontol 2018; 89:1061-1068. [DOI: 10.1002/jper.18-0028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/27/2018] [Accepted: 03/04/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Pranjali V. Bawankar
- Department of Periodontics & ImplantologyVSPM Dental College and Research Centre Nagpur India
| | - Abhay P. Kolte
- Department of Periodontics & ImplantologyVSPM Dental College and Research Centre Nagpur India
| | - Rajashri A. Kolte
- Department of Periodontics & ImplantologyVSPM Dental College and Research Centre Nagpur India
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9
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Moslemi N, Rouzmeh N, Shakerinia F, Bahador A, Soleimanzadeh Azar P, Kharazifard MJ, Paknejad M, Fekrazad R. Photodynamic Inactivation of Porphyromonas gingivalis utilizing Radachlorin and Toluidine Blue O as Photosensitizers: An In Vitro Study. J Lasers Med Sci 2018; 9:107-112. [PMID: 30026895 DOI: 10.15171/jlms.2018.21] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction:Porphyromonas gingivalis is one of the major pathogens in the development and progression of periodontal disease. Antimicrobial photodynamic therapy (aPDT) is a new approach which is sorted in non-invasive phototherapy for bacterial elimination. This in vitro study was conducted to compare photodynamic inactivation using Radachlorin and Toluidine blue O (TBO) as photosensitizers on P. gingivalis. Methods: Bacterial suspensions (200 µL) of P. gingivalis were exposed to either TBO with concentration of 0.1 mg/mL associated with portable light-emitting diode (LED) device (peak wavelength: 630 nm, output intensity: 2.000 mW/cm2, tip diameter: 6.2 mm) or 0.1% Radachlorin® and laser irradiation (InGaAlP, Peak wavelength: 662±0.1% nm, output power: 2.5 W, energy density: 6 J/cm2, fiber diameter: 2 mm). Those in control groups were subjected to laser irradiation or LED alone, Radachlorin® or TBO alone, and one group received neither photosensitizer nor light irradiation. Then counting of colony forming units (CFU) was performed to determine the bactericidal effects in each subgroup. Results: LED-based aPDT reduced the colony count of P. gingivalis more than that of TBO (P<0.001) or LED group (P=0.957). Also, laser-based aPDT had a great reduction in colony count of P. gingivalis in comparison with Radachlorin® (P<0.001) or laser irradiation alone (P=0.28). In addition, the colony count reduction of laser-based aPDT was significantly more than LED-based aPDT (P<0.05). Conclusion: Considering the results of this study, the viability of P. gingivalis was more affected by the combination of laser and Radachlorin® 0.1% in comparison with LED and TBO 0.1.
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Affiliation(s)
- Neda Moslemi
- Laser Research Center of Dentistry, Dental Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nina Rouzmeh
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Abbas Bahador
- Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Javad Kharazifard
- Dental Research Center, Dental Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Paknejad
- Dental Research Center, Dental Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Fekrazad
- Department of Periodontics, Dental Faculty, AJA University of Medical Sciences, Tehran, Iran
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10
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Alade GO, Ayanbadejo PO, Umeizudike KA, Ajuluchukwu JN. Association of Elevated C-Reactive Protein with Severe Periodontitis in Hypertensive Patients in Lagos, Nigeria: A Pilot Study. Contemp Clin Dent 2018; 9:S95-S99. [PMID: 29962772 PMCID: PMC6006880 DOI: 10.4103/ccd.ccd_104_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: Epidemiological studies have shown that individuals with chronic periodontitis have a significantly higher risk of developing cardiovascular complications, which might be attributed to the increased production of inflammatory cytokines initiated by the complex microbiota in dental biofilm. Aim: The study aims to evaluate the association between chronic periodontitis and C-reactive protein (CRP) levels in a group of hypertensive individuals in Nigeria. Materials and Methods: The investigator enrolled 50 hypertensive patients with chronic periodontitis into the study from the medical outpatient clinic of a teaching hospital in Lagos, Nigeria. Full-mouth periodontal examination was done to assess the participant's periodontal status, with probing depths and clinical attachment levels of six sites on all teeth. The investigator defined periodontitis as at least one interproximal site with probing depth ≥4 mm. Classification of participants into three groups was done based on their severity of periodontitis; mild (n = 16), moderate (n = 27), and severe (n = 7) periodontitis. Their CRP serum levels were measured, and the association with the severity of periodontitis was determined. P was found to be ≤ 0.05. Results: The median CRP levels were 1.0 (0.6, 2.2), 2.4 (1.1, 4.8), and 4.1 mg/L (3.3, 9.4) for mild, moderate, and severe chronic periodontitis, respectively. The association between the serum CRP levels and severity of periodontitis was statistically significant (P = 0.006). Conclusion: There was an association of elevated serum CRP level with increased severity of chronic periodontitis in hypertensive individuals. This preliminary finding among Nigerians suggests that chronic periodontal inflammation may contribute to systemic inflammatory burden in hypertensive patients.
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Affiliation(s)
- Grace Onyenashia Alade
- Department of Preventive and Social Dentistry, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Patricia Omowunmi Ayanbadejo
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Kehinde Adesola Umeizudike
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Janet Ngozi Ajuluchukwu
- Department of Medicine, Cardiology Unit, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
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11
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Teles R, Moss K, Preisser JS, Genco R, Giannobile WV, Corby P, Garcia N, Jared H, Torresyap G, Salazar E, Moya J, Howard C, Schifferle R, Falkner KL, Gillespie J, Dixon D, Cugini M. Patterns of periodontal disease progression based on linear mixed models of clinical attachment loss. J Clin Periodontol 2017; 45:15-25. [PMID: 28985450 DOI: 10.1111/jcpe.12827] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2017] [Indexed: 11/30/2022]
Abstract
AIM The goal of the present longitudinal cohort study was to examine patterns of periodontal disease progression at progressing sites and subjects defined based on linear mixed models (LMM) of clinical attachment loss (CAL). MATERIALS AND METHODS A total of 113 periodontally healthy and 302 periodontitis subjects had their CAL calculated bimonthly for 12 months. LMMs were fitted for each site and the predicted CAL levels used to categorize their progression state. Participants were grouped based on the number of progressing sites into unchanged, transitional and active subjects. Patterns of periodontal disease progression were explored using descriptive statistics. RESULTS Progression occurred primarily at molars (50% of progressing sites) and inter-proximal sites (72%), affected a higher proportion of deep than shallow sites (2.7% versus 0.7%), and pocketing was the main mode of progression (49%). We found a low level of agreement (47%) between the LMM and traditional approaches to determine progression such as change in CAL ≥3 mm. Fourteen per cent of subjects were classified as active and among those 93% had periodontitis. The annual mean rate of progression for the active subjects was 0.35 mm/year. CONCLUSION Progressing sites and subjects defined based on LMMs presented patterns of disease progression similar to those previously reported in the literature.
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Affiliation(s)
- Ricardo Teles
- Department of Periodontics, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA
| | - Kevin Moss
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John S Preisser
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robert Genco
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - William V Giannobile
- Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Patricia Corby
- New York University College of Dentistry, Bluestone Center for Clinical Research, New York, NY, USA
| | - Nathalia Garcia
- Section of Periodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, IL, USA
| | - Heather Jared
- Rho Inc., Contract Research Organization, Chapel Hill, NC, USA
| | - Gay Torresyap
- Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA
| | - Elida Salazar
- Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA
| | - Julie Moya
- New York University College of Dentistry, Bluestone Center for Clinical Research, New York, NY, USA
| | - Cynthia Howard
- New York University College of Dentistry, Bluestone Center for Clinical Research, New York, NY, USA
| | - Robert Schifferle
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - Karen L Falkner
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - Jane Gillespie
- Section of Periodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, IL, USA
| | - Debra Dixon
- Section of Periodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, IL, USA
| | - MaryAnn Cugini
- Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA
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12
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Leite FR, Peres KG, Do LG, Demarco FF, Peres MA. Prediction of Periodontitis Occurrence: Influence of Classification and Sociodemographic and General Health Information. J Periodontol 2017; 88:731-743. [DOI: 10.1902/jop.2017.160607] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Fábio R.M. Leite
- Currently, Department of Dentistry and Oral Health, Section of Periodontology, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark; previously, Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Karen G. Peres
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Loc G. Do
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Flávio F. Demarco
- Postgraduate Program in Epidemiology, Federal University of Pelotas
- Postgraduate Program in Dentistry, Federal University of Pelotas
| | - Marco A.A. Peres
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
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13
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Cho Y, Kim B, Bae H, Kim W, Baek J, Woo K, Lee G, Seol Y, Lee Y, Ku Y, Rhyu I, Ryoo H. Direct Gingival Fibroblast/Osteoblast Transdifferentiation via Epigenetics. J Dent Res 2017; 96:555-561. [PMID: 28081379 DOI: 10.1177/0022034516686745] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Alveolar bone resorption caused by trauma or periodontal diseases has represented a challenge for both dental clinicians and researchers. In this study, we evaluate the osteogenic potential of human gingival fibroblasts (HGFs) through a direct transdifferentiation from HGFs to functional osteoblasts via epigenetic modification and osteogenic signaling with bone morphogenetic protein 2 (BMP2) in vitro and in vivo. HGF treatment with 5-aza-2'-deoxycytidine (5-aza-dC) induced demethylation in the hypermethylated CpG islands of the osteogenic lineage marker genes RUNX2 and ALP, and subsequent BMP2 treatment successfully drove the fibroblasts to the osteoblasts' lineage. Cell morphological changes viewed under microscopy and alkaline phosphatase (ALP) and alizarin red S (ARS) staining confirmed the osteoblastic change mediated by epigenetic modification as did real-time polymerase chain reaction (PCR), methylation-specific PCR (MSP), and chromatin immunoprecipitation (ChIP) assay, which demonstrated the altered methylation patterns in the RUNX2 and ALP promoter regions and their effect on gene expression. Furthermore, micro-computed tomography (CT) analysis of in vivo mouse cell transplantation experiments showed high-density signal in the epigenetically modified HGF group; in addition, a significant amount of bone formation was observed in the transplanted material using hematoxylin and eosin (H&E) staining as well. Collectively, our results indicate that epigenetic modification permits the direct programming of HGFs into functional osteoblasts, suggesting that this approach might open a novel therapeutic avenue in alveolar bone regeneration.
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Affiliation(s)
- Y Cho
- 1 Department of Molecular Genetics, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea.,2 Department of Periodontology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - B Kim
- 1 Department of Molecular Genetics, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - H Bae
- 1 Department of Molecular Genetics, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - W Kim
- 1 Department of Molecular Genetics, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - J Baek
- 1 Department of Molecular Genetics, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - K Woo
- 1 Department of Molecular Genetics, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - G Lee
- 1 Department of Molecular Genetics, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - Y Seol
- 2 Department of Periodontology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - Y Lee
- 2 Department of Periodontology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - Y Ku
- 2 Department of Periodontology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - I Rhyu
- 2 Department of Periodontology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
| | - H Ryoo
- 1 Department of Molecular Genetics, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, South Korea
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14
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Hilgert JB, Hugo FN, Bandeira DR, Bozzetti MC. Stress, Cortisol, and Periodontitis in a Population Aged 50 Years and Over. J Dent Res 2016; 85:324-8. [PMID: 16567552 DOI: 10.1177/154405910608500408] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Periodontitis and its relationship with psycho-neuro-immunological variables, such as psychological stress and cortisol, have been little explored. The objective of this study was to evaluate the extent and severity of chronic periodontitis and its association with the levels of salivary cortisol and the scores obtained with a stress questionnaire in a population aged 50 years and over. We studied 235 individuals in a cross-sectional study. They answered the Lipp’s Inventory of Stress Symptoms for Adults, were instructed to collect three saliva samples for cortisol analysis, and were examined for evaluation for periodontitis. Based on logistic regression, cortisol levels were positively associated with the following outcomes: means of clinical attachment level (CAL) > = 4 mm [OR = 5.1, 95%CI (1.2, 20.7)]; 30% of sites with CAL > = 5 mm [OR = 6.9, 95%CI (1.7, 27.1)]; and 26% of sites with probing depth > = 4 mm [OR = 10.7, 95%CI (1.9, 54.1)] after adjustment for confounding variables. The results suggest that cortisol levels were positively associated with the extent and severity of periodontitis.
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Affiliation(s)
- J B Hilgert
- Post-graduate Program in Epidemiology, Faculty of Medicine, Federal University of Rio Grande do Sul, 2600/414 Porto Alegre, RS 90035-003, Brazil.
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15
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DeCarlo AA, Whitelock JM. The Role of Heparan Sulfate and Perlecan in Bone-regenerative Procedures. J Dent Res 2016; 85:122-32. [PMID: 16434729 DOI: 10.1177/154405910608500203] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tissue engineering, grafting procedures, regeneration, and tissue remodeling are developing therapeutic modalities with great potential medical value, but these regenerative modalities are not as effective or predictable as clinicians and patients would like. Greater understanding of growth factors, cytokines, extracellular matrix molecules, and their roles in cell-mediated healing processes have made these regenerative therapies more clinically viable and will continue advancing the fields of tissue engineering and grafting. However, millions of oral and non-oral bone-grafting procedures are performed annually, and only a small percentage yield the most desirable results. Here we review the heparan-sulfate-decorated extracellular biomolecule named perlecan and the research relating to its potential as an adjunct in bone-regenerative procedures. The review includes an overview of bone graft substitutes and biological adjuncts to bone-regenerative procedures in medicine as they apply to periodontal disease, alveolar ridge augmentation, and barrier membrane therapy. Perlecan is discussed as a potential biological adjunct in terms of growth factor sequestration and delivery, and promoting cell adhesion, proliferation, differentiation, and angiogenesis. Further, we propose delivery and application schemes for perlecan and/or its domains in bone-regenerative procedures, with particular emphasis on its heparan-sulfate-decorated domain I. The perlecan molecule, with its heparan sulfate glycosylation, may provide a multi-faceted approach for the delivery of a more comprehensive stimulus than other single potential adjuncts currently available for bone-regenerative procedures.
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Affiliation(s)
- A A DeCarlo
- Agenta Biotechnologies, Inc., OADI Technology Center, Birmingham, AL 35211, USA.
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16
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Meisel P, Schwahn C, Luedemann J, John U, Kroemer HK, Kocher T. Magnesium Deficiency is Associated with Periodontal Disease. J Dent Res 2016; 84:937-41. [PMID: 16183794 DOI: 10.1177/154405910508401012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In the multifactorial pathogenesis of periodontitis, there are still unknown factors influencing the outcome of the disease. An association between magnesium and periodontitis has been suggested by preliminary studies. However, relevant clinical data are lacking. We investigated the association between magnesium status and periodontal health in a population-based analysis. We conducted a cross-sectional epidemiological investigation involving 4290 subjects aged 20–80 yrs. We recorded periodontal risk factors and determined concentrations of serum magnesium and calcium, relating them to periodontal parameters. In a matched-pair study, 60 subjects using oral magnesium-containing drugs and 120 without were compared. In subjects aged 40 yrs and older, increased serum Mg/Ca was significantly associated with reduced probing depth (p < 0.001), less attachment loss (p = 0.006), and a higher number of remaining teeth (p = 0.005). Subjects taking Mg drugs showed less attachment loss (p < 0.01) and more remaining teeth than did their matched counterparts. These results suggest that nutritional magnesium supplementation may improve periodontal health.
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Affiliation(s)
- P Meisel
- Department of Pharmacology, Ernst Moritz Arndt University, F.-Loeffler-Str. 23d, D-17487 Greifswald, Germany.
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17
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Cho YD, Kim S, Koo KT, Seol YJ, Lee YM, Rhyu IC, Ku Y. Rescue of a periodontally compromised tooth by non-surgical treatment: a case report. J Periodontal Implant Sci 2016; 46:128-34. [PMID: 27127693 PMCID: PMC4848380 DOI: 10.5051/jpis.2016.46.2.128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/20/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This article describes a case of the successful non-surgical management of a periodontally compromised maxillary premolar. METHODS A combination therapy, including root planing, occlusal adjustment, and tooth splinting, was applied. Clinical and radiographic examinations were performed during the 16-month follow-up period. RESULTS All periodontal parameters were improved. There were dramatic decreases (3-6 mm) in the probing pocket depth, tooth mobility, and marginal bone loss. Interestingly, gradual resolution of the periapical radiolucency and alveolar bone regeneration were observed in the radiographs, and the periodontal condition was maintained during the follow-up period. CONCLUSIONS Within the limits of this study, these results demonstrate the importance of natural tooth preservation through proper periodontal treatment and occlusal adjustment of the periodontally compromised tooth, which is typically targeted for tooth extraction and dental implantation.
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Affiliation(s)
- Young-Dan Cho
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Yang-Jo Seol
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - In-Chul Rhyu
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Young Ku
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
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18
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Teles R, Benecha HK, Preisser JS, Moss K, Starr JR, Corby P, Genco R, Garcia N, Giannobile WV, Jared H, Torresyap G, Salazar E, Moya J, Howard C, Schifferle R, Falkner KL, Gillespie J, Dixon D, Cugini M. Modelling changes in clinical attachment loss to classify periodontal disease progression. J Clin Periodontol 2016; 43:426-34. [PMID: 26935472 PMCID: PMC5021116 DOI: 10.1111/jcpe.12539] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2016] [Indexed: 11/30/2022]
Abstract
AIM The goal of this study was to identify progressing periodontal sites by applying linear mixed models (LMM) to longitudinal measurements of clinical attachment loss (CAL). METHODS Ninety-three periodontally healthy and 236 periodontitis subjects had their CAL measured bi-monthly for 12 months. The proportions of sites demonstrating increases in CAL from baseline above specified thresholds were calculated for each visit. The proportions of sites reversing from the progressing state were also computed. LMM were fitted for each tooth site and the predicted CAL levels used to categorize sites regarding progression or regression. The threshold for progression was established based on the model-estimated error in predictions. RESULTS Over 12 months, 21.2%, 2.8% and 0.3% of sites progressed, according to thresholds of 1, 2 and 3 mm of CAL increase. However, on average, 42.0%, 64.4% and 77.7% of progressing sites for the different thresholds reversed in subsequent visits. Conversely, 97.1%, 76.9% and 23.1% of sites classified as progressing using LMM had observed CAL increases above 1, 2 and 3 mm after 12 months, whereas mean rates of reversal were 10.6%, 30.2% and 53.0% respectively. CONCLUSION LMM accounted for several sources of error in longitudinal CAL measurement, providing an improved method for classifying progressing sites.
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Affiliation(s)
- Ricardo Teles
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA
| | - Habtamu K Benecha
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John S Preisser
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kevin Moss
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jacqueline R Starr
- Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA.,Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | - Patricia Corby
- New York University College of Dentistry, Bluestone Center for Clinical Research, New York, NY, USA
| | - Robert Genco
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - Nathalia Garcia
- Section of Periodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, IL, USA
| | - William V Giannobile
- Department of Periodontics and Oral Medicine & Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Heather Jared
- Rho Inc., Contract Research Organization, Chapel Hill, NC, USA
| | - Gay Torresyap
- Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA
| | - Elida Salazar
- Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA
| | - Julie Moya
- New York University College of Dentistry, Bluestone Center for Clinical Research, New York, NY, USA
| | - Cynthia Howard
- New York University College of Dentistry, Bluestone Center for Clinical Research, New York, NY, USA
| | - Robert Schifferle
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - Karen L Falkner
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - Jane Gillespie
- Section of Periodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, IL, USA
| | - Debra Dixon
- Section of Periodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, IL, USA
| | - MaryAnn Cugini
- Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA
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19
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Van Leeuwen MPC, Rosema NAM, Versteeg PA, Slot DE, Hennequin-Hoenderdos NL, Van der Weijden GA. Effectiveness of various interventions on maintenance of gingival health during 1 year - a randomized clinical trial. Int J Dent Hyg 2016; 15:e16-e27. [DOI: 10.1111/idh.12213] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 11/27/2022]
Affiliation(s)
- MPC Van Leeuwen
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - NAM Rosema
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - PA Versteeg
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - DE Slot
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - NL Hennequin-Hoenderdos
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - GA Van der Weijden
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
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20
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Gupta S, Sawhney A, Jain G, Dhar S, Gupta B, Singh R, Kumar S, Pathak T. An evaluation of diode laser as an adjunct to scaling and root planning in the nonsurgical treatment of chronic periodontitis: A clinico-microbiological study. DENTISTRY AND MEDICAL RESEARCH 2016. [DOI: 10.4103/2348-1471.184733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Anyanechi CE, Chukwuneke FN, Ngim N. Clinical Evaluation of the Efficacy of Arthocare Forte, a Chondro-Protective and Anti-Arthritic Drug in the Management of Bacterial Plaque-Induced Chronic Periodontitis. Ann Med Health Sci Res 2015; 5:157-62. [PMID: 26097755 PMCID: PMC4455003 DOI: 10.4103/2141-9248.157481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Arthocare forte medication is made up of different constituents and the advantages offered by this disposition have not been explored in the management of chronic periodontitis. AIM The aim was to assess the clinical response of bacterial plaque-induced generalized chronic periodontitis to arthocare medication, and the relationship of age and gender to the prevalence of chronic periodontal disease. SUBJECTS AND METHODS This study was done at the Dental Surgery Clinic of the University of Calabar Teaching Hospital, Nigeria. It was a Prospective randomized controlled trial evaluating the effect of arthocare treatment on 81/162 patients with teeth mobility over a period of 5 years. All the patients (162) underwent root planing, and 81/162 (50%) were treated with arthocare for comparative analysis. The variables recorded were patient's age, gender, and degree of tooth mobility, periodontal pocket, and bleeding from the pocket after treatment. Statistical analysis was done using EPI INFO 7. RESULTS Majority of the patients were between 46 and 75 years in both control (n = 59/81, 72.8%) and experimental groups (n = 52/81, 64.2%). There were 86/162 (53.1%) males and 76/162 (46.9%) females, giving a male-to-female ratio of 1.1:1. Seventy-seven patients (95.1%) in the experimental group had total remission in comparison to 32/81 (39.5%) in control group which was statistically significant (P < 0.001). CONCLUSION The arthocare administered to patients in the experimental group speeds up the regenerative capacity and stability of the periodontium when compared with the control. Multicentre clinical trials are recommended to validate the use of arthocare forte in the treatment of generalized chronic periodontitis.
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Affiliation(s)
- C E Anyanechi
- Department of Dental Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - F N Chukwuneke
- Department of Oral and Maxillofacial Surgery, University of Nigeria Teaching Hospital, Enugu State, Nigeria
| | - N Ngim
- Department of Orthopedics and Trauma, University of Calabar Teaching Hospital, Calabar, Nigeria
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22
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Pei X, Ouyang X, He L, Cao C, Luan Q, Suda R. A 4-year prospective study of the progression of periodontal disease in a rural Chinese population. J Dent 2014; 43:192-200. [PMID: 25527246 DOI: 10.1016/j.jdent.2014.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 12/06/2014] [Accepted: 12/09/2014] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES The natural progression of periodontitis in the Chinese population is not well researched. We investigated the progression of periodontal disease over 4 years in 15-44-year-old Chinese villagers with no access to regular dental care. METHODS In 1992, 486 villagers were enrolled, and in 1996, 413 villagers were re-examined. Probing depth (PD) and clinical attachment level (CAL) were examined at six sites per tooth. Sites with ΔCAL ≥3 mm were defined as active sites. Cross-sectional and longitudinal analyses were performed using means and percentile plots. RESULTS The mean CAL increased by 0.26 mm over 4 years. The incidence of periodontitis (at least one site with CAL ≥3 mm) was 8%. The incidence of periodontitis among those with no periodontal disease at baseline was 44.9%. Seventy-eight percent of the subjects had at least one active site. In the 15-24-year group, 244 of 401 active sites had gingival recession, while only 51 active sites had both gingival recession and deeper pockets. In the 25-34-year and 35-44-year groups, almost one-third of the active sites (329/1087) and more than one-third of the active sites (580/1312) respectively had a combination of gingival recession and deeper pockets. CONCLUSIONS In this study, we demonstrated that in Chinese population without regular dental care, both the initiation of periodontitis and progression of previously existed periodontitis contributed to the natural progression of periodontitis and periodontal pocketing played a greater role with age increasing. CLINICAL SIGNIFICANCE This rare study reports the natural progression of periodontal disease in a group of Chinese villagers (15-44 years) with virtually no access to regular dental care.
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Affiliation(s)
- Xiyan Pei
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China; Outpatient Department, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiangying Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Lu He
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Caifang Cao
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Qingxian Luan
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Reiko Suda
- Departments of Periodontics, Showa University School of Dentistry, Tokyo, Japan
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23
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Zimmermann H, Zimmermann N, Hagenfeld D, Veile A, Kim TS, Becher H. Is frequency of tooth brushing a risk factor for periodontitis? A systematic review and meta-analysis. Community Dent Oral Epidemiol 2014; 43:116-27. [PMID: 25255820 DOI: 10.1111/cdoe.12126] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/09/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The epidemiology of periodontitis regarding oral-hygiene practices particularly the frequency of tooth brushing has been the subject of relatively few dedicated studies. This paper provides a systematic review of available relevant epidemiological studies and a meta-analysis of the effect of tooth brushing frequency on periodontitis. To review and to quantify the risk for periodontitis associated with frequency of tooth brushing. METHODS Systematic literature search was conducted in nine online resources (PUBMED, ISI and 7 additional databases). Related and cross-referencing publications were reviewed. Papers published until end of March 2013 reporting associations between tooth brushing frequency and periodontitis were considered. A meta-analysis was performed to quantify this association. RESULTS Fourteen studies were identified. The test of heterogeneity for cross-sectional studies was not significant (P = 0.31). A fixed-effects model yielded a significant overall odds ratio estimate of 1.41 (95%CI: 1.25-1.58, P < 0.0001) for infrequent compared to frequent tooth brushing. For all fourteen studies, there was a slight indication for heterogeneity (I² = 48%, P = 0.02) and the corresponding result with a random-effects model was 1.44 (95%CI: 1.21-1.71, P < 0.0001). CONCLUSIONS There are relatively few studies evaluating the association between tooth brushing frequency and periodontitis. A clear effect was observed, indicating that infrequent tooth brushing was associated with severe forms of periodontal disease. Further epidemiological studies are needed to precisely estimate the effect of key risk factors for periodontitis and their interaction effects.
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Affiliation(s)
- Heiko Zimmermann
- Unit of Epidemiology and Biostatistics, Institute of Public Health, University of Heidelberg, Germany
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24
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Bågesund M, Shafiee Z, Drivdal M, Berdén J, Storhaug K. Dental care and oral health in Aagenaes syndrome/lymphedema cholestasis syndrome 1. SPECIAL CARE IN DENTISTRY 2014; 35:83-9. [DOI: 10.1111/scd.12080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Mats Bågesund
- TAKO'Centre; National Resource Centre for Oral Health in Rare Medical Conditions; Lovisenberg Diakonale Hospital; Oslo Norway
- Department of Pediatrics and Department of Clinical and Experimental Medicine; Linköping University; Centre for Orthodontics and Pediatric dentistry; Norrköping Sweden
| | - Zahra Shafiee
- TAKO'Centre; National Resource Centre for Oral Health in Rare Medical Conditions; Lovisenberg Diakonale Hospital; Oslo Norway
| | - Monica Drivdal
- Centre for Rare Disorders; Oslo University Hospital; Oslo Norway
| | - Jan Berdén
- TAKO'Centre; National Resource Centre for Oral Health in Rare Medical Conditions; Lovisenberg Diakonale Hospital; Oslo Norway
| | - Kari Storhaug
- TAKO'Centre; National Resource Centre for Oral Health in Rare Medical Conditions; Lovisenberg Diakonale Hospital; Oslo Norway
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25
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Emani S, Gunjiganur GV, Mehta DS. Determination of the antibacterial activity of simvastatin against periodontal pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans: An in vitro study. Contemp Clin Dent 2014; 5:377-82. [PMID: 25191077 PMCID: PMC4147817 DOI: 10.4103/0976-237x.137959] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT AND OBJECTIVE Statin treatment, apart from its hypolipidemic action has proven its antimicrobial activity by improving the survival rate of patients with severe systemic bacterial infections. Periodontitis is an inflammatory disorder of tooth supporting structures caused by a group of specific microorganisms. The objective of the present study was to determine the antimicrobial activity of pure simvastatin drug against the primary periodontal pathogens. MATERIALS AND METHODS Minimum inhibitory concentration (MIC) was determined against Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans using serial dilution method. RESULTS MIC of simvastatin against P. gingivalis was 2 μg/ml and A. actinomycetemcomitans was found to be <1 μg/ml which requires further dilutions to determine the exact value. CONCLUSIONS Data suggests a potent antimicrobial activity of simvastatin against both A. actinomycetemcomitans and P gingivalis. Hence simvastatin can be prescribed as a dual action drug in patients with both hyperlipidemia and periodontal disease.
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Affiliation(s)
- Shilpa Emani
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Gayathri V. Gunjiganur
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Dhoom Singh Mehta
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Refulio Z, Rocafuerte M, de la Rosa M, Mendoza G, Chambrone L. Association among stress, salivary cortisol levels, and chronic periodontitis. J Periodontal Implant Sci 2013; 43:96-100. [PMID: 23678393 PMCID: PMC3651943 DOI: 10.5051/jpis.2013.43.2.96] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 03/05/2013] [Indexed: 11/08/2022] Open
Abstract
Purpose Chronic periodontitis (CP) seems to be associated with stress and depression, but little information on this possible association is available in the literature. Thus, the objective of this study was to evaluate the association among stress, the salivary cortisol level (SCL), and CP. Methods Seventy systemically healthy subjects were included in the study from January to September 2011. Full medical and dental histories were obtained, and the following measurements were recorded: 1) probing depth; 2) clinical attachment level; 3) bleeding on probing; and 4) tooth mobility. Saliva samples were collected for the evaluation of SCL (via a highly sensitive electrochemiluminescence immunoassay), and all subjects also answered a questionnaire (i.e., the Zung Self-rating Depression Scale). The odds ratio (OR) with a 95% confidence interval (CI) was calculated, and one way analysis of variance and the Tukey-Kramer method were performed. Results A total of 36 subjects with CP (51.4%) and 34 without CP were evaluated. Of them, all of the subjects with CP and one periodontally healthy subject were diagnosed with depression. Subjects with moderate CP had statistically significantly higher levels of SCL than subjects with a diagnosis of slight CP (P=0.006). Also, subjects with severe CP showed the same outcome when compared to those with slight CP (P=0.012). In addition, 46 subjects presented high SCL whereas 24 had a normal level. CP was found to be correlated with the SCL, with an OR of 4.14 (95% CI, 1.43 to 12.01). Conclusions Subjects with a high SCL and depression may show an increased risk for CP.
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Affiliation(s)
- Zoila Refulio
- Department of Periodontology, Universidad San Martin de Porres, Lima, Peru
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Mannem S, Chava VK. The effect of stress on periodontitis: A clinicobiochemical study. J Indian Soc Periodontol 2013; 16:365-9. [PMID: 23162330 PMCID: PMC3498705 DOI: 10.4103/0972-124x.100912] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Accepted: 04/11/2012] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Clinical and epidemiological data suggest that negative life experience events, like depression, may contribute to an increased susceptibility to periodontal disease. AIM To study the association between psychological stress and chronic periodontitis. MATERIALS AND METHODS One hundred and eleven dentate individuals, of age 40 years and above, were selected. The clinical examination included, the number of teeth present, plaque index, Probing Pocket Depth, and Clinical Attachment Level. Assessment of Psychological stress levels were done by a questionnaire and were correlated with salivary cortisol levels, which were estimated biochemically by using the Enzyme-Linked Immunosorbent Assay (ELISA) method. RESULTS Statistical analysis was done by using the student 't' test and Mann Whitney test. According to our observation, chronic periodontitis showed a significant correlation with hypercortisolemia (P<0.0001), work tension (P=0.04), economic problems (P<0.0001), clinical stress syndrome (P<0.0001), plaque index (P<0.0001), and unsecured job (P=0.003). CONCLUSION Stress may be considered as an important risk factor for periodontal disease. Routine salivary cortisol assessment may be an economical and useful diagnostic marker to rule out stress in periodontitis patients.
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Affiliation(s)
- Satheesh Mannem
- Department of Periodontics, Narayana Dental College, Nellore, Andhra Pradesh, India
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Matas F, Sentís J, Mendieta C. Ten-year longitudinal study of gingival recession in dentists. J Clin Periodontol 2011; 38:1091-8. [DOI: 10.1111/j.1600-051x.2011.01799.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2011] [Indexed: 11/26/2022]
Affiliation(s)
- Francesc Matas
- Department of Periodontology; Dental School, University of Barcelona; Barcelona; Spain
| | - Joan Sentís
- Department of Public Health (Statistics); School of Medicine; University of Barcelona; Barcelona; Spain
| | - Carlos Mendieta
- Department of Periodontology; Dental School, University of Barcelona; Barcelona; Spain
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Lorentz TCM, Cota LOM, Cortelli JR, Vargas AMD, Costa FO. Tooth loss in individuals under periodontal maintenance therapy: prospective study. Braz Oral Res 2010; 24:231-7. [PMID: 20658044 DOI: 10.1590/s1806-83242010000200017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Accepted: 03/09/2010] [Indexed: 11/22/2022] Open
Abstract
This prospective study aimed to evaluate the incidence, the underlying reasons, and the influence of predictors of risk for the occurrence of tooth loss (TL) in a program of Periodontal Maintenance Therapy (PMT). The sample was composed of 150 complier individuals diagnosed with chronic moderate-severe periodontitis who had finished active periodontal treatment and were incorporated in a program of PMT. Social, demographic, behavioral and biological variables were collected at quarterly recalls, over a 12-month period. The effect of predictors of risk of and confounding for the dependent variable TL was tested by univariate and multivariate analysis, as well as the underlying reasons and the types of teeth lost. During the monitoring period, there was a considerable improvement in periodontal clinical parameters, with a stability of periodontal status in the majority of individuals. Twenty-eight subjects (18.66%) had TL, totaling 47 lost teeth (1.4%). The underlying reasons for TL were: periodontal disease (n = 34, 72.3%), caries (n = 3, 6.4%), prosthetic reasons (n = 9, 19.2%), and endodontic reasons (n = 1, 2.1%). Additionally, subjects with 10% of sites with probing depth between 4 and 6 mm were 5 times more likely to present TL (OR = 5.13, 95% CI 2.04-12.09). In this study, the incidence of TL was small and limited to few individuals. Additionally, gender and severity of periodontitis were significantly associated with TL during the monitoring period.
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Oz HS, Chen T, Ebersole JL. A model for chronic mucosal inflammation in IBD and periodontitis. Dig Dis Sci 2010; 55:2194-202. [PMID: 19902356 DOI: 10.1007/s10620-009-1031-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Accepted: 10/13/2009] [Indexed: 12/31/2022]
Abstract
BACKGROUND Chronic inflammation of mucosal surfaces is an aberrant immune response to luminal bacteria and generates an array of oxygen radicals leading to tissue destruction and loss of function, as noted in IBD and periodontitis. We hypothesized that mucosal injury after "oral delivery" of dextran sulfate sodium (DSS) or TNBS for an extended period of 18 weeks is reflected by chronic inflammatory responses in a time-dependent fashion. METHODS Dextran sulfate sodium was administered in the diet biweekly; TNBS or sham controls was administered orally twice a week. Additional groups received TNBS or sham injections into gingival tissue. RESULTS Animals tolerated oral applications with no severe clinical symptoms. The DSS-group developed diarrhea during the period of administration, and returned to normal during DSS abstinence. The TNBS-group developed no systemic clinical symptoms. Splenic length and weight increased in the DSS-group in a time-dependent fashion (P < 0.01) and remained normal in the TNBS-group. Colons from the DSS-group were significantly shortened (P < 0.001) and colonic weight increased compared with controls or the TNBS-group (P < 0.05). The DSS-group developed extensive dilation of the stomach wall, ileum, and megacolon, with abdominal fat deposits. In addition, the DSS-group showed dysregulated hepatic concentrations of antioxidants (i.e. cysteine, GSH, SAMe) in a time-dependent manner that correlated with a significance increase in alveolar bone resorption. Localized TNBS-mucosal delivery caused severe inflammation, granuloma formation, and rapid bone resorption. CONCLUSIONS This model of mucosal stimulation eliciting chronic inflammatory responses in the gut and oral cavity mimics aspects of IBD and periodontal disease progression in patients.
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Affiliation(s)
- Helieh S Oz
- MN310 Center for Oral Health Research, College of Dentistry and Department of Internal Medicine, University of Kentucky Medical Center, Lexington, KY 40536, USA.
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Lang NP, Schätzle MA, Löe H. Gingivitis as a risk factor in periodontal disease. J Clin Periodontol 2009; 36 Suppl 10:3-8. [DOI: 10.1111/j.1600-051x.2009.01415.x] [Citation(s) in RCA: 176] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Schätzle M, Faddy MJ, Cullinan MP, Seymour GJ, Lang NP, Bürgin W, Ånerud Å, Boysen H, Löe H. The clinical course of chronic periodontitis: V. Predictive factors in periodontal disease. J Clin Periodontol 2009; 36:365-71. [DOI: 10.1111/j.1600-051x.2009.01391.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mettes TG, van der Sanden WJM, Mokkink HG, Wensing M, Grol RPTM, Plasschaert AJM. Routine oral examinations in primary care: which predictors determine what is done? A prospective clinical case recording study. J Dent 2008; 36:435-43. [PMID: 18406034 DOI: 10.1016/j.jdent.2008.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2007] [Revised: 02/27/2008] [Accepted: 02/28/2008] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES Elements of a routine oral examination (ROE) in dental practice may be determined by patients' oral status, as recommended by prevailing knowledge, as well as by other factors. Our aim was to identify patient and GDP characteristics associated with aspects of oral health assessment (OHA) and clinical management (CM) in patients with various oral conditions. METHODS A prospective observational study was performed, based on clinical case recording of 1059 ROEs by 128 GDPs. A clinical case recording form was used to record oral health assessment, diagnoses made, and clinical management for each ROE. Multilevel logistic regression analyses (with random coefficients) were performed. RESULTS Overall, 'patients' age' in domains OHA as well as CM was the most salient predictor, while 'positive attitude to periodontal screening' showed to be a prominent GDP-factor. Patient characteristics mostly involved in OHA and CM were 'disease-free period' (odds ratios from 0.21 to 0.66), 'oral health compliance' (odds ratios from 0.32 to 0.65) and 'risk for periodontal disease' (odds ratios from 1.79 to 4.97). 'Continuing professional development' (odds ratios from 2.54 to 4.95), 'mean reading hours' (odds ratios from 2.25 to 4.48) and 'cooperation with peers' (odds ratios from 2.78 to 3.72) showed to be significant GDP-predictors. CONCLUSIONS ROEs are determined by patient oral health status, particularly by aspects of oral health compliance and risk for oral disease, but also by GDP characteristics. The latter may reflect perceptions of a professional role, which need to be considered in efforts to improve the quality of ROE in oral care.
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Affiliation(s)
- Theodorus G Mettes
- Radboud University Nijmegen Medical Centre, College of Oral Sciences, Department of Preventive and Restorative Dentistry, Nijmegen, The Netherlands.
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TOMASI C, WENNSTRÖM JL, BERGLUNDH T. Longevity of teeth and implants – a systematic review. J Oral Rehabil 2008; 35 Suppl 1:23-32. [DOI: 10.1111/j.1365-2842.2007.01831.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Knöfler GU, Purschwitz RE, Jentsch HF. Clinical Evaluation of Partial- and Full-Mouth Scaling in the Treatment of Chronic Periodontitis. J Periodontol 2007; 78:2135-42. [DOI: 10.1902/jop.2007.070010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Röthlisberger B, Kuonen P, Salvi GE, Gerber J, Pjetursson BE, Attström R, Joss A, Lang NP. Periodontal conditions in Swiss army recruits: a comparative study between the years 1985, 1996 and 2006. J Clin Periodontol 2007; 34:860-6. [PMID: 17850604 DOI: 10.1111/j.1600-051x.2007.01124.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To compare the periodontal conditions of Swiss Army recruits in 2006 with those of previous surveys in 1996 and 1985. MATERIAL AND METHODS A total of six hundred and twenty-six Swiss Army recruits were examined for their periodontal conditions, caries prevalence, stomatological and functional aspects of the masticatory system and halitosis. In particular, this report deals with demographic data, the assessment of plaque index (PlI), gingival index (GI) and pocket probing depth (PPD). RESULTS Two per cent of all teeth were missing, resulting in a mean of 27.44 teeth per subject, and 77% of the missing teeth were the result of pre-molar extractions due to orthodontic indications. The mean PlI and GI were 1.33 and 1.23, respectively. On average, 27% of the gingival units bled on probing. The mean PPD was 2.16 mm (SD 0.64). Only 3.8% of the recruits showed at least one site of PPD > or = 5 mm, and 1.4% yielded more than one site with PPD > or = 5 mm. In comparison with previous, this survey yielded lower bleeding on probing (BOP) percentages than in 1985, but slightly higher scores than in 1996. This may be attributed to increased PlI scores in 2006. However, PPD remained essentially unaltered from 1996 to 2006 after having improved significantly from 1985. CONCLUSION A significant improvement of the periodontal conditions of young Swiss males was demonstrated to have taken place between 1985 and 1996, but no further changes during the last decade were noticed.
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Affiliation(s)
- Beat Röthlisberger
- Dental Services of the Swiss Army, Switzerland School of Dental Medicine, University of Bern, Bern, Switzerland
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Teles RP, Bogren A, Patel M, Wennstrom JL, Socransky SS, Haffajee AD. A three-year prospective study of adult subjects with gingivitis II: microbiological parameters. J Clin Periodontol 2007; 34:7-17. [PMID: 17243995 DOI: 10.1111/j.1600-051x.2006.01015.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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Affiliation(s)
- R P Teles
- Department of Periodontology, The Forsyth Institute, Boston, MA 02115, USA.
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Chambrone LA, Chambrone L. Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in Brazil. J Clin Periodontol 2006; 33:759-64. [PMID: 16899027 DOI: 10.1111/j.1600-051x.2006.00972.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. MATERIAL AND METHODS A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. RESULTS Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (> 60 years) and smoking were statistically significant (p < 0.05). CONCLUSION The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss.
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Affiliation(s)
- Luiz A Chambrone
- Discipline of Periodontics, Faculty of Dentistry, Methodist University of São Paulo (UMESP), São Bernardo do Campo, SP, Brazil.
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Ramseier CA, Abramson ZR, Jin Q, Giannobile WV. Gene therapeutics for periodontal regenerative medicine. Dent Clin North Am 2006; 50:245-63, ix. [PMID: 16530061 PMCID: PMC2572757 DOI: 10.1016/j.cden.2005.12.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There has been significant advancement in the field of periodontal tissue engineering over the past decade for the repair of tooth-supporting structures. Although encouraging results for periodontal tissue regeneration have been found in numerous clinical investigations using recombinant growth factors, limitations exist with topical protein delivery. Newer approaches seek to develop methodologies that optimize growth factor targeting to maximize the therapeutic outcome of periodontal regenerative procedures. Genetic approaches in periodontal tissue engineering show early progress in achieving delivery of growth factor genes, such as platelet-derived growth factor or bone morphogenetic protein, to periodontal lesions. Ongoing investigations in ex vivo and in vivo gene transfer to periodontia seek to examine the extent of the potential effects in stimulating periodontal tissue engineering.
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Affiliation(s)
- Christoph A Ramseier
- Center for Craniofacial Regeneration and Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI 48106, USA
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Rahardjo A, Yoshihara A, Amarasena N, Ogawa H, Nakashima K, Miyazaki H. Relationship between bleeding on probing and periodontal disease progression in community-dwelling older adults. J Clin Periodontol 2005; 32:1129-33. [PMID: 16212572 DOI: 10.1111/j.1600-051x.2005.00834.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The main objective of this study was to determine the relationship between bleeding on probing (BOP) and periodontal disease progression in community-dwelling older adults. METHODS A 3-year longitudinal study was carried out in 229 non-smoking healthy older adults aged 70 years. Using pressure-controlled periodontal probes, BOP, pocket depth and attachment level at 13,289 sites were measured annually. Periodontal disease progression was defined as an increase in attachment loss of >or=3 mm from the baseline to the final examination. The backward stepwise logistic regression analysis was performed to assess the relationship between the total number of sites with BOP in the four examinations and periodontal progression. RESULTS Logistic regression analysis showed that the odds ratios of BOP frequency for periodontal disease progression ranged from 1.4 to 6.2 after controlling for pocket depth >or=4 mm at baseline, number of missing teeth, jaw type and tooth site. CONCLUSION Increasing frequencies of bleeding might increase the probability of periodontal disease progression in community-dwelling older adults.
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Affiliation(s)
- A Rahardjo
- Department of Oral Health Science, Division of Preventive Dentistry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Zaher CA, Hachem J, Puhan MA, Mombelli A. Interest in periodontology and preferences for treatment of localized gingival recessions. A survey among Swiss dentists. J Clin Periodontol 2005; 32:375-82. [PMID: 15811055 DOI: 10.1111/j.1600-051x.2005.00690.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the views, knowledge and preferences of a large sample of practising dentists in periodontics, focusing specifically on the treatment of gingival recessions, and to compare the findings with the current evidence available in the dental literature. METHODS We conducted a cross-sectional postal survey of 3780 dentists, representing the majority of all dentists working in Switzerland. The questionnaire consisted of 17 questions, most of them giving the possibility of multiple choices of answers. The demographic profile, interests and satisfaction in periodontics were associated with the choice of treatment options offered for the management of six clinical situations. RESULTS One thousand two hundred and one dentists sent back the questionnaire within three months and were thus included in the analysis. In general, the interest and the satisfaction in periodontics were moderate to high (6-7 on an analogue scale from 1 to 10). Specialists in periodontics indicated a significantly higher interest and satisfaction in periodontics than the general dentists (p<0.001), and practitioners working in urban areas indicated a slightly higher interest (p=0.027) and satisfaction (0.047) than their colleagues established in a rural setting. The predominant indication of root coverage procedures was aesthetics (90.7%). The region in which dentists worked was the only significant predictor for choosing "no treatment" of buccal recessions: dentists from the German-speaking part were significantly less inclined to surgically treat gingival recessions than their colleagues from the French or Italian part. For those who opted for therapy, a free tissue graft was generally the favourite option, followed by a connective tissue graft and a coronally advanced flap. Throughout, only a small fraction of the dentists considered using a guided tissue regeneration procedure. The relative odds for not extracting teeth with severe periodontal disease were higher if the dentist was a specialist than a generalist. Satisfaction in practicing periodontics also positively strengthened the inclination towards keeping severely compromised teeth. CONCLUSIONS Aesthetic concerns were the predominant indication for root coverage procedures. Further research should therefore include aesthetic aspects as primary clinical outcome variables. Specific training of dentists and their satisfaction in periodontics influenced treatment decisions. Specialists involved in continuing education should inform practicing dentists more efficiently on the potential and usefulness of periodontal therapy for saving and maintaining periodontally compromised teeth.
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Affiliation(s)
- C-A Zaher
- School of Dental Medicine, University of Geneva, Geneva, Switzerland
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Haubek D, Ennibi OK, Poulsen K, Benzarti N, Baelum V. The highly leukotoxic JP2 clone of Actinobacillus actinomycetemcomitans and progression of periodontal attachment loss. J Dent Res 2004; 83:767-70. [PMID: 15381716 DOI: 10.1177/154405910408301006] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The JP2 clone of Actinobacillus actinomycetemcomitans has been implicated in the etiology of periodontitis in adolescents. The aim of this two-year longitudinal study was to describe clinical attachment loss (CAL) progression and to assess its association with baseline occurrence of the JP2 and non-JP2 types of A. actinomycetemcomitans. Clinical re-examination of 121 adolescents in Morocco was performed. Progression of CAL > or = 1 mm, > or = 2 mm, > or = 3 mm, and > or = 4 mm on at least one site was found in 58%, 48%, 22%, and 6% of the subjects, respectively. Subjects who, at baseline, harbored the JP2 clone had a significantly higher progression of CAL than did subjects harboring non-JP2 types of A. actinomycetemcomitans. Subjects harboring non-JP2 types displayed a marginally higher CAL progression than did subjects who were culture-negative for A. actinomycetemcomitans.
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Affiliation(s)
- D Haubek
- Dental Faculty, University of Rabat, Morocco.
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Schätzle M, Löe H, Lang NP, Heitz-Mayfield LJA, Bürgin W, Anerud A, Boysen H. Clinical course of chronic periodontitis. J Clin Periodontol 2003; 30:909-18. [PMID: 14710771 DOI: 10.1034/j.1600-051x.2003.00401.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The purpose of this study was to assess the rate of attachment loss during various stages of adult life in a well-maintained middle-class population. MATERIAL AND METHODS The data originated from a 26-year longitudinal study of Norwegian males who had received regular and adequate dental care and practised daily oral home care. The initial examination in 1969 included 565 individuals aged between 16 and 34 years. Subsequent examinations took place in 1971, 1973, 1975, 1981, 1988 and 1995. Thus, the study covers the age range of 16-59 years. The rate of the annual attachment loss was calculated as the difference between the individual mean attachment loss between two examinations divided by the years between examinations. The mean annualized relative risk of attachment loss was calculated as the frequency distribution of sites with initial periodontal attachment loss (loss of attachment at the first time of occurrence > or = 2 mm) and healthy sites (loss of attachment always < 2 mm). For comparison of significant changes in annual attachment loss rates between the age groups and mean annualized relative risks of attachment loss as they proceeded through adult life, the Wilcoxon Mann-Whitney U-test was used. RESULTS The mean overall individual attachment loss during 44 years (between 16 and 59 years) totaled 2.44 mm (range 0.14-2.44 mm), averaging an annual mean rate of 0.05 mm/year. The highest annual rate of attachment loss occurred before 35 years of age (0.08-0.1 mm/year), after which the mean annual rate decreased to about 0.04-0.06 mm/year for the next three decades of life leading to 60 years. The mean annualized relative risk of initial attachment loss increased significantly from adolescence (1.2%) to the maximum at 30-34 years of age (6.9%). After the age of 34 years, the risk of initial attachment loss decreased again, but after the age of 40 years, another continuous increase was observed. CONCLUSIONS Over a 26-year period, 25% of the subjects went through adult life with healthy and stable periodontal conditions. The remaining 75% developed slight to moderately progressing periodontal disease with progression rates varying between 0.02 and 0.1 mm/year with a cumulative mean of loss of attachment of 2.44 mm as they approached 60 years of age. The annual mean rate and the mean annualized risk of initial attachment loss were highest between 16 and 34 years of age. Only 20% of the sites continued to lose further attachment during the remainder of the observation period, and less than 1% of the sites showed substantial loss of attachment (> 4 mm).
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Affiliation(s)
- Marc Schätzle
- Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Berne, Switzerland.
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