hkr.sePublications
Change search
Refine search result
123 1 - 50 of 120
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the 'Create feeds' function.
  • 1.
    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, 445-452 p.Article 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.

  • 2.
    Adriaens, Laurence M
    et al.
    University of Bern, Bern, Switzerland.
    Alessandri, Regina
    University of Bern, Bern, Switzerland.
    Spörri, Stefan
    State Hospital of Fribourg, Fribourg, Switzerland.
    Lang, Niklaus P
    University of Bern, Bern, Switzerland.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington.
    Does pregnancy have an impact on the subgingival microbiota?2009In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 80, no 1, 72-81 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: We investigated clinical and subgingival microbiologic changes during pregnancy in 20 consecutive pregnant women > or =18 years not receiving dental care.

    METHODS: Bacterial samples from weeks 12, 28, and 36 of pregnancy and at 4 to 6 weeks postpartum were processed for 37 species by checkerboard DNA-DNA hybridization. Clinical periodontal data were collected at week 12 and at 4 to 6 weeks postpartum, and bleeding on probing (BOP) was recorded at sites sampled at the four time points.

    RESULTS: The mean BOP at week 12 and postpartum was 40.1% +/- 18.2% and 27.4% +/- 12.5%, respectively. The corresponding mean BOP at microbiologic test sites was 15% (week 12) and 21% (postpartum; not statistically significant). Total bacterial counts decreased between week 12 and postpartum (P <0.01). Increased bacterial counts over time were found for Neisseria mucosa (P <0.001). Lower counts (P <0.001) were found for Capnocytophaga ochracea, Capnocytophaga sputigena, Eubacterium saburreum, Fusobacterium nucleatum naviforme, Fusobacterium nucleatum polymorphum, Leptotrichia buccalis, Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros), Prevotella intermedia, Prevotella melaninogenica, Staphylococcus aureus, Streptococcus anginosus, Streptococcus intermedius, Streptococcus mutans, Streptococcus oralis, Streptococcus sanguinis, Selenomonas noxia, and Veillonella parvula. No changes occurred between weeks 12 and 28 of pregnancy. Counts of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Tannerella forsythia (previously T. forsythensis), and Treponema denticola did not change. Counts of P. gingivalis and T. forsythia at week 12 were associated with gingivitis (P <0.001).

    CONCLUSIONS: Subgingival levels of bacteria associated with periodontitis did not change. P. gingivalis and T. forsythia counts were associated with BOP at week 12. A decrease was found in 17 of 37 species from week 12 to postpartum. Only counts of N. mucosa increased.

  • 3.
    Agerbaek, Mette R
    et al.
    University of Bern, Bern, Switzerland.
    Lang, Niklaus P
    University of Bern, Bern, Switzerland.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Comparisons of bacterial patterns present at implant and tooth sites in subjects on supportive periodontal therapy. I. Impact of clinical variables, gender and smoking.2006In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 17, no 1, 18-24 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: (I) To compare the oral microflora at implant and tooth sites in subjects participating in a periodontal recall program, (II) to test whether the microflora at implant and tooth sites differ as an effect of gingival bleeding (bleeding on probing (BOP)), or pocket probing depth (PPD), and (III) to test whether smoking and gender had an impact on the microflora.

    MATERIAL AND METHODS: Data were collected from 127 implants and all teeth in 56 subjects. Microbiological data were identified by the DNA-DNA checkerboard hybridization.

    RESULTS: PPD> or =4 mm were found in 16.9% of tooth, and at 26.6% of implant sites (P<0.01). Tooth sites with PPD> or =4 mm had a 3.1-fold higher bacterial load than implant sites (mean difference: 66%, 95% confidence interval (CI): 40.7-91.3, P<0.001). No differences were found for the red, orange, green, and yellow complexes. A higher total bacterial load was found at implant sites with PPD> or =4 mm (mean difference 35.7 x 10(5), 95% CI: 5.2 (10(5)) to 66.1 (10(5)), P<0.02 with equal variance not assumed). At implant sites, BOP had no impact on bacterial load but influenced the load at tooth sites (P<0.01).

    CONCLUSION: BOP, and smoking had no impact on bacteria at implant sites but influenced the bacterial load at tooth sites. Tooth sites harbored more bacteria than implant sites with comparable PPD. The 4 mm PPD cutoff level influenced the distribution and amounts of bacterial loads. The subject factor is explanatory to bacterial load at both tooth and implant sites.

  • 4. Agerbaek, Mette R
    et al.
    Lang, Niklaus P
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Microbiological composition associated with interleukin-1 gene polymorphism in subjects undergoing supportive periodontal therapy.2006In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 77, no 8, 1397-1402 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Interleukin-1 gene polymorphism (IL-1 gene) has been associated with periodontitis. The present study examined the subgingival microbiota by IL-1 gene status in subjects undergoing supportive periodontal therapy (SPT).

    METHODS: A total of 151 subjects with known IL-1 gene status (IL-1A +4845/IL-1B -3954) (IL-1 gene) were included in this study. Clinical data and subgingival plaque samples (40 taxa) were collected. These taxa were determined by the checkerboard DNA-DNA hybridization method.

    RESULTS: Gender, smoking habits (n-par tests), age, and clinical periodontal conditions did not differ by IL-1 gene status. IL-1 gene-negative subjects had a higher total bacterial load (mean difference, 480.4 x 10(5); 95% confidence interval [CI], 77 to 884 x 10(5); P <0.02). The levels of Actinobacillus actinomycetemcomitans (mean difference, 30.7 x 10(5); 95% CI, 2.2 to 59.5 x 10(5); P <0.05), Eubacterium nodatum (mean difference, 4.2 x 10(5); 95% CI, 0.6 to 7.8 x 10(5); P <0.02), Porphyromonas gingivalis (mean difference, 17.9 x 10(5); 95% CI, 1.2 to 34.5 x 10(5); P <0.05), and Streptococcus anginosus (mean difference, 4.0 x 10(5); 95% CI, 0.2 to 7.2 x 10(5); P <0.05) were higher in IL-1 gene-negative subjects, an observation specifically found at sites with probing depths <5.0 mm.

    CONCLUSIONS: Bleeding on probing did not differ by IL gene status, reflecting clinical SPT efficacy. IL-1 gene-negative subjects had higher levels of periodontal pathogens. This may suggest that among subjects undergoing SPT, a lower bacterial load is required in IL-1 gene-positive subjects to develop the same level of periodontitis as in IL-1 gene-negative subjects.

  • 5.
    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, 666-673 p.Article 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.

  • 6. Akimoto, K
    et al.
    Becker, W
    Persson, G. Rutger
    University of Washington, Seattle, Washington.
    Baker, D A
    Rohrer, M D
    O'Neal, R B
    Evaluation of titanium implants placed into simulated extraction sockets: a study in dogs1999In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 14, no 3, 351-360 p.Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate the effect of gap width on bone healing around implants placed into simulated extraction socket defects of varying widths in 10 mongrel dogs. All premolars were removed and the alveolar ridges were reduced to a width of 7 mm. Nine weeks later, a total of 80 implants, 10 mm long by 3.3 mm wide, were placed into osteotomy sites prepared to 3 different diameters in the coronal half, simulating extraction sockets. Three experimental sites, with gap sizes of 0.5 mm, 1.0 mm, and 1.4 mm, were created; the control sites had no gap. The depth of each defect was measured at the time of implant placement. All implants were stable at the time of placement. The dogs were euthanized 12 weeks after implant placement, and blocks containing the implants and adjacent bone were submitted for histologic evaluation. Clinically, all control and test sites healed, with complete bone fill in the defect. Percentages of bone-to-implant contact were measured histologically. As the gap widened, the amount of bone-to-implant contact decreased, and the point of the highest bone-to-implant contact shifted apically. These changes were statistically significant (P < .001). No statistically significant differences in bone-to-implant contact were found between the sites when the apical 4 mm of implants were compared. Within the limits of this study, the simulated extraction socket defects healed clinically, with complete bone fill, regardless of the initial gap size. However, the width of the gap at the time of implant placement had a significant impact on the histologic percentage and the height of bone-to-implant contact.

  • 7.
    Baumgartner, Stefan
    et al.
    University of Bern, Bern, Switzerland.
    Imfeld, Thomas
    University of Zürich, Zürich, Switzerland.
    Schicht, Olivier
    University of Zürich, Zürich, Switzerland.
    Rath, Christian
    University of Zürich, Zürich, Switzerland.
    Persson, Rigmor E
    University of Bern, Bern, Switzerland & University of Washington.
    Persson, G Rutger
    University of Bern, Bern, Switzerland & University of Washington.
    The impact of the stone age diet on gingival conditions in the absence of oral hygiene.2009In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 80, no 5, 759-768 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The objective of this study was to assess the oral microbiota and clinical data in subjects without access to traditional oral hygiene methods and who ate a diet available in the Stone Age.

    METHODS: Ten subjects living in an environment replicating the Stone Age for 4 weeks were enrolled in this study. Bleeding on probing (BOP), gingival and plaque indices, and probing depth (PD) were assessed at baseline and at 4 weeks. Microbiologic samples were collected at the mesio-buccal subgingival aspects of all teeth and from the dorsum of the tongue and were processed by checkerboard DNA-DNA hybridization methods.

    RESULTS: No subject had periodontitis. Mean BOP decreased from 34.8% to 12.6% (P <0.001). Mean gingival index scores changed from 0.38 to 0.43 (not statistically significant) and mean plaque scores increased from 0.68 to 1.47 (P <0.001). PD at sites of subgingival sampling decreased (mean difference: 0.2 mm; P <0.001). At week 4, the total bacterial count was higher (P <0.001) for 24 of 74 species, including Bacteroides ureolyticus, Eikenella corrodens, Lactobacillus acidophilus, Capnocytophaga ochracea, Escherichia coli, Fusobacterium nucleatum naviforme, Haemophilus influenzae, Helicobacter pylori, Porphyromonas endodontalis, Staphylococcus aureus (two strains), Streptococcus agalactiae, Streptococcus anginosis, and Streptococcus mitis. Bacterial counts from tongue samples were higher at baseline (P <0.001) for 20 species, including Tannerella forsythia (previously T. forsythensis), Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans; serotype a), and Streptococcus spp.

    CONCLUSIONS: The experimental gingivitis protocol is not applicable if the diet (e.g., Stone Age) does not include refined sugars. Although plaque levels increased, BOP and PD decreased. Subgingival bacterial counts increased for several species not linked to periodontitis, whereas tongue bacterial samples decreased during the study period.

  • 8. Benjasupattananan, Supranee
    et al.
    Lai, Caroline S Y
    Persson, G. Rutger
    University of Bern, Bern, Switzerland.
    Pjetursson, Bjarni E
    Lang, Niklaus P
    Effect of a stannous fluoride dentifrice on the sulcular microbiota: a prospective cohort study in subjects with various levels of periodontal inflammation2005In: Oral Health & Preventive Dentistry, ISSN 1602-1622, E-ISSN 1757-9996, Vol. 3, no 4, 263-272 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess the effects of an experimental 0.454% stannous fluoride (SnF2) dentifrice on the oral sulcular microbiota in patients with various stages of oral diseases using checkerboard DNA-DNA hybridization.

    MATERIAL AND METHODS: In the present one-month, single center, single product, prospective cohort trial, 37 adults (mean age 37.6) were assigned to one of four oral health condition cohorts with seven to 10 subjects each: 1. mild gingivitis, 2. marked generalized gingivitis to moderate periodontitis, 3. caries-prone and 4. treated moderate to advanced chronic periodontitis in supportive periodontal care. All four groups were asked to use the test dentifrice and a power toothbrush twice a day for one minute during a four-week test period. Before and after the trial period, Plaque Indices (PII, Silness and Löe, 1964) and Gingival Indices (GI, Löe and Silness, 1963) were recorded. Subgingival plaque samples were collected from all patients at Baseline, as well as after two and four weeks. These samples were analyzed for content of 40 bacterial species using checkerboard DNA-DNA hybridization.

    RESULTS: As a result of the only one minute brushing with the stannous fluoride dentifrice, the mean PII at Baseline was significantly lower (p < 0.05) from the mean PII at four weeks. No statistically significant differences were found between premolar and molar mean values. Moreover, no statistically significant differences were found between the mean GI at Baseline and at four weeks. The microbiological analysis showed that at baseline subjects in groups 2 and 4 had significantly higher bacterial loads of bacteria than groups 1, and 3 (i.e. A. actinomyctemcomitans P. gingivalis, T. forsythia, and T. denticola. Over the study period, the total bacterial load did not change in groups 2, 3 and 4. In groups 1 and 3, however, an increase in the loads of Streptococci spp. were noticed (p < 0.05) including S. mitis, S. intermedius, and S. sanguis (p < 0.01) suggesting an increase in the presence of early colonizing and health associated bacteria.

    CONCLUSION: One minute brushing with a 0.454% stannous fluoride dentifrice did--after four weeks--not affect the subgingival microbial profiles in patients with moderate periodontitis and treated moderate to advanced periodontitis. However, the sulcular microbial profiles of mild gingivitis and caries-prone patients were affected, indicating a shift towards a gingival health associated microbiota in the sulcular region of patients not affected by attachment loss. RUNNING HEAD: Effect of stannous fluoride on sulcular microbiota.

  • 9.
    Bieri, Regina Alessandri
    et al.
    University of Bern.
    Adriaens, Laurence
    University of Bern.
    Spörri, Stefan
    State Hospital of Fribourg, Fribourg, Switzerland.
    Lang, Niklaus P
    The University of Hong Kong.
    Persson, G. Rutger
    University of Bern & University of Washington, Seattle, WA, USA .
    Gingival fluid cytokine expression and subgingival bacterial counts during pregnancy and postpartum: a case series.2013In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 17, no 1, 19-28 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to assess gingival fluid (GCF) cytokine messenger RNA (mRNA) levels, subgingival bacteria, and clinical periodontal conditions during a normal pregnancy to postpartum.

    MATERIALS AND METHODS: Subgingival bacterial samples were analyzed with the checkerboard DNA-DNA hybridization method. GCF samples were assessed with real-time PCR including five proinflammatory cytokines and secretory leukocyte protease inhibitor.

    RESULTS: Nineteen pregnant women with a mean age of 32 years (S.D. ± 4 years, range 26-42) participated in the study. Full-mouth bleeding scores (BOP) decreased from an average of 41.2% (S.D. ± 18.6%) at the 12th week of pregnancy to 26.6% (S.D. ± 14.4%) at the 4-6 weeks postpartum (p < 0.001). Between week 12 and 4-6 weeks postpartum, the mean probing pocket depth changed from 2.4 mm (S.D. ± 0.4) to 2.3 mm (S.D. ± 0.3) (p = 0.34). Higher counts of Eubacterium saburreum, Parvimonas micra, Selenomonas noxia, and Staphylococcus aureus were found at week 12 of pregnancy than at the 4-6 weeks postpartum examinations (p < 0.001). During and after pregnancy, statistically significant correlations between BOP scores and bacterial counts were observed. BOP scores and GCF levels of selected cytokines were not related to each other and no differences in GCF levels of the cytokines were observed between samples from the 12th week of pregnancy to 4-6 weeks postpartum. Decreasing postpartum counts of Porphyromonas endodontalis and Pseudomonas aeruginosa were associated with decreasing levels of Il-8 and Il-1β.

    CONCLUSIONS: BOP decreased after pregnancy without any active periodontal therapy. Associations between bacterial counts and cytokine levels varied greatly in pregnant women with gingivitis and a normal pregnancy outcome. Postpartum associations between GCF cytokines and bacterial counts were more consistent.

    CLINICAL RELEVANCE: Combined assessments of gingival fluid cytokines and subgingival bacteria may provide important information on host response.

  • 10.
    Bornstein, Michael M
    et al.
    University of Bern, Bern, Switzerland.
    Hakimi, Basir
    University of Bern, Bern, Switzerland.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA.
    Microbiological findings in subjects with asymptomatic oral lichen planus: a cross-sectional comparative study.2008In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 79, no 12, 2347-2355 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The bacterial colonization of the oral mucosa was evaluated in patients with asymptomatic oral lichen planus (OLP) and compared to the microbiologic status in mucosally healthy subjects.

    METHODS: Bacteria from patients with clinically and histopathologically diagnosed OLP from the Stomatology Service, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, were collected with a non-invasive swab system. Samples were taken from OLP lesions on the gingiva and from non-affected sites on the contralateral side of the mouth. The control population did not have OLP and was recruited from the student clinic. All samples were processed with the checkerboard DNA-DNA hybridization method using well-defined bacterial species for the analysis.

    RESULTS: Significantly higher bacterial counts of Bacteroides ureolyticus (P = 0.001), Dialister species (sp.) (P = 0.006), Staphylococcus haemolyticus (P = 0.007), and Streptococcus agalactiae (P = 0.006) were found in samples taken from OLP lesions compared to sites with no clinical evidence of OLP. Significantly higher bacterial counts were found for Capnocytophaga sputigena, Eikenella corrodens, Lactobacillus crispatus, Mobiluncus curtisii, Neisseria mucosa, Prevotella bivia, Prevotella intermedia, and S. agalactiae at sites with lesions in subjects with OLP compared to sites in control subjects (P <0.001).

    CONCLUSIONS: Microbiologic differences were found between sites with OLP and sites in subjects without a diagnosis of OLP. Specifically, higher counts of staphylococci and S. agalactiae were found in OLP lesions.

  • 11.
    Brito, Fernanda
    et al.
    Univ Estado Rio De Janeiro, Fac Odontol, Dept Periodontol, BR-20551030 Rio De Janeiro, Brazil.
    Zaltman, Cyrla
    Univ Fed Rio de Janeiro, Fac Med, Dept Gastroenterol, Rio De Janeiro, Brazil.
    Carvalho, Ana T P
    Univ Estado Rio De Janeiro, Fac Med, Dept Gastroenterol, BR-20551030 Rio De Janeiro, Brazil.
    Fischer, Ricardo G
    Univ Estado Rio De Janeiro, Fac Odontol, Dept Periodontol, BR-20551030 Rio De Janeiro, Brazil.
    Persson, G. Rutger
    Univ Bern, Sch Dent Med, Dept Periodontol, Bern, Switzerland & Univ Washington, Sch Dent, Dept Oral Med, Seattle, WA 98195 USA.
    Gustafsson, Anders
    Karolinska Inst, Div Perisodontol, Dept Dent Med, Stockholm, Sweden.
    Figueredo, Carlos M S
    Univ Estado Rio De Janeiro, Fac Odontol, Dept Periodontol, BR-20551030 Rio De Janeiro, Brazil & Karolinska Inst, Div Perisodontol, Dept Dent Med, Stockholm, Sweden.
    Subgingival microflora in inflammatory bowel disease patients with untreated periodontitis.2013In: European Journal of Gastroenterology and Hepathology, ISSN 0954-691X, E-ISSN 1473-5687, Vol. 25, no 2, 239-245 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To analyze the subgingival microflora composition of inflammatory bowel disease (IBD) patients with untreated chronic periodontitis and compare them with systemically healthy controls also having untreated chronic periodontitis.

    METHOD: Thirty IBD patients [15 with Crohn's disease (CD) and 15 with ulcerative colitis (UC)] and 15 control individuals participated in the study. All patients had been diagnosed with untreated chronic periodontitis. From every patient, subgingival plaque was collected from four gingivitis and four periodontitis sites with paper points. Samples from the same category (gingivitis or periodontitis) in each patient were pooled together and stored at -70 °C until analysis using a checkerboard DNA-DNA hybridization technique for 74 bacterial species.

    RESULTS: Multiple-comparison analysis showed that the groups differed in bacterial counts for Bacteroides ureolyticus, Campylobacter gracilis, Parvimonas micra, Prevotella melaninogenica, Peptostreptococcus anaerobius, Staphylococcus aureus, Streptococcus anginosus, Streptococcus intermedius, Streptococcus mitis, Streptococcus mutans, and Treponema denticola (P<0.001). CD patients had significantly higher levels of these bacteria than UC patients either in gingivitis or in periodontitis sites (P<0.05). CD patients harbored higher levels of P. melaninogenica, S. aureus, S. anginosus, and S. mutans compared with controls both at gingivitis and at periodontitis sites (P<0.05). UC patients harbored higher levels of S. aureus (P=0.01) and P. anaerobius (P=0.05) than controls only in gingivitis sites.

    CONCLUSION: Our study showed that even with similar clinical periodontal parameters, IBD patients harbor higher levels of bacteria that are related to opportunistic infections in inflamed subgingival sites that might be harmful for the crucial microbe-host interaction.

  • 12. Chung, Whasun O
    et al.
    Gabany, Joseph
    Persson, G. Rutger
    University of Washington, Seattle, WA, USA.
    Roberts, Marilyn C
    Distribution of erm(F) and tet(Q) genes in 4 oral bacterial species and genotypic variation between resistant and susceptible isolates.2002In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, no 2, 152-158 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Bacteroides forsythus, Porphyromonas gingivalis and Prevotella intermedia are Gram-negative anaerobic bacteria that are currently considered potential periopathogens. Prevotella nigrescens has recently been separated from P. intermedia and its rôle in periodontitis is unknown. The erm(F) gene codes for an rRNA methylase, conferring resistance to macrolides, lincosamides and streptogramin B (MLSB), and the tet(Q) gene for a ribosomal protection protein, conferring resistance to tetracycline. The presence of these resistance genes could impair the use of antibiotics for therapy.

    PURPOSE: The aim of this study was to determine the carriage of erm(F) and tet(Q), and genetic variability of 12 Porphyromonas gingivalis, 10 Prevotella intermedia, 25 Prevotella nigrescens and 17 Bacteroides forsythus isolates from 9 different patient samples.

    METHODS: We used polymerase chain reaction (PCR) for detecting antibiotic resistance genes, and pulsed-field gel electrophoresis (PFGE) for detecting genetic variability among the isolates.

    RESULTS: Thirty-one (48%) isolates were resistant to both erythromycin and tetracycline and carried the erm(F) and tet(Q) genes, eight (13%) were tetracycline resistant and carried the tet(Q) gene, 9 (14%) were erythromycin resistant and carried the erm(F) gene, and 12 (19%) isolates did not carry antibiotic resistance genes. PFGE was used to compare isolates from the same patient and isolates from different patient samples digested with XbaI. No association was found between antibiotic resistance gene carriage and PFGE patterns in any species examined. All isolates of the same species from the same patient had highly related or identical PFGE patterns. Isolates of same species from different patients had unique PFGE pattern for each species tested.

    CONCLUSION: All isolates of the same species from any one patient were genetically related to each other but distinct from isolates from other patients, and 66% of the patients carried antibiotic resistant isolates, which could impair antibiotic therapy.

  • 13.
    Cosyn, Jan
    et al.
    University of Ghent, Ghent, Belgium.
    Van Aelst, Louis
    University of Ghent, Ghent, Belgium.
    Collaert, Bruno
    Persson, G. Rutger
    Division of Oral Microbiology, University of Berne, Department of Periodontology, Berne, Switzerland, and Department of Periodontics, University of Washington, Seattle, WA, USA.
    De Bruyn, Hugo
    University of Ghent, Ghent, Belgium.
    The peri-implant sulcus compared with internal implant and suprastructure components: a microbiological analysis.2011In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 13, no 4, 286-295 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: A recent in vivo study has shown considerable contamination of internal implant and suprastructure components with great biodiversity, indicating bacterial leakage along the implant-abutment interface, abutment-prosthesis interface, and restorative margins. The goal of the present study was to compare microbiologically the peri-implant sulcus to these internal components on implants with no clinical signs of peri-implantitis and in function for many years. Checkerboard DNA-DNA hybridization was used to identify and quantify 40 species.

    MATERIAL AND METHODS: Fifty-eight turned titanium Brånemark implants in eight systemically healthy patients (seven women, one man) under regular supportive care were examined. All implants had been placed in the maxilla and loaded with a screw-retained full-arch bridge for an average of 9.6 years. Gingival fluid samples were collected from the deepest sulcus per implant for microbiological analysis. As all fixed restorations were removed, the cotton pellet enclosed in the intra-coronal compartment and the abutment screw were retrieved and microbiologically evaluated.

    RESULTS: The pellet enclosed in the suprastructure was very similar to the peri-implant sulcus in terms of bacterial detection frequencies and levels for practically all the species included in the panel. Yet, there was virtually no microbial link between these compartments. When comparing the abutment screw to the peri-implant sulcus, the majority of the species were less frequently found, and in lower numbers at the former. However, a relevant link in counts for a lot of bacteria was described between these compartments. Even though all implants in the present study showed no clinical signs of peri-implantitis, the high prevalence of numerous species associated with pathology was striking.

    CONCLUSIONS: Intra-coronal compartments of screw-retained fixed restorations were heavily contaminated. The restorative margin may have been the principal pathway for bacterial leakage. Contamination of abutment screws most likely occurred from the peri-implant sulcus via the implant-abutment interface and abutment-prosthesis interface.

  • 14. De Bruyn, Hugo
    et al.
    Bouvry, Peter
    Collaert, Bruno
    De Clercq, Calix
    Persson, G. Rutger
    University of Berne, Department of Periodontology, Division of Oral Microbiology, Berne, Switzerland; and University of Washington, Department of Periodontics, Seattle, WA, USA.
    Cosyn, Jan
    Long-term clinical, microbiological, and radiographic outcomes of Brånemark™ implants installed in augmented maxillary bone for fixed full-arch rehabilitation.2013In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 15, no 1, 73-82 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose of this study was to document the long-term outcome of Brånemark implants installed in augmented maxillary bone and to identify parameters that are associated with peri-implant bone level.

    MATERIAL AND METHODS: Patients of a periodontal practice who had been referred to a maxillofacial surgeon for iliac crest bone grafting in the atrophic maxilla were retrospectively recruited. Five months following grafting, they received 7-8 turned Brånemark implants. Following submerged healing of another 5 months, implants were uncovered and restorative procedures for fixed rehabilitation were initiated 2-3 months thereafter. The primary outcome variable was bone level defined as the distance from the implant-abutment interface to the first visible bone-to-implant contact. Secondary outcome variables included plaque index, bleeding index, probing depth, and levels of 40 species in subgingival plaque samples as identified by means of checkerboard DNA-DNA hybridization.

    RESULTS: Nine out of 16 patients (eight females, one male; mean age 59) with 71 implants agreed to come in for evaluation after on average 9 years (SD 4; range 3-13) of function. One implant was deemed mobile at the time of inspection. Clinical conditions were acceptable with 11% of the implants showing pockets ≥ 5 mm. Periodontopathogens were encountered frequently and in high numbers. Clinical parameters and bacterial levels were highly patient dependent. The mean bone level was 2.30 mm (SD 1.53; range 0.00-6.95), with 23% of the implants demonstrating advanced resorption (bone level > 3 mm). Regression analysis showed a significant association of the patient (p < .001) and plaque index (p = .007) with bone level.

    CONCLUSIONS: The long-term outcome of Brånemark implants installed in iliac crest-augmented maxillary bone is acceptable; however, advanced peri-implant bone loss is rather common and indicative of graft resorption. This phenomenon is patient dependent and seems also associated with oral hygiene.

  • 15.
    Dierens, Melissa
    et al.
    University of Ghent, Ghent, Belgium.
    Vandeweghe, Stefan
    University of Ghent, Ghent, Belgium & Malmö University, Malmö, Sweden.
    Kisch, Jenö
    Clinic for Prosthodontics, Centre of Dental Specialist Care, Malmö, Sweden.
    Persson, G. Rutger
    Department of Periodontology, University of Bern, Bern, Switzerland.
    Cosyn, Jan
    University of Ghent, Ghent, Belgium & Dental Medicine, Free University of Brussels (VUB), Brussels, Belgium.
    De Bruyn, Hugo
    University of Ghent, Ghent, Belgium & Malmö University, Malmö, Sweden.
    Long-term follow-up of turned single implants placed in periodontally healthy patients after 16 to 22 years: microbiologic outcome.2013In: Journal of periodontology, ISSN 1943-3670, Vol. 84, no 7, 880-894 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Survival rates in implant dentistry today are high, although late failures do occur for many reasons, including peri-implant infections. The primary objective of this study is to investigate microbiota around single turned implants after 16 to 22 years. Secondary objectives are to compare teeth and implants and to correlate microbiologic, radiographic, and clinical parameters.

    METHODS: A total of 46 patients with single implants were invited for a clinical examination. Clinical data were collected from implants and contralateral natural teeth. Radiographic bone level was measured around implants. Microbiologic samples were taken from implants, contralateral teeth, and the deepest pocket per quadrant. Samples were analyzed with DNA-DNA hybridization including 40 species. Statistical analysis was performed using Wilcoxon signed-rank tests, McNemar tests, and Spearman correlation coefficients with a 0.05 significance level.

    RESULTS: Mean follow-up was 18.5 years (range 16 to 22 years). Tannerella forsythia (1.5 × 10(5)) and Veillonella parvula (1.02 × 10(5)) showed the highest concentrations around implants and teeth, respectively. Porphyromonas gingivalis, Prevotella intermedia, and T. forsythia were significantly more present around implants than teeth. Mean counts were significantly higher around implants than teeth for Parvimonas micra, P. gingivalis, P. intermedia, T. forsythia, and Treponema denticola. Total DNA count was correlated to interproximal bleeding index (r = 0.409) and interproximal probing depth (r = 0.307). No correlations were present with plaque index or radiographic bone level.

    CONCLUSIONS: In the present study, bacterial counts around single implants in periodontally healthy patients are rather low. Although pathogenic bacteria are present, some in higher numbers around implants than teeth (five of 40), the majority of implants present with healthy peri-implant tissues without progressive bone loss.

  • 16.
    Duncan, W J
    et al.
    University of Otago, Dunedin, New Zealand.
    Persson, G. Rutger
    University of Washington, Seattle, WA, USA.
    Sims, T J
    University of Washington, Seattle, WA, USA.
    Braham, P
    University of Washington, Seattle, WA, USA.
    Pack, A R C
    University of Otago, Dunedin, New Zealand.
    Page, R C
    University of Washington, Seattle, WA, USA.
    Ovine periodontitis as a potential model for periodontal studies. Cross-sectional analysis of clinical, microbiological, and serum immunological parameters.2003In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 30, no 1, 63-72 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: : To investigate infection and host immunity patterns in sheep with naturally occurring "broken-mouth" periodontitis.

    MATERIALS AND METHODS: : Eight periodontally healthy (HS) and eight periodontally diseased ewes (PDS) were selected. Subgingival plaque and sera were collected and examined for evidence of human periodontitis-associated pathogens. Serum IgG titers were measured by ELISA to multiple strains of Porphyromonas gingivalis, Bacteroides forsythus, Dichelobacter nodosus, Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Fusobacterium nucleatum as well as several purified antigens (cysteine proteases, LPS, K, and fimbriae).

    RESULTS: : Neither the organism Aa nor antigens to Aa were found in any animal. Most animals were positive for Pg, Bf, and Pi, but DNA probes detected no difference between HS and PDS relative to amounts of pathogens in subgingival plaque. PDS had significantly higher serum IgG titers to all Pg strains, to 50% of Bf strains, to the Pi and Fn strains, and to fimbriae and the two cysteine proteases (p-values ranging from 0.05 to 0.001). Regression analysis demonstrated a significant association between number of teeth lost and serum IgG antibody titers to whole-cell sonicate antigens of P. gingivalis strains (p<0.01) and body weight (p<0.01).

    CONCLUSIONS: : The presence of pathogens associated with periodontitis was reflected in differences in serum IgG titers between healthy and diseased sheep. This may have influenced animal body weight and might have systemic health and economic consequences. The data suggest that susceptible and non-susceptible sheep can be identified for periodontal research.

  • 17.
    Duss, Christof
    et al.
    Department of Periodontology, Faculty of Medicine, University of Berne.
    Lang, Niklaus P.
    Department of Periodontology, Faculty of Medicine, University of Berne.
    Cosyn, Jan
    Department of Dentistry, University of Ghent.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society.
    A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery2010In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 37, no 11, 988-997 p.Article in journal (Refereed)
    Abstract [en]

    Background Chlorhexidine (CHX) rinsing after periodontal surgery is common. We assessed the clinical and microbiological effects of two CHX concentrations following periodontal surgery. Materials and methods In a randomized, controlled clinical trial, 45 subjects were assigned to 4 weeks rinsing with a 0.05 CHX/herbal extract combination (test) or a 0.1% CHX solution. Clinical and staining effects were studied. Subgingival bacteria were assessed using the DNA-DNA checkerboard. Statistics included parametric and non-parametric tests (p < 0001 to declare significance at 80% power). Results At weeks 4 and 12, more staining was found in the control group (p < 0.05 and p < 0.001, respectively). A higher risk for staining was found in the control group (crude OR: 2.3:1, 95% CI: 1.3 to 4.4, p < 0.01). The absolute staining reduction in the test group was 21.1% (9 5% CI: 9.4-32.8%). Probing pocket depth (PPD) decreases were significant (p < 0.001) in both groups and similar (p=0.92). No rinse group differences in changes of bacterial counts for any species were found between baseline and week 12. Conclusions The test CHX rinse resulted in less tooth staining. At the study endpoint, similar and high counts of periodontal pathogens were found.

  • 18. Dörtbudak, Orhun
    et al.
    Eberhardt, Rita
    Ulm, Martin
    Persson, G. Rutger
    University of Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Periodontitis, a marker of risk in pregnancy for preterm birth.2005In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 32, no 1, 45-52 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Why chronic periodontitis may induce an inflammatory response with premature pregnancy termination is unclear.

    AIMS: (1) To assess if periodontitis predicts premature gestation; (2) to study amniotic fluid cytokines and periodontitis variables in early-stage pregnancy.

    MATERIAL AND METHODS: A periodontal examination and collection of amniotic fluid was performed (weeks 15-20) of pregnancy in 36 women at risk for pregnancy complications. Amniotic fluid (bacteria), vaginal smears and intra-oral plaque samples were studied. Cytokine levels in amniotic fluid were studied in relation to other study variables.

    RESULTS: Periodontitis was diagnosed in 20% of normal and in 83% of preterm birth cases (p<0.01). Bacteria were never found in the amniotic fluids studied. Sub-gingival plaque samples including bacteria in the orange and red complexes were found in 18% of full-term 100% of preterm cases (p<0.001) and total colony-forming units (CFUs) were higher in preterm birth (p<0.01). Amniotic levels of interleukin (IL)-6 and prostaglandin-E2 (PGE2) were higher in preterm cases (p<0.001). Amniotic IL-6 (r=0.56, p<0.01) and PGE2 (r=0.50, p<0.01) cytokine levels were correlated with CFU from sub-gingival plaque samples (r2=0.44). The odds ratio of preterm delivery and having periodontitis was 20.0 (95% confidence interval (CI): 2.0-201.7, p<0.01). The odds of >60 CFU in sub-gingival plaque and preterm birth was 32.5:1 (95% CI: 3.0-335.1, p<01).

    CONCLUSIONS: Pregnant women with findings of elevated amniotic fluid levels of PGE2, IL-6 and IL-8 in the 15-20 weeks of pregnancy and with periodontitis are at high risk for premature birth. The implication of this is that periodontitis can induce a primary host response in the chorioamnion leading to preterm birth.

  • 19.
    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, 224-233 p.Article 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.

  • 20.
    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 trial2016In: Article in journal (Refereed)
  • 21.
    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, 463-473 p.Article 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.

  • 22.
    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, 37- p.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.

  • 23.
    Fardal, Øystein
    et al.
    Private practice, Egersund.
    Fardal, Patrick
    Dublin Dental University Hospital, Dublin.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Periodontal and general health in long-term periodontal maintenance patients treated in a Norwegian private practice: a descriptive report from a compliant and partially compliant survivor population2013In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 84, no 10, 1374-1381 p.Article in journal (Refereed)
    Abstract [en]

    Background There is weak evidence to support the benefit of periodontal maintenance therapy in preventing tooth loss. In addition, the effects of long-term periodontal treatment on general health are unclear.

    Materials/Methods Compliant and partially compliant patients (15-25 years follow-up) in private practice were observed for oral and systemic health changes.

    Results 219 compliant patients (128 females, 91 males) were observed for 19.1 years (range 15-25, SD ± 2.8). Age at reassessment was 64.6 years (range 39-84 SD ±9.0). 145 patients were stable (0-3 teeth lost), 54 were downhill (4-6 teeth lost) and 21 patients extreme downhill (>6 teeth lost). 16 patients developed hypertension, 13 developed diabetes II, and 15 suffered myocardial infarcts (MI). A minority developed other systemic diseases. Risk factors for MI included overweight (OR 9.04,95% CI:2.9-27.8, p=0.000), family history with cardiovascular disease (OR 3.10, 95 % CI:1.07-8.94, p=0.029), diabetes I at baseline (p=0.02) and developing diabetes II (O.R. 7.9, 95 % CI: 2.09-29.65, p=0.000). 25 partially compliant patients (8 females, 17 males) were observed for 19 years. This group had a higher proportion of downhill and extreme downhill cases and MI.

    Conclusion Patients who left the maintenance program in a periodontal specialist practice in Norway had a higher rate of tooth loss than compliant patients. Compliant maintenance patients in specialist practice in Norway have a similar risk of developing diabetes type II as the general population. A rate of 0.0037 myocardial infarcts per patient per year was recorded for this group. Due to the lack of external data, it is difficult to assess how this compares with untreated periodontal patients.

  • 24.
    Fischer, Carolin C
    et al.
    University of Bern, Bern, Switzerland.
    Persson, Rigmor E
    University of Bern, Bern, Switzerland & University of Washington.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA.
    Influence of the menstrual cycle on the oral microbial flora in women: a case-control study including men as control subjects.2008In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 79, no 10, 1966-1973 p.Article in journal (Refereed)
    Abstract [en]

    UNLABELLED: Changes in the levels of female sex hormones during the menstrual cycle may cause cyclic differences in subgingival bacterial colonization patterns. The purpose of the present study was to test the hypothesis that hormonal changes in the menstrual cycle cause changes in the oral microbiota.

    METHODS: Bacterial plaque samples were collected in 20 systemically and periodontally healthy women using no hormonal contraceptives (test group) over a period of 6 weeks. Twenty age-matched systemically and periodontally healthy men were assigned to the control group. Samples were processed by checkerboard DNA-DNA hybridization assay, and 74 species were analyzed.

    RESULTS: No cyclic pattern of bacterial colonization was identified for any of the 74 species studied in women not using hormonal contraceptives. Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) (Y4) was common at the beginning of menstruation (mean: 32%) and increased during the following 2 weeks (36%) in women (P <0.05). No cyclic differences in bacterial presence were found among the men (P values varied between 0.14 and 0.98). Men presented with significantly higher bacterial counts for 40 of 74 species (P <0.001), including Staphylococcus aureus and Pseudomonas aeruginosa but not Porphyromonas gingivalis (P = 0.15) or Tannerella forsythia (previously T. forsythensis) (P = 0.42).

    CONCLUSIONS: During a menstruation period, cyclic variation in the subgingival microbiota of periodontally healthy women of child-bearing age who were not using oral hormonal contraceptives could not be confirmed. Male control subjects presented with higher levels of many species but also without a cyclic pattern.

  • 25.
    Fritschi, B Zinsli
    et al.
    University of Berne, School of Dental Medicine, Freiburgstrasse 7, CH-3010 Berne, Switzerland.
    Albert-Kiszely, A
    University of Berne, School of Dental Medicine, Freiburgstrasse 7, CH-3010 Berne, Switzerland.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Staphylococcus aureus and other bacteria in untreated periodontitis.2008In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 87, no 6, 589-593 p.Article in journal (Refereed)
    Abstract [en]

    Whether the subgingival microbiota differ between individuals with chronic and those with aggressive periodontitis, and whether smoking influences bacterial composition, is controversial. We hypothesized that the subgingival microbiota do not differ between sites in individuals with chronic or aggressive periodontitis, or by smoking status. Bacterial counts and proportional distributions were assessed in 84 individuals with chronic periodontitis and 22 with aggressive periodontitis. No differences in probing pocket depth by periodontal status were found (mean, 0.11 mm; 95% CI, 0.6 to 0.8, p = 0.74). Including Staphylococcus aureus, Parvimonas micra, and Prevotella intermedia, 7/40 species were found at higher levels in those with aggressive periodontitis (p < 0.001). Smokers had higher counts of Tannerella forsythia (p < 0.01). The prevalence of S. aureus in non-smokers with aggressive periodontitis was 60.5%. The null hypothesis was rejected, in that P. intermedia, S. aureus, and S. mutans were robust in diagnosing sites in individuals with aggressive periodontitis. S. aureus, S. sanguinis, and T. forsythia differentiated smoking status.

  • 26.
    Fürst, Mirjam M
    et al.
    Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Berne, Berne, Switzerland.
    Salvi, Giovanni E
    Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Berne, Berne, Switzerland.
    Lang, Niklaus P
    Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Berne, Berne, Switzerland.
    Persson, G. Rutger
    Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Berne, Berne, Switzerland.
    Bacterial colonization immediately after installation on oral titanium implants.2007In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 18, no 4, 501-8 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Information on bacterial colonization immediately after dental implant insertion is limited.

    AIMS: (1) To assess the early colonization on titanium implants immediately after placement and throughout the first 12 post-surgical weeks, (2) to compare the microbiota at interproximal subgingival implant and adjacent tooth sites.

    MATERIAL AND METHODS: Subgingival plaque samples from implant and neighbouring teeth were studied by checkerboard DNA-DNA hybridization before surgery, 30 min after implant placement, and 1, 2, 4, 8, and 12 weeks after surgery.

    RESULTS: Comparing bacterial loads at implant sites between 30 min after placement with 1-week data showed that only the levels of Veillonella parvula (P<0.05) differed with higher loads at week 1 post-surgically. Week 12 data demonstrated significantly higher bacterial loads for 15/40 species at tooth sites compared with pre-surgery (P-values varying between 0.05 and 0.01). Between the period immediately after surgery and 12 weeks at implant sites, 29/40 species was more commonly found at 12 weeks. Included among these bacteria at implant sites were Porphyromonas gingivalis (P<0.05), Tannerella forsythia, (P<0.01), and Treponema denticola (P<0.001). Immediately post-surgery 5.9% of implants, and 26.2% of teeth, and at week 12, 15% of implants, and 39.1% of teeth harbored Staphylococcus aureus. Comparing tooth and implant sites, significantly higher bacterial loads were found at tooth sites for 27/40 species after 30 min following implant placement. This difference increased to 35/40 species at 12 weeks post-surgically.

    CONCLUSIONS: Bacterial colonization occurred within 30 min after implant placement. Early colonization patterns differed between implant and tooth surfaces.

  • 27.
    Gerber, Jeanne
    et al.
    Department of Periodontology and Fixed Prosthodontics, University of Berne, Berne, Switzerland.
    Wenaweser, Doris
    Department of Periodontology and Fixed Prosthodontics, University of Berne, Berne, Switzerland.
    Heitz-Mayfield, Lisa
    Department of Periodontology and Fixed Prosthodontics, University of Berne, Berne, Switzerland.
    Lang, Niklaus P
    Department of Periodontology and Fixed Prosthodontics, University of Berne, Berne, Switzerland.
    Persson, G. Rutger
    Department of Periodontology and Fixed Prosthodontics, University of Berne, Berne, Switzerland & Departments of Periodontics and Oral Medicine, University of Washington, Seattle, WA, USA.
    Comparison of bacterial plaque samples from titanium implant and tooth surfaces by different methods.2006In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 17, no 1, 1-7 p.Article in journal (Refereed)
    Abstract [en]

    Studies have shown similarities in the microflora between titanium implants or tooth sites when samples are taken by gingival crevicular fluid (GCF) sampling methods. The purpose of the present study was to study the microflora from curette and GCF samples using the checkerboard DNA-DNA hybridization method to assess the microflora of patients who had at least one oral osseo-integrated implant and who were otherwise dentate. Plaque samples were taken from tooth/implant surfaces and from sulcular gingival surfaces with curettes, and from gingival fluid using filter papers. A total of 28 subjects (11 females) were enrolled in the study. The mean age of the subjects was 64.1 years (SD+/-4.7). On average, the implants studied had been in function for 3.7 years (SD+/-2.9). The proportion of Streptococcus oralis (P<0.02) and Fusobacterium periodonticum (P<0.02) was significantly higher at tooth sites (curette samples). The GCF samples yielded higher proportions for 28/40 species studies (P-values varying between 0.05 and 0.001). The proportions of Tannerella forsythia (T. forsythensis), and Treponema denticola were both higher in GCF samples (P<0.02 and P<0.05, respectively) than in curette samples (implant sites). The microbial composition in gingival fluid from samples taken at implant sites differed partly from that of curette samples taken from implant surfaces or from sulcular soft tissues, providing higher counts for most bacteria studied at implant surfaces, but with the exception of Porphyromonas gingivalis. A combination of GCF and curette sampling methods might be the most representative sample method.

  • 28.
    Gonda, Tomoya
    et al.
    Osaka University.
    Macentee, Michael I.
    University of British Columbia.
    Kiyak, H. Asuman
    University of Washington.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Persson, Rigmor E.
    University of Washington.
    Wyatt, Christopher
    University of British Columbia.
    Predictors of multiple tooth loss among socioculturally diverse elderly subjects2013In: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 26, no 2, 127-134 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: This study identifies clinical factors that predict multiple tooth loss in a socioculturally diverse population of older adults.

    Materials and Methods: A total of 193 participants from English-, Chinese-, or Punjabi-speaking communities in Vancouver, British Columbia, with low incomes and irregular use of dental services were followed for 5 years as part of a clinical trial of a 0.12% chlorhexidine mouthrinse. The participants were interviewed and examined clinically, including panoramic radiographs, at baseline and annually for 5 years. Binary logistic regression was used to test the hypothesis that there was no difference between incidence of multiple (≥ 3) tooth loss in older people with various biologic, behavioral, prosthodontic, and cultural variables over 5 years.

    Results: Multiple tooth loss, which was distributed similarly among the groups in the trial, occurred in 39 (20%) participants over 5 years. The use of removable prostheses was the best predictor of loss, followed by the number of carious surfaces and number of sites with gingival attachment loss > 6 mm. The pattern of prediction was consistent across the three linguocultural groups.

    Conclusion: The use of removable dentures was the dominant predictor of multiple tooth loss in the three communities, but that tooth loss was not significantly associated with the cultural heritage of the participants.

  • 29.
    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, 999-1003 p.Article 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.

  • 30.
    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, 574-581 p.Article 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.

  • 31.
    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, 1063-1068 p.Article 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.

  • 32.
    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, 1285-1293 p.Article 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.

  • 33.
    Juusela, Pirjo L.
    et al.
    Finland.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap III. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life.
    Nieminen, Anja R.
    Finland.
    Kiuru-Enari, Sari M.
    Finland.
    Uitto, Veli-Jukka
    Finland.
    Relation of gelsolin amyloidosis and periodontal health2015In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 19, no 2, 229-235 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Hereditary gelsolin amyloidosis (AGel amyloidosis) is a rare, dominantly inherited systemic disease with worldwide distribution, caused by a gelsolin gene mutation. We studied the periodontal conditions and microbiological plaque composition of AGel amyloidosis patients.

    MATERIAL AND METHODS: A voluntary study group of 36 AGel amyloidosis patients (mean age 61) filled in a questionnaire. A thorough periodontal examination included periodontal pocket depth and attachment level measurements, registrations of visible plaque, bleeding on probing and panoramic radiographs. The presence of oral Candida was studied by fungal culture method. Bacterial samples from deepened pockets (≥4 mm) were analyzed with checkerboard DNA-DNA hybridization method.

    RESULTS: VPI (15.3 %) and BOP (11.2 %) of the patients were modest reflecting relatively adequate oral self-care. Still 89 % of the patients had at least one PPD of ≥4 mm; 78.5 % of the PPDs ≥6 mm were found in molars. Patients had lost one third of the molars due to periodontitis and/or tooth decay. Half of the patients (53 %) were Candida carriers. Bacterial analysis of subgingival plaque samples revealed bacterial species common to chronic periodontitis.

    CONCLUSION: AGel amyloidosis may increase the risk for periodontitis even when the oral self-care is adequate. Molar teeth appear to be mostly affected, leading to tooth loss.

    CLINICAL RELEVANCE: AGel amyloidosis as a systemic disease is related with a vast variety of symptoms with variable severity. Even though a causal relationship of the systemic disease and periodontitis has not yet been proven, increased risk for periodontal problems should be considered when examining AGel amyloidosis patients.

  • 34.
    Kamma, J J
    et al.
    University of Athens, Greece.
    Nakou, M
    University of Athens, Greece.
    Persson, G. Rutger
    University of Washington, Seattle, USA.
    Association of early onset periodontitis microbiota with aspartate aminotransferase activity in gingival crevicular fluid.2001In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 28, no 12, 1096-1105 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The objective of this study was to determine the relationship between the activity of the enzyme aspartate aminotransferase (AST) in gingival crevicular fluid (GCF) using the colorimetric PerioGard (PTM) test and the subgingival microflora in early onset periodontitis lesions.

    MATERIAL AND METHODS: The study population consisted of 25 otherwise healthy individuals exhibiting early onset periodontitis (EOP). In each patient four experimental sites were identified comprising one deep periodontal pocket (PD >5 mm) randomly chosen in each quadrant. Bacterial samples were obtained from the experimental sites, consecutively cultured anaerobically and in 10% CO(2) using selective and nonselective media. Isolates were characterized to species level by conventional biochemical tests and various identification kits. Clinical measurements as well as AST activity, assessed either as positive or negative using the PTM, were recorded at the same sites.

    RESULTS: Sixty-two sites exhibited AST positive and 38 AST negative activity. Analysis of bacterial counts using the ANOVA (Mann Whitney U-test) showed that Streptococcus intermedius, Peptostreptococcus micros, Campylobacter concisus, Bacteroides forsythus, Camplobacter gracilis, Campylobacter rectus and Selenomonas sputigena were significantly higher in sites with AST-positive activity. The odds ratio of having high prevalence of S. intermedius, P. micros, C. concisus, B. forsythus, C. gracilis, C. rectus and S. sputigena in the presence of a positive AST site was very high (range: 3.5-17.0). Streptococcus sanguis, Actinomyces naeslundii, Gemella morbillorum, Capnocytophaga gingivalis, Veillonella parvula, Fusobacterium varium, Eubacterium lentum and Prevotella oralis were detected in significantly higher proportions in sites with AST negative activity and manifested a negative odds ratio in the presence of AST positive sites. The logistic regression analysis revealed that smoking and bleeding upon probing showed a significant association with AST activity, while plaque and suppuration were not found to be significant predictors of AST activity. The co-infection of Porphyromonas gingivalis, B. forsythus and P. micros, or P. gingivalis, B. forsythus and C. rectus were found to be significantly associated with the AST activity (p<0.001). AST positive sites revealed significantly higher occurrence of co-infections by P. gingivalis, B. forsythus, S. sputigena or by P. gingivalis, B. forsythus, S. intermedius than AST negative sites (p<0.001). P. gingivalis, B. forsythus, A. naeslundii co-infection was found significantly higher in the AST negative sites (p<0.001).

    CONCLUSIONS: The present study found a high level of agreement between the presence of putative periodontal pathogens and positive AST scores at periodontal sites that clinically were considered to be potentially disease active. Prospective studies should be performed to confirm the findings.

  • 35. Kapferer, Ines
    et al.
    Beier, Ulrike S
    Jank, Siegfried
    Persson, G. Rutger
    Department of Periodontology, Clinical Dental Research Center, School of Dental Medicine, University of Bern, Bern, Switzerland.
    Randomized controlled trial: lip piercing: the impact of material on microbiological findings2013In: Pediatric dentistry, ISSN 1942-5473, Vol. 35, no 1, 23E-28E p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose of this study was to investigate whether there are microbiological differences in bacterial samples collected from labial piercings made of different materials.

    METHODS: Sterile piercings of 4 materials were randomly allocated to 80 pierced subjects. After 2 weeks, microbiologic samples were collected and processed by checkerboard DNA-DNA hybridization methods. Wilcoxon signed ranks and Mann-Whitney tests were used for statistical analysis (adjustment for multiple comparisons).

    RESULTS: There were no statistically significant differences between material groups in relation to baseline data. In samples from stainless steel piercings, the total microbial load was significantly higher than the other materials (P<.05). Ten (mainly periopathogenic) species were found at significantly higher levels (P<.001) on steel than on polypropylene and/or polytetrafluoroethylene piercings.

    CONCLUSIONS: Labial piercings made of stainless steel could promote the development of a pathogenic biofilm.

  • 36.
    Kapferer, Ines
    et al.
    Innsbruck Medical University, Innsbruck, Austria.
    Beier, Ulrike S
    Innsbruck Medical University, Innsbruck, Austria.
    Persson, G. Rutger
    University of Bern, Bern, Switzerland.
    Tongue piercing: the effect of material on microbiological findings.2011In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972, Vol. 49, no 1, 76-83 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Biofilms on oral piercings may serve as a bacterial reservoir and lead to systemic bacteremia or local transmission of pathogenic microbiota. The use of piercing materials which are less susceptible to biofilm accumulation could contribute to prevention of problems. The present study investigated whether there are microbiological differences in bacterial samples collected from tongue piercings made of different materials.

    METHODS: A total of 85 subjects with tongue piercings participated in this study. After a baseline dental examination, sterile piercings of four different materials were randomly allocated to the study subjects. After 2 weeks, microbiologic samples were collected and processed by checkerboard deoxyribonucleic acid- deoxyribonucleic acid hybridization methods.

    RESULTS: About 28.8% of subjects reported 61 lingual recessions (1.91 ± .96 mm), whereas 5% reported tooth chipping on one tooth each. With the exception of Aggregatibacter actinomycetemcomitans (Y4), Fusobacterium nucleatum species, and Parvimonas micra, bacteria associated with periodontitis were not commonly found in the samples from studs or piercing channels. Of the 80 bacterial species, 67 were found at significantly higher levels (p < .001) in samples from stainless steel than from polytetrafluoroethylene or polypropylene piercings.

    CONCLUSION: The low bacterial counts from piercing channels suggest that having a tongue pierced would not contribute to an increased risk for oral infection. The present study demonstrated that studs made of steel might promote the development of a biofilm, whereas those made of polytetrafluoroethylene or polypropylene may be rather inert to bacterial colonization. The finding of Staphylococci on steel and titanium studs may suggest an elevated risk for complication if the piercing channel is infected.

  • 37. Katsoulis, J
    et al.
    Heitz-Mayfield, L J R
    Weibel, M
    Hirschi, R
    Lang, N P
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Impact of sample storage on detection of periodontal bacteria.2005In: Oral Microbiology and Immunology, ISSN 0902-0055, E-ISSN 1399-302X, Vol. 20, no 2, 128-130 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/AIMS: Information on the impact of sample storage prior to analysis by DNA methods is limited. The aim of this study was to investigate the effect of subgingival sample storage on bacterial detection and enumeration.

    MATERIAL AND METHODS: Subgingival plaque samples were studied by a) checkerboard DNA-DNA hybridization by immediate processing, b) storage at + 4 degrees C for 6 weeks, c) storage at - 20 degrees C for 6 months or d) storage at - 20 degrees C for 12 months.

    RESULTS: No differences in total DNA were found between protocol 1 and 2, or between protocol 3 and 4. Protocol 1 yielded 2.4 times more total bacterial DNA than did protocol 3 (P < 0.001). Actinobacillus actinomycetemcomitans and Campylobacter gracilis were detected in 21.1% of the immediately processed samples but only in 6.6% of the samples after 12 months of storage. Similar changes were noticed for Treponema denticola, which was detected in 22.3% and 9.2%, respectively. Streptococci spp., Fusobacterium nucleatum and Tannerella forsythia did not seem to be affected by storage. In contrast, the level of Campylobacter rectus detection frequency changed from 2.6% if processed immediately to 15.8% if samples were stored for 12 months.

    CONCLUSIONS: In longitudinal clinical studies including microbiological samples and processed with DNA-DNA hybridization methods, samples should be stored for the same period of time before processing to avoid loss of microbiological information.

  • 38. Katsoulis, Joannis
    et al.
    Lang, Niklaus P
    Persson, G. Rutger
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Proportional distribution of the red complex and its individual pathogens after sample storage using the checkerboard DNA-DNA hybridization technique.2005In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 32, no 6, 628-633 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Information on the impact of sample storage prior to analysis by DNA methods is limited.

    AIMS: To investigate the effect of microbial sample storage on bacterial detection and proportional distribution of the red complex and its individual pathogens.

    MATERIAL AND METHODS: Subgingival plaque samples were analysed by (1) immediate processing, (2) after storage at +4 degrees C for 6 weeks, (3) after storage at -20 degrees C for 6 months or (4) after storage at -20 degrees C for 12 months using the checkerboard DNA-DNA hybridization.

    RESULTS: Proportional distribution of the red complex did not differ between the first three protocols. However, the total bacterial DNA for pathogens studied decreased significantly in protocols 3 and 4. Relative amounts of Tannerella forsythensis, Porphyromonas gingivalis and Treponema denticola remained stable in the second protocols and changed in an unpredictable way if stored for 6 or 12 months.

    CONCLUSIONS: Results from samples stored for maximum 6 months at -20 degrees C with high proportional amounts of the red complex and T. denticola may be used as an indicator of persistence. All bacterial samples for DNA extraction should be processed following a standardized storage protocol (i.e. samples stored at +4 degrees C for maximum 6 weeks) in order to get comparable qualitative and quantitative results for total DNA, bacterial complexes and individual pathogens. Most representative results are yielded if processing and hybridization could be performed immediately after sampling.

  • 39.
    Kim, Klara
    et al.
    University of Berne, Berne, Switzerland.
    Heimisdottir, Kristin
    University of Berne, Berne, Switzerland & University of Iceland, Reykjavik, Iceland.
    Gebauer, Urs
    University of Berne, Berne, Switzerland.
    Persson, G. Rutger
    University of Berne, Berne, Switzerland & University of Washington, Seattle, Wash.
    Clinical and microbiological findings at sites treated with orthodontic fixed appliances in adolescents.2010In: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 137, no 2, 223-228 p.Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Fixed orthodontic appliances can alter the subgingival microbiota. Our aim was to compare the subgingival microbiota and clinical parameters in adolescent subjects at sites of teeth treated with orthodontic bands with margins at (OBM) or below the gingival margin (OBSM), or with brackets (OBR).

    METHODS: Microbial samples were collected from 33 subjects (ages, 12-18 years) in treatment more than 6 months. The microbiota was assessed by the DNA-DNA checkerboard hybridization method.

    RESULTS: Bacterial samples were taken from 83 OBR,103 OBSM, and 54 OBM sites. Probing pocket depths differed by orthodontic type (P <0.001) with mean values of 2.9 mm (SD, 0.6) at OBSM sites, 2.5 mm (SD, 0.6) at OBM sites, and 2.3 mm (SD, 0.5) at OBR sites. Only Actinomyces israelii (P <0.001) and Actinomyces naeslundii (P <0.001) had higher levels at OBR sites, whereas Neisseria mucosa had higher levels at sites treated with OBSM or OBM (P <0.001). Aggregatibacter actinomycetemcomitans was found in 25% of sites independent of the appliance.

    CONCLUSIONS: Different types of orthodontic appliances cause minor differences in the subgingival microbiota (A israelii and A naeslundii) and higher levels at sites treated with orthodontic brackets. More sites with bleeding on probing and deeper pockets were found around orthodontic bands.

  • 40.
    Kiyak, H Asuman
    et al.
    University of Washington, Seattle, USA.
    Kamoh, Aman
    Persson, Rigmor E
    Kristianstad University, School of Health and Society, Avdelningen Oral hälsa.
    Persson, G. Rutger
    University of Washington, Seattle, USA.
    Ethnicity and oral health in community-dwelling older adults.2002In: General dentistry, ISSN 0363-6771, Vol. 50, no 6, 513-518 p.Article in journal (Refereed)
    Abstract [en]

    Epidemiological studies consistently have found differences in oral health status between white and non-white elders. This has been attributed primarily to lack of access to dental care, especially preventive services. The study reported here examined psychosocial factors in an attempt to explain these differences.

  • 41.
    Lauenstein, Marc
    et al.
    Department of Periodontology, University of Bern.
    Kaufmann, Marion
    Department of Periodontology, University of Bern.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Clinical and microbiological results following nonsurgical periodontal therapy with or without local administration of piperacillin/tazobactam2013In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 17, no 7, 1645-1660 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: We assessed if adjunct administration of piperacillin/tazobactam added clinical and microbiological treatment benefits.

    MATERIALS AND METHODS: Thirty-six subjects (mean age 52.1 years (SD ± 10.3)) (NS by group) with chronic periodontitis were randomly enrolled receiving subgingival debridement and the local administration of piperacillin/tazobactam (test group) or debridement alone (control group). Bleeding on probing (BOP), probing pocket depth (PPD), and microbiological counts of 74 species were studied by checkerboard DNA-DNA hybridization up to month 6 after treatment.

    RESULTS: Mean PPD changes between baseline and month 6 in the test and control groups were 1.5 and 1.8 mm, respectively (NS between groups). BOP in both groups decreased from about 80 to 40 %. At 4 and 12 weeks, lower counts of the following bacteria were found in the test group (site level): Fusobacterium species, Parvimonas micra, Pseudomonas aeruginosa, Staphylococcus aureus, Tannerella forsythia, Treponema denticola, and a composite load of nine pathogens (p < 0.001). At week 26, subjects receiving local antibiotics had a lower prevalence at tested sites for Fusobacterium nucleatum sp. polymorphum, Fusobacterium periodonticum, P. micra, and T. denticola.

    CONCLUSIONS: At 26 weeks, treatment with or without piperacillin/tazobactam resulted in similar BOP and PPD improvements. At week 26 and at the subject level, the prevalence of 4/74 pathogens was found at lower counts in the group receiving local antibiotics.

    CLINICAL RELEVANCE: Administration of piperacillin/tazobactam reduces the prevalence of Fusobacterium, P. micra, and T. denticola to a greater extent than debridement alone but with no short-term differences in PPD or BOP.

  • 42. Lessem, Jan
    et al.
    Drisko, Connie
    Greenwell, Henry
    Persson, G. Rutger
    Newman, Hubert
    Smart, Graham
    Hopkins, Lydia
    Parameshwar, Jayan
    Fishbein, Daniel
    Partridge, C
    Bhat, G
    Goldsmith, J
    Are cardiac transplant patients more likely to have periodontitis? A case record study.2002In: Journal of the International Academy of Periodontology, ISSN 1466-2094, Vol. 4, no 3, 95-100 p.Article in journal (Refereed)
    Abstract [en]

    In several large epidemiological studies chronic periodontitis has been implicated as an additional risk factor, independent of other risk factors, for the development of ischaemic heart disease. The underlying mechanism is thought to be a localised infection giving rise to an inflammatory host response, and some experimental data agree with this hypothesis. Recently, however, some studies have questioned the post dated relationship between the two diseases. The current case-record study was undertaken to evaluate the prevalence of chronic periodontitis and the severity of such periodontal disease in a heart transplant population, assuming the latter represented a relatively severely compromised cardiovascular patient population. The study demonstrated that 76% of the patients had various degrees of periodontal disease prior to undergoing a heart transplant. Thus, it is possible that a relationship between cardiovascular disease and periodontal disease exists, but further, large intervention studies will be needed to confirm such a conclusion.

  • 43.
    Moser, Peter
    et al.
    University of Berne, Switzerland.
    Hammerle, Christoph H F
    University of Berne, Switzerland.
    Lang, Niklaus P
    University of Berne, Switzerland.
    Schlegel-Bregenzer, Bettina
    University of Berne, Switzerland.
    Persson, Rutger
    Department of Periodontics, University of Washington, Seattle, WA, USA.
    Maintenance of periodontal attachment levels in prosthetically treated patients with gingivitis or moderate chronic periodontitis 5-17 years post therapy.2002In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, no 6, 531-539 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The present retrospective analysis was performed to evaluate the long-term results of initial periodontal and fixed prosthodontic treatment in patients with gingivitis or moderate chronic periodontitis during post-therapeutic irregular maintenance of 5-17 years.

    MATERIAL AND METHODS: Thirty-four patients participated in the study. Baseline data were taken from the patients' records when the periodontal and the prosthetic treatment was finished. A follow-up examination was performed in conjunction with the radiographic examination including assessment of plaque, bleeding on probing, probing pocket depth, recession and probing attachment loss. Information regarding the oral hygiene habits of the subjects as well as the amount of dental and initial therapy received between the observation time was obtained from the patients' records.

    RESULTS: The results from the clinical trial revealed that during the mean examination period of 11 years only 31 teeth were lost. The remaining restored and non-restored teeth did not show any significant differences in attachment loss (from 2.9 mm to 3.0 mm) in spite of a higher plaque value at the follow-up examination (from 42% to 48%). The BoP remained stable in the same time period and scored 31% to 28%.

    CONCLUSIONS: The periodontal attachment levels were maintained during a prolonged period despite irregular maintenance care. This indicates that in a population of obviously decreased susceptibility to chronic periodontitis, it is possible that fixed reconstructions will not - even under suboptimal supportive care - jeopardize the periodontal status.

  • 44.
    Mäntylä, Päivi
    et al.
    Institute of Dentistry, University of Helsinki.
    Buhlin, Kåre
    Institute of Dentistry, University of Helsinki.
    Paju, Susanna
    Institute of Dentistry, University of Helsinki.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    Nieminen, Markku S.
    Division of Cardiology, Department of Medicine, Helsinki University.
    Sinisalo, Juha
    Division of Cardiology, Department of Medicine, Helsinki University.
    Pussinen, Pirkko J.
    Institute of Dentistry, University of Helsinki.
    Subgingival Aggregatibacter actinomycetemcomitans associates with the risk of coronary artery disease2013In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 40, no 6, 583-590 p.Article in journal (Refereed)
    Abstract [en]

    Aim We investigated the association between angiographically verified coronary artery disease (CAD) and subgingival Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. Materials and Methods The cross-sectional study population (n = 445) comprised 171 (38.4%) patients with Stable CAD, 158 (35.5%) with acute coronary syndrome (ACS) and 116 (26.1%) with no significant CAD (No CAD). All patients participated in clinical and radiological oral health examinations. Pooled subgingival bacterial samples were analysed by checkerboard DNA–DNA hybridization assays. Results In all study groups, the presence of P. gingivalis, T. forsythia and T. denticola indicated a significant (p ≤ 0.001) linear association with the extent of alveolar bone loss (ABL), but A. actinomycetemcomitans did not (p = 0.074). With a threshold level of bacterial cells 1 × 105 A. actinomycetemcomitans was significantly more prevalent in the Stable CAD group (42.1%) compared to the No CAD group (30.2%) (p = 0.040). In a multi-adjusted logistic regression analysis using this threshold, A. actinomycetemcomitans positivity associated with Stable CAD (OR 1.83, 95% CI 1.00–3.35, p = 0.049), but its level or levels of other bacteria did not. Conclusions The presence of subgingival A. actinomycetemcomitans associates with an almost twofold risk of Stable CAD independently of alveolar bone loss.

  • 45. Page, R C
    et al.
    Lantz, M S
    Darveau, R
    Jeffcoat, M
    Mancl, L
    Houston, L
    Braham, P
    Persson, G. Rutger
    University of Washington, Seattle, WA, USA.
    Immunization of Macaca fascicularis against experimental periodontitis using a vaccine containing cysteine proteases purified from Porphyromonas gingivalis.2007In: Oral Microbiology and Immunology, ISSN 0902-0055, E-ISSN 1399-302X, Vol. 22, no 3, 162-8 p.Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Periodontitis is a common infectious disease to which Porphyromonas gingivalis has been closely linked, in which the attachment tissues of the teeth and their alveolar bone housing are destroyed. We conducted a study to determine if immunization using a purified antigen could alter the onset and progression of the disease.

    METHODS: Using the ligature-induced model of periodontitis in Macaca fascicularis, we immunized five animals with cysteine protease purified from P. gingivalis and used an additional five animals as controls. Alveolar bone loss was measured by digital subtraction radiography.

    RESULTS: Immunization induced high titers of specific immunoglobuin G serum antibodies that were opsonic. Total bacterial load, levels of P. gingivalis in subgingival plaque and levels of prostaglandin E(2) in gingival crevicular fluid were significantly reduced. Onset and progression of alveolar bone loss was inhibited by approximately 50%. No manifestations of toxicity were observed.

    CONCLUSIONS: Immunization using a purified protein antigen from P. gingivalis inhibits alveolar bone destruction in a ligature-induced periodontitis model in M. fascicularis.

  • 46.
    Persson, G. Rutger
    University of Washington, Seattle & University of Bern, Switzerland.
    Diabetes and periodontal disease: an update for health care providers2011In: Diabetes Spectrum, ISSN 1040-9165, E-ISSN 1944-7353, Vol. 24, no 4, 195-198 p.Article in journal (Refereed)
    Abstract [en]

    In Brief

    Periodontitis has been identified as the sixth complication of diabetes. Advanced glycation end-products, altered lipid mechanisms, oxidative stress, and systemically elevated cytokine levels in patients with diabetes and periodontitis suggest that dental and medical care providers should coordinate therapies.

  • 47.
    Persson, G. Rutger
    Kristianstad University, School of Health and Society.
    Rheumatoid arthritis and periodontitis - inflammatory and infectious connections: review of the literature2012In: Journal of Oral Microbiology, ISSN 2000-2297, E-ISSN 2000-2297, Vol. 4, 11829- p.Article in journal (Refereed)
    Abstract [en]

    An association between oral disease/periodontitis and rheumatoid arthritis (RA) has been considered since the early 1820s. The early treatment was tooth eradication. Epidemiological studies suggest that the prevalence of RA and periodontitis may be similar and about 5% of the population are aged 50 years or older. RA is considered as an autoimmune disease whereas periodontitis has an infectious etiology with a complex inflammatory response. Both diseases are chronic and may present with bursts of disease activity. Association studies have suggested odds ratios of having RA and periodontitis varying from 1.8:1 (95% CI: 1.0-3.2, NS) to 8:1 (95% CI: 2.9-22.1, p<0.001). Genetic factors are driving the host responses in both RA and periodontitis. Tumor necrosis factor-α, a proinflammatory cytokine, regulates a cascade of inflammatory events in both RA and periodontitis. Porphyromonas gingivalis is a common pathogen in periodontal infection. P. gingivalis has also been identified in synovial fluid. The specific abilities of P. gingivalis to citrullinate host peptides by proteolytic cleavage at Arg-X peptide bonds by arginine gingipains can induce autoimmune responses in RA through development of anticyclic citrullinated peptide antibodies. In addition, P. gingivalis carries heat shock proteins (HSPs) that may also trigger autoimmune responses in subjects with RA. Data suggest that periodontal therapies combined with routine RA treatments further improve RA status.

    CONCLUSIONS: Periodontal infection (P. gingivalis) carries a unique risk for development of autoimmune antibodies associated with RA. Patients with RA have either lost many teeth or usually have severe periodontitis. Additional research, both in regards to basic mechanisms as well as clinical studies, are necessary before it can be said that there are causative links between RA and periodontitis. Cross-disciplinary research in well-defined populations should be performed to further enhance knowledge and develop clinical strategies how to coordinate therapy and risk assessments of RA and periodontitis.

  • 48.
    Persson, G. Rutger
    et al.
    Kristianstad University, School of Health and Society.
    Berglund, Johan
    Blekinge Institute of Technology, Karlskrona.
    Persson, Rigmor E.
    Department of Periodontology, University of Bern.
    Renvert, Stefan
    Kristianstad University, School of Health and Society.
    Prediction of hip and hand fractures in older persons with or without a diagnosis of periodontitis2011In: Bone, ISSN 8756-3282, E-ISSN 1873-2763, Vol. 48, no 3, 552-556 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: In a prospective study, we assessed if a diagnosis of osteoporosis and periodontitis could predict hip and hand fractures in older persons. Materials and methods: Bone density was assessed by a Densitometer. Periodontitis was defined by evidence of alveolar bone loss. Results: 788 Caucasians (52.4% women, overall mean age: 76 years, S.D. +/- 9.0, range: 62 to 96) were enrolled and 7.4% had a hip/hand fracture in 3 years. Calcaneus PIXI T-values < - 1.6 identified osteoporosis in 28.2% of the older persons predicting a hip/hand fracture with an odds ratio of 3.3:1 (95% CI: 1.9, 5.7, p < 0.001). Older persons with osteoporosis had more severe periodontitis (p < 0.01). Periodontitis defined by >= 30% of sites with >= 5 mm distance between the cemento-enamel junction (CEJ) and bone level (ABL) was found in 18.7% of the older persons predicting a hip/hand fracture with an odds ratio of 1.8:1 (95% CI: 1.0, 3.3, p < 0.05). Adjusted for age, the odds ratio of a hip/hand fracture in older persons with osteoporosis (PIXI T-value <-2.5) and periodontitis was 12.2:1 (95% CI: 3.5, 42.3, p < 0.001). Conclusions: Older persons with osteoporosis and periodontitis have an increased risk for hip/hand fractures.

  • 49.
    Persson, G. Rutger
    et al.
    University of Bern, Bern, Switzerland & University of Washington, Seattle, WA, USA.
    Hitti, Jane
    Paul, Katie
    Hirschi, Regula
    Weibel, Marianne
    Rothen, Marilynn
    Persson, Rigmor E.
    Tannerella forsythia and Pseudomonas aeruginosa in subgingival bacterial samples from parous women.2008In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 79, no 3, 508-516 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Information on the subgingival microbiota in parous women is limited. The present study assessed 74 bacterial species at periodontal sites.

    METHODS: Subgingival bacterial plaque was collected from women > or =6 months after delivery. Bacteria were assessed by the checkerboard DNA-DNA hybridization method. Gingivitis was defined as > or =20% of sites with bleeding on probing (BOP), and periodontitis was defined as radiographic evidence of bone loss and probing depths > or =5.0 mm.

    RESULTS: A total of 197 women (mean age: 29.4 +/- 6.8 years; range: 18 to 46 years) were included in the study. Gingivitis was identified in 82 of 138 subjects without evidence of periodontitis (59.4%). Periodontitis was found in 59 women (32%). Higher bacterial levels in subjects with gingivitis compared to those without evidence of gingivitis were observed for Actinomyces neuii, Bifidobacterium bifidum, Corynebacterium pseudogenitalis, Porphyromonas endodontalis, Prevotella bivia, and Pseudomonas aeruginosa (P <0.001 for each). Higher bacterial levels in subjects with periodontitis compared to those without periodontitis (BOP not accounted for) were found for 32 of 79 species (P <0.001) including Lactobacillus iners, Haemophilus influenzae, Porphyromonas gingivalis, Tannerella forsythia (previously T. forsythensis), Prevotella bivia, P. aeruginosa, and Staphylococcus aureus. Binary univariate logistic regression analysis identified that P. aeruginosa (P <0.001) and T. forsythia (P <0.05) were independently predictive of periodontal status. The odds ratio of having P. aeruginosa at levels > or =1 x 10(5) in the sample and periodontitis was 3.1 (95% confidence interval: 1.6 to 5.9; P <0.001).

    CONCLUSION: In addition to P. gingivalis and T. forsythia, a diverse microbiota, including P. aeruginosa, P. endodontalis, P. bivia, and S. aureus, can be found in subgingival plaque samples from women of child-bearing age with periodontitis.

  • 50.
    Persson, G. Rutger
    et al.
    Schweiz.
    Hitti, Jane
    USA.
    Verhelst, Rita
    Belgien.
    Vaneechoutte, Mario
    Belgien.
    Persson, Rigmor
    Schweiz.
    Hirschi, Regula
    Schweiz.
    Weibel, Marianne
    Schweiz.
    Rothen, Marilynn
    USA .
    Temmerman, Marleen
    Belgien.
    Paul, Kathleen
    Belgien.
    Eschenbach, David
    USA.
    The vaginal microflora in relation to gingivitis2009In: BMC infectious diseases, ISSN 1471-2334, Vol. 9, 6- p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Gingivitis has been linked to adverse pregnancy outcome (APO). Bacterial vaginosis (BV) has been associated with APO. We assessed if bacterial counts in BV is associated with gingivitis suggesting a systemic infectious susceptibilty.

    METHODS: Vaginal samples were collected from 180 women (mean age 29.4 years, SD +/- 6.8, range: 18 to 46), and at least six months after delivery, and assessed by semi-quantitative DNA-DNA checkerboard hybridization assay (74 bacterial species). BV was defined by Gram stain (Nugent criteria). Gingivitis was defined as bleeding on probing at >or= 20% of tooth sites.

    RESULTS: A Nugent score of 0-3 (normal vaginal microflora) was found in 83 women (46.1%), and a score of > 7 (BV) in 49 women (27.2%). Gingivitis was diagnosed in 114 women (63.3%). Women with a diagnosis of BV were more likely to have gingivitis (p = 0.01). Independent of gingival conditions, vaginal bacterial counts were higher (p < 0.001) for 38/74 species in BV+ in comparison to BV- women. Counts of four lactobacilli species were higher in BV- women (p < 0.001). Independent of BV diagnosis, women with gingivitis had higher counts of Prevotella bivia (p < 0.001), and Prevotella disiens (p < 0.001). P. bivia, P. disiens, M. curtisii and M. mulieris (all at the p < 0.01 level) were found at higher levels in the BV+/G+ group than in the BV+/G- group. The sum of bacterial load (74 species) was higher in the BV+/G+ group than in the BV+/G- group (p < 0.05). The highest odds ratio for the presence of bacteria in vaginal samples (> 1.0 x 104 cells) and a diagnosis of gingivitis was 3.9 for P. bivia (95% CI 1.5-5.7, p < 0.001) and 3.6 for P. disiens (95%CI: 1.8-7.5, p < 0.001), and a diagnosis of BV for P. bivia (odds ratio: 5.3, 95%CI: 2.6 to 10.4, p < 0.001) and P. disiens (odds ratio: 4.4, 95% CI: 2.2 to 8.8, p < 0.001).

    CONCLUSION: Higher vaginal bacterial counts can be found in women with BV and gingivitis in comparison to women with BV but not gingivitis. P. bivia and P. disiens may be of specific significance in a relationship between vaginal and gingival infections.

123 1 - 50 of 120
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf