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  • 1.
    Persson, Rutger G
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Washington University, USA.
    Dental geriatrics and periodontitis2017Ingår i: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 74, nr 1, s. 102-115Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The present literature review is focused on two main areas: (i) periodontal conditions in older individuals; and (ii) the scientific data available on periodontal treatment outcomes in individuals ≥ 75 years of age. The population of older people is increasing but the data on periodontal therapies and their efficacy in this population are limited and need to be carefully reviewed. Although life expectancy has increased, this does not mean that older people are medically healthy. Several chronic systemic diseases are associated with periodontitis, and the prevalence of most chronic diseases increases with age. Furthermore, older people are challenged by impaired immunity (immune senescence) with a decline in the numbers of naïve T-cells in peripheral blood and lymphoid tissues. The most frequent significant correlates with successful ageing include not smoking and the absence of disability, arthritis and diabetes mellitus. Periodontal diseases in older individuals may have specific features that are not consistent with periodontal diseases. In this respect, data suggest that gingival lesions in older individuals develop differently from gingival lesions in younger adults. The progression of periodontitis may be slower in older individuals, and older individuals with periodontitis may benefit from more conservative treatment approaches. Diagnostic criteria used for the assessment and diagnosis of periodontitis in younger adults may not be fully applicable in older individuals. In summary, declining health, perception of treatment needs, dietary changes, comorbidity with other diseases and immune senescence are challenging factors to clinicians and researchers, in terms of therapies and in understanding periodontitis etiology in older individuals.

  • 2.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Supportive periodontal therapy2004Ingår i: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 36, s. 179-195Artikel, forskningsöversikt (Refereegranskat)
  • 3.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Persson, G. Rutger
    USA.
    Treatment of periodontal disease in older adults2016Ingår i: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 72, nr 1, s. 108-119Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Within the next 40 years the number of older adults worldwide will more than double. This will impact periodontal treatment needs and presents a challenge to health-care providers and governments worldwide, as severe periodontitis has been reported to be the sixth most prevalent medical condition in the world. Older adults (≥ 80 years of age) who receive regular dental care retain more teeth than those who do not receive such care, but routine general dental care for these individuals is not sufficient to prevent the progression of periodontitis with the same degree of success as in younger individuals. There is a paucity of data on the efficacy of different periodontal therapies for older individuals. However, considering the higher prevalence of chronic medical conditions seen in older adults, it cannot be assumed that periodontal therapy will yield the same degree of success seen in younger individuals. Furthermore, medications can influence the status of the periodontium and the delivery of periodontal care. As an example, anticoagulant drugs are common among older patients and may be a contraindication to certain treatments. Newer anticoagulants will, however, facilitate surgical intervention in older patients. Furthermore, prescription medications taken for chronic conditions, such as osteoporosis and cardiovascular diseases, can affect the periodontium in a variety of ways. In summary, consideration of socio-economic factors, general health status and multiple-drug therapies will, in the future, be an important part of the management of periodontitis in older adults.

  • 4.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Polyzois, Ioannis
    Irland.
    Treatment of pathologic peri-implant pockets2018Ingår i: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 76, nr 1, s. 180-190Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Peri-implant and periodontal pockets share a number of anatomical features but also have distinct differences. These differences make peri-implant pockets more susceptible to trauma and infection than periodontal pockets. Inadequate maintenance can lead to infections (defined as peri-implant mucositis and peri-implantitis) within peri-implant pockets. These infections are recognized as inflammatory diseases, which ultimately lead to the loss of supporting bone. Diagnostic and treatment methods conventionally used in periodontics have been adopted to assess and treat these diseases. Controlling infection includes elimination of the biofilm from the implant surface and efficient mechanical debridement. However, the prosthetic supra-structure and implant surface characteristics can complicate treatment. Evidence shows that when appropriately managed, peri-implant mucositis is reversible. Nonsurgical therapy, with or without the use of antimicrobials, will occasionally resolve peri-implantitis, but for the majority of advanced lesions this approach is insufficient and surgery is indicated. The major objective of the surgical approach is to provide access and visualize the clinical situation. Hence, a more informed decision can be made regarding whether to use a resective or a regenerative surgical technique. Evidence shows that following successful decontamination, surgical treatment to regenerate the bone can be performed, and a number of regenerative techniques have been proposed. After treatment, regular maintenance and good oral hygiene are essential for a predictable outcome and long-term stability.

  • 5.
    Renvert, Stefan
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL).
    Polyzois, Ioannis N
    Clinical approaches to treat peri-implant mucositis and peri-implantitis.2015Ingår i: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 68, nr 1, s. 369-404Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Therapies proposed for the treatment of peri-implant diseases are primarily based on the evidence available from treating periodontitis. The primary objective is elimination of the biofilm from the implant surface, and nonsurgical therapy is a commonly used treatment. A number of adjunctive therapies have been introduced to overcome accessibility problems or difficulties with decontamination of implant surfaces as a result of specific surface characteristics. It is now accepted that following successful decontamination, clinicians can attempt to regenerate the bone that was lost as a result of infection. The ultimate goal is re-osseointegration, and a number of regenerative techniques have been introduced. By reviewing the existing evidence, it seems that peri-implant mucositis is reversible when appropriately treated. Additionally, a combined therapy (mechanical therapy with local antimicrobials as adjuncts) can serve as an alternative to surgical intervention when treating peri-implantits in cases not suitable for surgery. Surgical therapy is an effective method for treating peri-implantitis, and various degrees of success of the use of regenerative procedures have been reported, regardless of whether or not radiographic evidence of defect fill has been achieved. Finally, no matter which therapy is employed, a prerequisite for the long-term stability of treatment results obtained is the ability of the patient to maintain good oral hygiene.

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