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  • 1.
    Abushahba, Faleh
    et al.
    School of Dental Science, Trinity College, Dublin.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Polyzois, Ioannis
    School of Dental Science, Trinity College, Dublin.
    Claffey, Noel
    School of Dental Science, Trinity College, Dublin.
    Effect of grafting materials on osseointegration of dental implants surrounded by circumferential bone defects: an experimental study in the dog2008In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 19, no 4, p. 329-334Article in journal (Refereed)
    Abstract [en]

    AIMS: This study was designed to evaluate the effect of gap width and graft placement on bone healing around implants placed into simulated extraction sockets in the mandibles of four beagle dogs. MATERIALS AND METHODS: Four Ti-Unite implants (13 mm x 3.3 mm) were placed on each side of the mandible. Three implants were surrounded by a 1.35 mm circumferential and a 5 mm deep gap around the coronal portion of the implants. A fourth implant was inserted conventionally into both sides of the mandibles as a positive control. The gaps were filled with either Bio-Oss, autogenous bone or with a blood clot alone. The study design was balanced for animal, side and modality. Ground sections were prepared from biopsies taken at 3 months, and computer-aided histometric measurements of bone/implant contact and area of bone within threads were made for the coronal 5 mm. Data were analysed using analysis of variance. RESULTS: The mean bone/implant contact was 9.8 mm for the control and ranged from 9.3 to 11.3 mm for the three test modalities. The corresponding values for area within threads were 1 mm(2) and 1-1.2 mm(2). Modality had a significant effect on both bone/implant contact (F=16.9; P<0.0001) and area within threads (F=16.7; P<0.0001). CONCLUSION: The results of this study suggest that both autogenous bone graft and Bio-Oss played an important role in the amount of hard tissue fill and osseointegration occurring within marginal bone defects around implants.

  • 2.
    Adel-Khattab, Doaa
    et al.
    Tyskland.
    Montero, Eduardo
    Spanien.
    Herrera, David
    Spanien.
    Zhao, Dan
    Kina.
    Jin, Lijian
    Kina.
    Al-Shaikh, Zahra
    Tyskland.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Department of Oral Health. Blekinge tekniska högskola.
    Meyle, Joerg
    Tyskland.
    Evaluation of the FDI chairside guide for assessment of periodontal conditions: a multicentre observational study2021In: International Dental Journal, ISSN 0020-6539, E-ISSN 1875-595X, article id S0020-6539(20)36555-2Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: There is a need to develop easy-to-use tools to screen periodontal condition in daily practice. This study aimed to evaluate the FDI World Dental Federation "Chairside Guide" (FDI-CG) developed by the Task Team of the FDI Global Periodontal Health Project (GPHP) as a potential tool for screening.

    METHODS: Databases from 3 centres in Germany, Hong Kong, and Spain (n = 519) were used to evaluate the association of the FDI-CG and its individual items with the periodontitis case definitions proposed by the Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) for population-based surveillance of periodontitis.

    RESULTS: Statistically significant differences were observed among the databases for the prevalence of periodontitis and the items included in the FDI-CG. The FDI-CG score and its individual components were significantly associated with the periodontal status in the individual databases and the total sample, with bleeding on probing showing the strongest association with severe periodontitis (odds ratio [OR] = 12.9, 95% CI [5.9; 28.0], P < .001, for those presenting bleeding on probing >50%), followed by age (OR = 4.8, 95% CI [1.7; 4.2], P = .004, for those older than 65 years of age). Those subjects with a FDI-CG score >10 had an OR of 54.0 (95% CI [23.5; 124.2], P < .001) and presented with severe periodontitis. A significant correlation was found between the different FDI-CG scoring categories (mild, moderate, and severe) and the categories for mild, moderate, and severe periodontitis using the Centers for Disease Control and Prevention and the American Academy of Periodontology criteria (r = 0.57, Spearman rank correlation test, P < .001).

    CONCLUSION: The FDI Chairside Guide may represent a suitable tool for screening the periodontal condition by general practitioners in daily dental practice.

  • 3.
    Ademovski, Seida Erovic
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Mårtensson, Carina
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    The effect of periodontal therapy on intra-oral halitosis: a case series2016In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 43, no 5, p. 445-452Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to evaluate the effects of non-surgical periodontal therapy on intra-oral halitosis 3months after therapy. Material and methods: Sixty-eight adults with intra-oral halitosis were included in a case series. Intra-oral halitosis was evaluated at baseline, and at 3months after treatment using the organoleptic scores (OLS), Halimeter (R), and a gas chromatograph. Results: Significant reductions for OLS (p<0.01), total sum of volatile sulphur compounds (T-VSC) (p<0.01) and methyl mercaptan (MM) (p<0.05) values were found after treatment. Hydrogen sulphide (H2S) levels were not significantly reduced. The numbers of probing pockets 4mm, 5mm and 6mm were significantly reduced as a result of therapy (p<0.001). Bleeding on probing (BOP) and plaque indices were also significantly reduced (p<0.001). For the 34 individuals with successful periodontal treatment (BOP<20% and a 50% reduction of total pocket depth) reductions in OLS (p<0.01) and T-VSC scores (p<0.01) were found. Eleven individuals were considered effectively treated for intra-oral halitosis presenting with a T-VSC value <160ppb, a H2S value <112ppb and a MM value <26ppb. Conclusion: Non-surgical periodontal therapy resulted in reduction of OLS, MM and T-VSC values 3months after therapy. Few individuals were considered as effectively treated for intra-oral halitosis.

  • 4.
    Aghazadeh, Ahmad
    et al.
    Uppsala Käkkirurgiska Centrum.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society.
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    A single-center randomized controlled clinical trial on the adjunct treatment of intra-bony defects with autogenous bone or a xenograft: results after 12 months2012In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 39, no 7, p. 666-673Article in journal (Refereed)
    Abstract [en]

    Background Limited evidence exists on the efficacy of regenerative treatment of peri-implantitis Materials and methods Subjects receiving antibiotics and surgical debridement were randomly assigned to placement of autogenous bone (AB) or bovine derived xenograft (BDX) with placement of a collagen membrane. The primary outcome was: evidence of radiographic bone fill and the secondary outcomes included reductions of probing depth (PD) bleeding on probing (BOP) and suppuration. Results 22 subjects were included in the AB and 23 subjects in the BDX group. Statistical analysis failed to demonstrate differences for 38/39 variables assessed at baseline. At 12 months, significant better results were obtained in the BDX group for bone levels (p < 0.001), BOP (p = 0.004), PI (p = 0.003), and suppuration (p < 0.01). When adjusting for number of implants treated per subject, a successful treatment outcome PD≤ 5.0 mm, no pus, no bone loss and BOP at 1/4 sites the likelihood of defect fill was higher in the BDX group (LR: 3.2, 95 % CI: 1.0 to 10.6, p < 0.05). Conclusions Bovine xenograft provided more radiographic bone fill than autogenous bone. The success for both surgical regenerative procedures was limited. Decreases in PD, BOP, and suppuration were observed.

  • 5.
    Aghazadeh, Ahmad
    et al.
    Tand & Implantat Specialistkliniken, Solna.
    Persson, Rutger G
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Department of Oral Health. USA.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Department of Oral Health. Blekinge Institute of Technology, Irland & China.
    Impact of bone defect morphology on the outcome of reconstructive treatment of peri-implantitis2020In: International Journal of Implant Dentistry, E-ISSN 2198-4034, Vol. 6, no 1Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess if (I) the alveolar bone defect configuration at dental implants diagnosed with peri-implantitis is related to clinical parameters at the time of surgical intervention and if (II) the outcome of surgical intervention of peri-implantitis is dependent on defect configuration at the time of treatment.

    MATERIALS AND METHODS: In a prospective study, 45 individuals and 74 dental implants with ≥ 2 bone wall defects were treated with either an autogenous bone transplant or an exogenous bone augmentation material. Defect fill was assessed at 1 year.

    RESULTS: At baseline, no significant study group differences were identified. Most study implants (70.7%, n = 53) had been placed in the maxilla. Few implants were placed in molar regions. The mesial and distal crestal width at surgery was greater at 4-wall defects than at 2-wall defects (p = 0.001). Probing depths were also greater at 4-wall defects than at 2-wall defects (p = 0.01). Defect fill was correlated to initial defect depth (p < 0.001). Defect fill at 4-wall defects was significant (p < 0.05).

    CONCLUSIONS: (I) The buccal-lingual width of the alveolar bone crest was explanatory to defect configuration, (II) 4-wall defects demonstrated more defect fill, and (III) deeper defects resulted in more defect fill.

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  • 6.
    Alhag, Mohamed
    et al.
    School of Dental Science, Trinity College, Dublin.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Polyzois, Ioannis
    School of Dental Science, Trinity College, Dublin.
    Claffey, Noel
    School of Dental Science, Trinity College, Dublin.
    Re-osseointegration on rough implant surfaces previously coated with bacterial biofilm: an experimental study in the dog2008In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 19, no 2, p. 182-7Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The purpose of the study was to investigate whether osseointegration can occur on rough implant surfaces that previously had been coated with bacterial biofilm. MATERIALS AND METHODS: The premolars on both sides of the mandible in four beagle dogs were extracted. Following 3 months healing, three titanium implants Ti-Unite, Nobel Biocare were partially inserted in the left side of each mandible. Some threads protruded from the tissues into the oral cavity. Plaque accumulated on the exposed part of the implant. Following a 5-week healing period, the contaminated parts of each implant were treated using three different techniques: (1) swabbing with citric acid for 30 s followed by rinsing with physiological saline, (2) cleansing with a toothbrush and physiological saline for 1 min, and (3) swabbing with 10% hydrogen peroxide for 1 min followed by rinsing with physiological saline. The treated implants and one pristine implant (control) were installed to the full implant length on the contralateral sides of the mandibles. Following 11 weeks of healing, the dogs were sacrificed and biopsies were obtained. Ground sections were prepared for histomorphometric analysis. RESULTS: All treatment modalities were associated with direct bone-to-implant contact on the portion of implant surface previously exposed to the oral environment. CONCLUSIONS: The results demonstrate that rough surfaces, which were plaque contaminated and cleaned by different methods, can re-osseointegrate.

  • 7.
    Alotaibi, Mohammad
    et al.
    Irland.
    Moran, Gary
    Irland.
    Grufferty, Brendan
    Irland.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Polyzois, Ioannis
    Irland.
    The effect of a decontamination protocol on contaminated titanium dental implant surfaces with different surface topography in edentulous patients.2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 1, p. 66-75Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate if it is possible to achieve complete decontamination of dental implant surfaces with different surface characteristics.

    MATERIALS AND METHODS: Twelve implant pieces with an Osseotite® surface and 12 implant pieces with a Ti-Unite® surface were attached on to the complete lower dentures of six patients and were allowed to accumulate plaque for 30 days. When retrieved, the implant decontamination protocol used, involved both mechanical (PeriBrush™) and chemical (3% H2O2) decontamination. The number of colony forming units per millilitre was determined and the dominant micro-organisms in selected samples was identified by 16s rRNA gene amplicon sequencing. The effect of the titanium brush on the implant surface was examined by SEM.

    RESULTS: Complete decontamination was achieved in five out of 24 implants (four Osseotite® and one Ti-Unite®). The mean CFU/ml detected after decontamination were 464.48 for Osseotite® and 729.09 for Ti-Unite® implants. On the surface of the implants in which complete decontamination was not achieved, all of the predominant bacteria identified were streptococci except for one which was identified as micrococcus. SEM images revealed that the surface features of the decontaminated implants were not significantly altered.

    CONCLUSIONS: Mechanical decontamination using a titanium brush supplemented with chemical treatment for one minute (3% H2O2) can achieve complete decontamination of implant surfaces in edentulous patients.

  • 8.
    Andersson, Pia
    et al.
    Kristianstad University, Department of Health Sciences.
    Persson, Lena
    Centre for Caring Sciences, Lund University.
    Hallberg, Ingalill
    Centre for Caring Sciences, Lund University.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Testing an oral assessment guide during chemotherapy treatmen in a Swedish care setting: a pilot study1999In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 8, no 2, p. 150-158Article in journal (Refereed)
    Abstract [en]

    Oral complications are common in patients with haematological malignancies who undergo chemotherapy treatment. A pilot study including 16 haematological patients was carried out to evaluate the oral status using an Oral Assessment Guide (OAG) and to test the reliability of the OAG. The oral assessments were made daily by registered nurses at a Department of Internal Medicine in Sweden. Once a week a dental hygienist made the oral assessments independent of the registered nurses in order to provide data for calculations of inter-rater reliability. All patients had varying degrees of alterations in the oral cavity, especially in the mucous membranes, teeth/dentures and gums. The inter-rater agreement between the nurses and the dental hygienist was good for saliva and swallow, and moderate for voice and gums. Assessments to detect alterations in the oral cavity afford the opportunity for early and individualized interventions and may decrease the risk of oral infections. It is necessary to train the nurses to ensure high levels of reliability in the oral assessments. The OAG seems to be a reliable and clinical useful tool for assessing the oral cavity status and determining changes.

  • 9.
    Andersson, Pia
    et al.
    Kristianstad University, Department of Health Sciences.
    Rahm Hallberg, Ingalill
    Lorefält, B.
    Department of Medicine and Care, Division of Nursing Science, Faculty of Health Sciences, Linköping University.
    Unosson, M.
    Department of Medicine and Care, Division of Nursing Science, Faculty of Health Sciences, Linköping University.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Oral health problems in elderly rehabilitation patients2004In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 2, no 2, p. 70-77Article in journal (Refereed)
    Abstract [en]

    A combination of poor oral hygiene and dry mouth may be hazardous to the oral health status. However, systematic assessments in order to detect oral health problems are seldom performed in the nursing care of the elderly. The aims of this study were to investigate the occurrence of oral health problems measured using the Revised Oral Assessment Guide (ROAG) and to analyse associations between oral health problems and age, gender, living conditions, cohabitation, reason for admission, number of drugs, and functional and nutritional status. One registered nurse performed oral health assessments using ROAG in 161 newly admitted elderly patients in rehabilitation care. Oral health problems were found in 71% of the patients. Thirty per cent of these patients had between four and eight problems. Low saliva flow and problems related to lips were the most frequent oral health problems. Problems in oral health status were significantly associated with presence of respiratory diseases (problems with gums, lips, alterations on the tongue and mucous membranes), living in special accommodation (low saliva flow, problems with teeth/dentures and alterations on the tongue), being undernourished (alterations on the tongue and low saliva flow) and being a woman (low saliva flow). The highest Odds ratio (OR) was found in problems with gums in relation with prevalence of respiratory diseases (OR 8.9; confidence interval (CI) 2.8–27.8; P < 0.0005). This study indicates the importance of standardised oral health assessments in order to detect oral health problems which can otherwise be hidden when the patients are admitted to the hospital ward.

  • 10.
    Andersson, Pia
    et al.
    Kristianstad University, Department of Health Sciences.
    Rahm Hallberg, Ingalill
    Kristianstad University, Department of Health Sciences.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Comparison of oral health status on admission and discharge in a group of geriatric rehabilitation patients2003In: Oral Health and Preventive Dentistry, Vol. 1, no 3, p. 221-228Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare oral health status on a geriatric rehabilitation ward among patients who were assessed using the Revised Oral Assessment Guide (ROAG) on admission and at discharge; and to investigate in what respect the oral health procedures (OHP) suggested in ROAG were applied when oral health problems were detected. MATERIALS AND METHODS: Registered nurses on the ward performed oral health assessments using ROAG with 107 patients on admission and at discharge. When oral health problems were detected measures to be taken were suggested using ROAG. RESULTS: Oral health problems were common among the patients on admission (86%), as well as at discharge (51%). The frequency of the problems was significantly lower at discharge compared to admission. The OHP that were recommended in ROAG were completely followed when saliva flow-related problems were detected. Regarding other oral health problems, measures other than the recommended ones were often performed. CONCLUSION: This study demonstrated that the oral health was better at the end of the hospital stay compared to admission.

  • 11.
    Andersson, Pia
    et al.
    Kristianstad University, Department of Health Sciences.
    Rahm Hallberg, Ingalill
    Department of Nursing, Medical Faculty, Lund University.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Inter-rater reliability of an oral assessment guide för elderly patients residing in a rehabilitation ward2002In: Special Care in Dentistry, ISSN 0275-1879, Vol. 22, no 5, p. 181-186Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to test the inter-rater reliability of a revised oral assessment guide (ROAG) for patients residing in a geriatric rehabilitation ward. A consecutive sample of 140 patients was recruited for the study. Oral assessments were performed for 133 newly admitted patients by one registered nurse (RN) during a period of six months. A dental hygienist (DH) carried out 103 oral assessments during the same half-year. For 66 patients, the RN and the DH performed independent assessments. There was an agreement between the RN and the DH in the majority of the independent assessments, except for tongue and teeth/dentures. The percentage agreement exceeded 80 percent. Inter-rater agreement measured by Cohen's Kappa coefficient ranged from moderate to very good and percentage agreement had a range of 58 to 91 percent. The agreement was highest in assessment of voice and swallowing (91%). Assessments of teeth and dentures seemed to be most difficult for the RN to evaluate. ROAG was found to be a clinically useful assessment tool. Additional education and training is needed to improve the reliability of the oral assessments and should include continuous support from a dental hygienist as well as a pictorial manual on how to use the ROAG.

  • 12.
    Andersson, Pia
    et al.
    Kristianstad University, Department of Health Sciences.
    Rejnefelt, Ingrid
    Kristianstad University, Department of Health Sciences.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Munhälsa hos äldre med demenssjukdom2005In: Tandhygienisttidningen. 25(3), 2005, Vol. 25, p. 64-Conference paper (Other academic)
  • 13.
    Andersson, Pia
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Research Platform for Collaboration for Health.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Blekinge Institute of Thechology & Trinity College, Dublin.
    Sjögren, P
    Oral Care.
    Zimmerman, M
    Karolinska Institutet.
    Dental status in nursing home residents with domiciliary dental care in Sweden2017In: Community Dental Health, ISSN 0265-539X, Vol. 34, no 4, p. 203-207Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe the dental health status of elderly people in nursing homes receiving domiciliary dental care.

    DESIGN: Case note review.

    CLINICAL SETTING: Nursing homes in 8 Swedish counties.

    PARTICIPANTS: Care dependent elderly people (≥65 years).

    METHODS: Clinical data, including the number of remaining natural teeth, missing and decayed teeth (manifest dental caries) and root remnants, recorded by dentists according to standard practices. Medical and dental risk assessments were performed.

    RESULTS: Data were available for 20,664 patients. Most were women (69.1%), with a mean age of 87.1 years (SD 7.42, range 65-109). The mean age for men was 83.5 years (SD 8.12, range 65-105). Two or more medical conditions were present in most of the population. A total of 16,210 individuals had existing teeth of whom 10,974 (67.7%) had manifest caries. The mean number of teeth with caries was 5.0 (SD 5.93) corresponding to 22.8% of existing teeth. One in four individuals were considered to have a very high risk in at least one professional dental risk assessment category.

    CONCLUSIONS: Care dependent elderly in nursing homes have very poor oral health. There is a need to focus on the oral health-related quality of life for this group of frail elderly during their final period of life.

  • 14.
    Andersson, Pia
    et al.
    Kristianstad University, Department of Health Sciences.
    Westergren, Albert
    Department of Nursing, Medical Faculty, Lund University.
    Karlsson, Siv
    North-east Skåne Health Care District, Central Hospital, Kristianstad.
    Rahm Hallberg, Ingalill
    Department of Nursing, Medical Faculty, Lund University.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Oral health and nutritional status in a group of geriatric rehabilitation patients2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 3, p. 311-318Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to evaluate the oral health status and nutritional status in a group of geriatric rehabilitation patients, and to analyse the relationship between these two parameters. Nurses at the ward performed structured assessments of oral and nutritional status using the Revised Oral Assessment Guide and the Subjective Global Assessment form in 223 newly admitted patients. Most oral health problems were found among patients who stayed longer at the hospital and were more dependent on help as compared with the healthier patients. Thirty-four per cent of the patients were either severely undernourished, at risk or suspected to be undernourished (UN). Oral health problems were more common among UN patients (p < 0.0005) compared with well-nourished patients. The most frequent oral health problem was found on teeth or dentures (48%). Problems related to the tongue and lips were also common among UN patients (56 and 44%, respectively). Oral health status was correlated (r = 0.32) to nutritional status. Problems with swallowing had the strongest association to the nutritional status (OR 6.05; 95% CI 2.41-15.18). This study demonstrated that poor oral health status was related to undernourishment.

  • 15. Badersten, Anita
    et al.
    Birkhed, D
    Lundgren, T
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Tandhälsovård1986 (ed. 1)Book (Other academic)
  • 16.
    Bashara, Haitham
    et al.
    Dublin Dental School and Hospital, Division of Restorative Dentistry and Periodontology.
    Wohlfahrt, Johan Caspar
    Department of Biomaterials, University of Oslo.
    Polyzois, Ioannis
    Dublin Dental School and Hospital, Division of Restorative Dentistry and Periodontology.
    Lyngstadaas, Staale Petter
    Department of Biomaterials, University of Oslo.
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    Claffey, Noel
    Dublin Dental School and Hospital, Division of Restorative Dentistry and Periodontology.
    The effect of permanent grafting materials on the preservation of the buccal bone plate after tooth extraction: an experimental study in the dog2012In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, no 8, p. 911-917Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the present study was to evaluate the effects of a novel bone substitute system (Natix®), consisting of porous titanium granules (PTG) and a bovine-derived xenograft (Bio-Oss®), on hard tissue remodelling following their placement into fresh extraction sockets in dogs. Material and methods: Six modalities were tested; Natix® granules with and without a covering double-layered Bio Gide® membrane; Bio-Oss® with and without a covering double-layered Bio Gide® membrane; and a socket left empty with and without a covering double-layered Bio Gide® membrane. Linear measurements, indicative of buccal bone height loss, and an area measurement indicative of buccal bulk bone loss were made. The statistical analysis was based on the Latin Square design with two blocking factors (dog and site). Tukey's post hoc test was used to adjust for multiple comparisons. Results: Histological observation revealed that while bone formed around both the xenograft and the titanium particles, bone was also noted within titanium granules. Of the five modalities of ridge preservation techniques used in this study, no one technique proved to be superior. Conclusion: The titanium granules were observed to have promising osseoconductive properties.

  • 17.
    Berglundh, Tord
    et al.
    University of Gothenburg.
    Armitage, Gary
    USA.
    Araujo, Mauricio G
    Brazil.
    Avila-Ortiz, Gustavo
    USA.
    Blanco, Juan
    Spain.
    Camargo, Paulo M
    USA.
    Chen, Stephen
    Australia.
    Cochran, David
    USA.
    Derks, Jan
    University of Gothenburg.
    Figuero, Elena
    Spain.
    Hämmerle, Christoph H F
    Switzerland.
    Heitz-Mayfield, Lisa J A
    Switzerland.
    Huynh-Ba, Guy
    USA.
    Iacono, Vincent
    USA.
    Koo, Ki-Tae
    South Korea.
    Lambert, France
    Belgium.
    McCauley, Laurie
    Belgium.
    Quirynen, Marc
    Belgium.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Salvi, Giovanni E
    Switzerland.
    Schwarz, Frank
    Germany.
    Tarnow, Dennis
    USA.
    Tomasi, Cristiano
    University of Gothenburg.
    Wang, Hom-Lay
    USA.
    Zitzmann, Nicola
    Switzerland.
    Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no S20, p. 286-291Article in journal (Refereed)
    Abstract [en]

    A classification for peri-implant diseases and conditions was presented. Focused questions on the characteristics of peri-implant health, peri-implant mucositis, peri-implantitis, and soft- and hard-tissue deficiencies were addressed. Peri-implant health is characterized by the absence of erythema, bleeding on probing, swelling, and suppuration. It is not possible to define a range of probing depths compatible with health; Peri-implant health can exist around implants with reduced bone support. The main clinical characteristic of peri-implant mucositis is bleeding on gentle probing. Erythema, swelling, and/or suppuration may also be present. An increase in probing depth is often observed in the presence of peri-implant mucositis due to swelling or decrease in probing resistance. There is strong evidence from animal and human experimental studies that plaque is the etiological factor for peri-implant mucositis. Peri-implantitis is a plaque-associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. Peri-implantitis sites exhibit clinical signs of inflammation, bleeding on probing, and/or suppuration, increased probing depths and/or recession of the mucosal margin in addition to radiographic bone loss. The evidence is equivocal regarding the effect of keratinized mucosa on the long-term health of the peri-implant tissue. It appears, however, that keratinized mucosa may have advantages regarding patient comfort and ease of plaque removal. Case definitions in day-to-day clinical practice and in epidemiological or disease-surveillance studies for peri-implant health, peri-implant mucositis, and peri-implantitis were introduced. The proposed case definitions should be viewed within the context that there is no generic implant and that there are numerous implant designs with different surface characteristics, surgical and loading protocols. It is recommended that the clinician obtain baseline radiographic and probing measurements following the completion of the implant-supported prosthesis.

  • 18.
    Bouchard, Phillipe
    et al.
    Department of Periodontology, School of Dentistry, University of Paris.
    Boutouyrie, Pierre
    Department of Pharmacology, Hospital Europeen Georges Pompidou, Paris.
    D'Aiuto, Francesco
    Periodontology Unit, University College London Eastman Dental Institute, London.
    Deanfield, John
    Cardiothoracic Unit, Great Olmond Street Hospital, University College London.
    Deliargyris, Efthymios
    Interventional Department, Athens Medical Center.
    Fernandez-Aviles, Francisco
    Department of Cardiology, Hospital Gregorio Marañón, University Complutense de Madrid.
    Hughes, Francis
    Department of Periodontology, Centre for Adult Oral Health, Barts and The London School of Medicine and Dentistry.
    Madianos, Phoebus
    Department of Periodontology, University of Athens Dental School.
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    Sanz, Mariano
    Department of Periodontology, Faculty of Odontology, University Complutense of Madrid.
    European workshop in periodontal health and cardiovascular disease consensus document2010In: European Heart Journal, Supplement, ISSN 1520-765X, E-ISSN 1554-2815, Vol. 12, no B, p. B13-B22Article in journal (Refereed)
    Abstract [en]

    There is evidence from epidemiological research on the association between periodontal diseases (PD) and cardiovascular disease (CVD). In spite of these significant associations, however, there is still a lack of awareness in the cardiovascular community on their possible importance. In view of this evidence, an expert panel composed by six European periodontists and four cardiologists addressed the following questions: a) How important is the association of PD and CVD?; b) How do we measure exposure (PD) and outcome (CVD)?; c) What is the pathogenic link?; d) What is the relative importance of periodontal therapy as prevention of CVD?; e) Is it justified to recommend periodontal health with the goal of reducing CV risk?; f) What clinical and experimental research is needed?. The general conclusions were that even though these proven epidemiological association between PD and CVD, there is, however, no compelling evidence that preventive periodontal care or therapeutic intervention will influence cardiac health. As Periodontitis continues to have a high prevalence within the population and the fact that CVD remains as the major cause of human death in developed countries, in light of these associations we can legitimately, based on evidence, state that oral health has an influence on systemic health in general and in CVD in particular, and therefore, we should promote oral health in general and periodontal health in particular as part of a healthy life style and hence as an important component in the prevention of CVD.

  • 19.
    Claffey, Noel
    et al.
    School of Dental Sciences, Trinity College, Dublin, Ireland.
    Clarke, Emily
    School of Dental Sciences, Trinity College, Dublin, Ireland.
    Polyzois, Ioannis
    School of Dental Sciences, Trinity College, Dublin, Ireland.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Surgical treatment of peri-implantitis2008In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 35, no 8 Suppl, p. 316-32Article, review/survey (Other academic)
    Abstract [en]

    OBJECTIVES: To review the literature on surgical treatment of peri-implantitis. MATERIAL AND METHODS: A search of PubMed and as well as a hand search of articles were conducted. Publications and articles accepted for publication up to November 2007 were included. RESULTS: A total of 43 studies were selected for the review. Only 13 of these were studies in humans and only one study directly addressed disease resolution. Thus the available evidence for surgical treatment of peri-implantitis is extremely limited. ANIMAL STUDIES: Re-osseointegration can occur on previously contaminated surfaces. The surface characteristics are decisive for regeneration and re-osseointegration. No single surface decontamination method appears to be distinctly superior. Open debridement with surface decontamination can achieve resolution. HUMAN STUDIES: Access surgery has been investigated in one study demonstrating that resolution occurred in 58% of the lesions. No single method of surface decontamination (chemical agents, air abrasives and lasers) was found to be superior. The use of regenerative procedures such as bone graft techniques with or without the use of barrier membranes has been reported with various degrees of success. However, it must be stressed that such techniques do not address disease resolution but rather merely attempt to fill the osseous defect.

  • 20.
    Dalago, Haline Renata
    et al.
    Brasilien.
    Schuldt Filho, Guenther
    Brasilien.
    Rodrigues, Mônica Abreu Pessoa
    Brasilien.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Bianchini, Marco Aurélio
    Brasilien.
    Risk indicators for peri-implantitis: a cross-sectional study with 916 implants2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 2, p. 144-150Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to identify systemic and local risk indicators associated with peri-implantitis.

    MATERIAL AND METHODS: One hundred eighty-three patients treated with 916 osseointegrated titanium implants, in function for at least 1 year, were included in the present study. The implants were installed at the Foundation for Scientific and Technological Development of Dentistry (FUNDECTO) - University of Sao Paulo (USP) - from 1998 to 2012. Factors related to patient's systemic conditions (heart disorders, hypertension, smoking habits, alcoholism, liver disorders, hepatitis, gastrointestinal disease, diabetes mellitus I and II, hyperthyroidism or hypothyroidism, radiation therapy, chemotherapy, menopause, osteoporosis, active periodontal disease, history of periodontal disease and bruxism), implant's characteristics (location, diameter, length, connection, shape, and antagonist), and clinical parameters (wear facets, periodontal status on the adjacent tooth, plaque accumulation on the adjacent tooth, modified plaque index, sulcus bleeding index, probing depth, bleeding on probing, width of keratinized tissue and marginal recession).

    RESULTS: An increased risk of 2.2 times for history of periodontal disease (PD), 3.6 times for cemented restorations compared to screw-retained prostheses, 2.4 times when wear facets were displayed on the prosthetic crown and 16.1 times for total rehabilitations when compared to single rehabilitations were found. Logistic regression analysis did not show any association between the implant's characteristics and peri-implantitis.

    CONCLUSIONS: A history of periodontal disease, cemented prostheses, presences of wear facets on the prosthetic crown and full mouth rehabilitations were identified as risk indicators for peri-implantitis. Implants' characteristics were not related to the presence of peri-implantitis.

  • 21.
    Erovic Ademovski, Seida
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Lingström, P
    University of Gothenburg.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Blekinge Institute of Techology, Dublin Dental University Hospital, Dublin.
    The effect of different mouth rinse products on intra-oral halitosis2016In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 14, no 2, p. 117-123Article in journal (Refereed)
    Abstract [en]

    AIM: To evaluate the effect of different mouth rinses 12 h after rinsing on genuine intra-oral halitosis.

    MATERIALS AND METHODS: Twenty-four adults with halitosis were included in a double-blind, crossover, randomized clinical trial. Halitosis was evaluated 12 h after rinsing with placebo and five mouth rinse products containing zinc acetate and chlorhexidine diacetate; zinc lactate, chlorhexidine and cetylpyridinium chloride; zinc acetate and chlorhexidine diacetate with reduced amounts of mint and menthol; zinc chloride and essential oil; and chlorine dioxide using the organoleptic method and a gas chromatograph. Test periods were separated by 1 week.

    RESULTS: Hydrogen sulphide (H2 S), methyl mercaptan (MM) and the organoleptic scores (OLS) were significantly reduced 12 h following rinsing with all substances compared to placebo (P < 0.05). H2 S was more effectively reduced after rinsing with zinc acetate and chlorhexidine diacetate and zinc acetate and chlorhexidine diacetate with reduced amounts of mint and menthol compared to rinsing with zinc chloride and essential oil (P < 0.05), and significantly lower values of MM were obtained after rinsing with zinc acetate and chlorhexidine diacetate compared to zinc lactate, chlorhexidine and cetylpyridinium chloride (P < 0.05). The percentage effectively treated individuals (H2 S (<112 ppb), MM (<26 ppb) and OLS score <2) varied from 58% percentage (zinc acetate and chlorhexidine diacetate) to 26% (zinc chloride and essential oil).

    CONCLUSION: All treatments resulted in reduction in halitosis 12 h after rinsing compared to placebo. H2 S and MM were most effectively reduced by zinc acetate and chlorhexidine diacetate.

  • 22.
    Erovic Ademovski, Seida
    et al.
    Kristianstad University, School of Health and Society.
    Lingström, Peter
    Kristianstad University, School of Health and Society.
    Winkel, Edwin
    Academic Centre for Oral Health, Department of Periodontology, University Medical Centre Groningen.
    Tangerman, Albert
    Academic Centre for Oral Health, Department of Periodontology, University Medical Centre Groningen.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society.
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    Comparison of different treatment modalities for oral halitosis2012In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 70, no 3, p. 224-233Article in journal (Refereed)
    Abstract [en]

    Objectives. To assess the effects on intra-oral halitosis by a mouth rinse containing zinc acetate (0.3%) and chlorhexidine diacetate (0.025%) with and without adjunct tongue scraping. Materials and methods. Twenty-one subjects without a diagnosis of periodontitis were randomized in a cross-over clinical trial. Organoleptic scores (OLS) were assessed to define intra-oral halitosis by total volatile sulfur compound (T-VSC) measurements and by gas chromatography. Results. Twenty-one subjects with a mean age of 45.7 years (SD: ±13.3, range: 21–66). The OLS were significantly lower following active rinse combined with tongue scraping (p < 0.001) at all time points. Immediately after, at 30 min, and at day 14, the T-VSC values were lower in the active rinse sequence than in the negative rinse sequence (p < 0.001, p < 0.001 and p < 0.05, respectively). At 30 min and at day 14, the hydrogen sulfide (H2S) and methyl mercaptan (MM) values were lower in the active rinse sequence compared to the inactive rinse sequence (p < 0.001). The inactive rinse sequence with tongue scraping reduced T-VSC at 30 min (p < 0.001) but not at 14 days. Similar reductions in T-VSC, H2S and MM were found in the active rinse sequence with or without tongue scraping. Conclusion. The use of a tongue scraper did not provide additional benefits to the active mouth rinse, but reduced OLS and tongue coating index.

  • 23.
    Erovic Ademovski, Seida
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Mårtensson, Carina
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Persson, Rutger G
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    The long-term effect of a zinc acetate and chlorhexidine diacetate containing mouth rinse on intra-oral halitosis: a randomized clinical trial2017In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 44, no 10, p. 1010-1019Article in journal (Refereed)
  • 24.
    Erovic Ademovski, Seida
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Persson, G. Rutger
    Department of Periodontology, School of Dental Medicine, University of Bern.
    Winkel, Edwin
    Academic Centre for Oral Health, Department of Periodontology, University Medical Centre Groningen.
    Tangerman, Albert
    Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen.
    Lingström, Peter
    Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    The short-term treatment effects on the microbiota at the dorsum of the tongue in intra-oral halitosis patients: a randomized clinical trial2013In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 17, no 2, p. 463-473Article in journal (Refereed)
    Abstract [en]

    Objectives This study aims to assess the effects of rinsing with zinc- and chlorhexidine-containing mouth rinse with or without adjunct tongue scraping on volatile sulfur compounds (VSCs) in breath air, and the microbiota at the dorsum of the tongue. Material and methods A randomized single-masked controlled clinical trial with a cross-over study design over 14 days including 21 subjects was performed. Bacterial samples from the dorsum of the tongue were assayed by checkerboard DNA–DNA hybridization. Results No halitosis (identified by VSC assessments) at day 14 was identified in 12/21 subjects with active rinse alone, in 10/21with adjunct use of tongue scraper, in 1/21 for negative control rinse alone, and in 3/21 in the control and tongue scraping sequence. At day 14, significantly lower counts were identified only in the active rinse sequence ( p &lt; 0.001) for 15/78 species including , Fusobacterium sp., Porphyromonas gingivalis , Pseudomonas aeruginosa , Staphylococcus aureus , and Tannerella forsythia . A decrease in bacteria from baseline to day 14 was found in successfully treated subjects for 9/74 species including: P. gingivalis , Prevotella melaninogenica , S. aureus , and Treponema denticola . Baseline VSC scores were correlated with several bacterial species. The use of a tongue scraper combined with active rinse did not change the levels of VSC compared to rinsing alone. Conclusions VSC scores were not associated with bacterial counts in samples taken from the dorsum of the tongue. The active rinse alone containing zinc and chlorhexidine had effects on intra-oral halitosis and reduced bacterial counts of species associated with malodor. Tongue scraping provided no beneficial effects on the microbiota studied. Clinical relevance Periodontally healthy subjects with intra-oral halitosis benefit from daily rinsing with zinc- and chlorhexidine-containing mouth rinse.

  • 25.
    Erovic, Seida
    et al.
    Kristianstad University, School of Health and Society.
    Lingström, P.
    Kristianstad University, School of Health and Society.
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    Winkel, E.
    Tangerman, A.
    Persson, G. Rutger
    Bern, Switzerland.
    The effect on bad breath using a zinc-lacete - chlorhexidine containing mouth rinse2009In: Europerio 6: Stockholm, Sweden, 4-6 June 2009 / [ed] Tonetti, Maurizio, Renvert, Stefan, 2009, p. 37-Conference paper (Refereed)
    Abstract [en]

    Background: Around 30% of the adult population has problems with Halitosis. Halitosis is caused by volatile sulfur compounds (VSC) by bacteria. The aim of this study was to evaluate the short term effect on halitosis using a zinc-lacete-chlorhexidine containing mouth rinse (SB12). Materials and methods: Twenty-five adults with halitosis were included in a clinical randomized double blind cross over study. Four test periods, each 2 weeks long separated by washout periods of 1 week was used to evaluate 4 treatments: A) SB12, B) placebo C) SB12 + tongue scraper, and D) placebo + tongue scraper. Registration of VSC using a Halimeter was done at Day 1 before rinsing, immediately after rinsing, after 30 minutes and at Day 14. Results: A reduction on VSC 30 min following treatment compared to baseline was found for substance A, C, D (P < 0.000). A reduction at Day 14 was only found for substance A (P < 0.004). Comparing treatments, significant differences was found at all time points between A and B (P < 0.01, P < 0.003, P < 0.042 respectively) and between C and B immediately after rinsing and 30 min after rinsing (P < 0.008, P < 0.003). There was non significant difference between treatment A and C or between treatments B and D. Conclusion: Rinsing with a zinc-lacete - chlorhexidine containing mouth rinse (SB12) demonstrated short term reductions of VSC. Tongue scraper alone had a limited effect on oral halitosis. The addition of tongue cleaning using a tongue scraper did not improve the results obtained by rinsing alone.

  • 26.
    Figuero, Elena
    et al.
    University Complutense, Madrid.
    Lindahl, Christel
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Marín, María José
    University Complutense, Madrid.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Herrera, David
    University Complutense, Madrid.
    Ohlsson, Ola
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Wetterling, Thomas
    Central Hospital Kristianstad.
    Sanz, Mariano
    University Complutense, Madrid.
    Quantification of periodontal pathogens in vascular, blood and subgingival samples from patients with peripheral arterial disease or abdominal aortic aneurysms2014In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 85, no 9, p. 1182-1193Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this investigation was to quantify periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus and Tannerella forsythia) in vascular, blood and subgingival samples. As secondary objective, two molecular bacterial identification methods [nested-polimerase chain reaction (PCR) and quantitative PCR (qPCR)] were compared.

    Methods: Seventy consecutive patients provided a vascular lesion, a blood sample, and 36 subgingival samples. Bacterial deoxyribonucleic acid (DNA) was extracted and qPCR was used to determine the prevalence and amounts of the target pathogens in each sample. Nested-PCR was only performed in the samples from vascular lesions. Periodontal examination was performed in 42 patients. U-Mann-Whitney or Chi-squared tests were used to compare microbiological results according to periodontal diagnosis.

    Results: All targeted periodontal pathogens (A. actinomycetemcomitans, P. gingivalis, T. forsythia or C. rectus) were detected in subgingival samples with a prevalence rate of 72.2%, 47.2%, 74.3% and 82.9%, respectively. In 7.1% and 11.4% of vascular and blood samples, bacterial DNA was detected. One patient was positive for A. actinomycetemcomitans in the three types of samples. No differences were found in the levels of targeted bacteria when comparing periodontitis and non-periodontitis patients. Prevalence rates obtained with nested PCR were significantly higher than those obtained by qPCR.

    Conclusions: The presence of of A. actinomycetemcomitans was demonstrated in vascular, blood and subgingival samples in one out of 36 patients. These results, although with a very low frequency, may support the hypothesis of a translocation of periodontal pathogens from subgingival microbiota to the blood stream and then to atheromatous plaques in carotid or other peripheral arteries. Nested-PCR is not an adequate method for identifying DNA of periodontal pathogens in low quantities, due to the high number of false negative results.

  • 27.
    Gkikas, Georgias
    et al.
    Irland.
    Maclaughlin, Mark
    Irland.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa. BTH.
    Polyzios, Ioannis
    Irland.
    A prospective study comparing the effect of L-PRF and porous titanium granules on the preservation of the buccal bone plate following immediate implant placement2020In: The international journal of periodontics & restorative dentistry, ISSN 0198-7569, E-ISSN 1945-3388, Vol. 40, no 5, p. 767-774Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare the effect of an autogenous blood concentrate (L-PRF) with the effect of white porous titanium granules (WPTG) on buccal bone remodeling. These materials were used to graft the void between the implant and the buccal bone following immediate implant placement. Clinical measurements were made at two time points, and the mean buccal bone horizontal dimension at placement was 2.94 ± 0.59 mm for L-PRF and 3.49 ± 0.99 mm for WPTG. At reentry, the values were 1.19 ± 0.90 mm and 2.12 ± 0.87 mm, respectively. Overall, there was no difference observed in the performance of the two materials regarding buccal bone resorption.

  • 28.
    Halling, Anders
    et al.
    Blekinge Institute for Research and Development, Karlshamn.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Berglund, Johan
    Blekinge Institute for Research and Development, Karlshamn & Department of Community Medicine, Lund University, Malmö, Sweden.
    Johansson, Owe
    Department of Periodontology, Public Dental Services, Karlskrona, Sweden.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Comparison between the Klemetti index and heel DXA BMD measurements in the diagnosis of reduced skeletal bone mineral density in the elderly.2005In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 16, no 8, p. 999-1003Article in journal (Refereed)
    Abstract [en]

    Osteopenia/osteoporosis affect many elderly people and might not be detected until symptoms of fractures occur. Early detection of osteopenia/osteoporosis is important and would allow preventive measures and treatment. Access to screening for osteopenia/osteoporosis is often limited, whereas panoramic radiography is commonly used in dentistry. The aim of this study was to determine the validity of the Klemetti index (KI), measured on panoramic radiographs, in the diagnosis of osteopenia/osteoporosis as defined by a bone mineral density (BMD) measurement below -1.5 standard deviations (SDs) of a community based sample. In total, 211 consecutive participants (102 men and 109 women) 60-96 years in the SNAC-Blekinge study (Swedish National Study on Ageing and Care) underwent bone densitometry [by dual-energy X-ray absorptiometry (DXA)] of both heels. A panoramic radiograph was taken of each participant, and mandibular cortex on a panoramic radiograph was classified as '0' or normal (even and sharp endosteal margin), '1', moderately eroded (evidence of lacunar resorption or endosteal cortical residues), or '2', severely eroded (unequivocal porosity). From logistic regression, the odds ratio of having a BMD measurement below -1.5 SD was 8.04 (95% CI 2.39 to 27.12, P<0.001) in the 'osteopenic' (KI category 2), compared with the 'normal' group (KI categories 0 and 1). Receiver operating characteristic (ROC) curve analysis was used to measure the validity of the KI indicating osteopenia (KI category 2) in predicting reduced BMD. This point provided a sensitivity of 50% and a specificity of 89%. Positive and negative predictive values were 21% and 97%, respectively. There were 87% correctly classified subjects. The area under the ROC curve was 0.64. The present study demonstrated that a negative finding (KI category <2) is highly predictive of the absence of osteopenia/osteoporosis as defined by the DXA measurements.

  • 29.
    Hallström, Hadar
    et al.
    Malmö University.
    Lindgren, Susann
    Halland Hospital, Halmstad.
    Widén, Cecilia
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Renvert, Stefan
    Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Twetman, Svante
    Danmark.
    Probiotic supplements and debridement of peri-implant mucositis: a randomized controlled trial2015In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 1, p. 60-66Article in journal (Refereed)
    Abstract [en]

    Objective.

    The aim of this double-blind randomized placebo-controlled trial was to evaluate the effects of probiotic supplements in adjunct to conventional management of peri-implant mucositis.

    Materials and methods.

    Forty-nine adult patients with peri-implant mucositis were consecutively recruited after informed consent. After initial mechanical debridement and oral hygiene instructions, the patients received a topical oil application (active or placebo) followed by twice-daily intake of lozenges (active or placebo) for 3 months. The active products contained a mix of two strains of Lactobacillus reuteri. Patients were clinically monitored and sampled at baseline and after 1, 2, 4, 12 and 26 weeks. The clinical end-points were pocket-probing depth (PPD), plaque index (PI) and bleeding on probing (BOP). In addition, the subgingival microbiota was processed with checkerboard DNA-DNA hybridization and samples of gingival crevicular fluid (GCF) were analyzed for selected cytokines with the aid of multiplex immunoassays.

    Results.

    After 4 and 12 weeks, all clinical parameters were improved in both the test and the placebo group. PPD and BOP were significantly reduced compared with baseline (p < 0.05), but no significant differences were displayed between the groups. The clinical improvements persisted 3 months after the intervention. No major alterations of the subgingival microflora were disclosed and the levels of inflammatory mediators in GCF did not differ between the groups.

    Conclusions.

    Mechanical debridement and oral hygiene reinforcement resulted in clinical improvement of peri-implant mucositis and a reduction in cytokine levels. Probiotic supplements did not provide added benefit to placebo.

  • 30.
    Hallström, Hadar
    et al.
    Maxillofacial unit, Halland Hospital, Halmstad.
    Lindgren, Susann
    Maxillofacial unit, Halland Hospital, Halmstad.
    Yucel-Lindberg, Tülay
    Department of Dental Medicine, Karolinska Institutet.
    Dahlén, Gunnar
    Department of Odontology, Oral microbiology, Sahlgenska Academy at Gothenburg University.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Twetman, Svante
    Maxillofacial unit, Halland Hospital, Halmstad.
    Effect of probiotic lozenges on inflammatory reactions and oral biofilm during experimental gingivitis2013In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 71, no 3-4, p. 828-833Article in journal (Refereed)
    Abstract [en]

    Aim. Probiotic bacteria have been introduced for prevention and treatment of periodontal diseases. The aim was to assess if daily oral administration of probiotic bacteria could influence the inflammatory response and the composition of supragingival plaque in an experimental gingivitis model. Materials and methods. Eighteen healthy female adults volunteered after informed consent. A double-blind randomized placebo-controlled cross-over design was used. The buccal surface of first molars was used as experimental sites. A mouth-guard covering the first premolar to second molar was used when brushing, preventing accidental cleaning during 3 weeks of plaque accumulation. Lozenges containing L. reuteri (ATCC55730 and ATCC PTA5289) or placebo were taken twice a day. During the run-in and washout periods, professional tooth cleaning was performed 5 days/week. At baseline and follow-up, plaque index, gingival index and bleeding on probing were recorded. Samples of gingival crevicular fluid (GCF) were analysed for concentration of seven inflammatory mediators. Bacterial samples were processed with checkerboard DNA/DNA-hybridization. Results. All subjects presented a local plaque accumulation and developed manifest gingivitis at the test sites during the intervention periods. The volume of GCF increased in both groups but was statistically significant only in the placebo group (p < 0.05). The concentrations of IL1-β and IL-18 increased significantly (p < 0.05), while IL-8 and MIP1-β decreased (p < 0.05). No differences were displayed between test and placebo. Likewise, the microbial composition did not differ between the groups. Conclusion. Daily intake of probiotic lozenges did not seem to significantly affect the plaque accumulation, inflammatory reaction or the composition of the biofilm during experimental gingivitis.

  • 31.
    Hallström, Hadar
    et al.
    Department of Periodontology, Maxillofacial Unit, Hospital of Halland, Halmstad.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society.
    Lindgren, Susann
    Department of Periodontology, Maxillofacial Unit, Hospital of Halland, Halmstad.
    Olofsson, Maria
    Department of Periodontology, Maxillofacial Unit, Hospital of Halland, Halmstad.
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    Systemic antibiotics and debridement of peri-implant mucositis: a randomized clinical trial2012In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 39, no 6, p. 574-581Article in journal (Refereed)
    Abstract [en]

    Background This RCT compared non-surgical treatment of peri-implant mucositis with or without systemic antibiotics. Materials and Methods Forty-eight subjects received non-surgical debridement with or without systemic Azithromax ® (4 days), and were followed during 6 months. The checkerboard DNA-DNA hybridization method was used to analyse the microbiological material. Results Five subjects were excluded due to antibiotic medication during follow-up. At baseline,1 and 3 months no group differences were found. Statistical analysis failed to demonstrate differences in probing pocket depths (PPD) values at 6 months (Mean diff PPD: 0.5 mm, SE: ±0.4 mm, 95% CI: −0.2, 1.3, p = 0.16). Mean% implant bleeding decreased between baseline and month 6 from 82.6% to 27.3% in the test, and from 80.0% to 47.5% in the control group (p < 0.02). Throughout the study, no study group differences in bacterial counts were found. Conclusion No short-term differences were found between study groups. The clinical improvements observed at 6 months may be attributed to improvements in oral hygiene. The present study does not provide evidence for the use of systemic antibiotics in treatment of peri-implant mucositis.

  • 32.
    Hallström, Hadar
    et al.
    Malmö University.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Strömberg, Ulf
    Halland Hospital.
    Twetman, Svante
    University of Copenhagen.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Reproducibility of subgingival bacterial samples from patients with peri-implant mucositis2015In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 19, no 5, p. 1063-1068Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of the present study was to investigate the reproducibility of bacterial enumeration from subsequent subgingival samples collected from patients with peri-implant mucositis.

    MATERIAL AND METHODS: Duplicate microbial samples from 222 unique implant sites in 45 adult subjects were collected with paper points and analyzed using the checkerboard DNA-DNA hybridization technique. Whole genomic probes of 74 preselected bacterial species were used. Based on the bacterial scores, Cohen's kappa coefficient was used to calculate the inter-annotator agreement for categorical data. The percentage agreement was considered as "good" when the two samples showed the same score or differed by 1 to the power of 10.

    RESULTS: Moderate to fair kappa values were displayed for all bacterial species in the test panel (range 0.21-0.58). There were no significant differences between Gram-positive and Gram-negative species. The percentage of good agreement between the first and second samples averaged 74.7 % (n = 74; range 56-83 %), while the proportion of poor agreement ranged from 1 to 19 % for the various strains.

    CONCLUSION: While an acceptable clinical agreement was obtained in most cases, diverging bacterial scores may appear in subgingival samples collected at the same time point from patients with peri-implant mucositis.

    CLINICAL RELEVANCE: The broad bulky base of implant crowns may present an obstacle for the collection of reproducible subgingival samples with paper points.

  • 33.
    Hallström, Hadar
    et al.
    Malmö University.
    Persson, Rutger G
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Lindgren, Susann
    Halland's hospital.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Open flap debridement of peri-implantitis with or without adjunctive systemic antibiotics: a randomized clinical trial.2017In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 44, no 12, p. 1285-1293Article in journal (Refereed)
    Abstract [en]

    AIMS: To investigate clinical, radiographic and microbiological outcome over 12 months following open flap debridement of peri-implantitis with or without antibiotics.

    MATERIALS AND METHODS: Peri-implantitis was surgically treated with or without Zithromax(®) in 19 control and 20 test individuals. Probing pocket depth (PPD), gingival inflammation (BOP), intra-oral radiographs and microbial samples were studied. Per protocol, and intent to treat analyzes were performed.

    RESULTS: The mean difference (reduction) in PPD values between baseline and month 12 in the test and control groups were: 1.7 mm (SD ± 1.1, 95% CI: 1.1, 2.3, p < 0.001), and 1.6 mm (SD ± 1.5, 95% CI: 0.8, 2,4, p < 0.001), respectively. Data analysis failed to show study group differences for BOP, PPD, radiographic bone level, and microbial load. Succesful treatment (per protocol: PPD≤ 5 mm, no BOP, no suppuration and no bone loss ≥ 0.5 mm) at 12 months in test and control groups were 7/15 (46.7%), and 4/16 (25.0%). Bacterial load reduction was similar in study groups with a temporary reduction following treatment.

    CONCLUSIONS: Surgical treatment of peri-implantitis with adjunctive systemic azithromycin did not provide one-year clinical benefits in comparison to those only receiving open flap debridement. This article is protected by copyright. All rights reserved.

  • 34. Hallström, Hadar
    et al.
    Samuelson, Agneta
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    Sällberg, Matti
    Virus vid lokal aggresiv parodontit studeras2009In: Tandläkartidningen, ISSN 0039-6982, Vol. 101, no 3, p. 58-Article in journal (Other academic)
    Abstract [sv]

    Under det senaste decenniet har virus roll i parodontitsjukdomens uppkomst och progression studerats. Data har publicerats som visar att virus förekommer och eventuellt har betydelse för sjukdomsutvecklingen vid vissa typer av parodontit. Vi har därför undersökt förekomsten av bakterier och virus hos ett antal unga patienter med lokal aggressiv parodontit. Vår studie kan dock varken belägga eller avvisa hypotesen om virusförekomstens betydelse.

  • 35.
    Hirooka, Hideaki
    et al.
    Japan.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Diagnosis of periimplant disease2019In: Implant Dentistry, ISSN 1056-6163, E-ISSN 1538-2982, Vol. 28, no 2, p. 144-149Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this review is to describe the current guidelines for the differential diagnosis of periimplant diseases.

    MATERIALS AND METHODS: Synopsis reviews were conducted to define the differential diagnosis of periimplant disease through an electronic literature search in MEDLINE up to February 2018.

    DISCUSSION: Periimplant mucositis is defined by the presence of bleeding and/or suppuration on gentle probing with or without an increased probing depth compared with previous examinations and by the absence of bone loss beyond crestal bone-level changes resulting from initial bone remodeling. Periimplantitis is defined by the presence of bleeding and/or suppuration on gentle probing with an increased probing depth compared with previous examinations and by the presence of bone loss beyond crestal bone-level changes resulting from initial bone remodeling. Thus, a combination of clinical registrations (probing pocket depth, bleeding on probing, and presence of pus) combined with radiographic signs of possible bone loss is needed for differential diagnosis.

    CONCLUSIONS: An accurate baseline registration at the time of placement of the prosthesis (probing pocket depth and bone level) with ongoing yearly monitoring is essential for diagnosis and appropriate disease management.

  • 36.
    Isehed, Catrine
    et al.
    Umeå university.
    Holmlund, Anders
    Uppsala university.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Svenson, Björn
    Örebro university.
    Johansson, Ingegerd
    Umeå university.
    Lundberg, Pernilla
    Umeå university.
    Effectiveness of enamel matrix derivative on the clinical and microbiological outcomes following surgical regenerative treatment of peri-implantitis: a randomized controlled trial2016In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 43, no 10, p. 863-873Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This randomized clinical trial aimed at comparing radiological, clinical and microbial effects of surgical treatment of peri-implantitis alone or in combination with enamel matrix derivative (EMD).

    METHODS: Twenty-six subjects were treated with open flap debridement and decontamination of the implant surfaces with gauze and saline preceding adjunctive EMD or no EMD. Bone level (BL) change was primary outcome and secondary outcomes were changes in pocket depth (PD), plaque, pus, bleeding and the microbiota of the peri-implant biofilm analyzed by the Human Oral Microbe Identification Microarray over a time period of 12 months.

    RESULTS: In multivariate modelling, increased marginal BL at implant site was significantly associated with EMD, the number of osseous walls in the peri-implant bone defect and a Gram+/aerobic microbial flora, whereas reduced BL was associated with a Gram-/anaerobic microbial flora and presence of bleeding and pus, with a cross-validated predictive capacity (Q(2) ) of 36.4%. Similar, but statistically non-significant, trends were seen for BL, PD, plaque, pus and bleeding in univariate analysis.

    CONCLUSION: Adjunctive EMD to surgical treatment of peri-implantitis was associated with prevalence of Gram+/aerobic bacteria during the follow-up period and increased marginal BL 12 months after treatment.

  • 37.
    Jannesson, Lillemor
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Birkhed, Dowen
    Scherl, Dale
    Gaffar, Abdul
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Effect of oxybenzone on PGE2-production in vitro and on plaque and gingivitis in vivo2004In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 31, no 2, p. 91-94Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To study the effect of oxybenzone on prostaglandin E2 (PGE2) production in cell culture and to evaluate the effect of an oxybenzone-containing dentifrice on plaque and gingivitis in a 6-week clinical trial.

    MATERIAL AND METHODS: Human embryo palatal mesenchyme (HEPM) cells were used for testing the inhibition of IL-1beta-stimulated PGE2-production in vitro by different concentrations of oxybenzone. For the in vivo study, a total of 66 individuals with a Quigley & Hein plaque index of at least 1.5 and an Ainamo & Bay gingival index of at least 0.2 were included in a double-blind clinical trial with two cells and a parallel design. Two compositions of fluoride dentifrice were used, one with the addition of 0.5% oxybenzone, and one without. Plaque and gingival index were obtained at three time points: (1) at baseline, (2) after 3 weeks, and (3) after 6 weeks.

    RESULTS: A dose-dependent inhibition of PGE2-production was found in the HEPM cell culture following oxybenzone exposure. In the clinical trial, a 25% reduction of gingival index was observed in the oxybenzone group (p<0.001) after 6 weeks as compared with 2% for the placebo group.

    CONCLUSIONS: These findings indicate that PGE2-production is reduced by oxybenzone in vitro and that the use of oxybenzone in a dentifrice reduces gingivitis in vivo.

  • 38.
    Jepsen, K.
    et al.
    Tyskland.
    Jepsen, S.
    Tyskland.
    Laine, M.L.
    Nederländerna.
    Anssari Moin, D
    Nederländerna.
    Pilloni, A
    Italien.
    Zeza, B
    Italien.
    Sanz, M
    Spanien.
    Roos-Jansåker, Anne-Marie
    Region Skåne.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Reconstruction of peri-implant osseous defects: a multicenter randomized trial2016In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 95, no 1, p. 58-66Article in journal (Refereed)
    Abstract [en]

    There is a paucity of data for the effectiveness of reconstructive procedures in the treatment of peri-implantitis. The objective of this study was to compare reconstruction of peri-implant osseous defects with open flap debridement (OFD) plus porous titanium granules (PTGs) compared with OFD alone. Sixty-three patients (36 female, 27 male; mean age 58.4 y [SD 12.3]), contributing one circumferential peri-implant intraosseous defect, were included in a multinational, multicenter randomized trial using a parallel-group design. After OFD and surface decontamination using titanium brushes and hydrogen peroxide, 33 defects received PTGs. The implants were not submerged. All patients received adjunctive perioperative systemic antibiotics. The primary outcome variable (defect fill) was assessed on digitalized radiographs. Clinical measurements of probing depth (PPD), bleeding on probing (BoP), suppuration, and plaque were taken by blinded examiners. After 12 mo, the test group (OFD plus PTG) showed a mean radiographic defect fill (mesial/distal) of 3.6/3.6 mm compared with 1.1/1.0 in the control group (OFD). Differences were statistically significant in favor of the test group (P < 0.0001). The OFD plus PTG group showed a mean reduction in PPD of 2.8 mm compared with 2.6 mm in the OFD group. BoP was reduced from 89.4% to 33.3% and from 85.8% to 40.4% for the test and control groups, respectively. There was no significant difference in complete resolution of peri-implantitis (PPD ≤4 mm and no BoP at six implant sites and no further bone loss), because this finding was accomplished at 30% of implants in the test group and 23% of implants in the control group. Reconstructive surgery using PTGs resulted in significantly enhanced radiographic defect fill compared with OFD. However, limitations in the lack of ability to discern biomaterial from osseous tissue could not be verified to determine new bone formation. Similar improvements according to clinical measures were obtained after both surgical treatment modalities (ClinicalTrials.gov NCT02406001).

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  • 39.
    Jepsen, S
    et al.
    Germany.
    Schwarz, F
    Germany.
    Cordaro, L
    Italy.
    Derks, J
    University of Gothenburg.
    Hämmerle, C H F
    Switzerland.
    Heitz-Mayfield, L J
    Australia.
    Hernández-Alfaro, F
    Spain.
    Meijer, H J A
    Netherlands.
    Naenni, N
    Switzerland.
    Ortiz-Vigón, A
    Spain.
    Pjetursson, B
    Iceland.
    Raghoebar, G M
    Netherlands.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Rocchietta, I
    England.
    Roccuzzo, M
    Italy.
    Sanz-Sánchez, I
    Spain.
    Simion, M
    Italy.
    Tomasi, C
    University of Gothenburg.
    Trombelli, L
    Italy.
    Urban, I
    USA.
    Regenration of alveolar ridge defects: Consensus report of group 4 of the 15th European Workshop on Periodontology on Bone Regeneration2019In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 46, p. 277-286Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Bone augmentation procedures to enable dental implant placement are frequently performed. The remit of this working group was to evaluate the current evidence on the efficacy of regenerative measures for the reconstruction of alveolar ridge defects.

    MATERIAL AND METHODS: The discussions were based on four systematic reviews focusing on lateral bone augmentation with implant placement at a later stage, vertical bone augmentation, reconstructive treatment of peri-implantitis associated defects, and long-term results of lateral window sinus augmentation procedures.

    RESULTS: A substantial body of evidence supports lateral bone augmentation prior to implant placement as a predictable procedure in order to gain sufficient ridge width for implant placement. Also, vertical ridge augmentation procedures were in many studies shown to be effective in treating deficient alveolar ridges to allow for dental implant placement. However, for both procedures the rate of associated complications was high. The adjunctive benefit of reconstructive measures for the treatment of peri-implantitis-related bone defects has only been assessed in a few RCTs. Meta-analyses demonstrated a benefit with regard to radiographic bone gain but not for clinical outcomes. Lateral window sinus floor augmentation was shown to be a reliable procedure in the long-term for the partially and fully edentulous maxilla.

    CONCLUSIONS: The evaluated bone augmentation procedures were proven to be effective for the reconstruction of alveolar ridge defects. However, some procedures are demanding and bear a higher risk for postoperative complications. This article is protected by copyright. All rights reserved.

  • 40. Johansson, Stig
    et al.
    Lindberg, Anders
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Anordning för befrämjande av tillväxt för benvävnad och anordning för förbättrad förankring av ett implantat2003Patent (Other (popular science, discussion, etc.))
  • 41. Klinge, Björn
    et al.
    Flemming, Thomas
    Cosyn, Jan
    De Bruyn, Hugo
    Eisner, Barbara M
    Hultin, Margareta
    Isidor, Flemming
    Lang, Niklaus P
    Lund, Bodil
    Meyle, Jürg
    Mombelli, Andrea
    Navarro, Jose Manuel
    Pjetursson, Bjarni
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL).
    Schliephake, Henning
    The patient undergoing implant therapy: summary and consensus statements: the 4th EAO Consensus Conference 20152015In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26 Suppl 11, p. 64-7Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The assignment for this working group was to update the existing knowledge regarding factors considered being of special relevance for the patient undergoing implant therapy. This included areas where conflicting opinions exists since long or recently has been expressed, like the role of antibiotic prophylaxis in dental implant surgery and peri-implantitis. Also areas with growing interest and concern such as patient-reported outcome measures (PROMs) and health-economy was included in this review.

    MATERIALS AND METHODS: The literature in the respective areas of interest (antibiotic prophylaxis, peri-implantitis, patient-reported outcome measurements and health-economic aspects) was searched using different strategies for the different papers. Search strategies ranged from a complex systematic review to systematic- and narrative reviews, depending on subject and available literature. All collected material was critically reviewed. Four manuscripts were subsequently presented for group analysis and discussion and plenum discussions and concensus approval. The selected areas were considered to be of key importance and relevance for the patient undergoing implant therapy.

    RESULTS: The results and conclusions of the review process are presented in the respective papers. The group's conclusions, identified knowledge gaps, directions for future research and concensus statements are presented in this article. The following reviews were available for group discussions and the foundation for subsequent plenary sessions: Lund B, Hultin M, Tranaeus S, Naimi-Akbar A, Klinge B. (2015) Perioperative antibiotics in conjunction with dental implant placement. A complex systematic review. Renvert S & Quirynen M. (2015) Risk indicators for peri-implantitis. A narrative review. De Bruyn H, Raes S, Matthys C, Cosyn J. (2015) The current use of patient centered/reported outcomes in implant dentistry. A systematic review. Beikler T & Flemmig T.F. (2015) Economic evaluation of implant-supported prostheses. A narrative review.

  • 42.
    Klinge, Björn
    et al.
    Karolinska Institutet, Huddinge & Malmö universitet.
    Meyle, J
    Justus Liebig University Giessen, Giessen, Germany.
    Claffey, Noel
    Flemmig, Thomas
    Flemming, Isidor
    Mombelli, Andrea
    Naert, Ignace
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Rocchietta, Isabella
    Schou, Soren
    Schwarz, Frank
    Teughels, Wim
    Valentini, Pascal
    Wennerberg, Ann
    Peri-implant tissue destruction: The Third EAO Consensus Conference 20122012In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, no Suppl 6, p. 108-110Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The task of this working group was to update the existing knowledge base regarding the prevalence of peri-implant tissue destruction, the role of occlusal overload, and the outcome of non-surgical and surgical treatment.

    MATERIALS AND METHODS: The literature was systematically searched and critically reviewed. Four manuscripts were presented in key areas deemed to be essential for the current understanding of the magnitude of the clinical entity peri-implantitis. The role of overload as an etiological component was reviewed. Also available data on the results from non-surgical and surgical interventions for the control of tissue destruction were presented.

    RESULTS: The consensus statements following plenary session approval, clinical implications, and directions for future research based on the group discussions are presented in this article. The results and conclusions of the systematic review process are presented by the respective authors in the subsequent papers.

  • 43. Kolonidis, Stavros G
    et al.
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Hämmerle, Christopher H F
    Lang, Niklaus P
    Harris, David
    Claffey, Noel
    Osseointegration on implant surfaces previously contaminated with plaque. An experimental study in the dog2003In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 14, no 4, p. 373-380Article in journal (Refereed)
    Abstract [en]

    This study investigated whether osseointegration can occur on a surface which had previously been coated with dental plaque. The mandibular premolar regions of four young adult Labrador dogs were used for the study. The lower premolars (P1, P2, P3, and P4) were extracted on either side of the mandibles. Following a 12-week healing period, three 3.75 mm x 13 mm commercially pure titanium implants (Nobel BiocareAB, Gothenburg, Sweden) were partially inserted in one side of each mandible. This resulted in some threads protruding from the tissues into the oral cavity. Plaque was allowed to accumulate on the exposed implant surfaces. Following a 5-week healing period, the contaminated parts of each implant were treated using three different cleaning techniques: (1) swabbing with supersaturated citric acid for 30 s on a cotton pellet followed by rinsing with physiological saline, (2) cleansing with a toothbrush and physiological saline only for 1 min, and (3) swabbing with 10% hydrogen peroxide (H2O2) on a cotton pellet for 1 min followed by rinsing with physiological saline. The treated implants and one previously unused implant (control) were then placed into freshly prepared tapped sites to the full implant length on the contralateral sides of the mandibles. Following 11 weeks of healing, biopsies were obtained and ground sections prepared for histomorphometric analysis. All treatment modalities were associated with direct bone to implant contact on the portion of implant surface previously exposed to the oral environment. In conclusion, The results demonstrate that osseointegration can occur to surfaces that were plaque contaminated and cleaned by different methods.

  • 44.
    Kröger, A
    et al.
    Tyskland & England.
    Hülsmann, C
    Tyskland.
    Fickl, S
    Tyskland.
    Spinell, T
    Tyskland & Italien.
    Hüttig, F
    Tyskland.
    Kaufmann, F
    Tyskland.
    Heimbach, A
    Tyskland.
    Hoffmann, P
    Tyskland .
    Enkling, N
    Tyskland.
    Renvert, Stefan
    Kristianstad University, Faculty of Health Science, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Faculty of Health Science, Avdelningen för oral hälsa.
    Schwarz, F
    Tyskland.
    Demmer, Ryan T
    USA.
    Papapanou, P N
    USA.
    Jepsen, S
    Tyskland.
    Kebschull, M
    USA & Tyskland.
    The severity of human peri-implantitis lesions correlates with the level of submucosal microbial sysbiosis2018In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no 12, p. 1498-1509Article in journal (Refereed)
    Abstract [en]

    AIM: To cross-sectionally analyze the submucosal microbiome of peri-implantitis (PI) lesions at different severity levels.

    MATERIALS AND METHODS: Microbial signatures of 45 submucosal plaque samples from untreated peri-implantitis lesions obtained from 30 non-smoking, systemically healthy subjects were assessed by 16s sequencing. Linear mixed models were used to identify taxa with differential abundance by probing depth, after correction for age, gender, and multiple samples per subject. Network analyses were performed to identify groups of taxa with mutual occurrence or exclusion. Subsequently, the effects of peri-implant probing depth on submucosal microbial dysbiosis was calculated using the microbial dysbiosis index.

    RESULTS: In total, we identified 337 different taxa in the submucosal microbiome of peri-implantitis. Total abundance of 12 taxa correlated significantly with increasing probing depth; a significant relationship with lower probing depth was found for 16 taxa. Network analysis identified two mutually exclusive complexes associated with shallow pockets and deeper pockets, respectively. Deeper peri-implant pockets were associated with significantly increased dysbiosis.

    CONCLUSION: Increases in peri-implant pocket depth are associated with substantial changes in the submucosal microbiome and increasing levels of dysbiosis. This article is protected by copyright. All rights reserved.

  • 45. Laine, Marja L
    et al.
    Leonhardt, Asa
    Roos-Jansåker, Ann-Marie
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Peña, A Salvador
    van Winkelhoff, Arie Jan
    Winkel, Edwin G
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    IL-1RN gene polymorphism is associated with peri-implantitis.2006In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 17, no 4, p. 380-385Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Interleukin (IL)-1alpha, IL-1beta and their natural specific inhibitor IL-1 receptor antagonist (IL-1ra) play a key role in the regulation of the inflammatory response in periodontal tissues. Polymorphisms in the IL-1 gene cluster have been associated with severe adult periodontitis. We aimed to investigate the IL-1 gene cluster polymorphisms in patients with peri-implantitis.

    MATERIAL AND METHODS: The study included 120 North Caucasian individuals. A total of 71 patients (mean age 68 years, 76% smokers) demonstrating peri-implantitis at one or more implants as evidenced by bleeding and/or pus on probing and bone loss amounting to >3 threads on Brånemark implants and 49 controls (mean age 66 years, 45% smokers) with clinical healthy mucosa and no bone loss around the implants were recruited for the study. The titanium implants, ad modum Brånemark, had been in function for at least 2 years. Mouthwash samples were collected and used for genotyping of the bi-allelic polymorphisms IL-1A(-889), IL-1B(+3953), IL-1B(-511) and a variable number of tandem repeat IL-1RN gene polymorphisms using PCR technique.

    RESULTS: Significant differences were found in the carriage rate of allele 2 in the IL-1RN gene between peri-implantitis patients and controls (56.5% vs. 33.3%, respectively; odds ratios (OR) 2.6; 95% confidence interval (CI) 1.2-5.6; P=0.015). Logistic regression analysis taking smoking, gender and age into account confirmed the association between the IL-1RN allele 2 carriers and peri-implantitis (OR 3; 95% CI 1.2-7.6; P=0.02).

    CONCLUSIONS: Our results provide evidence that IL-1RN gene polymorphism is associated with peri-implantitis and may represent a risk factor for this disease.

  • 46. Lang, Niklaus P
    et al.
    Berglundh, Tord
    Abrahamsson, Ingemar
    Claffey, Noel
    De Bruyn, Hugo
    Donos, Nikolaus
    Heitz-Mayfield, Lisa J.A.
    Klinge, Björn
    Mombelli, Andrea
    Palmer, Richard M.
    Quirynen, Marc
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Salvi, Giovanni E.
    Schwarz, Frank
    Sculean, Anton
    Vignoletti, Fabio
    Zitzmann, Nicola U.
    Periimplant diseases: where are we now?--Consensus of the Seventh European Workshop on Periodontology.2011In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 38, no Suppl 11, p. 178-81Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Peri-implant diseases present in two forms - peri-implant mucositis and peri-implantitis.

    MATERIALS AND METHODS: The literature was systematically searched and critically reviewed. Four manuscripts were produced in specific topics identified as key areas to understand the microbial aetiology and the pathogenesis of peri-implant diseases and how the implant surface structure may affect pathogenesis.

    RESULTS: While peri-implant mucositis represents the host response of the peri-implant tissues to the bacterial challenge that is not fundamentally different from gingivitis representing the host response to the bacterial challenge in the gingiva, peri-implantitis may differ from periodontitis both in the extent and the composition of cells in the lesion as well as the progression rate. A self-limiting process with a "protective" connective tissue capsule developing appears to dominate the periodontitis lesion while such a process may occasionally be lacking in peri-implantitis lesions. Bacterial biofilm formation on implant surfaces does not differ from that on tooth surfaces, but may be influenced by surface roughness. Nevertheless there is no evidence that such differences may influence the development of peri-implantitis.

    CONCLUSION: It was agreed that clinical and radiographic data should routinely be obtained after prosthesis installation on implants in order to establish a baseline for the diagnosis of peri-implantitis during maintenance of implant patients.

  • 47.
    Lang, Niklaus P.
    et al.
    Faculty of Dentistry, Comprehensive Dental Care, The University of Hong Kong.
    Jepsen, Søren
    Universtitätsklinikum, Department of Periodontology, Rheinische-Friedrich-Wilhelm-Universität, Bonn.
    Abrahamsson, Ingemar
    Albrektsson, Tomas
    Becker, Jürgen
    Berglundh, Tord
    Botticelli, Daniele
    Brunette, Donald M.
    Bullon, Pedro
    Esposito, Marco
    Geis-Gerstorfer, Jürgen
    Jansen, John A.
    Nisand, David
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    Schou, Søren
    Wennerberg, Ann
    Bösch, Adrian
    Sax, Caroline
    Implant surfaces and design (Working Group 4)2009In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 20 Suppl 4, p. 228-231Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The remit of this working group (4) was to update existing knowledge on the effects of implant surface topography, composition and design on bone integration and re-osseointegration. MATERIAL AND METHODS: Based on five narrative reviews that were performed following a defined search strategy, clinical implications as well as suggestions for further research have been formulated. RESULTS: The results and conclusions of the review processes in the following papers together with the group consensus, clinical implications and directions for future research are presented: 1. Effects of titanium surface topography on bone integration. 2. Effects of implant surface coatings and composition on bone integration (two reviews). 3. Effects of different implant surfaces and designs on marginal bone level alterations. 4. Re-osseointegration onto previously contaminated implant surfaces.

  • 48. Leonhardt, Asa
    et al.
    Dahlén, Gunnar
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Five-year clinical, microbiological, and radiological outcome following treatment of peri-implantitis in man2003In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 74, no 10, p. 1415-1422Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim of this study was to evaluate the long-term outcome of a combined surgical and antimicrobial treatment of peri-implantitis lesions in humans.

    METHODS: Nine partially dentate individuals with titanium implants demonstrating a marginal bone loss of > or = three threads as compared to baseline measurements made from 1-year intra-oral radiographs, bleeding on probing, and/or suppuration from the peri-implant sulci were included in the study. In each individual, subgingival bacterial samples were obtained and subjected to microbiological analysis by culture. Surgical exposure of the lesions and cleaning of the implants using hydrogen peroxide were performed. The patients were given systemic antibiotics according to a susceptibility test of target bacteria. The treatment was evaluated clinically, microbiologically, and radiograpically at 6 months, 1 year, and 5 years.

    RESULTS: Seven out of 26 implants with peri-implantitis at baseline were lost during the 5-year follow-up period despite a significant reduction in the presence of plaque and gingival bleeding. Four implants continued to lose bone, 9 had an unchanged bone level, and 6 gained bone. Five of the patients were treated with antibiotics directed against putative periodontopathogens, i.e., A. actinomycetemcomitans, P. intermedia, or P. gingivalis; three patients were treated for presence of enterics (E. coli and E. cloace); and, in one patient, treatment was directed against S. aureus.

    CONCLUSIONS: Despite treatment and retreatment, seven implants were lost. However, the applied surgical and antimicrobial treatment strategy for advanced peri-implantitis lesions was successful in 58% of the implants treated during the 5-year follow-up period. Smoking seemed to be a negative risk factor for treatment success.

  • 49.
    Lindhe, Jan
    et al.
    Department of Periodontology, Faculty of Odontology, The Sahlgrenslea Academy at Göteborg University.
    Meyle, Joerg
    Department of Periodontology, Zentrum für Zahn-Mund-und Kieferheilkunde, Justus-Liebig-Universitätt Giessen.
    Zitzmann, N.U.
    Berglundh, T.
    Heitz-Mayfield, L.J.A.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Roos-Jansåker, Anne-Marie
    Clarke, E.
    Polyzois, I.
    Peri-implant diseases: consensus report of the Sixth European Workshop on Periodontology.2008In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 35, no 8 Suppl, p. 282-285Article in journal (Refereed)
    Abstract [en]

    Issues related to peri-implant disease were discussed. It was observed that the most common lesions that occur, i.e. peri-implant mucositis and peri-implantitis are caused by bacteria. While the lesion of peri-implant mucositis resides in the soft tissues, peri-implantitis also affects the supporting bone. Peri-implant mucositis occurs in about 80% of subjects (50% of sites) restored with implants, and peri-implantitis in between 28% and 56% of subjects (12-40% of sites). A number of risk indicators were identified including (i) poor oral hygiene, (ii) a history of periodontitis, (iii) diabetes and (iv) smoking. It was concluded that the treatment of peri-implant disease must include anti-infective measures. With respect to peri-implant mucositis, it appeared that non-surgical mechanical therapy caused the reduction in inflammation (bleeding on probing) but also that the adjunctive use of antimicrobial mouthrinses had a positive effect. It was agreed that the outcome of non-surgical treatment of peri-implantitis was unpredictable. The primary objective of surgical treatment in peri-implantitis is to get access to the implant surface for debridement and decontamination in order to achieve resolution of the inflammatory lesion. There was limited evidence that such treatment with the adjunctive use of systemic antibiotics could resolve a number of peri-implantitis lesions. There was no evidence that so-called regenerative procedures had additional beneficial effects on treatment outcome.

  • 50. Lundgren, T
    et al.
    Parhar, R S
    Renvert, Stefan
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Tatakis, D N
    Impaired cytotoxicity in Papillon-Lefèvre syndrome2005In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 84, no 5, p. 414-417Article in journal (Refereed)
    Abstract [en]

    Papillon-Lefèvre syndrome (PLS), palmoplantar hyperkeratosis with periodontitis, has been genetically characterized. However, suspected associated immune dysfunctions remain elusive. The purpose of this study was to evaluate peripheral blood lymphocyte levels and natural killer (NK) cell cytotoxicity in PLS. Twenty patients and 20 healthy controls were examined. Peripheral blood lymphocytes were analyzed by flow cytometry for surface markers. NK cell cytotoxicity against K562 cells was determined by means of a 51Cr release assay. White blood cell differential and proportions of B-, T-, T-helper, T-suppressor, and NK cells revealed only sporadic borderline variations from control values. In contrast, NK cell cytotoxicity was consistently and severely depressed (32-53% of control values) in all patients. To the best of our knowledge, this newly described impairment of NK cell cytotoxic function is the first consistent immune dysfunction reported in PLS. This suggests that the impaired NK cell cytotoxicity might contribute to the pathogenesis of PLS-associated periodontitis.

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