Prevalence of juvenile periodontitis in Chile

Sex as a Biological Variable in Oral Diseases: Evidence and Future Prospects

The interest of the scientific community on sex and gender differences in health and disease has increased substantially over the past 25 to 30 y as a result of a long process of events and policies in the biomedical field. This is crucial as compelling evidence from human and animal model studies has demonstrated that sex and gender influence health, molecular and cellular processes, and response and predisposition to disease. The present scoping review aims to provide a synthesis of sex differences in oral diseases, ranging from periodontal disease to orofacial pain conditions, from risk of caries development to apical periodontitis. Overall, findings from this review further support a role for sexual dimorphism influencing disease predisposition and/or progression in oral diseases. Of note, this review also highlights the lack of consideration of additional factors such as gender and other psychosocial and external factors potentially influencing oral health and disease. New conceptual frameworks capable of capturing multiple fundamental domains and measurements should be developed in clinical and preclinical studies to inform sex-based individualized preventive and treatment strategies.

Gender differences in immunological response of African-American juveniles with Grade C molar incisor pattern periodontitis

BACKGROUND

Prevalence of Grade C molar incisor periodontitis (C/MIP) in females (F) and males (M) is controversial, although some studies suggest higher prevalence in females. The objective of this study was to evaluate differences in clinical parameters, and levels of cyto/chemokines in gingival crevicular fluid (GCF) and peripheral blood response.

METHODS

GCF and blood were collected from 79 C/MIP African-American participants (53F and 26 M) and healthy controls (58F and 38 M), aged 5 to 23. Blood was stimulated with ultrapure LPS from Escherichia coli (Ec) and Porphyromonas gingivalis (Pg) and we quantified levels of 14 cyto/chemokines. Clinical parameters were collected before and 12 months following treatment RESULTS: No clinical parameters or age differences were found between males and females, although age was negatively correlated with response to treatment. GCF levels of TNFα, IFNγ, MIP1α, and MCP1 from diseased and sites and healthy sites IFNγ levels were higher in M (P < 0.05). C/MIP females presented higher Pg and Ec LPS induced levels of Eotaxin, IFNγ, and GMCSF (P < 0.05), whereas healthy males presented higher Ec LPS induced levels of Eotaxin and IFNγ (P < 0.05). Inflammatory profiles were also different among genders in disease (P = 0.004).

CONCLUSIONS

Although males seemed to present few elevated inflammatory markers in the GCF in disease and in health, females presented an elevated systemic inflammatory response to LPS in disease, which indicates a possible differential susceptibility to inflammation. Future studies need to determine if sex hormones have a role in the peripheral host response and in the pathogenesis of C/MIP.

Global prevalence of aggressive periodontitis: A systematic review and meta-analysis

AIM

The prevalence of aggressive periodontitis (AgP) varies considerably between studies. The aim of this meta-analysis was to estimate, throughout the world, the prevalence of this disease.

MATERIALS AND METHODS

Pubmed/Medline, Scopus, Science Direct, EBSCO and Cochrane library were systematically searched up to March 2018. Study selection criteria included cross-sectional studies reporting prevalence of AgP in non-specific population and permanent dentition. We assessed risk of bias using the Joanna Briggs Institute tool. A random effect meta-analysis model was used to estimate the prevalence of AgP. Publication bias was assessed by Begg and Egger's tests and visual aspect of funnel plot.

RESULTS

A total of 33 articles were included. Pooled prevalence for AgP was 1.6% (95% CI 1.1-2.3). Higher pooled prevalence rates were reported in Africa (4.2%, 95% CI 2.0-7.1) and South America (4.0%, 95% CI 0.9-9.1) compared with Europe (0.1%, 95% CI 0.1-0.2). A pooled prevalence of 1.2%, 95% CI 0.5-2.2 was found in Asia and 0.8%, 95% CI 0.4-1.4 in North America. Heterogeneity between groups was statistically significant (Q statistic p < .001).

CONCLUSIONS

A relatively high prevalence of AgP was found in Africa. However, the data support the weakness of the definition of this form of periodontal disease. Studies with less heterogeneity are needed to address accurately the prevalence of AgP.

Supernumerary eumorphic mandibular incisor in association with aggressive periodontitis

According to the literature, the prevalence of supernumerary teeth is 1% to 4% of permanent dentitions; and among these, the presence of fifth mandibular incisor — a supernumerary eumorphic tooth — has rarely been described in literature, and its association with localized aggressive periodontitis is an even more rare entity. This paper reports a very rare case of unusual association of supernumerary eumorphic fifth mandibular incisor with aggressive periodontitis in a Muslim individual, so that these findings generate curiosity and inspire others to carry out further studies and investigations.

Macrophage inflammatory protein-1alpha: a salivary biomarker of bone loss in a longitudinal cohort study of children at risk for aggressive periodontal disease?

BACKGROUND

Periodontitis develops in a time-dependent manner. Cross-sectional studies document one moment in time but fail to capture the progressive nature of disease. Radiographic measures of bone loss are relatively insensitive but are reliable markers of irreversible disease. Longitudinal studies are needed to identify biomarkers that can precede radiographic evidence of bone loss and, thus, mark the period prior to clinical evidence of irreversible disease. A longitudinal study of students susceptible to localized aggressive periodontitis (LAgP) was conducted to evaluate chemokines/cytokines found in saliva derived from periodontally healthy children who subsequently developed alveolar bone loss.

METHODS

Students were screened, sampled for Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans [Aa]), and divided into a cohort of Aa+ and Aa- students. Ninety-six periodontally healthy Aa+ and Aa- students were recalled every 6 to 9 months following screening. Examinations, saliva collections, and radiographs were performed. After seven students developed bone loss, the levels of 21 cytokines were assessed and matched to saliva from seven Aa+ and seven Aa- students who remained healthy for > or =1 year. Subsequently, saliva from an additional 27 students who remained healthy was analyzed.

RESULTS

Nineteen cytokines were not detected or were detected at low levels. Macrophage inflammatory protein (MIP)-1alpha was elevated 50-fold in seven Aa+ students who developed disease 6 to 9 months prior to radiographic detection of bone loss compared to levels in 21 Aa+ and 20 Aa- students who remained healthy (P <0.001). Interleukin (IL)-1beta was also elevated (P = 0.01). MIP-1alpha had a specificity of 96.8% and a sensitivity of 100%, whereas IL-1beta showed 90.3% specificity and 85.7% sensitivity relative to bone loss. MIP-1alpha levels were also related to increasing probing depth and the number of pockets >6 mm.

CONCLUSION

The superior sensitivity and specificity of MIP-1alpha, which correlated well with probing depths and the onset of bone loss, suggested that it could be used as an early biomarker for LAgP.

Prevalence and distribution of principal periodontal pathogens worldwide

BACKGROUND

Detailed genetic analysis of bacteria has demonstrated an unanticipated genetic diversity within species, which often reveals evolutionary lineages that are disproportionately associated with infection. There is evidence that some evolutionary lineages of bacteria have adapted to particular ethnic groups.

AIM

This review analyzes to what extent observed differences in periodontal disease prevalence among ethnically or geographically distinct populations may be explained by restricted host adaptation of clones of principal periodontal pathogens.

RESULTS

Carriage rates of several putative periodontal pathogens and particular subsets of these species vary between ethnic groups. Few of these differences can, with the limited information available, be directly related to differences in periodontal disease prevalence. Asian populations are regularly colonized with Actinobacillus actinomycetemcomitans serotype c with questionable pathogenic potential. Conversely, the JP2 clone of A. actinomycetemcomitans has enhanced virulence and causes significantly higher prevalence of aggressive periodontitis in adolescents whose descent can be traced back to the Mediterranean and Western parts of Africa. Some genetically distinct types of Porphyromonas gingivalis are more associated with disease than others, but additional work is required to relate this to clinical differences.

CONCLUSIONS

Studies that take into account differences linked to the genetics of both patients and potential pathogens are likely to give better insight into the aetiology of periodontal diseases.

An overview of the epidemiology of periodontal diseases in Latin America

The aim of the present review was to identify the presence of periodontal diseases and the relative importance of known risk factors in Latin American countries. The retrieved data are sparse and inconsistent, lacking information for the majority of the countries. Gingivitis is ubiquitous in the region, affecting all ages independently of the socioeconomic background. The extension of bleeding may vary greatly, ranging from 40% to 70% of sites. The prevalence of aggressive periodontitis is higher in Latin America than in industrialized countries. Prevalence ranges from 0.3% to 4.5%, and the localized form is the less prevalent. The prevalence of chronic periodontitis is high, with a large variation (40-80%) probably due to differences in methodology and diagnostic criteria. Regional differences may be relevant. Known risk factors are present in the populations studied. Non-modifiable factors such as age, gender and genetics have been associated in Brazilian and Chilean populations. Tobacco smoking and diabetes are relevant risk factors. The importance of socioeconomic status, although present as a risk factor, has been largely underestimated. Oral hygiene is extremely deficient in the area although it is a cultural habit in most populations. It can be concluded that periodontal diseases are highly prevalent in Latin American populations. Its prevalence and extent are associated with known risk factors. Oral hygiene habits are deficient. Well designed epidemiological studies with external validity are needed.

Social gradients in periodontal diseases among adolescents

OBJECTIVE

To investigate the association between socioeconomic position and periodontal diseases among adolescents.

METHODS

Data were obtained from 9203 Chilean high school students. Clinical examinations included direct recordings of clinical attachment level and the necrotizing ulcerative gingival lesions. Students answered a questionnaire on various dimensions of socioeconomic position. Seven periodontal outcomes were analyzed. Logistic regression analyses were used to identify socioeconomic variables associated with the periodontal outcomes.

RESULTS

The occurrence of all periodontal outcomes investigated followed social gradients, and paternal income and parental education were the most influential variables.

CONCLUSIONS

The study demonstrates the existence of significant social gradients in periodontal diseases already among adolescents. This is worrying, and indicates a new potential for further insight into the mechanisms of periodontal disease causation.

Prevalence of Clinical Attachment Loss in Adolescents in Santo Domingo, Dominican Republic

BACKGROUND

Data on periodontal conditions in adolescents in the Dominican Republic are scarce. The aim of the present cross-sectional study was to estimate the prevalence of periodontal attachment loss among Dominican adolescents. This study did not attempt to classify the disease into aggressive and chronic periodontitis.

METHODS

A random sample of 2,007 Dominican adolescents was obtained. A probability, weighted sample was selected using a complex, multi-stage probability sampling design. The study was clustered in 26 schools and 106 classes. The study subjects were clinically examined under field conditions by a single calibrated examiner who measured gingival recession and probing depth at six sites per tooth, with subsequent calculation of clinical periodontal attachment level for each site.

RESULTS

The prevalence of clinical attachment loss > or = 1 mm was 49.5%, with the prevalence ranging between 48.7% and 50.2%, depending on age and gender. Clinical attachment loss > or = 2 mm was found in 15% of the students and attachment loss > or = 3 mm in 4.0% of the students. Logistic regression model revealed that only age significantly increased the probability of having clinical attachment loss.

CONCLUSION

We conclude that clinical attachment loss is common in adolescents in Santo Domingo, Dominican Republic, suggesting the necessity for improved standards of prevention, diagnosis, and treatment of these lesions.

Aggressive periodontitis with supernumerary teeth: a retrospective study

BACKGROUND

There are four key studies in the periodontology literature reporting the correlation between supernumerary teeth and aggressive periodontitis. The aim of this study is to detect such a relationship.

METHODS

Patients with supernumerary teeth were identified retrospectively from their orthopantomographs and were invited to the periodontology department for intraoral examination. They were then evaluated for aggressive periodontitis. The number of existing teeth, age, family histories, attachment loss, probing depths, and bleeding on probing scores were recorded.

RESULTS

Of the 5,850 subjects randomly observed among 48,000 patients, only 174 exhibited supernumerary teeth. Of these 174 subjects, only three patients were diagnosed with aggressive periodontitis. One of the patients was also suffering from Fanconi's anemia.

CONCLUSIONS

Despite the similarities (aggressive periodontitis accompanied by supernumerary teeth) in the previous reports, we do not agree with the earlier results. We rather suggest that this association might be a random occurrence, rather than a biological one, although this observation should be further investigated using genetic testing.

Aggressive Periodontitis in an Urban Population in Southern Brazil

BACKGROUND

There are limited data about the epidemiology and risk factors for aggressive periodontitis (AgP) in Latin American and Brazilian populations. The aim of this study was to assess the prevalence of AgP and the risk associated with demographic variables, smoking behavior, and other periodontal variables in a young urban population in southern Brazil.

METHODS

A representative sample of 612 subjects aged 14 to 29 years were sampled using a multistage probability method. A full-mouth clinical examination of six sites per tooth and an interview were performed in a mobile examination center. Subjects in the age groups 14 to 19 years and 20 to 29 years were classified with AgP if they had four or more teeth with attachment loss > or =4 mm or > or =5 mm, respectively.

RESULTS

AgP was found in 5.5% of the subjects. The disease occurred equally among males and females, but was twice as prevalent among non-whites than whites. In the age groups 20 to 24 years and 25 to 29 years, the AgP subjects had a significantly higher prevalence of tooth loss (90.2% versus 40.4% and 86.1% versus 43.4%, P <0.01) and mean number of missing teeth (2.6 versus 0.9 and 3.4 versus 1.5, P <0.05) than subjects without attachment loss. The AgP subjects also had significantly higher percentages of sites with dental plaque (P <0.0001), gingival bleeding (P <0.05), and supragingival calculus (P <0.0001) than normal subjects. The risk for AgP was higher in the 25- to 29-year than the 14- to 19-year age groups (odds ratio [OR] = 6.2), in the low than middle or high socioeconomic status (OR = 4.5), in moderate or heavy smokers than nonsmokers (OR = 3.1), and in subjects with > or =10% versus <10% sites with supragingival calculus (OR = 3.6).

CONCLUSION

Socioeconomic status, smoking, and dental calculus were significant risk indicators of aggressive periodontitis in this population. Suitable periodontal prevention programs implementing these risk indicators may prevent or reduce the prevalence of aggressive periodontitis in this and similar populations.

Comparison of interleukin-1 genotypes in two populations with aggressive periodontitis

The genetic association of interleukin-1 (IL-1) with periodontitis has been investigated in different populations. Failure to detect an association with IL-1 genotypes in European Caucasians with aggressive periodontitis (AGP) has recently been reported. No data from Central American Hispanics are available. The purpose of this explorative study was to study the association between IL-1 genotypes and AGP in two populations. Ninety-one subjects, 28 North European patients and 33 controls together with 16 Central American patients and 14 controls were included in the study according to validated radiographic and clinical criteria. Two polymorphisms, IL-1alpha G(+4845)-T and IL-1beta C(+3954)-T were analysed by means of polymerase chain reaction-restriction fragment length polymorphism. The association between presence of specific genotypes and disease status was estimated by the odds ratio. A logistic regression was also used in order to investigate whether the occurrence of the disease depends upon the combination of the IL-1A and IL-1B alleles in the population. A similar distribution of genotypes between patients and controls in both populations was detected. The frequency of allele 1 of the IL-1A gene was higher in patients of both populations compared with controls, however, no statistical significant differences were found between patients and controls.

Prevalence of aggressive periodontitis in school attendees in Uganda

AIM

The prevalence and severity of early onset periodontitis (EOP) among students attending secondary schools in two regions of Uganda was studied.

MATERIAL AND METHODS

690 students (393 males and 297 females) aged 12-25 years (mean 17 years), representing a range of tribal groups, were recruited from six schools in the peri-urban Central and rural Western regions of Uganda. The study subjects were clinically examined in field conditions by a single calibrated examiner to measure gingival recession and probing depth at six sites per tooth, with subsequent calculation of clinical periodontal attachment level for each site. Subjects exhibiting >or= 4 mm of clinical periodontal attachment loss at approximal surfaces of one or more teeth were classified with EOP. A structured written questionnaire obtained demographic characteristics of the study subjects.

RESULTS

199 (28.8%) study subjects showed clinical features of EOP, of which 16 (2.3%) subjects exhibited generalized EOP, 29 (4.2%) localized EOP, and 154 (22.3%) incidental EOP. The percentage of EOP-affected males was significantly higher than females (33.8% vs. 22.2%, P < 0.001). EOP prevalence tended to increase with increasing age, but no association was found between EOP prevalence and socioeconomic status or residency in urban vs. rural areas of Uganda. Molars and mandibular incisors generally demonstrated the highest occurrence of >or= 4 mm attachment loss. Clinical periodontal attachment loss of >or= 5 mm was mainly seen at first molars and incisors, suggesting that these two tooth types are first affected with attachment loss. Approximal tooth surfaces showed greater probing depth and attachment loss than buccal and lingual surfaces. Gingival recession was most prevalent at mandibular anterior teeth, whereas gingival margin coronal to CEJ was most frequently observed at second molars and maxillary incisors.

CONCLUSION

A relatively high prevalence of EOP (28.8%) was found in young Ugandan school attendees, with 6.5% of these showing severe disease. EOP in Uganda was significantly more prevalent in males than females, and most frequently characterized by approximal involvement of molars and mandibular incisors. Etiologic and predisposing factors associated with the high occurrence of EOP in Uganda, as well as therapeutic and preventive measures of the disease in this population, remain to be delineated.

Epidemiology of clinical attachment loss in adolescents

BACKGROUND

Relatively little is known about the prevalence, severity, and determinants of clinical attachment loss among adolescents.

METHODS

A multi-stage random sampling procedure was used to obtain a sample of 9,203 high school students aged 12 to 21 years from the Province of Santiago, Chile. All but 41 students were examined for clinical attachment loss in 6 sites of first and second molars and incisors. The students were interviewed with respect to tooth brushing habits, smoking habits, dental visits, and diabetic status. Logistic regression analyses were used to assess the relative strength of the associations between age, gender, smoking, tooth brushing habits, dental attendance patterns, diabetic status, and governmental school support and the occurrence of clinical attachment loss.

RESULTS

Overall, clinical attachment loss > or = 1 mm was seen in 69.2% of the students; > or = 2 mm in 16% of the students; and > or = 3 mm in 4.5%. The distribution of clinical attachment loss was markedly skewed, but followed a continuum of disease severity. Logistic regression analyses showed that attachment loss was associated with higher age, female gender, infrequent tooth brushing, infrequent dental visits, and attending a high school receiving governmental support.

CONCLUSIONS

No sharp distinction exists between periodontal health and disease among Chilean adolescents. Higher age, poor oral hygiene, and a lower socioeconomic background play a role in the occurrence of clinical attachment loss.

Dental services and needs in developing countries

People in developing countries are burdened excessively by oral diseases, particularly periodontal disease. These are aggravated by poverty, poor living conditions, ignorance concerning health education, and lack of government funding and policy to provide sufficient oral health care workers. WHO and FDI have identified the problems and developed strategies. However, acceptable goals and standards of oral health have to be agreed. Furthermore, barriers to oral health promotion need to be overcome through co-operation at all levels and appreciation of cultural sensitivity. There is the need for research to determine which types of oral health care systems are most effective in reducing the extent of inequality in oral health. In developing countries where there are huge problems, intervention programmes focusing on primary care and prevention should be designed and implemented urgently and their effectiveness monitored and analysed scientifically. The WHO, FDI and national and international professional organisations should play a leading role in encouraging a determined, co-ordinated effort towards improving the oral health status of disadvantaged people in developing countries.

Clinical features of early-onset periodontitis

The authors estimate the prevalence of early-onset periodontitis, or EOP, in U.S. adolescents and describe the clinical features that occur at an early stage in those who have EOP. In 1986 and 1987, about 10.0 percent of African-American, 5.0 percent of Hispanic and 1.3 percent of white U.S. adolescents had EOP. Clinical features that may be useful in the early detection of EOP include overt gingival inflammation, dental calculus and a high rate of caries, restorations and tooth loss.

Periodontal diseases: epidemiology

1. The interpretation of epidemiological data of periodontal disease is difficult, due to inconsistencies in the methodology used. It is not possible, therefore, to accurately assess if the prevalence of the periodontal diseases shows a world-wide decline. As long as the disease is assessed through accumulated clinical attachment loss, retention of the natural dentition in older ages entails increased prevalence in these cohorts. Contemporary epidemiological studies should ideally employ full-mouth examination of the periodontal tissues. Partial recording estimates are generally biased, especially when the prevalence of the disease is low. 2. Early-onset periodontitis is infrequent in all populations. Adult periodontitis is rather prevalent; however, advanced disease affects limited subfractions of the population (probably less than 10 to 15%). Although prevalence figures vary with race and geographic region, in most cases, the progression pattern of the disease seems compatible with the retention of a functional dentition throughout life. 3. Of a plethora of behavioral and environmental risk markers identified by multi-variate analysis, smoking and presence of certain subgingival microorganisms have been proven to be true risk factors. The same holds true for diabetes mellitus, a systemic condition that confers a risk for periodontal disease which is independent of the effect of other significant factors. 4. In certain cases, periodontal infections appear to have a systemic impact on the host. Most recent data indicate that periodontal disease may confer risk for coronary heart disease and pre-term low birth weight.

Gingival state and dental calculus in early-onset periodontitis

This study was undertaken to 1) compare the prevalence of gingival inflammation and dental calculus in adolescents with early-onset periodontitis and their matched controls and 2) assess and compare the relationship between the presence of dental calculus and the extent of gingival bleeding and attachment loss in these subjects. The study group consisted of 1,285 13 to 20 year-old individuals, 651 males and 634 females, selected from a national survey of the oral health of U.S. adolescents in 1986/1987. It included 709 (55.2%) Blacks, 224 (17.4%) Hispanics, and 352 (27.4%) Whites. Eighty-nine subjects had localized or generalized juvenile periodontitis (JP), 218 had incidental attachment loss (IAL), and 978 were without clinical attachment loss (controls). The controls were matched to cases on gender, race, age, and geographic location. The subjects were examined clinically to assess the percentage of sites with gingival bleeding and supragingival calculus only and subgingival calculus with or without supragingival calculus. The IAL and JP groups had significantly more gingival bleeding and subgingival calculus than the controls. Also, the JP group had significantly higher prevalence of both conditions than the IAL group. The percentage of sites with supragingival calculus was not different between the groups, but varied by ethnicity. Hispanics with JP had the highest percentage of sites with gingival bleeding and subgingival calculus, and the lowest percentage of sites with only supragingival calculus. The results demonstrate that gingival inflammation and subgingival calculus are associated with early periodontal breakdown, and contradict earlier reports of early-onset periodontitis not being associated with these factors.

Occurrence of certain bacterial species and morphotypes in juvenile periodontitis in Chile

The occurrence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Eikenella corrodens, Fusobacterium nucleatum, Campylobacter rectus, Capnocytophaga species, and certain bacterial morphotypes was determined in 18 affected and 18 unaffected sites in 10 localized juvenile periodontitis (LJP) patients, and in 10 affected and 10 unaffected sites in 5 generalized juvenile periodontitis (GJP) patients. The subgingival proportion of the 7 bacterial species was determined by selective and nonselective culturing. The results showed that when considering the pure prevalence of bacteria ( > 0%) there were significant differences (P < 0.05) in the subgingival plaque microflora of the affected sites versus those of the unaffected sites for P. gingivalis, A. actinomycetemcomitans, P. intermedia, E. corrodens, C. rectus, and F. nucleatum in LJP, and for P. gingivalis, P. intermedia, and F. nucleatum in GJP. The mean proportions of cocci, motile rods and spirochetes were also significantly different (P < 0.05) in affected sites compared to unaffected sites. Capnocytophaga sp, F. nucleatum, P. intermedia, and E. corrodens were found in more than 75% of affected sites in LJP. When taking the approach that an organism, to be associated with periodontal disease, has to be detected above a certain minimum threshold, the results indicated that bacteria most frequently associated with LJP and GJP in Chile are P. gingivalis (66% of LJP and 80% of GJP affected sites), and A. actinomycetemcomitans (44% of LJP and 50% in GJP affected sites). Different bacterial species may be judged to be important in the disease process depending upon whether a pure bacterial prevalence, or a prevalence above a certain detection level, is considered.

Bone loss in the oral cavity

Bone loss in the oral cavity may occur due to many causes, including infection, systemic or local alterations in the host response, or multifactorial causes. The purpose of this article is to review our present understanding of the major causes of oral bone loss in adults, with special emphasis on two major oral diseases: periodontitis and residual ridge resorption. Periodontitis is characterized by resorption of the alveolar bone as well as loss of the soft tissue attachment to the tooth. Progressive periodontitis will result in continued alveolar bone loss and may result in tooth mobility, abscesses, and ultimately tooth loss. Although the reported prevalence may vary according to the epidemiologic study design, the 1985 National Survey of Oral Health of United States Adults indicated that 94% of female senior citizens examined demonstrated at least one site with at least 2 mm loss of attachment. Resorption of alveolar bone that occurs following tooth extraction is termed residual ridge resorption. In many cases, the denture will loosen because of the inability of the resorbed ridge to stabilize the prosthesis. In the most severe cases, the denture may impinge on the exposed mandibular nerve, resulting in pain or total inability to tolerate the prostheses. Although clear statistics on the prevalence of residual ridge resorption are not available, this boss loss may result in the need for new dentures to replace ill-fitting prostheses.

Juvenile periodontitis--pattern of progression and relationship to clinical periodontal parameters

The present investigation was carried out 1) to identify subjects with juvenile periodontitis (JP) in a group of schoolchildren from a community with a high prevalence of periodontal diseases and with no access to preventive dental care, and 2) to study the clinical features of the disease and the progression pattern during a period of 1 yr, and the relationship of JP to clinical periodontal parameters. The periodontal condition of a group of 502 Iraqi schoolchildren (260 girls and 242 boys) was assessed radiographically and clinically at baseline. Children showing > or = 3 mm arc-shaped angular radiographic bone loss at the proximal surfaces of two or more first molars and who showed clinical attachment loss at the same sites were regarded as JP patients. A second group of children with no signs of JP were randomly chosen from the study material. One year later, the JP and the non-JP groups were re-examined radiographically and clinically to assess plaque, gingivitis and presence of calculus. The results showed that nine children (1.8%) had JP. The ratio of girls to boys was 3.5:1, and of localized to generalized forms 2:1. Mesial surfaces of first molars were more often affected than distal surfaces. Clinical assessments showed a more profound loss than was depicted radiographically. All JP patients exhibited evidence of periodontal disease progression during the following year. There were no differences between JP and non-JP children with respect to gingival inflammation, dental plaque, or calculus deposits on teeth.(ABSTRACT TRUNCATED AT 250 WORDS)

Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The committee screened several hundred articles, citing 518 published papers. Some are present quality in research, others provide clinical interest, and some are identified as misleading. New techniques in pulp physiology and pathology are reported. Laser use and techniques in prevention, restorative dentistry, and materials use are reported. Epidemiology of selected diseases and the results of various formulations for treatment are cited. Diagnosis of craniomandibular dysfunction is well represented as well as references to literature reviews and other sophisticated scientific investigation. Research on adhesives is presented in respect to bonding agents for dentin and enamel. Several clinical studies are included, along with customary laboratory reports on several materials.